February 2013

Insights from Our Integrated ERM and Claims Settlement Solutions Practices

HHS Announces Changes In The Final HIPAA Omnibus Rule

The U.S. Department of Health and Human Services (HHS) moved forward on January 17, 2013 to strengthen the privacy and security protections for health information established under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The final omnibus rule greatly enhances a patient's privacy protections, provides individuals new rights to their health information, and strengthens the government's ability to enforce the law. "Much has changed in health care since HIPAA was enacted over fifteen years ago," said HHS Secretary Kathleen Sebelius. "The new rule will help protect patient privacy and safeguard patients' health information in an ever expanding digital age."

For more information, click here.

CMS Offers Advice For Conditional Payment Administration

Through the Medicare Learning Network, CMS offers helpful advice to providers and claim professionals regarding claim submissions. Medicare is denying an increasing number of claims because providers are not identifying, nor sending claims to, the correct primary payer prior to claims submission. Medicare is reminding providers, physicians, and suppliers that they have the responsibility to bill correctly and to ensure claims are submitted to the appropriate primary payer.

For more information, click here.

The Affordable Care Act, Insurance Exchanges, and More

As employers prepare for the Patient Protection and Affordable Care Act (ACA), many organizations are focusing attention on implementing and improving their programs. Specific activities include compliance, communication, and implementation of strategic alternatives to traditional programs. Learn more about Health Insurance Exchanges and cost saving programs to manage this evolving subject for High Deductible Health Plans (HDHPs), Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), Medicare Set Asides (MSAs), Insurance Lien Verifications and Negotiations, and more.