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126 Matching News Items
1.
Agencies Change Surprise Billing IDR Resubmission Procedures Effective May 1, 2024
Solutions Law Press
May 1, 2024
Solutions Law Press
May 1, 2024
"Starting on May 1, 2024, certified IDR entities will notify parties through an email from the Federal IDR portal that a dispute is eligible for resubmission due to improper batching or bundling ... If the recipient initiated the dispute, the resubmission email notification will contain a unique link to a new form called the Notice of IDR Initiation ... Initiating parties have four business days from the date of the resubmission email notification to resubmit a dispute."
2.
OCR Guidance Reminds Health Plans to Ensure Online Tracking HIPAA Compliance
Solutions Law Press
Mar. 19, 2024
Solutions Law Press
Mar. 19, 2024
"The Guidance reminds covered entities that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules (HIPAA Rules) apply to their use of online tracking technologies like Google Analytics or Meta Pixel, collect and analyze information about how users are interacting with a regulated entity's website or mobile application."
3.
Manage Health Plan HIPAA, ERISA and Other Exposures from Change Healthcare Ransomware Attack
Solutions Law Press
Mar. 18, 2024
Solutions Law Press
Mar. 18, 2024
"While UHG works to remediate and restore the operability and security of the Choice Health tools and systems, health plans, and insurers, their fiduciaries, plan sponsors, and fiduciaries should take timely and prudent steps in response to the breach and resulting disruptions to mitigate the exposure of their health plans, and themselves under HIPAA and ERISA."
4.
$160k HIPAA Penalty Warns Health Plans and Other Covered Entities to Deliver Timely Access to Protected Health Information
Solutions Law Press
Jan. 8, 2024
Solutions Law Press
Jan. 8, 2024
"Once a health plan or other Covered Entity receives a request protected health information from the individual or his personal representative, the Right of Access Rule requires the Covered Entity to provide access to all requested protected health information within any 'designated record set' within 30 days unless the requested information falls within one of two exceptions to the Rule."
5.
No Surprises Act IDR Portal Fully Reopened, New Fees Announced
Solutions Law Press
Dec. 20, 2023
Solutions Law Press
Dec. 20, 2023
"The Department's establishment of the IDR fee for post-February 20, 2025 disputes and their previous December 15, 2023 announcement of the full reopening of the IDR portal for all dispute categories are part of the Departments' ongoing response to the August 3, 2023 Federal District court ruling ... which vacated portions of the previous guidance that the Departments previously adopted to establish the IDR process and the administrative fee amount for the Federal IDR process for disputes initiated during the calendar year beginning January 1, 2023." [Texas Medical Association (TMA) v. HHS, No. 23-0059 (E.D. Tex. Aug. 3, 2023)]
6.
First Phishing-Related HIPAA Settlement Provides Warning for Health Plans
Solutions Law Press
Dec. 10, 2023
Solutions Law Press
Dec. 10, 2023
"The resolution agreement ... resolves the first HIPAA charges OCR has classified officially as arising from a phishing attack [and] warns health plans, health care providers, health care clearinghouses and their business associates to ensure the adequacy of their risk analysis, safeguards, training and other processes for guarding electronic protected health information against phishing or other impermissible access."
7.
New HIPAA Resolution Agreement Warns Health Plans and Other HIPAA-Covered Entities to Manage Media Relations, Access and Disclosure
Solutions Law Press
Nov. 22, 2023
Solutions Law Press
Nov. 22, 2023
"While the Settlement involved a health care providers, health plans and other HIPAA entities also are subject to the same HIPAA requirements to prevent unauthorized photography, videos, or other sharing or disclosure of participant or other PHI to media in interviews or other media interactions or by workforce members, business associates or other third parties.... [EBSA] now views HIPAA compliance and other prudent steps to protect PHI and other sensitive health information as part of fiduciaries and plan administrator's ERISA compliance obligations[.]"
8.
DOL Settlement Warns Insurers, Plans to Timely Decide Insurability in ERISA-Covered Life, Disability and Other Plans
Solutions Law Press
Oct. 2, 2023
Solutions Law Press
Oct. 2, 2023
"The investigation found that United denied numerous claims based on a participant's failure to provide evidence of insurability, after accepting premiums for years without determining if insurability requirements were satisfied.... In light of this, and a prior similar enforcement action against another insurer in 2022, all sponsors, fiduciaries, administrators, and insurers of ERISA-covered group life, disability, or other insurance programs requiring insurability should verify the timeliness of insurability determinations made by their programs currently, and within the applicable statute of limitation period for claims"
9.
Tri-Agencies Announce New Surprise Billing IDR Fees While Continuing IDR Suspension After Federal Court Ruling
Solutions Law Press
Aug. 13, 2023
Solutions Law Press
Aug. 13, 2023
"[T]he IDR process remains in suspension pending further action by the Departments. In the meantime, however, the [No Surprises Act IDR Administrative Fee FAQs] clarify the administrative fee amount that each disputing party will be required to pay to engage in the Federal IDR process when the IDR process suspension resumes[.]" [Texas Medical Association (TMA) v. HHS, No. 23-0059 (E.D. Tex. Aug. 3, 2023)]
10.
Surprise Billing IDR Suspension Could Impact Plan Renewal Underwriting and Stop-Loss Coverage
Solutions Law Press
Aug. 6, 2023
Solutions Law Press
Aug. 6, 2023
"A lengthy delay in the Departments' correction of their rules could spell headaches for both payers and providers.... Many stop-loss policies and other funding arrangements limit or exclude coverage for plan claims not paid with the policy period or, if the policy includes run off coverage, that brief period following the policy year end. Delays in payment also could complicate year end underwriting for renewals." [Texas Medical Association (TMA) v. HHS, No. 23-0059 (E.D. Tex. Aug. 3, 2023)]
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