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Mandatory Disclosures for Healthcare Workers Under Idaho Law
/in HIPAA, Idaho Healthcare LawBy Kim Stanger
The HIPAA privacy rules allow healthcare providers to disclose protected health information to the extent another state or federal law or regulation requires it:
A covered entity may use or disclose protected health information to the extent that such use or disclosure is required by law and the use or disclosure complies with and is limited to the relevant requirements of such law.1
(45 C.F.R. § 164.512(a)(1)). Importantly, HIPAA only allows such disclosures if the other law requires the disclosure, not if the other law simply allows disclosures. (78 FR 5618). In cases where another law permits but does not require disclosure, HIPAA would preempt the other law and prohibit the disclosure unless another HIPAA exception applied. Read more
HHS Extends Deadline for Co-Provider Requirements Under the No Surprise Billing Rules
/in No Surprise BillingBy Kim Stanger
As discussed in our November 28 client alert, the No Surprise Billing Rules (NSBR) require that convening providers contact co-providers and include co-provider fees in the convening provider’s good faith estimate to uninsured (self-pay) patients. Read more
Gifts to Patients and Referring Providers
/in ProvidersBy Kim Stanger
At this time of year, healthcare providers may want to give gifts to patients, referring providers, or other sources of business, but such gifts may violate federal and state fraud and abuse laws and result in civil or criminal fines for both the giver and receiver. Read more
Prepare for the End of the Public Health Emergency: Compliance Concerns
/in Compliance, COVID-19By Kim Stanger
For nearly three years, federal and state agencies have waived or relaxed regulatory requirements and expanded reimbursement for services due to the COVID-19 public health emergency (PHE), but the signs indicate that the party is nearly over. Many states have already ended their emergency exceptions, and the federal PHE appears to be coming to an end. The current 90-day PHE extension issued by the Health and Human Services (HHS) will expire January 11, 2023. (See here.) The Biden Administration has informally promised that it would notify stakeholders at least 60 days in advance of ending the PHE; consequently, there is a good chance that the PHE will be extended an additional 90 days into April 2023, but no formal announcement has issued yet. In the meantime, HHS has warned providers that most of the PHE waivers will end upon termination of the PHE and that providers should prepare now for a return to normal standards. (See CMS, “Creating a Roadmap for the End of the COVID-19 Public Health Emergency” (8/18/22), available here.) Read more
No Surprise Billing Rules: Co-Provider Requirements Begin in 2023
/in No Surprise BillingBy Kim Stanger
Update: On December 2, 2022, HHS issued new guidance extending the January 1, 2023 compliance deadline for co-provider requirements until further rulemaking. For more information, click here. The new guidance affects the remaining content below.
Since January 1, 2022, the No Surprise Billing Rules (NSBR) have required virtually all healthcare providers to give a good faith estimate of anticipated charges to uninsured (self-pay) patients.1 Unless the Department of Health and Human Services (HHS) changes its rules, beginning January 1, 2023, the good faith estimate provided to patients will need to include the anticipated charges from co-providers or co-facilities in addition to the convening provider’s own charges. Read more