D.C. Report: Privacy Under HIPAA, ICD-10 Message from CMS, New CMS Administrator

July 11, 2010
| Reprints

Privacy NPRM Released. As part of changes enacted under the HITECH Act, HHS has published a Notice of Proposed Rule-Making NPRM for HIPAA that recognizes the adoption of EHRs. The proposed rules add teeth to HIPAA with fines applying to all business associates (hospitals, physicians as well as billing companies, customer service contractors and other businesses) that handle patient information. Fines range from $50,000 per violation up to an annual maximum of $1.5 million. A new HHS website (www.hhs.gov\healthprivacy) will track all activity including fines assessed. Additionally, HHS will create a special task force of Homeland Security to make healthcare a priority as part of government cyber security plans.

July 14 opened a 60-day public comment period on the 234-page rule that proposes to:
• Expand individuals’ rights to access their information;
• Establish new limitations on the use and disclosure of protected health information for marketing and fundraising purposes;
• Restrict certain disclosures of protected health information to health plans;
• Clarify that faxes and voice communications are not considered electronic media;
• Suppress bills or information going to a patient's insurance company if the patient self-pays the bill in full; and
• Clarify that data may not be shared across the health care and non-direct health care components just because both are within the same organization.

An ICD-10 Message from CMS. With the final Meaningful Use looming, ICD-10 is probably not high on the CIO priority list at the moment. Nevertheless, the deadlines remain for replacing the ICD-9 coding system for medical diagnosis and inpatient hospital procedures on Oct. 1, 2013. The first deadline is the transition to Version 5010 standard for electronic transactions on Jan. 1, 2012. A recent article from CMS noted that, "The compliance dates are firm and not subject to change," …."If you are not ready, your claims will not be paid. Preparing now can help you avoid potential reimbursement issues."

CMS Administrator Appointed. In an effort to avoid a Senate partisan fight, President Obama used the Congressional recess to appoint Donald Berwick as CMS Administrator. At the conclusion of the 111th Congress, Berwick must be re-nominated and confirmed by the Senate. As President and CEO of the Institute for Healthcare Improvement, Berwick pioneered the study of how the system can provide better care at lower cost, an area of focus for various pilots and demonstrations authorized under the health reform act. CMS is fortunate to have an innovative leader to guide this effort as well as the HITECH incentive program and other Stimulus provisions for improving healthcare delivery. Berwick will be the first permanent CMS administrator since Mark McClellan departed the Agency in 2006.

Topics