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Hello,
In this issue
HHS
and DOJ announce interagency healthcare fraud enforcement
Health
and Human Services (HHS) Secretary Kathleen Sebelius and Department of
Justice (DOJ) Attorney General Eric Holder recently announced the creation
of a new interagency effort, the Health Care Fraud Prevention and
Enforcement Action Team (HEAT), to combat Medicare fraud.
The HEAT
team will include senior officials from DOJ and HHS who will build on and
strengthen existing programs to combat fraud. HEAT will also invest in new
resources and technology to prevent fraud, waste and abuse before it
happens. The president’s budget invests $311 million — a 50 percent
increase from 2009 funding — to strengthen program integrity activities in
Medicare and Medicaid.
Enforcement
of the new privacy and security provisions represents one potential area of
scrutiny from both federal officials and state Attorneys General legal
entities. These new provisions were included in the American Recovery
and Reinvestment Act of 2009 (ARRA) – otherwise known as the stimulus
package – that became law in January. HHS should release these regulations
shortly.
Critical
changes include:
- Onerous new
provisions for accounting of disclosures;
- New patient
rights that you will need to incorporate into your policies and staff
training;
- New
requirements if your patient data are breached;
- Mandated
modifications to your business-associate relationships; and
- Increased
penalties of up to $50,000 per violation to a maximum of $1.5 million
a year in the most egregious cases of data breaches.
We
encourage members to prepare for these complex changes and their impact on
practice operations. We offer the latest regulatory information and tools
you need to prepare to meet these challenges in an important Aug. 27
Webinar.
House
committees complete action on healthcare reform
The third
and final House health committee, Energy and Commerce, passed its version
of America's Affordable Health Choices Act by 31 votes to 28. This version
of the health legislation includes a public plan option based on negotiated
rates for physicians – as opposed to Medicare rates. In addition, states
could establish health insurance co-operatives as well as state-based
health insurance exchanges.
An amendment on medical liability was accepted that provides incentive
payments to states that pass liability reform options. Visit the Energy
and Commerce Web site to review the amendments discussed.
The
other two House committees, Ways and Means and Education and Labor, passed
their versions of healthcare reform on July 17. House leaders indicated
their intention to merge the three versions during the August recess into a
single bill for consideration on the House floor when the House reconvenes
after Labor Day. MGMA will work with House and Committee leaders to
strengthen specific provisions affecting medical group practices.
The
Senate Finance Committee has not yet released its version of a healthcare
reform bill. After it does, the Finance committee must vote to approve its
version of healthcare legislation. It will then have to be merged with
language approved on July 15 by the Senate Health, Education, Labor and
Pensions (HELP) Committee before consideration by the full Senate.
Congress
reconvenes after its August recess on Sept. 8. The House and Senate will
continue their work on healthcare at that time. The next MGMA
Washington Connexion will contain updates on healthcare reform along
with grassroots advocacy instructions.
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