Did you know that modifications to the HIPAA privacy and security rules on privacy of health information and security went into effect on March 26, 2013? Did you know penalties for violations can be as high as $50,000 per violation?

The Department of Health and Human Services issued rules to modify the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, and Enforcement Rules to implement statutory amendments under the Health Information Technology for Economic and Clinical Health Act (''the HITECH Act''). These modified rules are meant to strengthen the privacy and security protection for individuals' health information and modify the rule for breach notification for unsecured protected health information, among other things.

These modifications include...

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Even though the holiday season is long gone, Healthcare Providers need to pay attention to the value of gifts they give or receive to avoid violating the Anti Kickback Laws. Providers may not accept any one gift with a value of more than approximately $30.00 or gifts worth more than $350.00 annually. The Government is concerned that gifts may cause billing for unnecessary services or may affect the referral of patients. Providers as well as their employees must not solicit gifts either. When a gift is given or received it must not be based upon either the volume or value of any referrals. Gifts that are given frequently after referrals or after any specific successful referral are red flags for violations of the law. In fact the Sunshine Act now requires pharmaceutical companies and durable medical equipment companies to report gifts to providers with a value over $25.00.

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Source:  Jeffrey L Cohen's Blog

The Centers for Medicare & Medicaid Services and the U.S. Department of Health and Human Services issued proposed rules that would extend the sunset date for the Stark Law exception and the federal Anti-Kickback Statute safe harbor for the "donation" of electronic health record items and services to physicians and other referral sources from December 31, 2013, to December 31, 2016.

Read the full article here.

As you are aware, Medicare is preparing to go live on

May 1 with the referring / ordering edits that will result in claims denials unless the referring / ordering physician or other health care provider is enrolled in Medicare (or has a valid opt-out affidavit on file with their local Medicare contractor).  To be clear, it is the billing provider's claim that is at risk of being denied.  The AMA was instrumental in securing a delay in the implementation of this policy (which was originally scheduled to go into effect in 2010) so that physicians had sufficient time to enroll (or file a valid opt-out affidavit). 
 
The AMA, together with the MGMA, has put together the attached fact sheet / FAQs which you may find helpful. 

For more information on Medicare enrollment please visit our website at www.ama-assn.org/go/medicareenrollment.