In the coming months, rheumatologists may want to pay particular attention to their email inboxes. By the end of the year, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) will complete stage I, phase II of a series of desk and on-site audits designed to assess providers and their business…
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HIPAA Cautions: The Problem with Personal Devices in Medical Practices
Should cell phones and other personal devices be used for work communications in a medical practice? According to one expert, these devices are a liability to rheumatologists and other providers, who should develop and enforce strict guidelines in their practices…
The ACR and Partners Help Get Legislation Passed in New York to Limit Step Therapy
In June, state lawmakers in New York passed legislation on step therapy designed to help ensure patient access to the best and most appropriate care. Step therapy mandates that a patient with a specific condition receive prescribed drugs approved for that condition in the order that an insurance company determines it will cover as the…
U.S. Regulators Sue to Block Anthem-Cigna & Aetna-Humana Mergers
NEW YORK (Reuters)—U.S. antitrust officials on Thursday moved to block an unprecedented consolidation of the national health insurance market, filing suit against Anthem Inc.’s proposed purchase of Cigna Corp. and Aetna Inc.’s planned acquisition of Humana Inc. The U.S. Department of Justice (DOJ) says the two mergers would reduce competition, raise prices for consumers and…
Practicing Telemedicine Raises Legal Considerations for Rheumatologists
With the evolution and advancement of technology, it was only a matter of time before such changes affected the medical industry. Although the concept of telemedicine dates back more than 50 years, emphasis on cost-effective quality healthcare coupled with technological advancements has caused a resurgence of telemedicine in recent years. What constitutes telemedicine largely depends…
Avoid the Trap of Balance Billing
It is no secret that payers and providers have conflict as it relates to reimbursement rates for medical services, and there is another stakeholder, the patient, that plays an important role in the financial impact of healthcare reimbursement. Usually, patients are faced with unforeseen bills from their providers due to an unpaid portion of a…
Not Junk Mail: Social Security Letter Can Cut Medicare Costs
CHICAGO (Reuters)—A letter arrives in the mail with this opening line: “We are writing to let you know how you can get help paying your Medicare costs.” Your fraud detector probably goes on high alert—the mailboxes of retirees routinely are stuffed with bogus come-ons. But this letter is no scam. More than 2 million seniors…
Patient Can’t Always Access Complete Medical Records, Doctors Say
(Reuters Health)—Technology makes it possible for patients to access medical records online, but a thicket of legal issues may still keep people from always seeing everything in their chart, some doctors say. The Health Insurance Portability and Accountability Act (HIPAA) gives U.S. patients the right to access their medical records and control who else has…
Drug Company Gifts Linked to Doctors’ Prescribing Habits
(Reuters Health)—Doctors who receive payments or gifts from pharmaceutical companies are more likely to prescribe brand name medications, a new study suggests. Dr. James Yeh, of Brigham and Women’s Hospital in Boston, and colleagues write May 9 online in JAMA Internal Medicine that some states require doctors to report what they receive from drug companies….
Preparing for Increased HIPAA Audits Among Smaller Rheumatology Providers
Recent enforcement activities of the Department of Health and Human Services’ Office for Civil Rights (OCR) have shown an increase in fines and penalties assessed against smaller providers for failing to comply with the privacy, security and breach notification requirements of the Health Insurance Portability and Accountability Act (HIPAA). Historically, OCR has focused on larger…
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