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HIPAA Series Part III of III: HIPAA and the Delivery of Healthcare
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This three part HC Topics Series: HIPAA examines the background and recent changes to the Health Insurance Portability and Accountability Act (HIPAA), which was introduced in 1996, and is increasingly utilized for safeguarding the privacy of health information. Part I discussed the history and background of HIPAA, as excerpted from the book authored by HCC CEO Bob Cimasi, entitled, "Healthcare Valuation: The Financial Appraisal of Enterprises, Assets, and Services," to be published by John Wiley & Sons later this year; Part II of the series addressed the implications of the new rule, effective October 2013, affecting the definition and treatment of business associates under HIPAA; and, Part III, the final installment in this series, assesses various compliance concerns and other related privacy laws.
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 HIPAA Series Part III of III: HIPAA and the Delivery of Healthcare
Following Part II, which discussed the latest amendment to the HIPAA legislation, this third installment of the series considers HIPAA regulation and its significance within the context of the current healthcare marketplace. In October 2013, the current version of HIPAA standards will be updated to ASC X12 Version 5010, which will likely affect healthcare industry stakeholders that participate in electronic transactions.
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Intermountain Pays $25.5 Million in Stark Violations
On April 3, 2013, the U.S. Department of Justice announced that Intermountain Health Care Inc. (Intermountain), the largest healthcare system in Utah, will pay $25.5 million to settle allegations of improper financial relationships with referring physicians that violated Stark Law. The violations were self-reported by Intermountain after a routine review in 2009.
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Healthcare Fraud and Abuse Program Nets $4.2 Million in FY 2012
On February 11, 2013, the 2012 fiscal year (FY) end report released for the Health Care Fraud and Abuse Control Program (HCFAC) reported that a record $4.2 billion in taxpayer dollars were recovered in FY 2012. The majority of the monies recovered ($3.0 billion) were negotiated from civil settlements and judgments related to False Claims Act violations.
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The ACA in 2013: What Can Stakeholders Expect?
Since the inception of the ACA on March 23, 2010, healthcare regulation and delivery has undergone significant changes, many not without controversy. With the re-election of President Barack Obama, the ACA will continue to impact the healthcare industry in 2013, including four major stakeholders: (1) consumers; (2) employers; (3) states; and, (4) healthcare providers.
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