Category: Health Law Highlights

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Health Law Highlights

HIPAA Unique Identifiers Explained

Summary of article from The HIPAA Journal, by Steve Adler:

HIPAA mandates unique identifiers for employers, health plans, and healthcare providers to enhance transaction efficiency and reduce administrative costs, though no standards for individual identifiers were adopted due to cost and complexity. Employer identifiers use IRS-issued EINs, while health plan identifiers, initially introduced in 2012, were rescinded in 2019 due to implementation challenges. Healthcare providers use National Provider Identifiers (NPIs), established before HIPAA and extended in 2004. It’s crucial to distinguish these HIPAA unique identifiers from PHI identifiers, which must be removed for data de-identification. Entities uncertain about these distinctions should seek HIPAA compliance guidance to avoid violations.

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Health Law Highlights

Ramping Up: Antitrust Enforcement in Health Care

Summary of article from Dickinson Wright, by Patrick Masterson, Pahl Zinn:

In early 2024, the Biden administration intensified antitrust enforcement, particularly targeting the healthcare sector. December 2023 saw the release of new Merger Guidelines by the FTC and DOJ, lowering thresholds for anti-competitive assessments and focusing on healthcare mergers. February 2024 marked a joint inquiry into private equity’s influence in healthcare, with public comments open until July. The FTC also finalized a rule banning noncompete agreements, extending its jurisdiction to certain nonprofit healthcare entities. Additionally, the DOJ established a Task Force on Health Care Monopolies and Collusion to address antitrust issues in the sector.

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Health Law Highlights

Information Blocking: Disincentives Established for Health Care Providers

Summary of article from Baker Donelson, by Julie Kilgore:

The Disincentives Final Rule, established under the Cures Act, aims to deter information blocking among Medicare-enrolled health care providers by implementing specific penalties. These penalties include disqualifying providers from being recognized as meaningful EHR users, impacting their financial incentives under Medicare programs, and potentially excluding them from the Medicare Shared Savings Program. The rule will come into effect 30 days after its publication, with the Office of Inspector General (OIG) beginning investigations thereafter. Health care providers will be notified of any disincentives and may appeal decisions before they are finalized. The Office of the National Coordinator for Health Information Technology (ONC) will publicly post information about disincentives, ensuring transparency, but only after appeals are concluded.

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Health Law Highlights

ChatGPT Gives Better Answers to Health-Related Questions Than Human Physicians, Study Finds

Summary of article from PsyPost, by Vladimir Hedrih:

A study published in JAMA Internal Medicine found that ChatGPT provided superior responses to health-related questions compared to human physicians in 79% of cases. Licensed healthcare professionals evaluated responses from both ChatGPT and physicians on Reddit’s r/AskDocs forum, rating ChatGPT’s answers higher in quality and empathy. Despite the promising results, the study authors caution that further research is needed to understand the potential impact of AI in clinical settings. They also note that the comparison was made against volunteered physician responses on a public forum, which may not reflect the full effort physicians typically invest. The study highlights the potential of AI to assist in healthcare but emphasizes the need for cautious integration.

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Health Law Highlights

5 Best Practices for Achieving Healthcare Cloud Compliance

Summary of article from Pro IT Today, by Christopher Tozzi:

Healthcare organizations can ensure cloud compliance by adopting several key practices. Implementing a zero trust security strategy is essential to protect sensitive data by granting access only when necessary. Educating cloud engineers about specific compliance requirements and using cloud data loss prevention (DLP) tools to detect and secure sensitive information are also crucial steps. Additionally, considering on-premises storage for highly sensitive data and opting for simpler cloud architectures can help minimize compliance risks. These measures collectively support the secure and compliant management of healthcare data in cloud environments.

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Health Law Highlights

The Wearable Revolution: How to Use Personal Health Device Data in Litigation

Summary of article from Butler Snow LLP, by Katelyn Ashton, Susanna Moldoveanu:

Wearable technology can play an important role in civil litigation due to its ability to collect extensive health and activity data, such as heart rate, sleep patterns, and physical activity. This data can provide critical evidence in personal injury and product liability cases, helping to substantiate or refute claims about a plaintiff’s physical condition and activity levels before and after an alleged incident. Legal standards for discovering and admitting such data are evolving, with courts generally supporting its relevance while balancing privacy considerations. Strategic use of written discovery requests, specific data formats, and expert testimony can effectively incorporate wearable device data into legal proceedings. This shift underscores the growing evidentiary value of personal health data from wearable devices.

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Health Law Highlights

CMS Releases Proposed Rule on Anomalous DME Spending and MSSP Financial Calculations

Summary of article from American Hospital Association:

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule to address significant, anomalous, and highly suspect (SAHS) billing activity affecting the Medicare Shared Savings Program (MSSP) financial calculations for 2023. CMS proposes excluding payment amounts for certain intermittent urinary catheter codes from expenditure and revenue calculations for 2023, impacting benchmarks for subsequent years and application cycles for new agreements starting in 2025. This decision follows advocacy from the AHA and others to relieve accountable care organizations (ACOs) from the financial burden of anomalous spending beyond their control. CMS has initiated a 30-day comment period, ending July 29, to ensure minimal disruption to ACO timelines. The AHA supports this move and anticipates further measures in the upcoming CY 2025 Physician Fee Schedule to address anomalous spending comprehensively.

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Health Law Highlights

Texas Supreme Court Upholds Ban on Youth Gender Transitions. It’s the Largest State With Such a Law

Summary of article from AP News, by Jim Vertuno, Andrew Demillo:

The Texas Supreme Court upheld a state law banning gender-affirming medical care for transgender minors, rejecting parental pleas that it violates their rights to seek care for their children. The 8-1 ruling maintains the law, effective since September 2023, making Texas the largest state to enforce such restrictions among at least 25 others. The law prohibits hormone therapies, puberty blockers, and transition surgeries for minors, with exceptions for certain medical conditions, drawing criticism for its perceived discriminatory nature. Opponents, including major medical organizations, argue the law harms transgender youths’ mental health and limits essential care, while supporters claim it protects children. The decision aligns with a broader national trend of legislative actions against transgender rights, with ongoing legal challenges and potential future federal implications.

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Health Law Highlights

Why Nurses Are Protesting AI

Summary of article from Healthcare Brew, by Tom McKay:

The National Nurses United (NNU) is protesting the increasing use of AI in healthcare, arguing it devalues nursing skills and exacerbates understaffing issues. They claim that AI-driven continuous data collection cannot replace the expertise and physical presence of nurses, often leading to inefficiencies and potentially harmful practices. Nurses report that AI systems sometimes prevent them from overriding critical decisions and can limit direct patient-doctor communication. Additionally, many AI tools are unregulated and untested, raising concerns about their reliability and the speed at which they are being implemented. While nurses acknowledge the benefits of certain technologies, they emphasize that poorly integrated AI can become a significant burden.

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Health Law Highlights

Blockchain-Based Healthcare Credentialing: A Solution to High Costs and Administrative Burdens

Summary of article from Cureus, by Ebenezer Chinedu-Eneh, Priya Ramaswamy, Patrick E. Farmer:

The healthcare sector faces significant inefficiencies in its credentialing system, leading to staff shortages, delayed patient care, and financial waste. The COVID-19 pandemic highlighted these issues, prompting temporary suspensions of credentialing processes. Blockchain technology offers a promising solution by automating and securing credential verification, potentially saving time and costs, increasing trustworthiness, and enhancing workforce resilience. Successful implementations in other countries demonstrate blockchain’s potential to revolutionize healthcare administration. Adopting blockchain for credentialing could transform the system, making it more efficient, reliable, and secure.