How ACOs Will Use and Disclose Protected Health Information While Complying with HIPAA

The Centers for Medicare & Medicaid Services (CMS) has released proposed regulations establishing Accountable Care Organizations (ACOs) and creating the Medicare Shared Savings Program (the Program). The Program will permit health care providers and suppliers to form ACOs and to reward those that lower health care costs for Medicare fee-for-service beneficiaries, while meeting quality of care performance standards. The Program will also hold accountable ACOs that fail to generate savings. CMS will assign beneficiaries to ACOs based on their utilization of primary care services.

To facilitate beneficiary assignment and to ensure that ACOs have the baseline data necessary to evaluate and improve care, Medicare is proposing various uses and disclosures of beneficiary data constituting protected health information (PHI). This PHI ranges from demographic information to claims history, and all of it is protected by the privacy regulations issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This advisory discusses CMS’s proposed uses and disclosures of PHI in connection with the Program, its rationale under HIPAA for using PHI, and additional protections proposed by CMS that exceed HIPAA requirements.

Please see full article below for more information.

LOADING PDF: If there are any problems, click here to download the file.

Written by:

Published In:

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Mintz Levin - Health Law & Policy Matters | Attorney Advertising

Don't miss a thing! Build a custom news brief:

Read fresh new writing on compliance, cybersecurity, Dodd-Frank, whistleblowers, social media, hiring & firing, patent reform, the NLRB, Obamacare, the SEC…

…or whatever matters the most to you. Follow authors, firms, and topics on JD Supra.

Create your news brief now - it's free and easy »

All the intelligence you need, in one easy email:

Great! Your first step to building an email digest of JD Supra authors and topics. Log in with LinkedIn so we can start sending your digest...

Sign up for your custom alerts now, using LinkedIn ›

* With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name.