In the News

HHS Issues Proposed Rule to Modify HIPAA Security Rule

Alliance Daily

On Friday, December 27, the U.S. Department of Health and Human Services (HHS) Office of Civil Rights released a Notice of Proposed Rulemaking to amend the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule. This proposed rule would propose significant changes intended to improve cybersecurity standards for the protection of electronic protected health information (ePHI). This is in response to an evolving healthcare landscape, characterized by an alarming increase in cyberattacks and cybersecurity breaches occurring nationwide in the healthcare sector. HHS has published a press release and fact sheet with information on topline proposals accompanying the proposed rule. Comments on the proposed rule are due March 7, 2025.

The Security Rule,[1] part of the HIPAA regulations,[2] was initially published in 2003 and last modified in January 2013. It creates standards for protecting the confidentiality and integrity of ePHI, and applies to covered entities—including health plans, healthcare clearinghouses, and healthcare providers—that create, receive, maintain, or transmit ePHI.

The proposed rule addresses significant changes in technology, changes in breach trends and cyberattacks, HHS’ Office for Civil Rights’ (OCR’s) enforcement experience, and other guidelines, best practices, methodologies, procedures, and processes for protecting ePHI. In addition, the proposed rule addresses the following topics, including a request for comments in each section:

  • Updating Definitions: The proposed rule clarifies and updates terminology used in a non-exhaustive list of examples of electronic storage material, including preparing for future technology. It also includes updates to reflect the role of emerging technologies, such as artificial intelligence (AI) and quantum computing in data security.
  • Security Standards: HHS proposes improving consistency of language between the Security Rule and other sections of HIPAA, by including more flexibility and scalability.
  • Administrative Safeguards: HHS proposes to update policies and procedures for the management and execution of security measures, including requirements for risk analyses that incorporate testing and evaluation of security measures.
  • Physical Safeguards: The proposed rule would modify Security Rule physical safeguard standards and addresses recent case law regarding steps to protect confidentiality, integrity, and available of ePHI.
  • Technical Safeguards: The proposed rule aims to improve guidance to ensure covered entities are adequately implementing, reviewing, and updating their policies and procedures, and includes, among other things, requirements for encryption and multi-factor authentication (MFA) to safeguard ePHI.
  • Organizational Requirements: HHS proposes adding additional requirements to business associate agreements and when to activate contingency plans, to address risk trends and contingency planning for data breaches and service interruptions.
  • Documentation Requirements: HHS proposes to delete and modify documentation requirements to align with administrative, physical, and technical safeguards changes throughout this proposed rule by requiring written documentation to be in electronic form. In addition, the rule would modify specifications for documentation time limits, availability, and updates.
  • Transition Provisions: HHS proposes to remove compliance date information in 45 CFR 164.318 and replace this language for transitioning to the revised Security Rule, if finalized.
  • New and Emerging Technologies Request for Information (RFI): HHS is requesting information on quantum computing, AI, virtual and augmented reality (VR and AR) and its impact on the Security Rule.  

The Alliance is working on a more detailed breakdown of the proposed rule as well as scheduling opportunities for members to provide feedback. If you have feedback or questions, please reach out to [email protected].

 

The Top 10 Home Health Care News Stories Of 2024

Home Health Care News / By Joyce Famakinwa
 
Major deals hit snags. Home health cuts continued. Regulatory noise came in from all sides, in Medicare and in Medicaid. All of those realities made their way into Home Health Care News’ most popular stories for the year. In order to summarize the 2024 that providers had, HHCN is revisiting 10 of its most widely read stories.
 
1. Home Care Industry Slams Finalized 80-20 Rule, Warns Agency Closures Are Coming (April 22)
  
2. Court Orders VitalCaring to Share 43% of Profits With Encompass Health, Enhabit (December 3)
   
3. How The Supreme Court’s Chevron Decision Could Help Stop Home Health Cuts (June 28)
 
4. DOJ Sues To Block ‘Anticompetitive and Illegal’ UnitedHealth Group-Amedisys Deal (November 12) 
  
5. Home Care’s Industry-Wide Turnover Rate Reaches Nearly 80% (July 3)
 
6. The Looming Home Care Disaster In New York State (March 18) 
  
7. ‘We Need A Break, Please!’: Home Health Providers Sound Off On CMS Over Rate Cuts (October 11)
 
8. Enhabit Walks Away From UnitedHealthcare After ‘9 Months Of Unsuccessful Negotiations’ (August 7) 
 
9. 6 Home Care Leaders To Watch, According To Other Home Care Leaders(January 29)
  
10. Pinnacle Home Care CEO: Home Health Margins Will Increase ‘Significantly’ With AI (October 22)

 

Telehealth Gets Short Extension, Physician Pay is Cut in Spending Bill

Healthcare Finance / By Susan Morse

President Joe Biden on Saturday signed a spending bill that averts a government shutdown, but some healthcare provisions that were in the original bill didn't make it to final passage.

Acute hospital-care-at-home and telehealth temporary waivers were continued, but were not given the long-term extensions that were included in a Dec. 18 bipartisan resolution. Both received short-term extensions until March 31.

The original bill extended telehealth for two years and acute hospital care at home by five years.

Stripped out of the bill is a provision to prevent the Medicare pay cut to physicians. This means physicians get a 2.8% Medicare payment cut on January 1, 2025...

Read Full Article 

 

OASIS-E1 Manual Finalized

The Alliance / By Katie Wehri

CMS posted the final OMB-approved OASIS-E1 time points Instruments, effective 1/1/2025, are now available in a zip file in the Downloads section of the OASIS Data Sets webpage.  The Agency has also reposted the final OASIS-E1 Manual effective 1/1/2025. Alliance staff are in the process of reviewing the materials.

A change table OASIS-E1 Instruments March 2024 – December 2024 Changes, also available in the Downloads section of the OASIS Data Sets webpage, lists minor corrections from the draft to final versions. The final OASIS-E1 All Items instrument will be posted when available.

 

2024 in Review and What to Expect in 2025

SESCO Management Consultants

2024 In Review

  • The Fair Labor Standards Act and the White-Collar Exemptions. In April, the U.S. Department of Labor (DOL) issued a rule aimed at raising the salary threshold for overtime exemptions under the Fair Labor Standards Act (FLSA). In November, a federal judge in Texas struck down the DOL's proposed rule on a nationwide basis. As a result, the salary thresholds reverted to the 2019 rule, resetting the White-Collar Exemptions to $35,568 per year.
  • The Federal Trade Commission and Non-Compete Agreements. In May, the Federal Trade Commission (FTC) promulgated a rule that effectively banned non-compete agreements and required employers not to enforce them, which was supposed to take effect in September 2024. The National Labor Relations Board also stated its intent to join the FTC's efforts to curb the use of non-compete agreements. The FTC's rule came under fire in federal litigation and has been blocked.
  • Equal Employment Opportunity Commission Guidance on the Pregnant Workers Fairness Act. The Pregnant Workers Fairness Act (PWFA) offers protections for pregnant employees, including requiring employers to provide workplace accommodations. In April, the Equal Employment Opportunity Commission (EEOC) published final interpretative guidance and regulations implementing the PWFA, which became effective in June. According to the EEOC, accommodations may be available for the temporary inability to perform an essential job function if the employee is expected to be able to perform the function at a to-be-determined time in the future. Moreover, a qualifying medical condition under the PWFA doesn't have to be solely caused by pregnancy and childbirth and can include conditions such as lactation, vomiting, abortion, and pre-eclampsia. This rule survived an initial federal challenge by a coalition of state attorneys general earlier this year.
  • Hourly Earnings. Real average hourly earnings for all employees were unchanged from October to November; this result stems from an increase of 0.4 percent in average hourly earnings combined with an increase of 0.3 percent in the Consumer Price Index (CPI). Real average hourly earnings increased 1.3 percent from November 2023 to November 2024.

What to Expect in 2025

  • AI Legislation on the Rise. As 2025 approaches, the legal landscape for employer use of artificial intelligence (“A.”) is poised for further evolution. In 2024 alone, over 400 AI-related bills were introduced across 41 states—a substantial increase from prior years. While Congress has yet to take decisive action, the trends from 2024 suggest a continued rise in state-led AI policies and federal agency guidance in 2025.
  • NLRB Poised to Switch to Republican Majority in Early 2025. It is likely there will be changes at the National Labor Relations Board (NLRB or Board). President-Elect Trump likely will remove Jennifer Abruzzo from her position as the NLRB’s current General Counsel. President-Elect Trump will have the opportunity to fill two open Member slots on the Board after his inauguration. While we can safely assume the new Republican Board and General Counsel will unwind many of the Biden Administration-era NLRB’s more controversial decisions, including its notable decisions which changed the standard for review of employer rules and policies, and which concocted a union-friendly procedure for recognition without any election – the timing of such is uncertain.
 
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