The Biden administration in February issued what it said would be the final, 90-day renewal of the COVID-19 public health emergency, setting the end date to May 11, 2023. Officials emphasized that key metrics showed improvement: Since the omicron variant surge in January 2022, COVID-19 reported cases are down 92%, deaths have declined by more than 80%, and new hospitalizations are down nearly 80%.
The end of the public health emergency has implications for SARS-CoV-2 testing, and some consumers could pay more out of pocket. For vaccines, government-purchased doses will remain free of charge.
Who might pay more for SARS-CoV-2 testing depends on several factors. Medicare beneficiaries enrolled in Part B will continue to have coverage without cost sharing for laboratory-conducted tests when ordered by a provider, but access to free over-the-counter (OTC) tests will end. Likewise, private insurance will not be required to cover either lab or OTC tests without cost sharing. However, the Centers for Disease Control and Prevention (CDC) will continue programs that offer testing for uninsured individuals through pharmacies and community-based sites.
Reporting of SARS-CoV-2 laboratory results to CDC will also change. After May 11, the government will no longer have authority to require this data from labs. Hospital data reporting will continue as required through April 30, 2024, but reporting may be reduced from the current daily reporting to a lesser frequency.
PROPOSED RULE WOULD STANDARDIZE HEALTHCARE ELECTRONIC TRANSACTIONS, SIGNATURES
The Centers for Medicare & Medicaid Services (CMS) is proposing a rule that would standardize electronic transactions in healthcare. These include medical charts, X-rays, provider notes, laboratory orders, and more. CMS says providers could save $454 million annually in administrative costs due to reduced paperwork.
“Healthcare providers are often forced to use manual processes such as mail, fax, or internet web portals when they respond to requests from health plans, leading to delays and less time for patient care,” said CMS Administrator Chiquita Brooks-LaSure. “These important steps would promote more consistent and reliable communications among the partners involved in healthcare transactions.”
Another benefit, according to CMS: the rule would help make the process of submitting and adjudicating healthcare claims more efficient by providing structured, standardized electronic data to payers.
The proposed rule specifically notes the significance of signatures for clinical laboratories. “A healthcare providers’ signature…on medical record documentation generally serves as the attestation that the appropriate provider representative has reviewed and approved the documentation,” it says. And “if the laboratory is unable to produce a signed order, it may not be reimbursed.”
CMS will accept comments on the rule, known as CMS-0053-P, through March 22, 2023.
GOVERNMENT SETTLES WITH BANNER HEALTH OVER CYBERSECURITY HACKING
The Department of Health and Human Services’ Office for Civil Rights (OCR) announced a settlement with Phoenix, Arizona-based Banner Health over a data breach resulting from a 2016 hacking incident. The incident resulted in the disclosure of the protected health information of 2.81 million consumers. Banner Health paid $1,250,000 and is implementing a corrective action plan.
OCR’s investigation found evidence of “long term, pervasive noncompliance” with the HIPAA Security Rule across the organization. According to OCR, organizations must be “proactive in their efforts to regularly monitor system activity for hacking incidents and have measures in place to sufficiently safeguard patient information from risk across their entire network.”
OCR expects healthcare providers to perform an analysis to determine risks and vulnerabilities to electronic protected health information across the organization. Among other requirements, a hospital must monitor its health information systems’ activity to protect against cyberattacks, implement an authentication process to safeguard its electronic protected health information, and establish security measures to protect electronic protected health information from unauthorized access when it is being transmitted electronically.