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It is not just about following rules but about maintaining the highest standards of patient care and ethical behavior. Healthcare organizations must comply with many regulations, including the HealthInsurance Portability and Accountability Act (HIPAA) , the Affordable Care Act (ACA), and various state-specific regulations.
Enforced by the HHS Office of Civil Rights (OCR), the Privacy Rule established a set of standards that control the use and release of protected data by covered entities intended to protect patient data and privacy.
Fraud and abuse, waste between $59 bn and $84 bn; and, Administrative complexity, wasting about $266 bn each year. Thus, administrative complexity, which includes billing and coding waste, and physician time spent reporting on quality measures, accounted for the largest component of waste in American health care.
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Healthinsurance agents who fraudulently enroll consumers in Affordable Care Act health plans could be subject to criminal charges — and civil penalties of $10,000 to $200,000 — under legislation introduced Wednesday by Sen. “The bottom line is to stop fraud and help the consumer,” she said. Ron Wyden (D-Ore.),
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