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The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Compliance now involves reporting quality data and participating in payment models that incentivize better care.
Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting “reasonable and customary charges” requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed.
OIG differentiated the vetting HealthInsurance Portability and Accountability Act (“HIPAA”) covered entities may conduct of entities that would be their business associates before granting access and use of EHI. Other than the information blocking penalties, the rest of the final rule’s provisions are effective August 2, 2023.
Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting "reasonable and customary charges" requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed.
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