New year, new regulations. Four essential resources to guide you.

The year 2017 is here. If you participate in a government reimbursement program such as Medicare or Medicaid, are you aware of how well you performed this past year? Have you been keeping up with the changing healthcare regulations? Have you been reporting properly throughout the year?

If the answer to any of these questions is no, chances are you will be leaving money on the table. You could be missing programs that could benefit your practice, or you could be reporting on the wrong information or missing key metrics.

It’s time to catch up! Spending just an hour or two each month reading industry newsletters, following industry experts on blogs, social media, or websites, or watching webinars can ultimately save you time and improve your process.

Industry regulations are always changing. What you learned one year might not apply to the next. Reporting requirements changed in 2014 after the required implementation–and in 2015 and 2016.  Here’s just one example: in August 2012, the Centers for Medicare & Medicaid Services (CMS) announced a final rule to govern Stage 2 of the Medicare and Medicaid EHR Incentive Programs. Though Stage 2 was announced in 2012, it wasn’t implemented until 2014. Then reporting requirements changed in 2015. In 2016, reporting changed again.

What all this means is that if a practice is running the same reports in 2016 that it was in 2014, the reports may be inadequate and the practice is wasting time processing them.

With the Quality Payment Program (QPP) going into effect in 2017, there will be continued shifts in data reporting. Practices need to be monitoring their progress throughout the year, regularly running reports from the electronic health records (EHR) to catch any discrepancies, so that inquiries can be made in a timely manner.

And it’s not just reporting rules that you need to follow. Pay attention to privacy policies. The HIPAA Security Rule requires that health care providers set up physical, administrative, and technical safeguards to protect patient electronic health records. That means that there should be safety measures built into EHR systems. And a practice’s security policies should also cover connected devices, EHRs, and patient portals. Do a risk assessment regularly to know if you are meeting HIPAA regulations.

Wherever possible, get information from the source of the program(s) you participate in. Here are 4 useful resources to help you proactively educate yourself on changing industry regulations in 2017 and beyond:

  • Health information technology: The website helps providers learn how health IT can transform access to information. Learn about incentives for certification and how to get paid to go paperless. Best of all, learn how to improve patient care, lower costs, and save time. Have a question? Visit their FAQ section to get answers.
  • Centers for Medicare & Medicaid Services: The website has everything you need to know about CMS programs. Sign up at the bottom of the home page to receive email updates.
  • Quality Payment Program: The new website covers the CMS QPP, formerly known as MACRA. Learn about the Merit Based Incentive Program (MIPS) that will replace Meaningful Use and PQRS and what you need to do to report quality measures for 2017. Subscribe to their emails by filling in your email address in the footer of the page.
  • HIPAA: Go to to get all the latest information on health privacy and what you need to do to protect individually identifiable health information. There is also a link near the bottom of the page to sign up for their Office for Civil Rights Privacy and Security Listserv to stay informed on any changes.

Be sure to join the email list for all of these sites to receive the most up-to-date information. Also be sure to follow those that are on Twitter (@ONC_HealthIT, @CMSGov, and @HHSOCR) and participate in their webinars. Doing these things can help you stay on top of your reporting requirements in the new year.

Your Quest Diagnostics team is here to guide you. Just give us a call at 1.800.697.9302.

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Sources:  HHS, HDM

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