Local Healthcare Regulations
Medical Document Retention Requirements
Federal regulations impose certain document retention requirements upon healthcare
providers relative to encounters with Medicare and Medicaid patients. This matrix
provides the basic details regarding these requirements. Please remember that many
states also have document retention laws that impose additional requirements relative
to encounters with Medicare, Medicaid, commercial payer and uninsured patients.
Publication Date: 06/2011
Copyright 2011.
Photocopying Fees for Patient Records
Most states set limits regarding the highest fees that providers may charge for
releasing copies of patient records. This matrix provides the basic details regarding
these laws and hyperlinks to the relevant state statutes. As you will note, state
statutes vary not only with regard to the permissible fees, but also as to whether
certain requestors (e.g., attorneys) can be charged higher fees, whether an additional
search fee can be assessed, etc. In some situations, a provider’s violation of these
statutes can result in fines and other penalties.
Publication Date: 06/2011
Copyright 2011.
Insurance Prompt Payment Laws
Many healthcare providers suffer from health insurance reimbursement delays, which
can have dramatic adverse effects upon their cash flow. Collective efforts of both
federal and state legislatures have resulted in the enactment and enforcement of
prompt payment laws that require payers to adjudicate claims and render appropriate
reimbursement within certain timelines. Healthcare providers must be fully aware
of the prompt payment laws of their respective states so that they may effectively
enforce their statutory rights and demand appropriate remedies.
Publication Date: 06/2011
Copyright 2011.
Notification of Actual or Likely Data Breach
Widespread security breaches and identity theft have prompted legislatures across
the nation to enact data breach notification laws. These laws impose notification
obligations that are triggered when a medical office or other entity discovers that
its computerized records containing personal information have been accessed by an
unauthorized third party. Many of these laws impose very serious penalties on non-compliant
entities, so it is important that you understand the law(s) that apply to your practice.
Publication Date: 01/2008
Copyright 2008.
Refund, Deduction and Recoupment of Overpayments
Insurance overpayment recoupment and overpayment refund disputes are now commonplace
in modern medicine. The majority of states have enacted refund and recoupment laws
that govern a payer’s ability to demand a refund or to recoup previous overpayments.
Since payers are becoming more aggressive in demanding repayment, it is important
that you understand your rights under state law.
Publication Date: 06/2011
Copyright 2011.
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