Regulations to look at in 2022 – an overview
COVID-19 still remains a central topic of discussion among healthcare professionals today. However, there are some other aspects of equal importance that you need to look at in 2022, such as:
- The No Surprises Act
- New rules of information blocking
- Demand for telemedicine services
- Rules of electronic prescribing of controlled substances
Each of these issues can directly impact the reimbursement flow of your practice. Now is the perfect time to refresh your memory. Below is a brief summary of these four aspects.
I. The No Surprises Act – a guardian of price transparency
The law, which went into effect on January 1, 2022, prohibits surprise bills for out-of-network treatments and limits consumers' obligation to copayments and deductibles inside their networks. The guidelines also establish a procedure for resolving disputes related to charges billed to uninsured patients. Finally, the Act determines a list of occasions where healthcare providers are required to provide a good faith estimate to their patients.
II. New rules of information blocking – ensuring greater authorized access to medical records
The 21st Century Cures Act's Information Blocking regulation went into effect on April 5, 2021. It barres IT developers and healthcare providers from "engaging in any action or omission that is likely to impede with the access, exchange, or use of electronic health information”.
A notable feature of this legislation is the definition of “electronic health information”. Effective October 6, 2022, it will include any electronic protected health information contained within a specified record set, as defined by HIPAA.
III. Telehealth is here to stay, but it will soon become less popular
According to our internal research, in 2022 healthcare industry will witness a decreasing demand for telemedicine services. By the end of this year, less patients will be satisfied with the quality of such services, and payers are likely to tighten their telemedicine coverage guidelines. In fact, this tendency already started in 2021, with RockHealth reporting that only 43% of patients would prefer telemedicine to in-person visits.
IV. New requirements on the prescription of controlled substances
Effective January 1, 2022, the CMS requires healthcare providers to utilize electronic prescribing of controlled substances (EPCS) for Medicare Part D beneficiaries. Although this requirement is not enforced yet (it will be in 2023), we strongly recommend you implement an EPCS solution this year.
Just a quick reminder: We Can Help you understand all the new reimbursement and clinical policies!
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