Congress will probably authorize Medicare to keep telehealth coverage rolling next year and maybe forever along the lines of the COVID-19 flexibilities, according to Kim Brandt, former principal deputy administrator of CMS. That would mean continued payments for services delivered everywhere by audiovisual and audio-only technology, she said. They’ve already been kept alive through the end of this year by the 2023 Consolidated Appropriations Act (CAA). “We’ll definitely see action in Congress on telehealth,” said Brandt, who also was the Senate Finance Committee’s general counsel for five years, at HCCA’s Compliance Institute April 16. “The expectation is they will be extended again or be made permanent.”

Health care entities and technology companies seeking to use health data within artificial intelligence (AI) systems need a good grasp of the HIPAA implications to avoid inadvertently creating privacy risks, experts say.

Ty Kayam, principal corporate counsel for digital health, artificial intelligence, and technology transactions at Microsoft, and Jodi Daniel, an attorney with Crowell & Moring, spoke on the use of protected health information (PHI) in AI systems at the 41st National HIPAA Summit Feb. 27.^[1]

The HHS Office of Inspector General prepared this chart to summarize some key differences between its longstanding compliance program guidance (CPG) and new General Compliance Program Guidance (GCPG)/forthcoming industry segment-specific compliance program guidances (ICPGs). The ICPGs will start to be released later this year.^[1]

Here's data from the HHS Office for Civil Rights showing a shift in what's driving breaches affecting 500 or more people. The data was presented at the HCCA Compliance Institute April 15.

The rewards of voluntary self-disclosure are now being offered to individuals—not just the corporations they work for—under a new U.S. Department of Justice (DOJ) pilot program.^[1] In a nutshell, individuals who come forward with information about criminal conduct may escape prosecution—if they meet certain conditions. DOJ said it’s hoping the possibility of a non-prosecution agreement (NPA) will entice people to reveal corporate and white-collar offenses and encourage companies to have effective compliance programs.

When Laura Ellis, a senior counsel at the HHS Office of Inspector General (OIG), evaluates organizations under a corporate integrity agreement, sometimes she will see what she calls these “fatal words” in its compliance reporting policy: “first go to your supervisor.” Compliance problems “are not an area where you want to reinforce your chain of command,” Ellis said at the HCCA Compliance Institute April 15. “You want to find out what’s worrying employees and contractors and there should be no obstacles to getting that message to the compliance department.”

◆ HHS Inspector General Christi Grimm testified about the “significant vulnerabilities” of risk adjustment in Medicare Advantage at an April 16 hearing before the House Committee on Energy and Commerce’s Subcommittee on Oversight and Investigations.^[1] “One troubling concern is the potential for plans to game risk adjustment by overstating how sick enrollees are so the plans can receive higher payments than they should,” she said.