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Federal Anti-Trust Modernization Commission (AMC):

The Antitrust Modernization Commission was created pursuant to the Antitrust Modernization Commission Act of 2002, Pub. L. No. 107-273, §§ 11051-60, 116 Stat. 1856. The Commission consists of 12 members, 4 of which were appointed by the President, 4 of which were appointed by the leadership of the Senate, and 4 of which were appointed by the leadership of the House of Representatives. Id. § 11054(a).

The Commission is charged by statute:

(1) to examine whether the need exists to modernize the antitrust laws and to identify and study related issues;
(2) to solicit views of all parties concerned with the operation of the antitrust laws;
(3) to evaluate the advisability of proposals and current arrangements with respect to any issues so identified; and
(4) to prepare and submit to Congress and the President a report.

Id. § 11053. The report is to “contain[] a detailed statement of the findings and conclusions of the Commission, together with recommendation for legislative or administrative action the Commission considers to be appropriate.” Id. § 11058.

The Commission has public meetings, which are announced on its web site www.amc.gov along with documents and transcripts of the meetings that have been held.

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Centers for Medicare & Medicaid Services (CMS):

Centers for Medicare & Medicaid Services. To view the home page, click here.

The following provider notices are linked for your conveyance. Click on the notice you wish to view.

EMTALA:

On-Call Requirements-EMTALA (Ref #S&C-02-34)

Simultaneously On-Call EMTALA (Ref #S&C-02-35)

See HHS OIG Guidance below

Uninsured:

In response to questions from hospitals regarding offering discounts to the uninsured, CMS posted a number of new "frequently asked questions" (or FAQs) on its web-site. Please refer to the following web-site address to access this information:

Questions and Answers on Charges to the Uninsured - http://www.cms.hhs.gov/FAQ_Uninsured.pdf

HHS Secretary Thompson's letter AHA President Dick Davidson - http://www.os.dhhs.gov/news/press/2004pres/20040219.html

OIG Report on Hospital Discounts Offered to Patients Who Cannot Afford to Pay Their Hospital Bills - http://oig.hhs.gov/fraud/docs/alertsandbulletins/2004/FA021904hospitaldiscounts.pdf

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Health Insurance Portability and Accountability Act of 1996 (HIPAA):

HIPAA Hotline:
The Centers for Medicare & Medicaid Services (CMS) has a variety of resources available to assist providers seeking more information about the administrative simplification provisions of HIPAA. A CMS hotline has been established to assist in responding to provider questions about transactions and code sets. That telephone number is (410) 786-4232. Although this hotline is designed primarily to answer questions about electronic transactions, CMS has acknowledged a large volume of questions surrounding the privacy regulations. CMS will be working with the Office of Civil Rights, the Federal agency charged with enforcing the HIPAAs privacy aspects, to set-up a town hall meeting to provide further direction on that particular component.

The following American Hospital Association summaries have been linked for your conveyance. Click on the notice you with to view.

HIPAA Security Rule Published February 20, 2003.

HHS Office of Civil Rights Medical Privacy - National Standards to Protect the Privacy of Personal Health Information Page:
The Health and Human Services (HHS) Office of Civil Rights - Medical Privacy - National Standards to Protect the Privacy of Personal Health Information web page where they post answers to questions regarding privacy and HIPAA. To view the page, go to http://www.hhs.gov/ocr/hipaa/

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HHS Office of Inspector General (OIG):

The Department of Health & Human Services Office of Inspector General. To view the home page, click here .

The OIG Advisory Opinions To view the Advisory Opinions, click here .

EMTALA Guidance - OIG issues supplemental compliance program guidance for hospitals - HHS' Office of Inspector General (OIG) published a draft supplement to its Compliance Program Guidance for hospitals on June 8, 2004. OIG said the guidance will supplement, rather than replace, its 1998 CPG for hospitals, which addressed the fundamentals of establishing an effective compliance program. It said the new guidance takes into account recent changes to hospital payment systems and regulations, evolving practices, current enforcement priorities, and lessons learned in the area of corporate compliance. Areas addressed include submission of accurate claims and information; the referral statutes; payments to reduce or limit services; the Emergency Medical Treatment and Labor Act (EMTALA); substandard care; relationships with Federal health care program beneficiaries; HIPAA privacy and security rules; and billing Medicare and Medicaid substantially in excess of usual charges. OIG said that neither the supplemental guidance nor the original 1998 guidance is intended as a model program, but that the two documents collectively offer a set of guidelines that hospitals should consider when developing and implementing a new compliance program or evaluating an existing one. The draft guidance can be found in the June 8, 2004 Federal Register at http://www.access.gpo.gov/su_docs/fedreg/a040608c.html under "Inspector General Office, Health and Human Services Department."

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President Bush Backs Malpractice Reform:

To read a copy of the President's July 25, 2002 speech regarding Medical Malpractice Reform, please click here.

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Office of Management & Budget (OMB):

The Office of Management and Budget approved the new Advance Beneficiary Notice form CMS-R-131 on June 18, 2002. It replaces the model language HCFA-R-131 used by physicians and suppliers since 1988. The new form is nearly identical to the temporarily approved ABN in use since June 25, 2001. The ABN is available online at http://cms.hhs.gov/medicare/bni/ , as are draft form instructions. A Program Memorandum, in Centers for Medicare & Medicaid Services clearance now, will provide implementing instructions for Part B and Part A use of the ABN. The PM will soon be issued, with implementation of the new form planned for Oct. 1, 2002. In the meantime, the forms themselves are officially approved as of June 18, 2002, and may be used immediately on a voluntary basis. Health care professionals, suppliers, and providers may use the new ABN, following the draft form CMS-R-131 instructions online at http://cms.hhs.gov/medicare/bni/ .

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UB-92 Billing Manual:

To obtain a copy of the UB92 Billing Manual or to subscribe to the UB92 mailings, go to http://www.nubc.org/become.html for more information.

Note: Additional regulatory information can be accessed by Association Members under the Members Only section of the website by choosing Advisory and Advocacy.
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