HIPAA Privacy Rule
In April, the Health Insurance Portability and Accountability Act (HIPAA) added requirements for the better protection of reproductive healthcare data. The ruling of the Department of Health and Human Services (HHS), through the Office for Civil Rights (OCR), addresses the concerns of protecting patient confidentiality and preventing medical records from being used against individuals providing or obtaining lawful reproductive health care.
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CAA Prescription Data Reporting
The Consolidated Appropriations Act, 2021 (CAA) requires plans and issuers offering group or individual health insurance coverage to submit information regarding the costs of prescription drugs and other health care services each year to the Center for Medicare & Medicaid Services (CMS).
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Communitas Achieves 3-Year NCQA Accreditation for Case Management and Utilization Management Programs
Communitas is redefining health care clinical management by prioritizing health outcomes through comprehensive member engagement.
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Unlocking Cost Control: WebTPA's Flexibility in Healthcare Administration
In the ever-evolving landscape of healthcare administration, a paradigm shift is underway as hospitals and large employers recognize the limitations of traditional network contracts with carriers.
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Federal Legislation for Self-Funded Health Plans
WebTPA is committed to keeping its clients up to date on federal healthcare policies and legislation. Here you will find our interpretation of said legislation and how these statutes may impact your health plan.
Publicly Available, Machine-Readable Files
In-Network Rates and Historical Out-of-Network Allowed Amounts
To meet transparency requirements effective July 1, 2022, WebTPA will assist plan sponsors in making the two machine-readable files available (in-network rates for covered services or item covered by the plan, historical billed charges from out-of-network providers and the allowable amount of such charges considered by the plan).
Important Note
These are very large JavaScript Open Notation (JSON) files (20GB to 70GB) that may take a while to download. If your system has limited capability, they may not be downloadable. Download speeds and time are dependent on your internet speed, browser and computer hardware.
