What applies to a practice owner in West Virginia

Applies to your practice

6 entries

• FederalFinalIn force since March 18, 2024
  HHS Office for Civil Rights, Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates (bulletin issued December 2022, revised March 18, 2024)

  Applies to: HIPAA covered entities and business associates that use tracking technologies on websites or mobile apps

  HHS guidance for HIPAA covered entities: tracking technologies on patient portals and apps may not send PHI to vendors without a business associate agreement or patient authorization.

• FederalFinalIn force since Jan. 10, 2025
  HHS Office for Civil Rights, Dear Colleague letter: Ensuring Nondiscrimination Through the Use of Artificial Intelligence and Other Emerging Technologies (Jan. 10, 2025)

  Applies to: Covered entities under Section 1557 that use patient care decision support tools

  OCR guidance on 45 CFR 92.210 for Section 1557 covered entities, such as practices and hospitals; it changes no coverage, payment or licensure decision reaching physicians.

• FederalIn forceIn force since May 1, 2025
  Nondiscrimination in Health Programs and Activities, final rule, 89 FR 37522 (May 6, 2024); 45 CFR 92.210, Nondiscrimination in the use of patient care decision support tools

  Applies to: Covered entities under Section 1557 of the Affordable Care Act: health programs and activities receiving HHS federal financial assistance, HHS-administered programs and ACA Exchanges

  Binds Section 1557 covered entities, such as practices and hospitals receiving HHS funds, on decision support tools; it changes no coverage, payment or licensure decision reaching physicians.

• FederalFinal
  HHS Office for Civil Rights, Business Associates guidance (web page, content last reviewed July 30, 2026): AI chatbot example

  Applies to: HIPAA covered entities and the vendors that handle PHI for them

  HHS guidance for HIPAA covered entities: a vendor's AI chatbot handling PHI on a patient portal is a business associate, so the practice or hospital needs a business associate agreement first.

• FederalProposedSigned Jan. 6, 2025
  HIPAA Security Rule To Strengthen the Cybersecurity of Electronic Protected Health Information, proposed rule, 90 FR 898 (Jan. 6, 2025), RIN 0945-AA22

  Applies to: HIPAA covered entities and business associates

  Proposed rule binding HIPAA covered entities and business associates: asset inventory, network map, ePHI encryption and multifactor authentication, with ePHI in AI training data protected.

• FederalIntroduced
  S. 3062, Guidelines for User Age-verification and Responsible Dialogue Act of 2026 (GUARD Act), 119th Congress, reported by the Senate Judiciary Committee with an amendment (Calendar No. 406)

  Applies to: Anyone who makes an AI chatbot publicly available to consumers

  Would bind anyone who makes an AI chatbot publicly available to consumers, which reaches a practice's or hospital's patient-facing chatbot.

Applies to your physicians

0 entries

None on the map.

Also affects your practice

8 entries

• FederalIn forceIn force since Jan. 1, 2024
  Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly, final rule (CMS-4201-F), 88 FR 22120 (April 12, 2023), RIN 0938-AU96; 42 CFR 422.101(b)(6) and (c)(1) and 422.566(d)

  Applies to: Medicare Advantage organizations

  Binds Medicare Advantage plans only: medical necessity decisions rest on the enrollee's own circumstances, and a qualified professional reviews adverse decisions before issue.

• FederalFinalIn force since Feb. 6, 2024
  CMS, Frequently Asked Questions related to Coverage Criteria and Utilization Management Requirements in CMS Final Rule (CMS-4201-F), HPMS memo, Feb. 6, 2024

  Applies to: Medicare Advantage organizations and Medicare-Medicaid Plans

  Applies to Medicare Advantage organizations and Medicare-Medicaid Plans only: AI alone may not deny an admission, downgrade to observation or end post-acute care, and decisions rest on the patient's own circumstances.

• FederalIn forceIn force since Jan. 1, 2025
  Medicare physician fee schedule payment for digital mental health treatment devices, HCPCS G0552, G0553 and G0554: CY 2025 final rule (CMS-1807-F), 89 FR 97710 (Dec. 9, 2024), expanded in the CY 2026 final rule (CMS-1832-F), 90 FR 49266 (Nov. 5, 2025)

  Applies to: Physicians and other practitioners billing the Medicare physician fee schedule

  Fee schedule codes G0552 to G0554 let clinicians bill for FDA-cleared digital mental health treatment devices; a payment option, not a duty.

• FederalIn forceIn force since Jan. 1, 2026
  Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Advancing Interoperability and Improving Prior Authorization Processes, final rule (CMS-0057-F), 89 FR 8758 (Feb. 8, 2024), RIN 0938-AU87

  Applies to: Medicare Advantage organizations, state Medicaid and CHIP fee-for-service programs, Medicaid managed care plans, CHIP managed care entities and qualified health plan issuers on the federally facilitated Exchanges

  Binds MA, Medicaid, CHIP and Exchange payers only: prior authorization deadlines, specific denial reasons and a prior authorization API; no AI rule, listed for prior authorization.

• FederalIn effectIn force since July 5, 2026
  CMS Innovation Center, Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model (request for applications issued Dec. 5, 2025; version 1.1, Feb. 12, 2026)

  Applies to: Medicare Part B-enrolled organizations that join the model, other than suppliers of durable medical equipment, prosthetics, orthotics and supplies and laboratory suppliers; their Original Medicare patients; and clinicians who co-manage those patients

  Voluntary CMS model: participating organizations and co-managing clinicians gain new billing options; no duty unless an organization joins.

• FederalProposedSigned July 16, 2026
  Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies, proposed rule (CMS-1848-P), 91 FR 43842 (July 16, 2026), RIN 0938-AV82

  Applies to: Physicians and other practitioners paid under the Medicare physician fee schedule

  Proposed fee schedule pricing for 10 software analysis codes, paid to whoever bills the fee schedule; a payment change, not a duty.

• FederalIntroduced
  H.R. 3514, Improving Seniors' Timely Access to Care Act of 2025, 119th Congress, ordered reported by the House Ways and Means Committee

  Applies to: Medicare Advantage organizations; CMS and ONC for a report to Congress

  Would bind Medicare Advantage plans only: electronic prior authorization and annual reports on requests approved or denied with AI or other decision technology.

• FederalIntroduced
  S. 3097, Health Information Privacy Reform Act, 119th Congress, reported by the Senate Health, Education, Labor, and Pensions Committee with an amendment (Calendar No. 538)

  Applies to: HHS (rulemaking); entities that process identifiable health information outside HIPAA's protections for protected health information, including data brokers; HIPAA covered entities for the AI-related minimum necessary rules

  Would direct HHS to write rules on how the minimum necessary standard applies to PHI used for AI; covered entities would be bound only through those future rules, so it affects them.