Tom counsels health insurers, health plans, and their business partners on state and federal regulatory issues. He works with state and federal agencies, including the Department of Health and Human Services and State Departments of Insurance. He has extensive experience dealing with the application of State and Federal regulations to complex circumstances.

Regulatory Schemes

Tom has expertise with a variety of regulatory schemes, including the following:

  • HIPAA Privacy, Security, and Data Breach Rules and the HITECH Act;
  • Federal Confidentiality of Substance Use Disorder Patient Record Rule (Part 2);
  • FSAs, HRAs, and HSAs: Regulatory schemes related to consumer-directed health plan vehicles, including flexible spending arrangements and health savings accounts;
  • Health Reform--the Affordable Care Act and Federal Rules to implement the Act
  • HIPAA Transactions and ASC X12 5010 TR3 implementation guides;
  • State privacy, security, and data breach requirements;
  • Mental Health Parity;
  • The Red Flags Rule and the Fair Credit Reporting Act;
  • The Genetic Information Nondiscrimination Act (GINA);
  • HIPAA Title I (wellness programs, anti-discrimination, portability, creditable coverage, etc.);
  • State insurance law, including Medicare supplement insurance.

HIPAA / HITECH Privacy, Security, and Breach Notification

Training Programs and Compliance Assessments

Tom provides on-site training on the HIPAA Privacy, Security, and Breach Notification Rules. He will work with you to produce a training session tailored to meet your specific needs.

Tom also conducts compliance assessments with respect to HIPAA Privacy, Security, and Breach Notification requirements for health plans and their business associates. The assessments are based on the Department of Health and Human Services' HIPAA Audit protocols-- click here to see a Health Law Alert on the subject. Perform a self-assessment or evaluate a business associate.

Flat Fee Arrangements

Tom contracts with health plans and their business associates to provide advice and counseling for Privacy Officers and legal counsel under an inexpensive flat fee arrangement--a great way to provide backup to an experienced person or support for someone new to the area.

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