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Medicare contractors rejecting pay for some legitimate services

A government watchdog's audit of improper payment determinations for Medicare services showed that contractors had denied payments for some valid services in 2010. The Centers for Medicare & Medicaid Services uses contractors to manage a comprehensive error-rate testing program that determines the frequency of improper payments in Medicare fee-for-service. In 2010, that error rate was 10.5% and represented an estimated $34.3 billion in improper payments, according to a February report by the Dept. of Health and Human Services Office of Inspector General. However, a review of those audits showed that the error rate would have been lower if contractors had taken extra steps to obtain records showing that billed services were medically necessary. "Additional efforts to obtain missing documentation could more clearly reflect the true status of improper payments" in the error rate estimate, the OIG said. The error rate in 2010 would have been 10.2%, a total of nearly $1 billion less i ...

Patient room notes, pop quizzes boost hand hygiene

A note on the white boards in hospital patients' rooms saying, "I like clean hands," can result in higher rates of hand-washing among health professionals, but a sign in the staff lounge urging hand-hygiene compliance probably will not make a difference. These are among the findings of a rapid intervention-testing process used at seven hospitals in the Sentara Healthcare system, headquartered in Norfolk, Va., that pushed the hand-hygiene compliance rate to 92.5%. The nationwide hand-washing rate has hovered around 50%, depending on the study and measurement used. Like many health systems, Sentara finds itself under pressure to improve hand-hygiene compliance rates that have been linked to nosocomial infections. Rates of such infections are being publicly reported, and many insurers withhold payment for treating some infections acquired in the hospital. Sentara already had easily accessible sinks and sanitizer foam, yet a revised audit process had shown its compliance rate at a ...

NHSC provides $9 million for medical students to go into primary care

Seventy-seven fourth-year medical students will receive $9.1 million in loan repayments for participating in a new National Health Service Corps program aimed at encouraging more young people to go into primary care. Dept. of Health and Human Services Secretary Kathleen Sebelius announced the awards for the Students to Service Loan Repayment Program at a Los Angeles community health center on Feb. 13. "This new program is an innovative approach to encouraging more medical students to work as primary care doctors," she said. The Health Resources and Services Administration estimates that 17,722 primary care professionals are needed in medically under-served areas to meet a target of having one primary care professional for every 2,000 U.S. residents. Students in the pilot program, funded through the Patient Protection and Affordable Care Act, will receive up to $30,000 annually for four years. In exchange, they must agree to practice at least 40 hours a week for three years ...