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HHS settles first small data breach case at medical practice
For the first time, the Dept. of Health and Human Services has reached a settlement over a data breach that affected fewer than 500 people, reinforcing its message that no medical practice is too small to be held accountable for not following privacy and security laws. On Jan. 2, Hospice of North Idaho settled a 2010 security case by agreeing to pay $50,000 to HHS. The case stemmed from a stolen laptop with unencrypted data containing the protected health information of 441 patients. HHS reached the agreement after a long investigation by its Office for Civil Rights, which found that the practice never conducted a risk assessment to safeguard patient data, a requirement under the Health Insurance Portability and Accountability Act. The agency also found that there were no policies and procedures to address mobile security, despite the fact that the practice routinely uses laptops as part of its field work. “This action sends a strong message to the health care industry that, [Read more]
VA finds shorter stays don’t lead to readmissions
Hospitals have been under pressure to reduce costs and send patients home earlier, and there has been speculation that shorter stays would mean more re-admissions. But a 14-year study of Veterans Affairs hospitals found that reducing a patient’s stay does not increase the chance that person will be readmitted later. Researchers studied more than 4 million admissions from 1997 to 2010 in 129 VA hospitals. Hospital lengths of stay dropped 27%, and readmission rates after 30 and 90 days went down by 16%. Mortality rates at 30 and 90 days decreased by 3%. The study was published in the Dec. 18, 2012, issue of Annals of Internal Medicine. Reducing the length of a hospital stay can have positive effects for the patient as well as a hospital’s bottom line, he said. “Every day someone sits in a hospital bed is one more day they can get an infection,” said Peter Kaboli, MD, lead author of the study, who conducted the research with colleagues from the Iowa City VA Medical Center [Read more]
Rule change lets House ignore Medicare IPAB
Any recommendation sent to Congress by the Medicare Independent Payment Advisory Board likely will never be taken up by the Republican-controlled House. The House adopted rules for the 113th Congress that included a provision addressing the IPAB’s authority to make recommendations on Medicare payment policy. The House rules are an attempt to nullify provisions in the Affordable Care Act “that limit the ability of the House to determine the method of consideration for a recommendation from” IPAB. “The rules package will better enable us as an institution to perform our constitutional duties and obligations with integrity and transparency, while streamlining our operations,” House Rules Committee Chair Pete Sessions (R, Texas) said in a statement. House Republicans, who have controlled the chamber since 2011 and will do so at least through 2014, have voted numerous times to repeal the 2010 health system reform law or eliminate certain sections. The IPAB was authorized [Read more]
Demand rises for CME linked to physician quality improvement
As physicians face increasing pressure to demonstrate performance improvement, more are utilizing a model of continuing medical education that gives them tools to assess the care they provide patients, and make measurable enhancements. The concept of Performance Improvement Continuing Medical Education was introduced in the early 2000s, and the model has expanded significantly since then. In 2011, 44,275 physicians and 7,492 nonphysician health professionals participated in 502 PI CME activities offered in the U.S., according to the Accrediting Council for Continuing Medical Education. That’s a steep increase from the 744 physicians and 175 nonphysician health professionals who participated in 22 PI CME activities offered just six years earlier. The model makes up a small fraction — less than 1% — of the more than 132,000 CME activities offered nationwide. But demand for PI CME is expected to grow as the country shifts to a pay-for-performance system of care that emphasizes [Read more]
Medicaid primary care pay to more than double in 6 states
Primary care doctors who provide services to Medicaid patients may experience significant fee increases starting in January 2013, when an Affordable Care Act provision to boost Medicaid pay rates to Medicare levels goes into effect for the next two years. Rhode Island doctors, for example, will see primary care fees go up by nearly 200% on average. For New York state, the overall increase will amount to 156%, and in California, 136%, according to a 50-state survey conducted by the Urban Institute on behalf of the Kaiser Commission on Medicaid and the Uninsured. In three other states — Florida, Michigan and New Jersey — fees also are expected to more than double for primary care physicians that qualify for the increase. “The states that are seeing the high percentages are merely the states that have been paying such abysmal rates to start with,” said Jeffrey Cain, MD, president of the American Academy of Family Physicians. Rhode Island, the state with the highest projected [Read more]
FDA gives green light to remote monitoring in clinical trial
The Federal Drug Administration has approved a clinical drug trial that is unique for two reasons. It used crowd-sourcing, including physicians, for the design of the trial. And it’s using tele-monitoring to track patient data. The FDA granted new drug status to a proposal by drug development company Transparency Life Sciences to conduct a phase II study of the effect of a widely used hypertension drug, lisinopril, in patients with multiple sclerosis. The trial was designed using feedback from an online crowd-sourcing system, the first clinical drug trial of its kind to use crowd-sourcing in its design. “What we aim to do is get physicians involved with the design of these trials more systematically,” said Marc Foster, co-founder and chief operating officer of TLS. The company wants a broader set of ideas when it comes to clinical trial design. It is opening up the process through an online system where both physicians and patients can submit ideas. The company will use [Read more]
Stem cell research center needs overhaul, IOM panel says
An Institute of Medicine review of California’s prominent center for stem cell research found organizational flaws and called for sweeping changes to reduce potential conflicts of interest. The report praised the taxpayer-funded California Institute for Regenerative Medicine for its aggressive pace in awarding grants totaling $1.3 billion to 59 institutions, saying, “CIRM and those it has funded have set in motion a significant scientific enterprise.” However, the IOM found the center’s practices generate concerns about transparency and potential bias that could undermine support for the CIRM. Reviewers found “far too many” CIRM board members represent organizations that were awarded grants or benefited from the grants. The majority of board members should be independent with no conflicting personal or professional interests, the committee said. The CIRM definition of conflict of interest should be retooled to “include non-financial interests, such as the potenti [Read more]
Medicare pay struggle a familiar year-end cliffhanger
Physician organizations are working toward a permanent plan to bring payment stability and higher quality to Medicare, but they have run into a familiar roadblock on Capitol Hill — impending deep payment cuts and no immediate relief in sight. Doctors participating in Medicare again found themselves just days away from a large decrease in pay rates, with Congress working against the clock to craft another temporary solution. At this article’s deadline, no deal had been reached to stop a 26.5% cut under the sustainable growth rate formula even as lawmakers pledged to prevent the decrease before it hits on Jan. 1, 2013. Congress has enacted stopgap legislation to prevent statutory reductions since the last cut took place in 2002. Some pay patches lasting a matter of weeks or a few months have been enacted — and applied retroactively — days or weeks after the cuts technically had taken effect. Virtually no one believes Congress will allow the SGR to lower pay in 2013, but doc [Read more]
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