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New ICD-10 deadline will be Oct. 1, 2014
Federal health officials are using an administrative simplification rule to propose delaying by one year the implementation of new diagnosis coding sets used for billing medical services. ICD-10 diagnosis codes would be required for billing physician services starting on Oct. 1, 2014, according to the April 9 proposed rule from the Dept. of Health and Human Services. Currently, doctors and hospitals use the ICD-9 standard, which contains far fewer individual codes but also permits less specificity when making diagnoses. The proposed rule is expected to be finalized this year after a 30-day comment period. The American Medical Association led the movement to push off the ICD-10 implementation deadline, citing concerns about doctors’ ability to be compliant by Oct. 1, 2013. The substantial number of new codes that must be learned, combined with initial problems with implementing the new 5010 electronic transaction standards that are a prerequisite for taking on the new code sets, [Read more]
Primary care and public health encouraged to work together
The nation’s health probably would improve if primary care and public health were better integrated, says an Institute of Medicine report. Such integration should include health professionals sharing and collaboratively using data, asking the community to help define its medical needs and pursuing a shared goal of improving the population’s health, said the report, issued on March 28. “While integrating fields that have long operated separately may seem like a daunting endeavor, our nation has undertaken many major initiatives. ... It’s time we did the same for primary care and public health, which together form the foundation of our population’s overall well-being,” said IOM committee Chair Paul J. Wallace, MD. He is senior vice president and director of the Center for Comparative Effectiveness Research, which works to improve patient health outcomes and health care delivery. Chronic disease prevention and treatment, which increasingly are becoming the focus of pr [Read more]
Civil liberties group criticizes health information exchanges over privacy
A report by the New York Civil Liberties Union examining health information exchanges in the state questioned the legalities of the patient privacy policies in place and criticized the exchanges for not doing enough to protect patients. The findings are applicable to health information exchanges across the country, the report’s author says, because there are no established best practices for the sharing of data through HIE organizations. New York is often viewed as a leader in such exchanges, as it had some of the first ones in the nation. Corrine Carey, assistant legislative director of the NYCLU and author of the report, said because information can be uploaded to an HIE without patient consent, the NYCLU and other patient privacy groups have argued that these policies are not consistent with state law, which requires physicians to get consent from a patient before transferring records to a third party. Patients do, however, have to give consent before those files can be acce [Read more]
Washington state suspends Medicaid emergency department limits
Washington state emergency physicians are claiming a victory with the governor’s decision to suspend a zero-tolerance Medicaid emergency department payment policy that was scheduled to kick in on April 1. The American College of Emergency Physicians praised Gov. Chris Gregoire for putting a hold on the implementation of the policy, which would have denied Medicaid payment for ED care given to patients diagnosed with one of about 500 conditions deemed by the state to be non-urgent. State legislators approved the limits as a way to cut down on paying EDs for care that patients should be receiving in physician offices or other less costly settings. ACEP and its state chapter warned that the exclusion list was too broad and would apply to many patients who legitimately believed they were dealing with emergency situations when they showed up at EDs. A prohibition on paying for the treatment of sprains in the ED, for instance, would affect Medicaid patients who needed to rule out the [Read more]
CMS rules contribute to drug shortages, hospital pharmacists say
Federal guidance requiring strict adherence to manufacturer labels for inject-able drugs has forced hospitals to throw away perfectly good drugs that are in short supply, according to a survey of pharmacy directors and managers. The Institute for Safe Medication Practices, based in Horsham, Pa., has called on the Centers for Medicare & Medicaid Services to review its policies involving stability and beyond-use dating of medicines. The institute surveyed 715 hospital pharmacists and managers who reported that following manufacturer directions has contributed to national drug shortages. CMS requires pharmacists to be compliant with Food and Drug Administration-approved labels to avoid the use of expired drugs. But pharmacists who were surveyed said some labels are not current and that newer, evidence-based research supports a longer shelf life in certain circumstances. Those studies have shown that diluted drugs remain stable beyond their stated expiration dates, said Allen J. V [Read more]
Sleeping pills pose added death risk for obese patients
The mortality rate for obese patients who regularly take sleeping pills is nine times higher than the death risk for similar patients who do not use the drugs, said a study presented at an American Heart Assn. scientific meeting in March. Researchers examined the medical records of more than 34,000 patients treated in the Geisinger Health System in Pennsylvania. After controlling for sex, age, smoking status, alcohol use, marital status and ethnicity, the obese patients who took hypnotic medicines regularly — at least 132 pills annually — were 9.3 times likelier to die than patients with similar health who did not. Even obese patients who took 18 pills or fewer annually had a death rate eight times higher. The added risk of sleeping pills for obese patients also applied to drugs such as zolpidem, marketed as Ambien by Sanofi-Aventis, which is thought to be less problematic than older, longer-acting sedatives. Obese patients using zolpidem regularly had an eightfold higher dea [Read more]
National health information network soon will stand on its own
A once-conceptual “network of networks” that evolved into the Nationwide Health Information Network Exchange is leaving the direct oversight of the Health and Human Services’ Office of the National Coordinator of Health Information Technology to stand as its own nonprofit organization. The ONC is making the newly coined “NwHIN Exchange” into an independent, nonprofit, public-private partnership that includes the Dept. of Defense, the Social Security Administration, the Dept. of Veterans Affairs, the Centers for Medicare & Medicaid Services and a host of non-federal hospitals and health care organizations, as well as local health information exchanges. Details of the new business model are being worked out, including a sustainability plan. The network is expected to continue evolving as new technologies are introduced and new partners come aboard. The planning process and transfer of power are expected to be complete by the fall. Physicians who use a health information e [Read more]
HHS says insurance rate reviews are working
The Dept. of Health and Human Services says its authorization under the health system reform law to review double-digit premium increases by insurers has led to fewer such rate hikes being proposed in the first place. HHS Secretary Kathleen Sebelius announced March 22 that the department had undertaken 186 reviews of health plans that had proposed raising premiums on subscribers by 10% or more. After the reviews, HHS determined that two insurers had proposed unreasonable rate hikes as high as 24% on enrollees in nine states — Arizona, Idaho, Louisiana, Missouri, Montana, Nebraska, Virginia, Wisconsin and Wyoming. The two insurers named in the reviews were John Alden Life Insurance Co. and Time Insurance Co., both Assurant Health plans that are based in Milwaukee. “Thanks to the Affordable Care Act, consumers are no longer in the dark about their health insurance premiums,” Sebelius said. “Now insurance companies are required to justify rate increases of 10% or higher. It [Read more]
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