News Briefs
HIPAA regulations delayed again
The final regulations for several standards in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) have been delayed once again. In mid-March, William R. Braithwaite, MD, PhD, FACMI, senior advisor on health information policy for the Health Care Financing Administration, told attendees at a HIPAA conference that the Department of Health and Human Services would publish the transaction and code sets regulation by the end of June. He also said the security regulations would be delayed until the third quarter of this year.
Braithwaite made his comments at the 2000 HIPAA Conference in McLean, VA. The conference was sponsored by the Joint Healthcare Information Technology Alliance in Washington, DC.
OIG urges providers to disclose improper conduct
Health care providers who promptly disclose their own improper conduct to the government may be eligible for favorable treatment in the resolution of their cases, including less rigorous corporate integrity agreements, Inspector General June Gibbs Brown told the health care community in an open letter dated March 9.
Typically, all corporate integrity agreements include a provision to exclude a provider from participation in the federal health care programs if the Office of Inspector General (OIG) determines that the provider has materially breached the terms of the agreement. The OIG may forgo the exclusion remedy in appropriate self-disclosure cases where the providers demonstrate sufficient trustworthiness to allow the OIG to conclude that the federal health care programs can be safeguarded without the exclusion remedy.
Additionally, if a self-disclosing provider has demonstrated that its compliance program is effective and agrees to maintain its compliance program as part of a False Claims Act settlement, the OIG may not even require a corporate integrity agreement. The decision on whether to impose a corporate integrity agreement is influenced by a number of variables, including the scope and seriousness of the misconduct, the risk of recurrence, whether the disclosed matter was identified and reported as a result of the provider’s compliance measures, and the degree of the provider’s cooperation during the disclosure verification process.
The self-disclosure protocol is designed only for providers who believe a potential violation of the law may have occurred. Matters exclusively involving overpayments or errors that do not indicate that violations of the law have occurred should be brought directly to the attention of the entity responsible for claims processing and payment.
AHIMA offers HIM scholarships and loans
As part of a mission to support professional education through the Foundation of Research and Education (FORE), the American Health Information Management Association (AHIMA) in Chicago is offering scholarship and loan awards to full-time graduate and undergraduate students pursuing degrees in health information management (HIM) and health information technology (HIT). The awards range from $1,000 to $5,000.
The application deadline is May 30, and awards will be presented in August. Submission of one application creates eligibility for all applicable scholarships and loans. In addition to a completed application, students must also provide proof of acceptance into an HIT or HIM program or related graduate program and evidence of their AHIMA membership. If applicants are not currently members of AHIMA, they can simultaneously apply for both an AHIMA student membership and for the available scholarships and loans.
For an application or more information, visit the AHIMA Web site at http://www.ahima.org and follow links to FORE and then to scholarships and loans. Alison Feinberg can be contacted via telephone at: (312) 233-1168. E-mail: alisonf @ahima.org. AHIMA members also can call the association’s FaxLink service: (888) 424-4040. Request documents 503 and 504.
Report asks HCFA to review Medicare policy
The Health Care Financing Administration (HCFA) soon may be reviewing hospitals with a high number of Medicare same-day readmissions.
A report released in February by the Depart-ment of Health and Human Services’ Office of Inspector General found that same-day readmissions were a cause of concern regarding quality of care issues, in addition to billing and overpayment problems.
The report, "Analysis of Readmissions Under the Medicare Prospective Payment System for Calendar Years 1996 and 1997," (A-14-99-00401) also recommended that HCFA:
• make the data in its report available to peer review organizations for use in determining the scope of their peer review activities;
• perform beneficiary-specific reviews on the claims of beneficiaries who had multiple continuous same-day readmissions;
• review a sample of same-day readmission claims in which the same-day readmission was coded with the same DRG as the first hospital stay.
HCFA generally concurred with the recommendations but noted that only 61 providers had 30 or more readmissions in 1996 and 1997. HCFA will ask peer review organizations to investigate. HCFA, however, may suspend payment for same-day readmissions pending verification of their appropriateness. The full report is available at www.hhs.gov/progorg/oas/cats/ hcfa.html.
Hospitals can access Medical Encyclopedia
A partnership between adam.com, a medical information Web site based in Atlanta and MedSeek, a Solvang, CA-based developer of Web sites and services for health care, will bring adam.com’s Medical Encyclopedia to many hospitals, clinics and physicians.
adam.com’s proprietary library contains more than 10,000 pages of medical and health content covering over 1,500 topics, and includes archives of medical illustrations, interactive animations, 3-D models, broadcast-quality video, and fully dissectible male and female bodies. adam.com’s content and products are also used in the education, broadcast, legal, and print publishing markets.
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