Medicine & Health articles from January 2009

Medicine & Health archives from January 2009

Organizations must innovate their way through 2009: healthcare facilities could see profit if they play their cards right, PwC says.(Industry Outlook)
January 9, 2009... Healthcare organizations will have to be nimble, this year, experts say. Auditing giant Pricewaterhouse Coopers has identified a laundry list of challenges that the healthcare industry must negotiate in 2009, including the financial downturn, a...

Overall level of U.S. health spending is slowest since 1998: CMS report shares stats from 2007 figures.(Spending)
January 9, 2009... Health spending in the U.S. grew 6. l percent in 2007 to $2.2 trillion or $7,421 per person, states a press release from the Centers for Medicare & Medicaid Services. This was the slowest growth rate since 1998 and 0.6 of a percentage point...

CMS unveils new rating system for nursing homes: 'stars' designate quality measures in 10 areas.(Nursing Homes)
January 9, 2009... For the first time ever, the Centers for Medicare & Medicaid Services released quality ratings in December for each of the nation's 15,800 nursing homes that participate in Medicare or Medicaid. Information on the ratings came from the CMS...

HHS targets healthcare-associated infections: watch for public input opportunities this Spring.(Hospitals)
January 9, 2009... The Department of Health and Human Services wants to reduce and possibly eliminate healthcare-associated infections and has unveiled a set of five-year national prevention targets to help reach that point. HAIs are infections that patients...

President-elect's stimulus plan includes EHRs: healthcare to be a focus of new administration.(EHR)
January 9, 2009... The use of electronic health records has grown among physician practices in recent years but will receive even more attention in 2009, thanks to President-elect Barack Obama. In his weekly address on Dec. 6, 2008, Obama described details of...

New administration looks for input through Community Healthcare Discussions: forums gave opportunity for public input.(Healthcare Reform)
January 9, 2009... Obama's transition team gave Americans the chance to share their perspectives on health care during a series of Health Care Community Discussions in December, according to information from www.change.gov. The discussions were designed to...

General surgeon shortage draws national attention: specialty training and other factors turn young physicians in other directions.(Physicians)
January 9, 2009... General surgeons are the backbone of rural medicine, but they're a dying breed across America, reported the Jan. 1, 2009 edition of The Washington Post. Many young physicians are opting for non-surgical specialties such as radiology where...

Online Medicare enrollment now available in 44 states: CMS says the internet process will speed signup considerably.(Enrollment)
January 9, 2009... Medicare says its new online system will speed up enrollment processing for providers. The Centers for Medicare and Medicaid Services has begun to roll out enrollment in its Provider Enrollment, Chain, and Ownership System, but only for solo...

Unique pharmacist program helps hospital readmissions: home care patients ideally suited for a pharmacist's help, project finds.
January 9, 2009... In a one-of-a-kind pilot project, the University of Minnesota and the Minnesota Visiting Nurse Agency teamed up to send a pharmacist into home care patients' homes to evaluate their medications, reported the Minneapolis-St. Paul Star-Tribune....

Providers soon may have a chance to give their two cents about their Medicare contractors' performance.(In other news ...)
January 9, 2009... Providers soon may have a chance to give their two cents about their Medicare contractors' performance. The Centers for Medicare & Medicaid Services has selected 30,000 providers to participate in the fourth annual provider satisfaction survey...

CMS soon may rework its HCPCS coding for negative pressure wound therapy (NPWT) devices.(In other news ...)(Centers for Medicare and Medicaid Services )(Healthcare Common Procedure Coding System)(Brief article)
January 9, 2009... CMS soon may rework its HCPCS coding for negative pressure wound therapy (NPWT) devices. CMS and the Agency for Healthcare Research and Quality are reviewing the items. CMS is calling for "relevant studies and information for use in...

Maybe Medicare will consider adding coverage for telehealth now that the Veterans Administration has shown its benefits regarding hospitalizations.(In other news ...)
January 9, 2009... Maybe Medicare will consider adding coverage for telehealth now that the Veterans Administration has shown its benefits regarding hospitalizations. A new VA study found a 25 percent reduction in the average number of days hospitalized and...

Government work may not be brain surgery, but it looks like President-elect Barack Obama would like a brain surgeon in his administration.(In other news ...)
January 9, 2009... Government work may not be brain surgery, but it looks like President-elect Barack Obama would like a brain surgeon in his administration. Sanjay Gupta, MD, a 39-year-old Atlanta neurosurgeon and CNN's chief medical reporter, has been...

DME suppliers have a few extra months to get into compliance with a new diagnosis coding requirement.(In other news ...)
January 9, 2009... DME suppliers have a few extra months to get into compliance with a new diagnosis coding requirement. Starting in October 2009, the VMS system will capture and process all diagnosis codes reporting on a DME claim, CMS noted in Dec. 19 CR...

CMS claims it's full steam ahead for value-based purchasing: integration and payment-bundling are Medicare's keywords for the future.(Pay-for-Performance)
January 16, 2009... The Centers for Medicare and Medicaid Services recently told Congress it has listened to stakeholders' input and is ready to advance the cause of value-based purchasing or "pay-for-performance." As early as this spring, expect to see "analyses...

Balanced billing becomes a no-no in California: the issue of how much doctors should be paid is unresolved.(Emergency Care)
January 16, 2009... An ambulance rushes a patient to the hospital. Emergency doctors patch him up and send him home. Later, a new injury manifests itself, this time to the patient's wallet. Turns out, that hospital wasn't in his HMO's network, and the hospital has...

Do electronic health records bolster evidence-based medicine? The answer is 'yes,' proponents say.(EHR)
January 16, 2009... There's a widespread adoption of electronic health records, and that might greatly increase evidence-based medicine, according to a recent New York Times story. Across the national spectrum of healthcare politics, there is broad agreement...

CMS gears up for long-term care hospital reviews: providers and staff in LTCHs should prepare for medical necessity scrutiny.(LTCHs)
January 16, 2009... Long-term care hospitals are under the medical necessity radar. The Centers for Medicare & Medicaid Services recently awarded contracts for expanded review of medical necessity for admission and continued stay at LTCHs, according to a CMS email...

Mission complete: last 5 MAC contracts awarded: but providers' mission in transition challenges is just beginning.(Claims Processing)
January 16, 2009... After several years of selecting contractors in a competitive bidding process, the Centers for Medicare & Medicaid Services announced the final five contractors that will process and pay Medicare claims, according to a press release. This...

Hospitals reap rewards of outpatient quality data reporting: vast majority of participants to receive full payment update for CY 2009.(Quality)
January 16, 2009... Some U.S. hospitals received good news from the Centers for Medicare & Medicaid Services to start the New Year: they'll receive the full payment update for calendar year 2009 as part of the new Hospital Outpatient Quality Data Reporting...

More Medicare coverage for PET scans gets a thumbs-up: providers may log on to share comments until Feb. 5.(Coverage)
January 16, 2009... Providers used to the Centers for Medicare and Medicaid Services using its national coverage determination process to slash their reimbursement are in for a surprise. In a Jan. 6 news release, CMS announced that it proposed an NCD to "expand...

CMS launches 'ACE' to evaluate bundled hospital payments: five hospitals to participate in studies of certain orthopedic and cardiac procedures.(Demonstration Projects)
January 16, 2009... Five Western U.S. hospitals are gearing up to participate in the new CMS Acute Care Episode demonstration, the Centers for Medicare & Medicaid Services announced on Jan. 7. ACE is a new hospital-based demonstration to test the use of a bundled...

Congress tackles therapy caps once again: lawmakers shoot for a full repeal.
January 16, 2009... While rehab providers in non-hospital-based settings work to avoid the Medicare Part B therapy caps by using the exceptions process, Congress is doing some work as well. Sen. John Ensign (R-Nev.) and Rep. Xavier Becerra (D-Calif.) recently...

CMS recently assigned 'CLIA-Waived' status to five additional lab tests.(In other news ...)(Clinical Laboratory Improvement Amendments)(Centers for Medicare & Medicaid Services)(Brief article)
January 16, 2009... CMS recently assigned 'CLIA-Waived' status to five additional lab tests. According to Transmittal 1652, CMS will now consider these five tests CLIA-waived effective Jan. 1. Providers will have to append modifier QW (CLIA-waived test) to these...

Watch for CMS's new competitive bidding rule to come out any day now, the American Association for Homecare says.(In other news ...)
January 16, 2009... Watch for CMS's new competitive bidding rule to come out any day now, the American Association for Homecare says. The U.S. Office of Management and Budget has cleared an interim final rule for the Medicare DMEPOS competitive bidding program,...

CMS soon may rework its HCPCS coding for negative pressure wound therapy devices.(In other news ...)(Healthcare Common Procedure Coding System )(Centers for Medicare & Medicaid Services)(Brief article)
January 16, 2009... CMS soon may rework its HCPCS coding for negative pressure wound therapy devices. CMS and the Agency for Healthcare Research and Quality are reviewing the items. CMS is calling for "relevant studies and information for use in consideration of...

HHS gives providers more breathing room for ICD-10 implementation: but providers should start preparing now for ICD-10's Oct. 1, 2013 compliance date.(Coding)
January 23, 2009... After much uproar from the provider and medical coding community about a 20 l0 ICD-l0 implementation, the Department of Health and Human Services has offered three additional years of transition time. In a final rule HHS released on Jan. 15 the...

Companion rule addresses electronic transactions: updated X12 standard accommodates ICD-10 code sets.(Electronic Transactions)(Brief article)
January 23, 2009... Along with the ICD-10 final rule, HHS released another final rule on Jan. 15 that addresses three areas of healthcare reporting: an updated X12 standard--Version 5010--for certain electronic healthcare transactions, an updated version of the...

This just in: hormone replacement therapy may cause brain shrinkage: add one more to the list of side effects of the treatment for menopause symptoms.(Studies)
January 23, 2009... Two new studies show that commonly prescribed forms of postmenopausal hormone therapy may slightly accelerate the loss of brain tissue in women 65 and older beyond what normally occurs with aging, sciencecodex.com recently reported. ...

Stimulus package would pour $20 billion into EHR: House Dems propose billions to fight disease, compare treatments.(Health IT)
January 23, 2009... House Democrats say their proposed $850 billion economic stimulus will save jobs, money and even lives. With $20 billion for electronic health records, it sure would pump life into health information technology. That's the biggest piece of...

Interim rule shields coverage for 6 drug classes: CMS is still studying possible changes to drug-treatment guidelines.(Part D)
January 23, 2009... The Centers for Medicare & Medicaid Services doesn't want beneficiaries with conditions such as epilepsy, mental illness, and depression to be discouraged from enrolling in any Part D plan, nor experience any interruptions in their drug...

Hospitals get creative with tackling general surgeon shortage: services and bottom lines are both affected by the change--with no end in sight.(Surgery)
January 23, 2009... The number of general surgeons in America is shrinking, as reported previously in Medicine & Health Vol. 63, No. 1. Nearly three-quarters of surgeons-in-training are opting for more lucrative subspecialties with more predictable hours, such as...

Recession skirts around some healthcare sectors: lab business down, but nursing home, home health companies seeing positive swings.(Economy)
January 23, 2009... The healthcare sector is offering investors a mixed bag as the economy worsens and the ranks of the unemployed swell, a recent Forbes article reported. Laboratory testing companies are at one end of the spectrum, facing a dismal year as...

New NCDs swipe payment from 'never events': it's not just the inpatient providers under the gun.(Coverage)
January 23, 2009... The Centers for Medicare and Medicaid Services announced Jan. 15 three national coverage determinations to prevent Medicare from paying for certain serious, preventable errors in medical care. The errors covered in these NCDs--known as...

Medicare puts PHR in beneficiaries' hands: Arizona and Utah will be the first states to test this program.(PHR)
January 23, 2009... More patient participation in personal health records is on the horizon. In an announcement on Jan. 13, the Centers for Medicare and Medicaid Services launched its Medicare PHR Choice Pilot in Arizona and Utah. The pilot program offers...

CMS relaunches DME competitive bidding program: despite some changes, major flaws remain, industry reps charge.
January 23, 2009... In the Jan. 16 Federal Register, the Centers for Medicare & Medicaid Services issued a new interim final rule on competitive bidding for durable medical equipment. CMS will take comments on the final rule for 60 days, but the rule actually goes...

The home health pay for performance demonstration project is halfway through its term.(In other news ...)
January 23, 2009... The home health pay for performance demonstration project is halfway through its term, but CMS isn't divulging any details yet. In its newly updated "Roadmap for Implementing Value Driven Healthcare in the Traditional Medicare Fee-for-Service...

Michigan became the 48th state to pass licensure legislation for speech-language pathologists last December, the American Speech-Language Hearing Association reported in an email to members.(In other news ...)
January 23, 2009... Michigan became the 48th state to pass licensure legislation for speech-language pathologists last December, the American Speech-Language Hearing Association reported in an email to members. Governor Jennifer Granhoim is expected to sign the...

Medicare's not the only one talking about e-prescribing for 2009.(In other news ...)
January 23, 2009... Medicare's not the only one talking about e-prescribing for 2009. Practices that participate with Blue Cross Blue Shield of Massachusetts and take part in the physician incentives program are soon going to have to start e-prescribing. The payer...

CMS issues roadmaps on healthcare reform: pay-for-performance discussion emerges once again.(Policy)
January 30, 2009... Plans--albeit broad--for a better Medicare healthcare delivery and reimbursement system, are starting to take a more distinct form. On Jan. 16 the Centers for Medicare & Medicaid Services issued Quality Measurement, Resource Use Measurement,...

Cervical cancer proficiency testing program goes under the microscope: if there's only one test interpreter, the interpretation had better be stellar, CMS says.(Proposed Rules)
January 30, 2009... Medicare providers who analyze Pap smears may soon have some higher standards to meet. The Centers for Medicare & Medicaid Services recently announced proposals to further improve the current regulations "to assure the competency of those...

Pollution dangers take on a whole new meaning: cleaner air could add five months to one's life.(Research)
January 30, 2009... Heads up, policymakers: Air pollution now has measurable, research-supported ties to longevity. A new study by researchers at Brigham Young University and Harvard School of Public Health shows that average life expectancy in 51 U.S. cities...

Big hospice settlement puts industry in the hot seat: hospice eligibility and six-month-prognosis focus of successful whistleblower lawsuit.(Hospice)
January 30, 2009... A hospice chain's $25 million settlement may make life harder for all hospices, thanks to increased scrutiny placed on the industry. Birmingham, Ala.-based SouthernCare Inc., a hospice chain with 95 offices in 15 states, has announced a...

Cigarette tax would expand health insurance for kids: SCHIP bill sparks heated debate over effect on immigration.(Legislation)
January 30, 2009... The Senate was expected to vote last week to expand the State Children's Health Insurance Program, a popular health care program for uninsured children. The Democrat-crafted $31.5 billion proposal to expand the State Children's Health...

Georgia takes a tough stand on cigarettes: advocates aim to hike state's cigarette tax by a long shot.(Stateside)
January 30, 2009... In addition to the national talk of cigarette tax (see story on page 4), there's some drastic movement happening on the state level too. The Floyd Board of Health in Georgia passed a resolution supporting a one-dollar-a-pack increase in the...

FDA: peanut butter maker knew about salmonella: deadly outbreak has triggered numerous recalls.(Public Health)
January 30, 2009... Snack makers across the U.S. are still yanking products from store shelves as more revelations surfaced recently about the source of a salmonella outbreak that started in the fall. The government accused a peanut butter manufacturer of...

CMS gets specific about oxygen billing: many questions left unanswered, suppliers say.
January 30, 2009... Nearly a month after Medicare's new oxygen payment policy took effect, CMS is issuing some details about how to bill under the confusing new system. Oxygen providers can deliver up to three months' worth of oxygen contents at one time, the...

CMS has extended for three years.(In other news ...)
January 30, 2009... CMS has extended for three years a demonstration project for disease management of chronically ill, high-cost Medicare beneficiaries. CMS awarded the extensions to Key to Better Health, a division of Village Health in New York; Massachusetts...

Providers may have a few more hassles to deal with as CMS tightens up its enrollment procedures.(In other news ...)
January 30, 2009... Providers may have a few more hassles to deal with as CMS tightens up its enrollment procedures. When a contractor denies an enrollment application or revokes billing privileges based on "adverse legal action," it now will search PECOS to see...

Providers who get a letter from a CERT contractor should take the matter seriously.(In other news ...)
January 30, 2009... Providers who get a letter from a CERT contractor should take the matter seriously. Several readers have told us that if a CERT contractor requests an audit of one record, they put the request on the back burner as "low priority." However, even...