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Archive for October, 2009

Rule Updating HIPAA Enforcement Regulations Published

Friday, October 30th, 2009

The Department of Health and Human Services (HHS) has published an interim final rule amending regulations that enforce civil money penalties under the Health Insurance Portability and Accountability Act (HIPAA). Effective November 30, the rule incorporates provisions of the HITECH Act related to HIPAA violations, penalty amounts, and limits on the HHS secretary’s authority to impose penalties for violations of HIPAA’s administrative simplification rules. HHS will accept comments on the rule through December 29.

The rule can be viewed at http://edocket.access.gpo.gov/2009/pdf/E9-26203.pdf

ACC Launches PINNACLE Network

Monday, October 26th, 2009

The American College of Cardiology (ACC) announced the launch of the PINNACLE NetworkTM, the first-ever registry-based cardiovascular network to link thousands of cardiology practices to each other and to the ACC’s National Cardiovascular Data Registry® (NCDR), the preeminent cardiovascular data repository in the United States.

The PINNACLE NetworkTM addresses the rapidly shifting business environment that private cardiovascular practice faces with a practice management and financial management tools. The PINNACLE NetworkTM also builds a foundation for innovative, registry-based systems to reward practices for high quality care.

 For more information view


2010 Medicare Premiums And Deductibles Announced

Tuesday, October 20th, 2009

The Centers for Medicare & Medicaid Services (CMS) has announced the Medicare premiums and deductibles for beneficiaries in 2010. Under Medicare Part A, which pays for inpatient hospital, skilled nursing facility, hospice and home health care services, beneficiaries will see their deductible increase by $32, to $1,100. However, most Medicare beneficiaries will not see Part B monthly premium increase as a result of a “hold harmless” provision in the current law. This allows for 73% of beneficiaries to be protected from an increase raising the 2010 Part B monthly premiums from $96.40 to $110.50.

For more on the 2010 premiums and deductibles, see the CMS “fact sheet” available at www.cms.hhs.gov under press releases.

DMEPOS Competitive Bidding Program Re-opened

Friday, October 16th, 2009

The Centers for Medicare & Medicaid Services (CMS) has begun accepting bids from medical equipment suppliers for the Round One Rebid of Medicare’s Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). With the exception of Puerto Rico, the rebid will occur in the same areas as the initial round-one bidding: Cincinnati-Middletown (OH, KY and IN); Cleveland-Elyria-Mentor (OH); Charlotte-Gastonia-Concord (NC and SC); Dallas-Fort Worth-Arlington (TX); Kansas City (MO and KS); Miami-Fort Lauderdale-Pompano Beach (FL); Orlando (FL); Pittsburgh (PA); and Riverside-San Bernardino-Ontario (CA). The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) required CMS to rebid the contracts awarded in the first round of the program.

The press release can be found here.

Medicare Part C and D Proposed Rules Issued

Friday, October 9th, 2009

On October 9, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to improve the performance of prescription drug and health plans by strengthening standards to participate in the Medicare program.

Over the next 60 days, CMS will receive comments on the proposed revisions to the Medicare Advantage (MA) program (Part C) and Prescription Drug benefit program (Part D). The proposed changes would clarify program requirements for the 4000 prescription drug and health plan offerings and improve protections for Medicare beneficiaries enrolled in these plans. The proposed enhancements would strengthen Part C and Part D performance requirements, extend greater protections to people with Medicare, and ensure that companies offering more than one drug plan or health plan in the same area offer meaningful differences between those plans.

For more details, click here.

Surgical Errors Billing Policy Implemented

Friday, October 2nd, 2009

Beginning October 5, 2009, hospitals must submit two claims to Medicare whenever a surgical error is reported along with a covered service: one claim for covered services unrelated to the error and another no-pay claim with the error coded on it. The billing change and non-payment policy became effective for inpatient and outpatient claims submitted October 5 or later for services delivered after January 15, 2009. They pertain to surgical procedures involving the wrong patient, procedure or body part under a national coverage decision implemented by Medicare in January

MedLearn Matters instructions are available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6405.pdf

Patient Information Breach Forms Posted

Thursday, October 1st, 2009

The Department of Health and Human Services (HHS) has released forms for hospitals to use in submitting information to HHS about breaches of a patient’s unsecured medical information under the breach notification interim final rule. HIPAA-covered entities must notify the HHS secretary by electronically submitting the breach report form via the HHS Web site.

For further details, go to http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brinstruction.html