New Generic Drugs for 2013 and 2014

Millions of people are currently utilizing brand name prescription drugs that have premium prices.  Excellus Blue Cross released a fact sheet that contains a list of 37 brand name prescription drugs that are scheduled to become available in their generic form in 2013 and 2014.  Many of your home health and hospice patients may utilize some of these name brand prescription drugs. 

To obtain the detailed information please utilize the following link:

https://www.excellusbcbs.com/wps/wcm/connect/3b077339-3270-41fc-90cb-1d781c5af698/Generic+Savings+2013-2014+FS-EX+FINAL+1.pdf?MOD=AJPERES&CACHEID=3b077339-3270-41fc-90cb-1d781c5af698

CMS May Combine ZPICs and MACs

CMS is in the planning stages of developing a new program integrity entity.  This new program entity is a Unified Program Integrity Contractor (UPICs) and it would consolidate the Zone Program Integrity Contractors (ZPICs) and the Medicare Administrative Contractors (MACs).  This will not impact the Recovery Audit Contractors (RACs).  This is in the very early planning stages. 

For more information on CMS solicitation of information please use the following link:

https://www.fbo.gov/index?s=opportunity&mode=form&id=daa5a47204cdac248f44083b0103e309&tab=core&_cview=1

HIPAA Videos From Office of Civil Rights

The Office of Civil Rights (OCR) has published two YouTube videos summarizing the HIPAA omnibus rules.  The HIPAA rules become enforceable on September 23, 2013.  The first is a short video provides a high level review of the HIPAA rules.  The second even shorter video explains HIPAA rights to patients.

The first video can be found at the following link:

https://www.youtube.com/watch?v=mX-QL9PoePU

The second video can be found at the following link:

https://www.youtube.com/watch?v=3-wV23_E4eQ

Home Care Saves Money on Rehospitalization

A recent study shows transitional care cut hospital readmissions for North Carolina Medicaid patients with complex chronic conditions.  This study abstract was published in Health Affairs.  North Carolina initiated a statewide population-based transitional care initiative to prevent current rehospitalization for high-risk Medicaid recipients in 2008.  The targeted patients were Medicaid recipients with complex chronic medical conditions.  It found that patients who received transitional care were 20 percent less likely to experience a readmission during the subsequent year compared to patients that did not receive transitional care.  You can download the abstract of the article by using the following link.  Unfortunately to obtain the entire article you will be required to pay a fee to Health Affairs.

http://content.healthaffairs.org/content/32/8/1407.abstract

Frequency of Hospice Surveys is Unimproved

The Office of Inspector General of the Department of Health and Human Services issued a Recommendation Follow up Memorandum Report: Frequency of Medicare Recertification Surveys for Hospices is Unimproved, OEI-06-13-00130.

The report found that the frequency of recertification surveys had not improved since 2005.  As of February 28, 2013, 17 Percent of State-surveyed hospices had not been recertified within the preceding 6 years, with some hospice experiencing longer intervals.  The findings (1) suggest that CMS’s use of fluctuating annual targets does not ensure timely recertification surveys of all hospices and (2) raise concerns about whether CMS and contracted State survey agencies can ensure that hospice comply with Medicare CoPs and quality-of-care requirements for hospices.  They recommend that CMS set specific timeframes for the frequency of hospice recertification surveys.

For more information please utilize the following link:

http://oig.hhs.gov/oei/reports/oei-06-13-00130.pdf