Wednesday, January 16, 2013

Eight Quality Measures for Medicaid Home Health Given To State Medicaid Directors


On January 15, 2013 CMS issued a letter to the State Medicaid Directors on eight Medicaid Home Health Quality Measures.  The measures are not to be implemented by the states until CMS publishes final rule making.  The eight proposed Medicaid Home Health Quality Measures are listed below:

  • 1.       Adult Body Mass Index (BMI) Assessment
  • 2.       Ambulatory Care – Sensitive Condition Admission
  • 3.       Care Transition – Transition Record Transmitted To Health Care Professional
  • 4.       Follow-up After Hospitalization for Mental Illness
  • 5.       Plan – All Cause Readmission
  • 6.       Screening for Clinical Depression and Follow-up Plan
  • 7.       Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
  • 8.       Controlling High Blood Pressure


For more information please utilize the following link.

http://www.medicaid.gov/Federal-Policy-Guidance/downloads/SMD-13-001.pdf

Monday, January 14, 2013

Lower Rates at the Monte Carlo for our Seminar


Richard and I are excited about our Seminars in Las Vegas and looking forward to seeing you.

We learned last week that the rates for the Monte Carlo listed on their website were lower than the rates that they had offered to us for our seminars.  So we contacted them and they have adjusted the rates, from $55 to $50.  If you already have registrations they will adjust your rate when you arrive.

If you do not have reservation, they have opened the block back up, with a cutoff date of January 18, 2013.

The OIG Solicits New Anti-Kickback Safe Harbors


The Office of Inspector General issues annual notice to solicit new proposals and recommendations for developing new and modifying existing safe harbors provisions under the Federal anti-kickback statute. Section 1128B (b) of the Social Security Act provides criminal penalties for individuals or entities that knowingly and willfully offer, pay, solicit, or receive remuneration to induce or reward business reimbursable under the Federal health care programs.  The offense is classified as a felony and is punishable by fines of up to $25,000 and imprisonment for up to 5 years.  The OIG may also impose civil money penalties.

Since this statute is so broad, the OIG has developed many “Safe Harbors”  provisions that specify various payment practices that, although potentially capable of inducing referrals of business reimbursable under the Federal health care programs, would not be treated as criminal offenses under the anti-kickback statute and would not be serve as a basis for administrative sanctions.  Annually the OIG issues a notice to solicit new proposals and recommendations for developing new and modifying existing safe harbor provisions under the Federal anti-kickback statute.


For more information please utilize the following link.

https://oig.hhs.gov/authorities/docs/2012/FRAnnualSolicitation12282012.pdf

Friday, January 4, 2013

Office of Civil Rights Flexing Its Muscles


Be Prepared
Office of Civil Rights Flexing Its Muscle on HIPAA Data Breaches
New Enforcement Actions for Data Breaches of Patient Records Involving Less Than 500 Patients

The Office of Civil Rights announced its first HIPAA breach settlement involving less than 500 patients. 
The Hospice of North Idaho agreed to pay the US Department of Health and Human Services $50,000 to settle potential violations of the Health Insurance Portability and Accountability Act of 1996.  This is the first settlement involving a breach of unprotected electronic protected health information affecting fewer than 500 individuals. 

For more information please utilize the following link.

http://www.hhs.gov/news/press/2013pres/01/20130102a.html

Thursday, January 3, 2013

IRS Publishes Proposed Rule for Shared Responsibility for Employers Regarding Health Coverage


New Healthcare Reform Regulations continue to be published every month.  The latest is a proposed rule by the Internal Revenue Service on shared responsibility for employers regarding health coverage.  The proposed regulation only applies to employers with 50 or more full-time employees.  Employers may rely on these proposed regulations for guidance pending the issuance of final regulations.

For more information please utilize the following link.

http://www.gpo.gov/fdsys/pkg/FR-2013-01-02/pdf/2012-31269.pdf

Wednesday, January 2, 2013

Reservation at the Monte Carlo

Have you made your Reservation at the Monte Carlo for Dixon Healthcare Solutions, Inc. Seminars?

Solving the Home Health Puzzle  - January 28-30, 2013
and / or
Solving the Hospice Puzzle - January 23-25, 2013

The Monte Carlo has extended the deadline for you to make your reservation until January 5, 2013 on the block of rooms.

Call them at (800) 311-8999 and use Group Code XDHS13

Hope to see you in Vegas.
Margaret

OIG Releases CMS and Contractor Oversight Report on Home Health Agencies


In 2010, Medicare paid $19.5 billion to 11,203 home health agencies for 3.4 million Medicare beneficiaries.  The OIG stated that home health agencies are considered to be particularly vulnerable to fraud, abuse, and waste.  The study collected information from CMS, Medicare Administrative Contractors (MAC) and Zone Program Integrity Contractors (ZPIC).  They found two of the MACs prevented $275 million in improper payments and referred 14 instances of potential fraud and 5 home health had their billing privileges revoked.

The OIG recommends that CMS establish additional contractor performance standards for high-risk providers in fraud-prone areas.  Develop a system to tract revocation recommendations and respond to them in a timely manner.  Follow up and prevent inappropriate payments made to HHAs with suspended or revoked billing privileges.

For more information please utilize the following link


If you have questions or need additional information please call Richard Dixon at
(321) 473-8561.