If you’re involved in utilization review and have found yourself in the uncomfortable position of having to tell a doctor that a patient doesn’t meet criteria for an inpatient stay, you may want to consider different ways to approach these conversations.
Q: I am an acupuncturist and have a patient who owes me $100. I contacted the patient about the missing payment but received no response. Would it be a HIPAA violation to get in touch with the patient’s emergency contact person about the missing payment? Or should I go to a debt collector?
This week’s Medicare updates include an FAQ on the new price transparency rule for 2019, an update to the Medicare Benefit Policy Manual to include new payment policies for rural health clinics, a fact sheet on the Value-Based Purchasing Program for FY 2019, and more!
HHS Office for Civil Rights has issued a request for information seeking input from the public on how the HIPAA Privacy Rule could be modified to meet HHS’s goal of promoting coordinated, value-based care.
Q: I am still not sure whether I need RNs or social workers or both as case managers. Is there any evidence to help me make a decision? I want everyone to be effective, work together well, and be respected as a service.
A proposed rule that would expand the use of prior authorization and step therapy for Part D and Medicare Advantage beneficiaries has earned criticism from patient advocacy groups and praise from pharmacy groups.
A recent study in the Journal of the American Medical Informatics Association found that using population health data could help identify patients with a high risk of developing cardiovascular disease who have not been previously identified as high risk due to lack of relevant cholesterol data.
Q: If a patient participating in a clinical trial is allergic to one of the drugs used in the trial, how do we report the drug that is used as a substitute?
Medicare’s new method of calculating payment rates for laboratory tests, intended to reduce Medicare spending by $360 million in the first year, could cost the agency billions in overpayments, according to a recent report from the U.S. Government Accountability Office.
The opioid crisis in the U.S. continues to touch on issues of patient rights and privacy. In October, OCR launched an education campaign about civil rights protections that include specific guidelines for covered entities under HIPAA
