This week's note from the instructor looks at the progress CMS has made in reducing burden through the Patients over Paperwork initiative and explores potential topics for providers to comment on to drive additional improvement.
CMS may have overpaid hospitals, physicians, and freestanding facilities almost $270 million for polysomnography services that did not meet Medicare requirements over a two-year period, according to an Office of Inspector General report.
This week’s Medicare updates include the extension of a final rule on improvements for acute care and critical access hospitals, an OIG report on potential abuse and neglect at skilled nursing facilities, a revision to the July update of HCPCS codes, and more!
It can be impractical for medical researchers to seek authorization from all the patients whose medical records are sought for a study. That’s why HIPAA allows researchers to use de-identified PHI from records without individual authorization.
Q: Our clinical trial claims often hit edits for missing drugs or devices when those are supplied by the trial sponsor and we can't bill for them. We've been manually reviewing these edits. Is there a recommended method for handling these types of edits that's more efficient?
Medical Informatics Engineering, Inc., an Indiana-based medical records service has agreed to a $100,000 settlement with OCR and a $900,000 multi-state settlement with 16 state attorney general offices for a HIPAA breach that compromised the protected health information of approximately 3.5 million people.
Hospitals are doing a better job at protecting patients from safety problems leading to deaths from accidents, infections, injuries, and medical errors, but there is still much room for improvement, according to the most recent Leapfrog Hospital Safety Grade report.
Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better monitor and project reimbursement and compliance.
Q: We have a patient who received a pancreas transplant for the treatment of diabetes. The patient was later admitted to the hospital for treatment of an unrelated kidney stone. Would I still need to assign the ICD-10-CM code for diabetes as a chronic condition based on the patient’s medical history?
