News & Analysis

August 3, 2016
Medicare Insider

This week’s note is about potential changes to provider-based billing in the OPPS proposed rule.

August 2, 2016
News & Insights

When it comes to providing high-quality patient care, most American hospitals simply don’t. That’s if the recent round of five-star rankings from CMS are to be believed. About 1,700 hospitals (39%) earned just three out of five stars, an “average” rating, FierceHealthcare reported.

August 2, 2016
News & Insights

What is a benchmark for conversion rates from observation to inpatient status?

August 1, 2016
HIM Briefings

Observation services are an ongoing point of confusion for hospitals and patients, many of whom have become fearful of out-of-pocket costs and SNF coverage eligibility associated with outpatient observation services. Developing a workflow to comply with the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act and the Medicare Outpatient Observation Notice (MOON) is essential and is intended to help hospitals ease patients' concerns by clearing up the implications of observation.

August 1, 2016
Briefings on HIPAA

Hackers and malware are routine threats for most healthcare organizations, but this year saw criminals add a devastating tool to their arsenal: ransomware.

Although the dramatic increase in ransomware attacks against healthcare organizations is largely a recent phenomenon, ransomware itself is not new. According to the FBI, it's been around for several years, but the agency began to see an uptick in ransomware attacks in 2015, particularly against organizations. Early this year, the Department of Defense specifically warned healthcare organizations that they are a top target for ransomware. As ransomware continued to grab headlines and lawmakers called for official action, HHS released ransomware response and prevention guidance for healthcare organizations (www.aha.org/content/16/160620cybersecransomware.pdf).

State and federal lawmakers took notice as well. At a March 22 joint hearing of the House of Representatives subcommittees on Information Technology and Health Care, Benefits, and Administrative Rules, some lawmakers suggested HIPAA should be modified to specifically require covered entities and business associates to report ransomware attacks.

Security officers must act now to protect their organizations, and in turn, organizations must be prepared to invest in security and carefully follow related policies. The price for failing to do so could be high.

August 1, 2016
Case Management Monthly

One of the more challenging aspects of a case manager's job is helping to ensure a patient successfully transfers from the hospital to the next level of care. Under a set of proposed revisions to Medicare's Conditions of Participation (CoP) announced in November 2015. 

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