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.
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 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.
Advanced Care Hospitalists PL in Lakeland, Florida, has agreed to pay $500,000 and undergo a corrective action plan in a settlement with the HHS Office for Civil Rights (OCR) for its alleged violations of HIPAA’s Privacy and Security Rules.
Q: My hospital's marketing team is becoming ambitious on social media lately. They like images, of course. What should we know about posting images of patients in social circles as it relates to HIPAA?
Q: As a case manager, I know about motivational interviewing, especially for patients with mental health or substance abuse disorder, but a colleague recently mentioned the “ask me 3” technique to me. Is it similar to motivational interviewing?
On December 4, CMS released additional FAQs regarding the 2019 IPPS final rule requirement that hospitals post a list of their standard charges on the internet.
