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CMS reminded organizations to pay attention to billing and coding for specimen validity testing done in conjunction with drug testing. The agency reviewed recent code changes and billing guidelines for these lab tests in Special Edition MLN Matters 18001 released on March 29. CMS emphasized that providers that perform validity testing on urine specimens cannot separately bill the validity testing.

Primary Health Care in Des Moines, Iowa, recently announced an email breach of its system one year after discovery. This exceeds the timeframe outlined in the HIPAA Breach Notification Rule, which states that organizations are required to report a breach within 60 days of discovery.

CMS recently released its annual report of Health Insurance Exchange open enrollment, which revealed that open enrollment is down from 12.2 million in 2017 to 11.8 million for 2018.

Q. I’ve been taught to tell our patients, “We look forward to seeing you on x day at x time with x doctor.” This has always been left on cell phone voice mails or home phones. Is this a HIPAA-compliant practice?

What would be the ideal partnering model between social workers and nurse case managers in hospitals?

What strategies would you recommend for building an effective denials management team?

A former employee of the Transformations Autism Treatment Center in Bartlett, Tennessee, was sentenced to a 30-month imprisonment with a three year supervised release on March 2 for hacking 300 patient files, states a press release from the Department of Justice. The employee will also be facing a monetary fine of $14,941.36 in restitution, as decided by U.S. District Judge John T. Fowlkes, Jr.

Medicare Advantage plan payment rates will increase by an average of 3.4% in 2019 due to higher projected per-capita cost growth for Medicare fee-for-service. The final pay bump is significantly higher than the 1.84% increase proposed in the 2019 advance notice.

Virtual reality is not just for entertainment, it is a valuable tool that healthcare professionals can employ in clinical scenarios, according to CMSA Today. Virtual reality has been used in healthcare since the 1990s, and today serves as a valuable clinical and educational tool.

Using EHRs to share laboratory results with other hospitals within a system is associated with significant reductions in heart failure and pneumonia mortality scores, according to a study in The American Journal of Managed Care. Results showed a statistical significance of a .24 reduction in pneumonia mortality scores and a .19 reduction in patient heart failure.