Do you know where your cell phone is? If it falls in the wrong hands, and unsecured data is breached, you could conceivably be in violation of the Health Insurance Portability and Accountability Act (HIPAA).

The number of health care professionals who store patient data on laptops, USB memory sticks, and other portable electronic devices is growing, but some say data security is not.

Read more »

President Obama signed a presidential memorandum March 10 that directs all federal departments and agencies to expand and intensify their use of payment recapture audits under their current authority to crack down on waste and fraud in Medicare, Medicaid, and other government programs. He also announced his support for the Improper Payments Elimination and Recovery Act, which would expand the ability of government agencies to fund the audits with recaptured payments. Read more »

The 2010-2011 seasonal influenza vaccine in the United States will include a pandemic 2009 H1N1 virus in the composition. Unlike this past year, however, the H1N1 inclusion will not likely limit availability. The Advisory Committee on Immunization Practices (ACIP) is recommending the vaccine for everyone 6 months of age and older.

Read more »

Health insurance executives and commissioners gathered in the Roosevelt room at the White House with Health and Human Services (HHS) Secretary Kathleen Sebelius March 3 to discuss insurance rate hikes that have occurred or are set to occur across the country.

According to an HHS Assistant Secretary for Public Affairs (ASPA) pool report, the meeting began at 11 a.m. with Sebelius thanking everyone for “being here on short notice to have this conversation.” The conversation was just as short.

Read more »

The Military Health System (MHS) set up a version of its Armed Forces Health Longitudinal Technology Application (AHLTA) electronic health record (EHR) system for use in the White House.

Read more »

An independent panel of health professionals convened by the National Institutes of Health (NIH) in Bethesda, Md. on March 10, voiced their concerns for the decline of vaginal birth after cesarean (VBAC) services and recommended current guidelines be revisited.

Read more »

The American Medical Association (AMA) recently posted on its website updates to several CPT® Category I codes and a listing of Category III codes that extends into 2014.

Category I Code Additions

• 90664  Influenza virus vaccine, pandemic formulation, live, for intranasal use
• 90666  Influenza virus vaccine, pandemic formulation, split virus, preservative free, for intramuscular use
• 90667  Influenza virus vaccine, pandemic formulation, split virus, adjuvanted, for intramuscular use
• 90668  Influenza virus vaccine, pandemic formulation, split virus, for intramuscular use

Read more »

The Office of the National Coordinator for Health Information Technology (ONC) has issued a Notice of Proposed Rulemaking (NPRM) for the establishment of two certification programs—one temporary and one permanent—for the purposes of testing and certifying electronic health record (EHR) systems and other health information technology (HIT).

Read more »

Since announcing that CPT® consultation codes (ranges 99241-99245 and 99251-99255) would no longer be recognized for Medicare Part B payment effective Jan. 1, the Centers for Medicare & Medicaid Services (CMS) has been bombarded with questions.

In response, the agency has issued MLN Matters Special Edition article SE1010, entitled “Questions and Answers on Reporting Physician Consultation Services.” MLN Matters article MM6740 was also revised Feb. 24 to clarify some language and add reference to SE1010. Read more »

Office of Inspector General (OIG) investigations in 2009 resulted in $4 billion in health care fraud settlements and court-ordered returns, and this is just the “tip of the iceberg,” Inspector General Daniel R. Levinson said in his March 4 testimony before the subcommittee on Labor, Health and Human Services, Education, and related agencies of the House Committee on Appropriations.

“More disturbing,” said Levinson, “even if the rate of fraud remains constant, as health care expenditures continue to rise, the financial impact of health care fraud will continue to increase.”

To counter this trend, Levinson said the OIG will make the most of its proposed $272 million budget for 2011 to expand its activities in support of the joint Health and Human Services and Department of Justice (HHS-DOJ) Health Care Fraud Prevention and Enforcement Action Team (HEAT), including expanding the OIG-DOJ Medicare Fraud Strike Forces to 13 new locations.

Levinson said that the OIG also will continue to combat fraud using its “comprehensive strategy of prevention, detection, and enforcement” based on the following five principles:

1. Enrollment. Scrutinize individuals and entities that want to participate as providers and suppliers prior to their enrollment in the health care programs. Levinson said the OIG will continue to monitor the effectiveness of provider enrollment safeguards.
2. Payment. Establish payment methodologies that are reasonable and responsive to changes in the marketplace and medical practice. Levinson said the OIG has recommended cost-cutting measures, such as capping rental of oxygen concentrators at 13 months instead of 36 months.
3. Compliance. Assist health care providers and suppliers in adopting practices that promote compliance with program requirements. The OIG recommends providers and suppliers be required to adopt compliance programs as a condition of participating in the Medicare and Medicaid programs.
4. Oversight. Vigilantly monitor the programs for evidence of fraud, waste, and abuse.
5. Response. Respond swiftly to detected fraud, impose sufficient punishment to deter others, and promptly remedy program vulnerabilities.

Levinson’s testimony goes on to tout the effectiveness of the Health Care Fraud and Abuse Control (HCFAC) program and its successes in cooperation with the HEAT program.

Read Inspector General Levinson’s full testimony.