News briefs
June 1, 2000 5 minutes read
News briefs
Six groups agree to HIPAA standard-setting protocol
Six standard-setting organizations signed a memorandum of understanding (MOU) on March 31, agreeing to cooperate and communicate on implementation of electronic transactions standards adopted by the Department of Health and Human Services (HHS).
The 1996 Health Insurance Portability and Accountability Act (HIPAA) mandates HHS to adopt standards that will help reduce the costs of administrative and financial transactions in the health care industry. The development of maintenance and updating protocols for these standards has been one factor delaying publication of a final rule, now expected out this month.
The standards groups currently include the Accredited Standards Committee X12 in Alexandria, VA; the Dental Content Committee in Chicago; Health Level Seven in Ann Arbor, MI; the National Council for Prescription Drug Programs in Phoenix; the National Uniform Billing Committee in Chicago; and the National Uniform Claim Committee in Chicago. Other organizations may be added in the future.
The MOU establishes a process that will allow "a single entry point" for requesting changes to HIPAA standards, for the request’s evaluation, and for a response to the request to be sent to the National Committee on Vital and Heath Statistics in Washington, DC, for review and HHS for adoption, according to the Medical Group Management Association in Englewood, CO.
Several issues, such as providing for ongoing funding for Web site maintenance and the timing of changes, must still be ironed out. Each of the standards groups, though, now has in place an important vehicle for modifying or adding to HIPAA-mandated standards.
Web site offers career help for health care pros
A new on-line resource is available to help health care professionals with confidential job searches, resume building, and networking.
MedCAREERS allows health care job seekers and their potential employers to review an on-line database of jobs and resumes devoted exclusively to their specialty area.
The Web resource offers on-line features such as customized search and sorting tools, resume building, messaging centers, and automated management of job postings.
At its launch, MedCAREERS already had posted more than 10,000 positions for physicians, clinicians, nurses, pharmacists, administrators, and allied health professionals. In addition, the site had a resume database of more than 4,500 resumes.
(For more information, go to: www.medcareers. com.)
There’s help for hospitals that rely on Medicare
An independent panel of experts has added its voice in support of increased Medicare payments to hospitals.
The Medicare Payment Advisory Commission (MedPAC) in Washington, DC, has called for an annual increase in Medicare inpatient hospital payments — the so-called "update factor" — of more than twice the current law. This action recognizes the need for Medicare to keep pace with the high cost of providing health care today.
The high costs of new drugs and new technology for hospitals are said to have influenced MedPAC.
"The expert’s recommendations add weight to what we’ve been hearing from hospitals across the nation: their ability to care for patients is being severely jeopardized," says Rick Pollack, executive vice president of the American Hospital Association in Washington, DC.
OIG report finds problems with billing software
Although Medicare claims software written for commercial distribution to a large audience poses little risk of producing erroneous or false claims, proprietary software appears more likely to pose some risk of misuse or fraudulent use, according to a report released by the Office of the Inspector General (OIG) in Washington, DC.
The OIG had decided to review software literature and claim preparation processes because of the vast numbers of claims that were being electronically submitted to Medicare.
The report, "Medical Billing Software and Processes Used to Prepare Claims" (OEI-05-99-00100), found many potential problems with the submission of the claims, including these:
• Medicare cannot identify most of the clearinghouses and billing agencies submitting claims into the Medicare systems since most use the physician’s or medical supplier’s billing number and submitter number.
• Medicare can’t determine whether claims enter its system from an authorized biller’s site and computer or from unauthorized sites and computers.
• Billing companies, their employees, and employees of providers have access to patient and provider information needed to access the Medicare system.
According to the report, the Health Care Financing Administration in Baltimore has taken a "step in the right direction" by creating a new computer system, the Provider Enrollment, Chain and Ownership System (PECOS). The OIG made these further recommendations in its report:
• Identify and register all clearinghouses and third-party billers. This would provide an audit trail.
• Improve safeguards to ensure that electronic claims are accepted only from authorized sites and terminals.
• Educate the provider community about its liability for erroneous claims submitted to Medicare using their provider number(s).
AHIMA sponsors special HIM research program
The American Health Information Manage-ment Association’s (AHIMA) Foundation of Research and Education (FORE) in Chicago is offering a Grant-in-Aid Research Program, which financially supports applicants conducting research of theoretical and practical aspects of health information practice.
Eligibility for the Grant-in-Aid Research award requires that the primary or secondary investigator must be an active, associate, or student member of AHIMA. Recipients are limited to one funded grant per year. Grant funding may be requested for supplies and expenses but may not be used for salaries, indirect costs, wages or for product development.
Submissions required include: details regarding the research objectives, methodology, and evaluation systems; the problem/hypothesis behind the research; and a detailed work plan. Researchers are encouraged to submit topics in their established areas of expertise. In cases where the proposal is a resubmission, the applicant must include a summary of how the deficiencies cited in the original application have been addressed in the resubmitted application.
The deadline for submissions is Sept. 29. Award notifications will take place within three months of the application deadline. The total amount of funding to be awarded in 2000 is $50,000. Grant-in-Aid Research awards are expected to range from $5,000 to $20,000.
To receive a Grant-in-Aid Research application, visit AHIMA’s Web site at http://www.ahima. org and follow links to "FORE" and then to "Grant-in-Aid."
AHIMA members can also call the association’s Fax Link at (888) 424-4040 and request documents 505 and 506. For more information contact Alison Feinber. Telephone: (312) 233-1168. E-mail: alisonf @ahima.org.
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