News briefs
CMS expands transplant coverage
The Centers for Medicare and Medicaid Services (CMS) in Baltimore is expanding Medicare coverage of liver transplants to include certain patients with primary hepatocellular carcinoma. This will be Medicare’s first movement toward transplant coverage for a liver malignancy.
"Although we do not expect a large number of Medicare transplants for hepatocellular carcinoma, the procedure is extremely important, because there are few alternative curative therapies for these patients," said Jeffrey Kang, MD, director of CMS’ Office of Clinical Standards and Quality.
Kang said a technology assessment would be sought for other types of malignancies in an effort to further expand Medicare coverage. A technology assessment is a study conducted either internally by CMS specialists or by an outside consulting firm.
The review of existing policy that led to the decision memorandum was initiated internally at CMS under the agency’s new national coverage process, which bases coverage decisions on the best available scientific evidence. Scientific literature studied emphasized the appropriateness of performing transplants on carefully selected patients and used statistical techniques to identify significant risk factors, such as tumor size.
Details of the decision memorandum are available at www.hcfa.gov/coverage/8b3-rr.htm.
Health web sites choose accreditation program
Hi-Ethics has announced that its members would rely on URAC’s Health Web Site Accreditation Program to demonstrate adherence to quality standards based on the 14 Hi-Ethics Principles. (The principles can be viewed at www.hiethics.com/Principles/index.asp.) Hi-Ethics members include some of the most popular health information Web sites, including adam.com, America Online, and WebMD.
Hi-Ethics and URAC both say they want to establish and promote high standards for privacy, security, and information quality so consumers can realize the fullest benefits of the Internet’s health resources. URAC will control and administer the independent accreditation program.
URAC’s independent standards development and accreditation review process includes input from a broad array of stakeholders, including consumers, regulators, health care providers, and industry representatives. The organization is in the final stages of developing and testing its accreditation standards. Implementation of the program will begin this month, with the first accreditations announced before the end of the year. URAC plans to work with TRUSTe, a company that certifies Web sites’ privacy practices, to implement the program.
More information about the URAC Health Web Site Accreditation Program — including information on how web sites can begin the application process — is available at www.urac.org or by calling URAC at (202) 216-9010.
AHIMA to review SNOMED RT mapping to ICD-9-CM
The American Health Information Management Association (AHIMA) in Chicago has announced a collaborative agreement with the College of American Pathologists (CAP) in Northfield, IL, to validate the mapping of SNOMED RT, the Systematized Nomenclature of Medicine Reference Terminology, to ICD-9-CM diagnostic coding terms. The mapping of SNOMED RT to ICD-9-CM facilitates administrative and statistical reporting.
Under the agreement, AHIMA will review a 5% sample of SNOMED terms to assess the effectiveness and reliability of the process of mapping SNOMED RT to ICD-9-CM. Results will be used to refine the mapping process, as well as to advance the health care industry’s understanding of any limitations the crosswalk between the systems may have.
SNOMED RT, developed and maintained by the CAP, is a multidimensional reference terminology covering diseases, clinical findings, etiologies, therapies, and procedures. Its design allows for full integration of all medical information into a single data structure, facilitating interoperability between a wide variety of systems and clinical records.
CMS postpones deadline for filing cost reports
The deadline for providers to file their cost reports has been extended to Aug. 31, 2001, the Centers for Medicare and Medicaid Services (CMS) in Baltimore announced in Program Memorandum A-01-62. Programming difficulties have caused a three-month delay in the release of the Provider Statistical and Reimbursement Report (PS&R). The extension gives providers more time to prepare the cost report and to undergo the electronic vendor approval process.
Providers are usually required to file their cost reports five months following the end of the fiscal year or 30 days from the date of receipt of the PS&R. The new deadline of Aug. 31, 2001, could be pushed back further if CMS continues to have programming difficulties.
To read the program memorandum, visit the web site at www.hcfa.gov/pubforms/transmit/A0162.pdf.
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