Claims must comply with HIPAA rules
Beginning Oct. 1, the Centers for Medicare & Medicaid Services (CMS) will no longer process electronic Medicare claims for payment unless they comply with the Health Insurance Portability and Accountability Act (HIPAA). Noncompliant claims will be returned to the filer for resubmission as compliant claims. The decision affects claims for services provided under fee-for-service Medicare, ending a portion of the CMS HIPAA contingency plan in effect since Oct. 16, 2003, under which Medicare continued accepting noncompliant electronic claims after the deadline. As of June 2005, only 1.45% of claims from hospitals were not HIPAA-compliant, CMS said. Although the contingency continues for other electronic health care transactions, CMS said it expects to end the contingency plan for those transactions in the future, beginning with the remittance advice transaction.
Heart attack patients wait longer in off-hours
Heart attack patients who arrive at the hospital during off-hours and on weekends wait longer for artery-opening procedures, such as angioplasty, decreasing their odds for survival, suggests a recent study reported in the Journal of the American Medical Association. The study found that the after-hours patients waited an average of 116 minutes for percutaneous coronary intervention procedures, compared to an average of 95 minutes for patients arriving between 7 a.m. and 5 p.m. on weekdays.
The study’s authors attributed the delay to longer wait times at catheterization laboratories, which few hospitals staff around the clock. They suggested that hospitals consider 24-hour staffing of catheterization laboratories or regional arrangements in which off-hours patients are taken to facilities with continuous catheterization lab coverage and faster treatment times. The article noted, however, that the first approach would have resource implications for hospitals, and that the second approach could increase transportation times for some patients, potentially offsetting any improvements in treatment times. The authors, who used data from a national heart attack registry and the American Hospital Association’s annual hospital survey, also compared wait times for clot-busting drugs and found no appreciable difference, with both groups waiting slightly less than 35 minutes for the medications.
Registering volunteers topic of disaster report
A report by the American Hospital Association (AHA), which summarizes hospital recommendations on an advanced registration system for health care workers interested in volunteering in disasters, has been published by the Department of Health and Human Services’ Health Resources and Services Administration. Federal law requires that all states and territories in the United States put into place a registration system that will enable hospitals to quickly verify the identity, licensure, and qualifications of volunteer physicians, nurses, and behavioral health personnel who step in to help in disaster situations.
The report stems from a meeting of the AHA and teams of representatives from the 10 states involved in a pilot of the program, including state department of health staff, state hospital association representatives, and hospitals. Among the participants’ recommendations were that states should work with the health care community to identify and close gaps in legal protections for hospitals using volunteers in emergencies, and the federal government should work with states to ensure registration systems are interoperable and include sufficient information to be of value to hospitals.
Participants also called for the development of a web-based tool summarizing state workers’ compensation laws and a tool summarizing license reciprocity agreements across states. The meeting was the second of four planned between 2004 and 2006 to discuss the Emergency System for Advance Registration of Volunteer Health Personnel and its implementation.
‘Most wired’ found to have better outcomes
The country’s top tech hospitals also have better outcomes, suggests an analysis performed in connection with the release of a list of the nation’s 100 “most wired” hospitals. The list, which was based on 502 surveys representing 1,255 hospitals, identifies hospitals and health systems that have made significant investments in health information technology, most notably to address quality and safety, assist physicians with orders, and conduct clinical activities. Those listed “have, on average, risk-adjusted mortality rates that are 7.2% lower than other hospitals, even after controlling for the size of the hospital and teaching status,” according to the journal Hospital & Health Networks, which compiled the list. While the new survey does not establish a cause-and-effect relationship between IT use and improved outcomes, the journal said, it does show technology can play “an important role in quality.”
Beginning Oct. 1, the Centers for Medicare & Medicaid Services will no longer process electronic Medicare claims for payment unless they comply with the Health Insurance Portability and Accountability Act.
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