On August 5, 2010, four major insurers announced meaningful use incentives.  Aetna, Highmark, UnitedHealth Group and WellPoint, at minimum, will align their pay-for-performance programs with federal meaningful use criteria.  In a joint statement, National Coordinator for Health Information Technology David Blumenthal, M.D., and Centers for Medicare and Medicaid Services' Principal Deputy Administrator Marilyn Tavenner, stated:

The AHA reports that CMS' New Issue Review Board approved the first "medical necessity review" audits last week.  The  audits include eighteen types of inpatient hospital claims and one type of DME claim. Remember that the RAC's must post the issues on their websites before issuing Additional Documentation Requests.  CMS expects the RACs to post the new audits and begin issuing ADR's within the next two weeks.  So, watch the RAC websites.  For your convenience, the issue pages on the RAC websites are:

Summary of Changes to Questions Sets - Second Quarter 2010

We would like to notify you of changes that have been made to the ComplyTrack Risk Assessment questions in the Comprehensive Library for the Provider Baseline. As part of the Quarterly Review Process, the following Risk Assessments were reviewed this quarter:

On June 11, 2010, CMS issued a transmittal containing the first two chapters of a new Manual.  The Manual is Pub. 100-22 and is titled "Medicare Quality Reporting Incentive Programs".  The Manual addresses the Physician Quality Reporting Initiative (PQRI) and E-Prescribing (eRx) Medicare Quality Reporting Incentive Programs.  The Manual does not establish new requirements for the PQRI and eRx programs.  It simply manualizes existing requirements to the programs. 

On May 5, 2010, CMS issued an interim final rule implementing provisions of the Patient Protection and Affordable Care Act (PPACA).  The rule implements the provision which requires all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted under the programs.

On March 8, 2010, the American Hospital Association (AHA) submitted comments to CMS on its proposed "meaningful use" rule.

The Office of Inspector General (OIG) found that public disclosure of information about adverse events was limited, according to its review of 17 state adverse event report systems, eight Patient Safety Organizations overseen by the Agency for Healthcare Research and Quality (AHRQ), and the Centers for Medicare and Medicaid Services (CMS).

A Department Appeals Board (DAB) order upholding the finding of an immediate jeopardy level violation and the imposition of $3,500 per day civil money penalty (CMP) against a skilled nursing facility (SNF) was vacated by the Eighth Circuit Court of Appeals because the DAB's finding was based on pure

The HIT Standards Committee met on October 29, 2009 and formed an "Implementation Workgroup" which is charged with bringing forward “real-world” implementation experience to the HIT Standards Committee recommendations.  The Implementation Workgroup will have a special emphasis on strategies to accelerate the adoption of proposed standards, or mitigate barriers, if any.  In addition to public meetings designed to uncover new strategies, the Committee also launched a blog. Industry groups, including the AHA, are encouraging hospital leader's to partic

Let’s take a look at the definition of a consultation. A consultation is a type of service provided by a physician or qualified provider whose opinion or advice regarding the evaluation and/or management of a specific problem is requested by another physician or provider. Another way of defining a consultation is a rendering of advice of your professional opinion, followed by a report of your findings to the referring physician.