Click Here to view a replay of the How to Avoid Penalties by Understanding and Reducing Your Hospital Readmission Rates webinar. The CMS readmission penalty is up to 1% of all Medicare IPPS payments in FFY 2013 climbing to 3% in 2015. Hospitals with higher readmission performance as compared to expected readmissions will face millions in lost payments.

The July issue of Management Science contains a study that "quantifies the effect of state privacy regulation on the diffusion of electronic medical records." The study, by Amalia Miller, Department of Economics, University of Virginia and Catherine Tucker, MIT Sloan School of Management, Massachusetts Institute of Technology, found that "state privacy regulation restricting hospital release of health information reduces aggregate EMR adoption by hospitals by more than 24%."  To see the abstract, click

On May 21, 2009, the OIG posted an advisory opinion regarding a proposal to compensate physicians for on-call services performed on behalf of it’s uninsured patients.  Although the OIG acknowledged the legitimate reasons for such arrangements, they also stated there is a substantial risk that improperly structured payments for on-call coverage could be used to disguise unlawful remuneration.  However, the key inquiry is whether the compensation is: (i) fair market value in an arm’s-length transaction for actual and necessary items

Acute care hospitals will receive a net 0.2 percent increase in payments for inpatient hospitals services in fiscal year (FY) 2010 under the proposed rule for the inpatient hospital prospective payment system (IPPS). Hospitals face a net decrease in payments in FY 2011 and 2012 under the proposed rule.

Unplanned rehospitalizations of Medicare beneficiaries within 30 days leaving the hospital cost the program $17.4 billion in 2004, according to a study published April 2 on the web site of the New England Journal of Medicine. This equals about 17 percent of all hospital payments from Medicare in 2004. Almost one-fifth (19.6 percent) of beneficiaries discharged from a hospital that year were rehospitalized within 30 days. Only about 10 percent of these rehospitalizations were planned.

Medicare's postacute care transfer policy pays full DRG payments to hospitals for patients discharged to home.  Medicare pays hospitals that transfer patients to postacute care settings (e.g., skilled nursing, home health care) a per diem rate.  In a recent audit report, the OIG found that of 150 claims sampled, 92 of them were improperly coded as discharges to home rather than transfers to postacute care settings.  The OIG noted that multiple prior reports have found that hospitals are not complying with the postacute transfer policy.  Perhaps it is time for your hospital to audit its compliance with the policy?  See OIG Report A-04-07-03035 (February 2009).

Sens. Chuck Grassley (R-Iowa) and Jeff Bingaman (D-NM) propose amendments to the economic stimulus bill "intended to ratchet up the scrutiny on charity care and not-for-profit hospitals" says ModernHealthcare.com.  The Wall Street Journal Health Blog reports that "[o]ne Grassley-sponsored amendment would require the Treasury department (which includes the IRS) to compare the amount of uncompensated care and executive compensation provided at nonprofit versus for-profit hospitals.

Two employees over the age of 40 who were fired for violating a hospital’s confidentiality policy failed to show they were discharged because of their age under the ADEA or Kentucky law or that the hospital’s cost-cutting measures targeting higher-paid workers with seniority had a disparate impact on older employees, held the Sixth Circuit Court of Appeals. (Allen v. Highlands Hosp. Corp., 6th Circuit)