Medicaid, health IT to see billions from stimulus package signed by Obama

NEW ARTICLE February 23, 2009!!!
The law offers bonuses for health IT adoption but will penalize physicians who don't have adequate systems by 2015.
Click Here to read the full article.

Stimulus Package Provides Incentives for the Use of Health Information Technology, Electronic Health Records

The American Recovery and Reinvestment Act of 2009, passed by Congress on Friday, Feb. 13, 2009, includes the Health Information Technology for Economic and Clinical Health Act (the HITECH Act). The purpose of the HITECH Act is to promote the use of health information technology with a goal of utilization of an electronic health record for each person in the United States by 2014. The Act provides incentives to physicians and hospitals to adopt and use certified electronic health records (or EHR) technology.

Participation in the incentives is voluntary; however, the Act contains penalties for physicians and hospitals who do not adopt use of EHR by 2015. The penalties reduce Medicare payments physicians and hospitals would otherwise receive by percentages on an increasing scale for each year the physician or hospital does not adopt use of EHR.

For Additional information:

http://www.wallerlaw.com/articles/2009/02/14/stimulus-package-provides-incentives-for-the-use-of-health-information-technology-electronic-health-records.8163

http://govhealthit.com/articles/2009/01/19/new-stimulus-bill-contains-complete-health-it-act.aspx

Full text of HITECH Act:
http://democrats.science.house.gov/Media/File/Commdocs/HealthIT%20Bill.pdf

AMA's enhanced Web site

Thanks to the World Wide Web, a wealth of information truly can be found at one's fingertips. In the best cases, it's just a few clicks away.

With that in mind, the American Medical Association has taken steps to ensure that its vast online resources are within easy reach of physicians at all points in their careers and training.

The AMA unveiled late in January a redesign of its online identity -- an interactive Web site, full of easy-to-find resources. It's a new look, the result of months of work, at the same address the AMA has used for years (www.ama-assn.org). To read the full article Click Here.

Quoted from: American Medical News

Substantial changes to HIPAA under the Health Information Technology for Economic and Clinical Health Act (the HITECH Act)

The Health Information Technology for Economic and Clinical Health Act (HITECH Act) contains provisions that would significantly expand the reach of the Health Information Portability and Accountability Act of 1996 (HIPAA). These provisions will have significant impact on the policies and procedures used by healthcare providers who create or receive Protected Health Information (PHI).

For additional information:

http://www.wallerlaw.com/articles/2009/02/13/stimulus-bill-expands-the-reach-of-hipaa.8147

http://www.medicalnewstoday.com/articles/136472.php

FREE electronic prescribing for every physician in America

The National ePrescribing Patient Safety Initiative (NEPSI) is a project with the goal of increasing patient safety by making ePrescribing accessible—and desirable—to all physicians and medication prescribers by providing it free of charge.

Electronic prescribing (ePrescribing) can counter shortcomings of the current paper-based prescribing processes. However, accessibility and cost barriers have slowed adoption of ePrescribing by providers.

Now ePrescribing is being provided without cost by Allscripts and the members of NEPSI. For more information: http://www.nationalerx.com/

A Clinician’s Guide to Electronic Prescribing

The eHealth Initiative Foundation, in collaboration with the American Medical Association,the American Academy of Family Physicians, the American College of Physicians, the Medical Group Management Association, and the Center for Improving Medication Management are pleased to present “A Clinician’s Guide to Electronic Prescribing”.

“A Clinician’s Guide to Electronic Prescribing” is designed for two target audiences:

     (1) Practices new to e-prescribing and who want an overview of what it is.
Section I of the guide provides basic information on what electronic prescribing is, how it works, its benefits and challenges, and the current status of adoption.

     (2) Practices that are ready to move forward with implementing e-prescribing, and already have a good grasp of the fundamentals provided in Section I of the guide. Section II is geared toward office-based clinicians who are ready to bring e-prescribing into their practices. This section provides guidance on the steps to take and pitfalls to avoid. It presents essential questions and considerations for planning, selecting, and implementing an e-prescribing system.

The guide also provides a list of key references and resources readers can consult to help make the transition to e-prescribing as smooth as possible.

For a complete copy of the guide: Click Here

Incentives Push More Doctors to E-Prescribe

With a host of new incentives, doctors are finally beginning to scrap pen and paper in favor of electronic prescriptions.

Medicare this month began paying doctors a bonus if they switch their patients over to e-prescribing. Some private health plans also have begun offering extra payments along with free equipment, such as digital handheld devices. And a coalition of technology companies is giving doctors free software to encourage them to ditch their paper prescription pads. As a result, the number of physicians prescribing medicines electronically has more than doubled in the past year to about 70,000, or about 12% of all office-based doctors.

E-prescribing allows doctors to transmit prescriptions via a secure Internet network directly to pharmacies using an office or laptop computer or a digital handheld device. The practice has been shown in studies to reduce prescription errors and to cut costs for consumers and health-care providers. It also encourages patients to get more of their prescriptions filled, because it reduces the time spent waiting at drug stores. The Obama administration's plan to invest $50 billion over five years to encourage broader adoption of health-information technology is expected to include additional incentives for electronic prescribing.

Excerpted from: The Wall Street Journal; Wednesday, January 21, 2009; B7
To see the full article:Click Here

CMS’s Permanent Recovery Audit Contractors (RAC) program

The Centers for Medicare and Medicaid Services (CMS) is required by law to make Recovery Audit Contractors (RACs) a permanent, national program by January 1, 2010 with additional state rollouts occurring in stages. The nationwide RAC program creates a significant potential cost liability for healthcare providers who are required to turn over challenged payments immediately, and may be able to recoup disputed claims only after enduring an appeals process.

The permanent RAC program grew out of a demonstration project. Unlike the demonstration project, the permanent RAC program limits the medical-record review period to three years and prohibits audits on claims paid before Oct. 1, 2007. CMS has delineated the number of medical records RACs may request per National Provider Identifier (NPI) for 2009. CMS can adjust these limits annually.

For Part B providers, the 2009 limits are:

• 10 medical records per 45-day period for solo practitioners;


• 20 medical records per 45-day period for two to five provider offices;


• 30 medical records per 45-day period for groups of six to 15 providers; and


• 50 medical records per 45-day period for groups of 16 or more providers.

For Part A claims, the 2009 maximum number of records RACs may demand varies by the hospital’s NPI and will equal 10 percent of their average monthly Medicare claims. The RACs cannot request more than 200 records in a 45-day period for both inpatient and outpatient claims combined. NOTE: Wellmont Health System is currently undergoing a RAC audit. This might make it more likely that physician practices in our area will be audited as well.

Note: To prepare physician practices who are members of the Medical Group Practice Association (MGMA) for the RAC program, MGMA will host a Webinar on April 7, 2009. For registration details: Register

For additional informational resources on the RAC program:
Tax Relief and Health Care Act of 2006, Section 302 [pdf, 29kb]
Map of Future RAC Jurisdictions [pdf, 154kb]
RAC Expansion Schedule [pdf, 61.0kb]
2008 Press Release Announcing New National RACs
2008 RAC Fact Sheet
Frequently Asked Questions
Get Recovery Audit Contractor (RAC) e-mail updates

2009 HPI Meeting Schedule

As a member of the organization you are invited to attend all Highlands Physicians, Inc. (HPI) Board of Directors meetings. The HPI Board is governed by a 28 physician member Board of Directors. It employs a full-time executive director who, with staff, manages the operations for the organization.
The HPI Board of Directors meets the third Wednesday of every month at 7:00 P.M., at HPI’s Corporate Office located at 2004 American Way, Suite 201, Kingsport, TN. Diners will be served at each meeting.

The meeting dates scheduled for the HPI Board for 2009 is as follows:

January 21
February 18
March 18
April 15
May 20
June 17
July 15
August 19
September 16
October 21
November 18
December 16

I hope you will be able to attend some of the meetings this year. Please RSVP to HPI at 423/392-1920 if you plan to attend any meetings so we can arrange to have dinner available for you. Your continued membership and support of HPI is, as always, much appreciated.

Health Savings Accounts (HSAs)

HSAs were established as part of the Medicare Prescription Drug, Improvement, and Modernization Act which was signed into law by President George W. Bush on December 8, 2003. They were developed to replace the Medical Savings Account system. A health savings account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a High Deductible Health Plan (HDHP).

A survey of employers published by the Kaiser Family Foundation in September 2008 found that 8% of covered workers were enrolled in a consumer-driven health plan (including both HSAs and Health Reimbursement Accounts), up from 4% in 2006. The study found that roughly 10 percent of firms offered such plans to their workers. Large firms were more likely to offer a high-deductible plan (18%), but enrollment was higher in small firms (8% of covered workers, versus 4% in larger firms).

Locally, Eastman initiated an HSA effective January 1, 2009. Most HSA’s want the patient to be very aware of the cost at the time of service. Many HSA’s provide enrollees with a swipe card which can be used at the time of service. Eastman’s HSA, administered through Cigna, will be problematic for at least some of our members because they have been asked to not collect deductibles and co-insurance at the time of service. Wellmont Health System and Mountain States Health Alliance have both challenged the directive to not collect the patient pay portion at the time of service. Our physician practices and providers will have to decide individually how and when to collect the patient pay portion of medical expenses. Depending upon which health plan option a patient is covered under, annual in-network deductibles range from $200 to $1,250 and annual in-network out of pocket maximums range from $1,000 to $4,000.

The links below provide you with educational material and resources to increase your knowledge to make informed decisions regarding your practices handling of HSA’s.


http://en.wikipedia.org/wiki/Health_savings_account

http://www.hsainsider.com/learn/basics.aspx

http://www.ustreas.gov/offices/public-affairs/hsa/

http://www.ustreas.gov/offices/public-affairs/hsa/pdf/all-about-HSAs_072208.pdf

http://www.ustreas.gov/offices/public-affairs/hsa/pdf/HSA-Tri-fold-english-07.pdf

http://www.ustreas.gov/offices/public-affairs/hsa/faq.shtml

Consumer-Driven Health Care May Not Be What Patients Need—Caveat Emptor

Consumer-directed health care has received recent attention as a fundamentally new approach to organizing the financing and delivery of health care. Consumer-directed health care consists of tax-advantaged health savings accounts, coupled with high-deductible health plans, which theoretically would make consumers, paying much more out of their own pocket, more prudent in seeking health care services. Insurance would be relegated to true catastrophic expenses. As patients, having become consumers, become accustomed to shopping for health care services, they would focus more on quality and service, leading clinicians to become market responsive, improving the care they provide, and, in Herzlinger's vision,1 organizing into "focused factories," actively competing for the business of increasingly savvy customers.

This approach has been broadly debated in traditional policy terms including whether the increased cost consciousness of individuals actually reduces health care costs, whether consumers are able to selectively reduce . . .Click here for full article