HHS Issues $4.3 Million Fine for HIPAA Violations

The Department of Health and Human Services (HHS) has imposed $4.3 million in fines against Cignet Health of Prince George's County, Maryland for violations of the HIPAA Privacy Rule.

The HHS Office of Civil Rights found that 41 patients were denied access to their medical records. The HIPAA Privacy Rule requires that this information be provided to patients within 30 days of the request.

To read more, click here:
http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/cignetcmpresolution.html


Source: U.S. Department of Health and Human Services

Government Cracks Down on $225 Million in False Claims

Last week, the Medicare Fraud Task Force brought criminal charges against 111 people including doctors, nurses, and healthcare executives nationwide have been linked to $225 million in false Medicare claims.

The Medicare Task Force is a joint effort between the Department of Health and Human Services, the Department of Justice, and FBI to crack down on Medicare fraud and false claims in an effort to avoid wrongful and wasteful spending.

Actions of the charged individuals include the submission of claims for services and equipment never rendered and the recruitment of patients in order to receive financial kickbacks.

It is reported that since the Task Force started in 2007, it has recovered more than $4 billion. The average prison sentence for those convicted has been 43 months.

To read the full article, click here:
http://articles.latimes.com/2011/feb/17/nation/la-na-medicare-fraud-20110218


Source: Los Angeles Times

Dr. Watson?

Watson, IBM's supercomputer, gained the world's attention last week when he beat two humans at Jeopardy. But could Watson soon be coming to your hospital?

In a CNN interview, representatives from IBM, Columbia University, and Nuance Healthcare discuss the use of supercomputers like Watson to support clinicians. They do not believe that Watson would provide hands-on robotic care; however, they believe that doctors would be able to run questions past the computer when making treatment decisions to verify that they are taking the correct actions. Doing this, they claim, can help prevent the growing number of medical errors.

To see the full interview, click here:
http://www.cnn.com/video/?/video/tech/2011/02/18/nr.ibm.watson.call.him.doctor.cnn


Source: CNN

HHS Proposes Rule Exempting Certain Law Enforcement Data from NPDB

The February 17, 2011 Federal Register includes a proposed rule issued by the Department of Health and Human Services (HHS) which would exempt law enforcement data connected to ongoing investigations from having to be reported to the National Practitioner Data Bank (NPDB).

The Privacy Act already exempts law enforcement information connected to ongoing investigations from having to be reported to the Healthcare Integrity and Protection Data Bank (HIPDB). Only law enforcement information connected to final adverse actions taken has to be reported.

The purpose of the rule is to prevent "[t]he premature disclosure of the existence of a law enforcement activity to an outside party(who may also be the subject of the investigation) could lead to, among other things, the destruction or alteration of evidence and the tampering with witnesses.”

HHS is accepting comments on the proposed rule through April 18, 2011. To see the proposed rule and instructions on how to submit comments, click here:
http://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=nnKHXl/0/2/0&WAISaction=retrieve


Sources: BNA, Federal Register

CMS to Withdraw Physician Signature Rule

The American Association of Bioanalysts has announced that the Centers for Medicaid & Medicare Services intends to withdraw the current physician signature rule regarding diagnostic laboratory tests. The rule, which was supposed to be in effect starting January 1, 2011, but was delayed, required physicians or qualified nonphysician practitioners to sign requisitions and paperwork for clinical lab tests in order to have the test paid for under Medicare Part B.

Opponents of the rule stated that it was disruptive and complicated matters since many physicians relied on nonphysician staff to process laboratory test paperwork. CMS stated that they will re-evaluate the policy.

To see the American Association of Bioanalysts' announcement, click here:
http://www.aab.org/aab/NewsBot.asp?MODE=VIEW&ID=86&SnID=1949563646


Sources: BNA, American Association of Bioanalysts

TJC Granted Extension on Telemedicine Standards Compliance

Since the Centers for Medicare and Medicaid Services (CMS) still has not published final regulations on telemedicine, it has allowed The Joint Commission (TJC) to delay changes to its telemedicine standards until July 1, 2011. Currently, TJC's telemedicine standards are in conflict with the Medicare Conditions of Participation, which do not allow "credentialing by proxy." The proposed rule issued by CMS last year would permit credentialing by proxy between CMS-accredited hospitals.

Below is a statement from The Joint Commission:

The Centers for Medicare & Medicaid Services (CMS) has not yet published its new telehealth regulations, which it had expected to do by March 1, 2011. Therefore, CMS has now notified The Joint Commission that it has an extension to July 1, 2011 before The Joint Commission will need to alter its telehealth standards to comply with CMS telehealth regulations. Our hope is that the new regulation will modify existing CMS standards in this area to be more in keeping with Joint Commission requirements. CMS expects to publish its telehealth regulations shortly and when it does, The Joint Commission will make changes to its standards in accordance with the regulation and will notify its accredited hospitals and critical access hospitals of the timeframe expected for implementation of the new CMS regulations.

As background on this issue, since September 2009, The Joint Commission has engaged CMS and members of Congress regarding the issue of credentialing and privileging by proxy as it relates to telemedicine providers and users. The Joint Commission took the position that there would be an adverse affect on the access to some telehealth services if organizations were not allowed to comply with Joint Commission requirements addressing credentialing and privileging by proxy. The Joint Commission’s position has been that the CMS requirements place an undue burden on many organizations without improving the quality of services, provider accountability and the effectiveness of the credentialing and privileging processes.

Source: The Joint Commission

Medical Staff Elects Nurse Practitioner as President

The title "director of emergency medicine and president of the medical staff" usually evokes the image of a physician. However, in Ellenville Regional Hospital in New York, it is a nurse practitioner who holds that title.

Bob Donaldson is a nurse practitioner who has attending status in Ellenville Regional's emergency room. He is part of an innovative structure that replaced all ER doctors with nurse practitioners and physician assistants -- and has increased admissions since making the change.

When the hospital had difficulty attracting volunteers to run for the medical staff leadership position, Donaldson volunteered and was elected president.

As the number of nurse practitioners and physicians assistants in the hospital setting continues to rise, it will be interesting to see if more and more non-physicians begin to assume medical staff leadership roles.

To read the full article, click here:
http://www.healthleadersmedia.com/page-3/NRS-262335/Nurse-Practitioner-Elected-Medical-Staff-President


Source: HealthLeaders Media

Proposed Legislation Would Require Transparent Disclosure of Credentials

Rep. John Sullivan (R-OK) and Rep. David Scott (D-GA) have re-introduced a bill which would require healthcare professionals who advertise services to state that they possess the license that authorizes them to perform the services listed. The bill, which is titled the Healthcare Truth and Transparency Act, is supported by groups such as the American Medical Association and American Osteopathic Association.

Introduction of the bill follows a trend among states that have passed legislation to ensure that patients are more aware of the credentials held by health professionals.

To read more, click here:
http://www.ama-assn.org/amednews/2011/02/07/prl20207.htm


Source: amednews.com

Challenge to Nurse Anesthetists' Scope of Practice Continues in California

California physicians are appealing the latest court decision that upheld the right for nurse anesthetists to administer anesthesia without physician supervision, an issue that has pitted nurses and doctors against each other in a nationwide turf battle.

Medicare allows state governors to opt out of a federal policy that requires physician supervision of nurse anesthetists when delivering anesthesia to Medicare patients. This provision is intended to address staffing shortages where anesthesiologists may not be readily available. California and 16 other states currently operate under the opt-out provision.

Opponents of the provision claim that the state's current scope of practice for nurse anesthetists does not allow for unsupervised practice.

To read more, click on the following link:
http://www.healthleadersmedia.com/page-1/TEC-262136/Nurse-Anesthetists-Scope-of-Practice-Challenged-Again-in-CA


Source: HealthLeaders Media