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Tuesday, July 27, 2010

Daily news & Analysis

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Inpatient Admissions Decision Fuels RAC Uncertainty

By: James Carroll, for HealthLeaders Media, July 26, 2010

The approval of a Region C Recovery Audit Contractor issue for inpatient hospital claims review has initiated uncertainty among providers, putting an emphasized onus on them to lean on Centers for Medicare & Medicaid Services guidance and policy manuals.

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HIPAA Faces HITECH-Empowered State AGs

By: Dom Nicastro, for HealthLeaders Media, July 27, 2010

If your organization is paying close attention to the HIPAA proposed rule published in the Federal Register July 14, keep paying attention. However, perhaps lost in the shuffle of the proposed rule is the July 6 announcement by Connecticut Attorney Richard Blumenthal’s office of the $250,000 settlement Health Net and its affiliates agreed to pay for a breach of protected health information (PHI) affecting nearly a half million Connecticut enrollees. The settlement is a landmark one.

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Health Plan Rate Filings to Be Emailed to California Enrollees

By: Cheryl Clark, for HealthLeaders Media, July 26, 2010

California's e-mail notification program follows an attempt in April by the state's largest for-profit health insurer, Anthem Blue Cross, to raise premiums by 39%. That effort came under fire, especially after an actuarial audit discovered the plan had made substantial errors in math.

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CMS Issues Payment Rule and Quality Incentive For Dialysis Providers

By: Cheryl Clark, for HealthLeaders Media, July 27, 2010

Dialysis services for nearly 330,000 Medicare patients with end stage renal disease will be paid under a new system that creates a bundled, case-adjusted rate starting Jan. 1, the Centers for Medicare & Medicaid Services announced yesterday with its final rule.

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Miami Children's, HCA's Palms West Partner on Pediatric Emergency Care

By: John Commins, for HealthLeaders Media, July 26, 2010

Miami Children’s Hospital and HCA’s Palms West Hospital have formed an affiliation to provide pediatric emergency care in Palm Beach County. Beginning Oct. 1 physicians from Miami Children’s Hospital’s emergency department will provide care at PWH, a 175-bed, acute-care hospital, where children account for 39% of emergency department visits.

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Seniors Unclear on Healthcare Reform Law

By: Janice Simmons, for HealthLeaders Media, July 27, 2010

While the new healthcare reform law calls for significant changes to the payment process for care delivered under Medicare, that information has not been effectively filtering down to the major beneficiaries of that care. According to a survey released by the National Council on Aging on Monday, many seniors appeared to not know how the law would be impacting their healthcare.

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Despite Recent Layoffs, Hospitals May Be Poised for Hiring

By: John Commins, for HealthLeaders Media, July 26, 2010

The second quarter of 2010 was not kind to hospitals. April posted a record 18 mass layoffs of 50 employees or more in the hospital sector. And as I reported earlier this month, hospitals reported 2,200 payroll reductions in June, which followed 2,400 reductions in May.

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Berwick's First Reimbursement Challenge

By: Elyas Bakhtiari, for HealthLeaders Media, July 26, 2010

New CMS Administrator Donald Berwick, MD, has not yet been on the job a month, and he’s already finding himself in the middle of one of those reimbursement tugs-of-war that seem to define modern healthcare. How he responds may indicate what hospitals and physicians can expect from CMS during his tenure, particularly when it comes to getting paid.

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