In his health reform legislation, which is called the Affordable Health Choices Act, Sen. Edward M. Kennedy (D-MA), included a provision for long-term care that would provide more healthcare options for elderly and disabled individuals who wish to remain in their homes.
The 615-page bill that was filed last week also aims to reduce healthcare costs, make health insurance more affordable, and improve access to quality care.
"Our healthcare system is a crisis for American families and President Obama and members of Congress of both parties recognize the urgency of the problem. Our goal is to strengthen what works and fix what doesn't," said Kennedy, who is chairman of the Committee on Health, Education, Labor and Pensions (HELP) Commission. "Much work remains, and the coming days and weeks won't be easy. But we have a unique opportunity to give the American people, at long last, the healthcare they need and deserve."
According to a Senate press release, the five main components of the Affordable Health Choices Act are:
Choice: The bill would provide new, more affordable health insurance options for people who are unhappy with their current insurance or do not have insurance. Individuals who like their current healthcare coverage may keep it.
Cost reduction: The bill would lower healthcare costs through stronger prevention, better quality of care, information technology, and efforts to reduce fraud and abuse efforts.
Prevention: The bill would promote prevention and education efforts and early screening for certain health conditions.
Health systems modernization: The bill would work to ensure all healthcare professionals receive adequate training and care is better coordinated.
Long-term care and services: The bill would establish support services and programs to assist elderly and disabled people who want to live at home, rather than in an institution.
HHS hasn't released any significant news around HIPAA regulations since its draft guidance on unsecure protected health information April 17, but that does not mean it is time to sit idle.
Major regulations surrounding breach notifications on PHRs by the Federal Trade Commission and unsecure PHI by the Department of Health and Human Services are due in August.
Know your business associates. The HITECH Act says your BAs must comply directly with the HIPAA Security Rule and the use and disclosure requirements of the HIPAA Privacy Rule. As long as a company handles PHI, it's a business associate, according to CMS.
So get to know them better. Or, better yet, get them to know HIPAA better. Section 13401 of the HITECH Act includes the new requirements for BAs. The Act also says civil and criminal penalties for violations of the HIPAA and compliance audits apply directly to BAs. As a covered entity, you must incorporate these additional requirements in your agreements with the BAs, according to the new law.
"I've done over 150 business associate security and privacy program reviews, and one of the most common answers I get from business associates is that, 'Well, HIPAA does not apply to us,'" says Rebecca Herold, CISSP, CIPP, CISM, CISA, FLMI, of Rebecca Herold & Associates, LLC, of Des Moines, IA. "They can't say that anymore. They can no longer argue that they don't have to have safeguards in place."
Breaches within healthcare account for 12% of all breaches, according to www.DataLossDB.org
That site also reported 10 breaches in June alone, totaling nearly 600,000 records
There have been 260 million security breaches since 2005, according to Privacy Clearing House
Track audit logs on EHRs. Whether or not your facility has moved to EHRs, it's going to have to by 2014. And it must comply with certain patient requests on accounting of disclosures per the HITECH.
A good place to start–as reported in HCPro's recent HIPAA white paper is to document your uses, disclosures, and storage of PHI with EHRs or any other system or data repository. Keep audit logs of who accessed records, and what their role is, says Chris Apgar, CISSP, president, Apgar & Associates LLC, in Portland, OR. Besides the future requirement to track and make available PHI disclosed from an EHR, the HIPAA Security Rule requires the generation and review of audit logs. Use a database to ensure all uses and disclosures are tracked as required by the HIPAA Privacy Rule and plan to maintain similar information related to disclosures when the future EHR accounting of disclosure requirements become reality.
Privacy development. Are patients getting more control over their records? New technology and companies want to shift responsibility for decisions about who can use PHRs for research or other purposes from hospitals to patients, says Richard S. Dick, founder of You Take Control, Inc., an electronic consent management company in Alpine, UT, and co-author of the book, The Computer-Based Patient Record: An Essential Technology for Healthcare.
"Researchers are willing to pay thousands of dollars for this information, so why not let the patients benefit from that money, too," Dick asks.
A group of healthcare CEOs, meeting near the Capitol on Friday, urged Congress to move ahead with reform plans to improve patient access to care, reduce cost growth, and enhance quality.
The group, called Health CEOs for Health Reform, issued a white paper that focused on creating a new payment system that they said would reward high-quality care while discouraging fragmented low-value care.
Nancy-Ann DeParle, head of the White House Office of Health Reform, who introduced the group, told them that they were "putting your money where your mouth is by doing the hard work of identifying the $500 million to $600 million" that could be saved over the next 10 years to reform the system.
"These folks are willing to put their own business models up to the looking glass and say how we might realign incentives to better serve the patient we're serving now," said Len Nichols, director of the Health Policy Program of the New America Foundation, which organized the CEO group.
Scott Armstrong, president and CEO of Group Health Cooperative, headquartered in Seattle, talked about how investment in an electronic medical records system "changed the way we practice medicine in our organization" and how they "eliminated wasteful redundant decisions thousand of times a day."
Overall, "we do know how to deliver care differently," said Nicholas Wolter, MD, of the Billings (MT) Clinic. With more physician-hospital organizations and other integrated approaches emerging, changes can occur, but it has to happen "fairly quickly because we do not have longer than 5 to 10 years to deal with what is truly becoming not just a healthcare burden but a burden on our entire society."
Among the proposals the group made are:
Switch Medicare fee-for-service payments with outcome-driven bundled payments.
Hold higher cost-providers accountable to the cost, quality, and utilization standards reached by more efficient peers.
Give providers a bundled payment based on comprehensive services and shared risk.
Eliminate the Sustainable Growth Rate formula for determining physician payments.
Regionalize high-cost, resource-intensive services under Medicare.
Continue investments in quality infrastructure, including health information technology, decision-support tools, and comparative effectiveness research.
Other members of the CEO team are:
Bruce Bodaken, president, chairman and CEO, Blue Shield of California; Lloyd Dean; president and CEO, Catholic Healthcare West; Kenneth C. Frazier, president, Global Human Health, Merck & Co. Inc.; Patricia A. Gabow, MD, CEO and medical director, Denver Health; Gary Kaplan, MD, chairman and CEO, Virginia Mason Medical Center; Donna Katen Bahensky, president and CEO, University of Wisconsin Hospital and Clinics; and Anthony R. Tersigni, EdD, FACHE, president and CEO, Ascension Health.
Hospitals and other medical-industry groups are pushing back against President Barack Obama's proposal to cut $313 billion in government health spending as the White House intensifies its effort to revamp the nation's health system. Under pressure to amplify its payment plan, the White House outlined $313 billion in additional spending cuts over that period to healthcare providers paid through Medicare and Medicaid. That would bring total cost savings and tax increases identified by the Obama administration to help pay for the overhaul to nearly $950 billion.
In closed-door talks, President Obama has been making the case that reducing malpractice lawsuits can help drive down healthcare costs and should be considered as part of any healthcare overhaul, according to lawmakers of both parties, as well as American Medical Association officials. It is a position that could hurt Obama with the left wing of his party and with trial lawyers who are major donors to Democratic campaigns. But one Democrat close to the president said Obama, who wants health legislation to have broad support, views addressing medical liability issues as a "credibility builder."
Lanham-based Doctors Community Hospital ihas been fined by Maryland health regulators after failing to notify them that a patient had died and that at least seven others suffered serious harm last year as a result of mistakes by the medical staff. The 185-bed medical surgical hospital paid the $30,000 fine last month for violating a Maryland law that requires hospitals to report serious medical errors. State officials agreed to reduce a proposed penalty of $95,000 as long as the hospital uses the remaining $65,000 to develop a patient safety program.
Republicans continue to express strong concerns over the Obama administration's plan to reform healthcare and its call for a public insurance option. "I think that, for virtually every Republican, a government plan is a non-starter," Senate Minority Leader Mitch McConnell said. "We know that, if the government gets in this business, pretty soon nobody else will be in the business."
While President Obama pitches his healthcare plan to the American Medical Association in Chicago, much of the selling of the proposal to the American public is already well underway, thanks to several outside groups that have been organizing and advertising for weeks. But to date, there have been almost no coordinated efforts by conservatives to fight Obama's plan.
Health and Human Services Secretary Kathleen Sebelius said President Barack Obama's plan to create a government-run health insurance program would bring competition to private insurers and lower healthcare costs nationwide. Sebelius said that in many markets, private insurers currently have no competitors, giving them wide latitude to raise premiums on customers. She said a government-run option, as long as it followed the same rules as private providers, would force such insurers to lower prices to keep existing customers.
If President Barack Obama wants to win U.S. doctors' support for his plans to expand medical coverage to more than 46 million uninsured Americans, he may need to hike physicians' pay from Medicare and install liability reform. Obama will soon address the American Medical Association, and the group's president, Nancy Nielsen, MD, sounded an aggressive call for changes that doctors say are long overdue. Among the AMA's key wants are increased payments from Medicare and medical liability reform that caps non-economic damages and allows doctors to abide by the coming trend of quality measures that pay physicians based on performance without being penalized for mistakes.
