Second Look—Advocacy

HIPAA privacy provisions
In response to Ebola outbreak concerns, the U.S. Department of Health and Human Services (HHS) has issued a bulletin regarding Health Insurance Portability and Accountability Act (HIPAA) rules in emergency conditions. HHS states that if the president of the United States announces an emergency, the secretary of HHS may waive certain provisions under the Project Bioshield Act of 2004 and section 1135(b)(7) of the Social Security Act. HHS states that if such a waiver is issued, it only applies in the emergency area and for the emergency period identified in the public health emergency declaration; to hospitals that have instituted a disaster protocol; and for up to 72 hours from the time the hospital implements its disaster protocol.

ICD-10 conversion costs
Information published online in the Journal of AHIMA suggests that converting to ICD-10 is likely to cost small medical practices (defined as three physicians and two affected staff) between $1,960 and $5,900, based on data from surveys, published reports, and ICD-10 conversion experience with various stakeholders. The researchers note that a recent 2014 update of a 2008 report by Nachimson Advisors to the American Medical Association estimated the cost for a small practice to implement ICD-10 to be in the range of $22,560 to $105,506.

Scrutiny of ASC quality, safety likely to increase
An article in HealthLeaders magazine (October 2014) looks at recent growth in the number of ambulatory surgery centers (ASCs). The number of Medicare-certified ASCs increased by 19 percent between 2006 and 2013, and approximately 3.4 million fee-for-service Medicare beneficiaries had a procedure done in an ASC during 2011. Procedures for Medicare beneficiaries are performed in ASCs at payment rates that are about 55 percent of the level reimbursed by Medicare to hospital outpatient departments. However, the number of adverse events reported by ASCs is “significantly below the rates reported for inpatients in the hospital setting,” according to a spokesperson from the Ambulatory Care Accreditation Program at The Joint Commission.

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