The OIG has been busy issuing more reports, CMS finally got around to the OPPS rule, and Post-Acute care also gets some attention, recently. So, it’s not time to say happy holidays, yet.
Copy & Paste Crackdown?
Here’s the latest definition of “fraud” from CMS:
A Physician hitting Control-C, Control-V.
After requiring everyone to install computer-based records systems, the Feds now say that the cut-and-paste features common to those required electronic medical records (EMR) systems actually invite fraud — via the use of duplicated clinical notes. Go figure, right?
Oh… and they’re not done, yet. They also say that it’s far too easy to turn off features of EMR systems that allow tracking of “sloppy or fraudulent” entries.
Wait… I have a solution: let’s use paper! Ok, never mind, that’s not progressive thinking…
Another solution is for the EMR vendors to figure out how to turn off such features, which I hear is happening, as you read this…
The OIG issued a report about all this, and said that “nearly all hospitals with EHR technology had [the] recommended audit functions in place, but they may not be using them to their full extent.” But what they seem most concerned about had more to do with the usage logs and internal policies about cut and paste.
Recent Attention on Post-Acute Care Spending
Evidently, Medicare beneficiaries in Connecticut wind up in a nursing home twice as much as those in Arizona. In Chicago, 25% of Medicare beneficiaries receive additional post-acute services, while in Phoenix, less than 10% do. Also, CMS pays $5,000 more for home health care in Lousiana than it does for similar services in New Jersey. Read that sentence again… I thought it would be more expensive in New Jersey, but it’s reversed.
To learn more, see a recent article in Healthcare Finance News.
Becker’s Hospital Review – The 10 Biggest Hospital Stories of 2013
Perhaps the biggest story in the industry came from the rollout (or not) of the ACA’s healthcare exchanges. Many health systems worried about all this, especially how many and who would enroll in those plans and what reimbursement would be like under the plans.
Then, the launch happened in the middle of yet another government shutdown. Add to that, the official exchange website, www.Healthcare.gov, had so many difficulties that the Obama Administration had to delay penalties.
Becker’s Hospital Review covered it all, as well as other stories…
CMS Published OPPS & ASC Final Rules
On November 27, 2013, CMS released the Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems final rules. Find a short review in the article link:
New Bedside Reading
On November 21, 2013, the OIG published the “OIG Strategic Plan 2014-2018” – just in time to download, print and use as a stocking stuffer for your favorite compliance professional. Personally, I’d reserve this for someone I don’t care for, but that’s me.
The report identifies four goals for the next four years:
1. Fight Fraud, Waste and Abuse
2. Promote Quality, Safety, and Value
3. Secure the Future
4. Advance Excellence and Innovation
I find it interesting that the word “Clarity” is not among their goals. Oh wait, I’m thinking about what would be a good goal for CMS… sorry, my mistake.
Find an article here: OIG announces strategic plan for 2014-2018
And there is another more detailed article here: OIG defines its priorities in 2014-2018 plan