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What HR regulations and changes you need to look out for in 2012?

It's time for your 2012 work plan, mark your calendar for these upcoming new human resources related rules or changes with deadlines in 2012 that require some research and planning for implementation prior to the due date.  
  • W-2 reporting requirements - As per the new IRS guidelines, employers with 250 or more employees in 2012 have to report individual health insurance costs on those workers’ W-2s (which will be issued in 2013).  Small employers can wait another year.  The IRS has said the reporting requirement for small employers could be pushed back even further.  The W-2 reporting requirements do not make workers’ healthcare benefits taxable.  They simply meant to let employees know how much their coverage costs.  

When is the HIPAA audit start?

Will you be the target of an HHS Office of Civil Rights (OCR) HIPAA privacy and security audit? 

The HITECH Act requires HHS to conduct periodic audits to ensure covered entities and business associates are complying with the HIPAA Privacy and Security Rules. To implement this mandate, OCR is piloting a program to perform up to 150 audits of covered entities for compliance. Audits conducted during the pilot phase will begin November 2011 and conclude by December 2012.

All health care providers, health plans of all sized and functions, health care clearinghouses and business associates may be selected for an audit. OCR will select and audit as wide a range of types and sizes of covered entities as possible.  Business Associates will be included in future audits.  

OCR will use this pilot audit program to examine the mechanisms for compliance, identify best practices, and discover risks and vulnerabilities that haven’t otherwise come to light. All audits will include site visits and the issuance of audit reports.

HIPAA 5010 Delay in Enforcement, Not in Implementation Date

Great,  I saw the news HIPAA 5010 is delayed and I think I have more time to implement.  But what does it mean when the Centers for Medicare & Medicaid Services, Office of E-Health Standards and Services, announced they won’t enforce compliance with the HIPAA 5010 transaction set until March 31, 2012?  

To clarify, CMS did not change the actual implementation date of HIPAA 5010. Providers must still comply with the 5010 transaction standards by January 1, 2012 and small health plans have until January 1, 2013.  So if providers submit claims to small health plans, they have until January 2013. 

CMS also simply decided it will not take any enforcement actions until March 31, 2012, if they receive any complaint against the covered entities for non-compliance.  Many covered entities are still waiting for software updates.  

CMS will accept complaints related to compliance between January 1 and March 30, 2012. Covered entities will have to provide evidence that they are complying or are making a good faith effort to comply with the new HIPAA standards during the 90-day period if asked. 

The 90-day delay will not affect the implementation date for the ICD-10-CM/PCS coding systems. That date remains October 1, 2013.  All HIPAA covered entities are required to switch to HIPAA 5010 in preparation for the conversion to ICD-10-CM/PCS.  

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Health Care Innovation Challenge - $1 Billion Available!

$1 billion dollars will be awarded to innovative projects that can deliver high quality health care and better outcomes at a lower costs to people enrolled in Medicare, Medicaid and CHIP (Child Health Insurance Program)

Funded by the Affordable Care Act, the Center of Medicare and Medicaid Innovation Center will award funds to test alternative models for care delivery and payment, facilitate learning, diffuse best practices, and promote the development of a workforce capable of supporting care transformation.  The awards will be conducted in 2 rounds, the first round of awards will be announced in March 2012.  The awards will range from $1 million to $30 million for a three-year period.  

Projects will be evaluated based on the following priorities:
  • Ability to rapidly hire, train and deploy new types of health care workers and the ability to create the workforce of the future
  • Ability to begin within six months of award and demonstrate a model of sustainability post-award
  • Projects or care model for the high risk, chronic, complex and high needs population
  • Enhanced or new types of infrastructure to enable others to learn, support and diffuse best practices

Legal Protection for EHR Users?

U.S. Rep. Tom Marino introduced H.R. 3239, the Safeguarding Access For Every Medicare Patient Act, on Oct. 26, 2011 to provide greater legal protection to Medicare and Medicaid providers who are mandated to use electronic health records by 2014 per the HITECH Act.  

The bill is designed to ensure patient access to Medicare and Medicaid providers as many of these providers are reluctant to use EHR with concerns that errors will make them more vulnerable to unnecessary legal action and will cease to participate as providers in these programs.

H.R. 3239 would create a system for reporting potential errors that occur when using electronic records without the threat of that information being used as an admission of guilt. It also prevents electronic records from being used as an easy source for “phishing expeditions’’ . The proposal allows for providers who use electronic records to take remedial measures without having those actions be used to establish guilt, places time limits on the filing of lawsuits and offers protection against libel and slander lawsuits.

How do you know you are ready for HIPAA 5010?

Providers and billing staff, if you have not yet started to make sure your system is or will soon be 5010 compliant and have all your required data elements in place to test, you may face reduced reimbursement come January 1st, 2012.   There is no talk of any delay in the timeline to date.

For managers who do not have to deal with this billing headaches, what is this 5010 fuss is all about?  It is a change in claim submission standards for covered entities per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  For those who are new to healthcare, please don't abbreviate HIPAA as HIPPA.  You have no idea how many times I have seen HIPPA this and can't figure out what it stands for.

Examples of couple new standard changes are:  the billing provider address cannot be a PO Box, this include lock boxes or lock bins; the patient address needs to have the 4 digit extension and so on... This is why you have to start now to make changes to your process and data.

Patient Satisfaction A Factor in Medicare Payment to Hospitals!

In the coming months, Medicare will start taking patient satisfaction into account when reimbursing hospitals.

Kaiser Health News: When TLC Doesn't Satisfy Patients, Elite Hospitals May Pay A Price
Winning praise from patients has become a pressing — and often elusive — obsession for ... hospitals nationwide. In the coming months, Medicare will start taking patient satisfaction into account when reimbursing hospitals. Disgruntled patients will mean reduced revenue, a frightening prospect for hospitals already facing empty beds because of the recession and pressure from insurers to hold down costs (Rau, 11/8).

The Wall Street Journal: A Financial Incentive For Better Bedside Manner
How patients feel they were treated has always colored their opinions of a hospital. Now, those feelings are being factored into how hospitals get paid. Starting next fall, the federal Medicare program will withhold 1% of a vital payment—totaling an estimated $850 million, with the percentage doubling to 2% in 2017—as part of a program in last year's U.S. health-care overhaul designed to force hospitals to improve the quality of care and trim costs (Landro, 11/7).

This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from more than 300 news organizations. This was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Teach Kids Social Networking Safety with Game App

For parents worried about the dangers of social networking, Carnegie Mellon University, in partnership with Web Wise Kids, has launched a free mobile game app BeSeen to teach kids how to use social sites with caution.

It is a single-player game that replicates a social networking site where player must make positive choices when presented with challenging social situations and solve puzzles along the way. The game is designed to help kids understand responsible online behavior such as securing their personal information, protecting their privacy and defending their peers against cyberbullying.

Do you know of any teaching game app for children?

How to Pay for Health IT Systems?

Federal stimulus funds are paying to build or expand systems enabling health care providers within each state to share patient information.  It's a tall order with good intention but how will state officials get all providers to implement, use and participate?  Are the incentive payments worth the costs of change for providers?

An iWatch News survey reveals concerns among state officials about how they will keep paying for the programs once the federal money runs out.  As states adopting a wide variety of different software for electronic health record exchange, how to get those different systems to talk to each other?

What does it take to attract and retain Millennial talent?

Not a surprising finding by a study from Cisco Systems, for a whole generation of tech-savvy young professionals, more than 4 in 10 say access to social media, a choice in the devices they could use at work, and flexibility in working remotely, are more important than earning a heftier salary.  

For those of us who are seasoned healthcare managers, are you prepared to adapt to this trend?

Austin Carr writes @ A bigger salary? Just give us Facebook access, workers say (11/2)