Health Information Compliance Alert

Published on Wed Aug 08, 2012 PDF

The Obama administration is determined to fight drug abuse as is evident from a pilot project to "measure the effects of expanding and improving access to prescription drug monitoring programs (PDMPs)" which has been launched in Indiana and Ohio according to a June 21 HHS press release.

"Existing prescription drug use data will be made available to providers and pharmacists when treating patients in ambulatory and emergency departments through a new pilot program launched today by the Department of Health and Human Services' (HHS) Office of the National Coordinator for Health Information Technology (ONC)," the press release explains.

What are PDMPs? "PDMPs are statewide electronic databases designed to be used as a tool by health care providers to identify and intervene in cases of potential prescription drug abuse," according to the press release. Pharmacies and dispensing practitioners submit prescribing and dispensing data which are transmitted electronically for it to be collected, monitored, and analyzed.

"Technology plays a critical role in our comprehensive efforts to address our nation's prescription drug abuse epidemic," said Gil Kerlikowske, director of National Drug Control Policy (ONDCP) in the press release. "Together with education, proper disposal practices, and enforcement; improving existing prescription monitoring programs is a priority for this administration."

Stressing that new systems were not being created; rather old ones were being given new impetus and value, Farzad Mostashari, M.D., Sc.M., national coordinator for health IT was quoted in the press release as saying, "The PDMP pilot projects being launched today will help hospital staff identify a patient's controlled substance history at the point of care to enable better targeting appropriate treatments and reduce the potential of an overdose or even death."

The Ohio pilot project will test the impact of having a drug risk indicator in the electronic health record and how that affects clinical decision making; while in Indiana it will demonstrate how emergency department staff can receive a patient's controlled substance prescription history directly through the Regenstrief Medical Record System (RMRS).

New App Contest Announced By HHS

In a move to reduce and control heart risk, the HHS invites developers to "create a mobile app to help consumers reduce their risk for heart disease by controlling their blood pressure and managing their cholesterol," according to a July 27 press release.

"This new challenge and the supporting consumer education campaign are examples of how new consumer health information technology, using information, data and electronic tools that many health care systems and physicians are already using, can help individuals better manage their health and work closely with their care providers," Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology, was quoted as saying at the Tulsa (Okla.) Beacon Community's Annual Provider Summit in the press release.

The Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services are the co-leaders of the initiative. "Partners include federal agencies, doctors, nurses, pharmacists and other health care professionals, private insurers, businesses, health advocacy groups and community organizations," the release added.

Switch To 5010 Remittance Advices (RA)

You should have switched over to the 5010 version of electronic remittance advices (835s) by the end of the month, or you'll miss out on seeing your RAs. Beginning Aug. 1, "the Medicare FFS program shall produce only the 835 remittance advice transaction in the ASC X12 Version 5010," CMS says in a message to providers. "Medicare FFS has stated in previous communications that trading partners would be allowed an additional 30 days to complete the 835 remittance advice transaction transition."

Benefits: You'll see some improvements in the 5010 version, CMS promises. "In version 5010, the Health Policy Segment will report the National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)," the agency says. "The 835 also will have the website where the specific LCD/NCD code is explained. Providers will have access to the code as well as the code description."

The 5010 version of the 835 also will contain technical contact information not in version 4010, CMS adds. "Version 5010 contains new segments such as coverage expiration date and claim received date which will help provider's access important information without manual intervention."