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Issue #153 - July 21, 2010
AAPC EdgeBlast

Agencies Release EHR "Meaningful Use" Final Rules
The Centers for Medicare & Medicaid Services (CMS) released on July 14th a final "Meaningful Use" rule that specifies the long-anticipated requirements providers must meet to qualify for electronic health record (EHR) incentive payments in 2011 and 2012. At the same time, the Office of the National Coordinator (ONC) released a final rule that specifies the technical capabilities that EHR technology must have to be certified and to support providers in achieving those requirements.

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AAPC Special Presentation: Meaningful Use July 27

HHS, Justice Department Make Major Fraud Bust
The morning of July 16, 94 people have been charged for their alleged participation in schemes to collectively submit more than $251 million in false claims to the Medicare program in the continuing operation of the Medicare Fraud Strike Force in Miami; Baton Rouge, La.; Brooklyn, N.Y.; Detroit and Houston, announced Attorney General Eric Holder, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, FBI Director Robert Mueller and Daniel R. Levinson, Inspector General of HHS. The operation announced today is the largest federal health care fraud takedown since Medicare Fraud Strike Force operations began in 2007.

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HHS Proposes New HIPAA Privacy Rule Regulations
The U.S. Department of Health and Human Services (HHS) announced July 8 proposed regulations under the Health Insurance Portability and Accountability Act (HIPAA) that are intended to further strengthen the privacy of personal health information (PHI). "The benefits of health IT can only be fully realized if patients and providers are confident that electronic health information is kept private and secure at all times," said Georgina Verdugo, HHS Office for Civil Rights (OCR) director at HHS.

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NY Hospital Data Breach Affects Thousands
A letter dated June 4 from Lincoln Medical and Mental Health in Bronx, NY notifies 130,945 patients that the security of their protected health information (PHI) has been compromised. Seven CDs created by Siemens Medical Solutions USA, Inc., a company that performs billing and claims processing for Lincoln, were lost while in transit to the hospital "sometime between March 16 and 24."

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CMS Releases RAC Vulnerabilities
The Centers for Medicare & Medicaid Services (CMS) released July 12 a special edition MLN Matters article (SE1024), "Recovery Audit Contractor (RAC) Demonstration High-Risk Vulnerabilities – No Documentation or Insufficient Documentation Submitted." The article is the first of a series providing information on RAC high-dollar improper payment vulnerabilities.

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HealthCare.gov Compares Imaging Usage Rates
The U.S. Department of Health and Human Services' (HHS) updated July 7 HealthCare.gov's Hospital Compare website with quality data on the rates of outpatient magnetic resonance imaging (MRI) for low back pain, outpatient re-tests after a screening mammogram, and two ratios that explain how frequently outpatient departments gave patients "double" computed tomography (CT) scans "when a single scan may be all that is needed."

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DMEPOS Bidding Contract Offers in the Mail
The Centers for Medicare & Medicaid Services (CMS) has begun mailing contract offers to winning bidders of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. The first round of the program is scheduled to begin Jan. 1, 2011 for contract suppliers and beneficiaries in nine areas of the country. CMS says it plans to announce the contract suppliers in September.

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Coding Tips
MRA Now Covered (or not) Under MRI NCD
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Get Paid for Certain Supply Code Rate Changes
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DME Modifier KX Claims Require More Documentation
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AMA Summarizes 2011 MPFS Proposed Rule
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2010 Payment System Updates at a Glance
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Insurer Delays Once in a Lifetime Procedures Policy
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Palmetto Receives Stop-Work Order for J11
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Medical News

FDA Orders Recall of Colleague Infusion Pump
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New Test Improves Detection of 2009 H1N1
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CDC Updates Vaccine Price Lists
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Test Yourself Online
The Test Yourself questions can be accessed online at www.aapc.com/testyourself/. Once you go there and take the test, you can automatically grade your answers, correct any mistakes, and have your CEUs automatically added to your CEU Tracker for submission.

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Featured Items
"Meaningful Use" Rules
Major Fraud Bust
New HIPAA Regulations
NY Hospital Data Breach
RAC Vulnerabilities
Imaging Usage Rates
DMEPOS Bidding Contract
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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