Healthcare Financial News

At the request of the National Committee on Vital and Health Statistics, the Workgroup for Electronic Data Interchange (WEDI) has developed two surveys to assess healthcare industry progress toward achieving 5010 and ICD-10 implementation.

WEDI is seeking a single response to each of the two surveys from each participating organization, in order to maintain the integrity of the survey results.

The group has removed any questions that could be used to identify respondents. WEDI assures prospective respondents that no enforcement will result from survey participation.

Responses will be accepted until Nov. 12.

Access the surveys and files that may be downloaded for use as worksheets from the WEDI survey announcement.

The Federal Trade Commission (FTC) is delaying enforcement of the Red Flags rule until June 1, 2010, for financial institutions and creditors subject to enforcement by the FTC. The extension follows previous delays that were set to expire on Nov. 1. The Rule was promulgated under the Fair and Accurate Credit Transactions Act, in which Congress directed the FTC and other agencies to develop regulations requiring “creditors” and “financial institutions” to address the risk of identity theft. The resulting Red Flags rule requires all such entities that have “covered accounts” to develop and implement written identity theft prevention programs to help identify, detect, and respond to patterns, practices, or specific activities – known as “red flags” – that could indicate identity theft.

Read the FTC announcement.

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule on home health payment that includes a 2.0 percent market basket update to Medicare’s CY10 home health prospective payment system rates and a 2.75 percent coding reduction. The CY10 reduction is the third of four reductions authorized in a prior rule. In other provisions of the rule, CMS will cap home health outlier payments at 10 percent per home health agency and target total aggregate outlier payments at 2.5 percent of total payments. The current target for aggregate outlier payments is 5 percent of total expenditures.

The final rule will be published in the Federal Register on Nov. 10, 2009. The effective date is Jan. 1, 2010.

The Centers for Medicare & Medicaid Services (CMS) has published a final rule updating payment policies and rates for hospital outpatient departments (OPPS) and ambulatory surgical centers (ASCs) in CY10.

Most hospitals will receive an inflation update of 2.1 percent in their payment rates for Medicare outpatient services. Under the Hospital Outpatient Department Quality Data Reporting Program, hospitals that did not participate in the program or did not successfully report the quality measures will receive an update equal to the annual inflation update factor minus 2.0 percentage points for a net update of 0.1 percent.

ASCs will receive a 1.2 percent inflation update.

CMS projects that aggregate Medicare payments to hospitals and community mental health centers in CY10 will be approximately $32.2 billion, while aggregate Medicare payments to ASCs will total $3.4 billion.

The final rule will appear in the Nov. 20 Federal Register. Comments are due by Dec. 29. CMS will respond to comments in the CY11 OPPS/ASC final rule.