Healthcare Application Downloads To Reach 142 Million By 2016

Smartphones already are starting to change the way consumers access patient data, but a new report finds they also are starting to change the way patients use remote monitoring devices.

Juniper Research, a Hampshire, England-based market research firm, published a report  projecting by 2016, 3 million patients worldwide will be using remote monitoring devices that use a smartphone as a hub to transmit information.  The predictions are in line with broader remote monitoring device trends and predictions that point to a rise in the use of remote monitoring devices.

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A Shift From Nursing Homes To Managed Care

Faced with soaring health care costs and shrinking Medicare and Medicaid financing, nursing home operators are closing some facilities and embracing an emerging model of care that allows many elderly patients to remain in their homes and still receive the medical and social services available in institutions.

The rapid expansion of this new type of care comes at a time when health care experts argue that for many aged patients, the nursing home model is no longer financially viable or medically justified. In the newer model, a team of doctors, social workers, physical and occupational therapists and other specialists provides managed care for individual patients at home, at adult day-care centers and in visits to specialists. Studies suggest that it can be less expensive than traditional nursing homes while providing better medical outcomes.

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Stage 2 EHR Incentive Program Details Released

The Department of Health and Human Services (HHS) has released details of the requirements for the second phase of the EHR incentive program.  Under this program, eligible professionals (EPs) can qualify for up to $44,000 over five years under Medicare or up to $63,750 over six years under Medicaid.

HHS proposes to now require in Stage 2 a number of the reporting criteria that were optional in Stage 1. In addition, many of the thresholds for reporting criteria have been increased. HHS recently announced the start date for Stage 2 of the program would be extended from 2013 to 2014 to permit EPs attesting in 2011 an additional year to move to the more rigorous Stage 2 requirements.

To read the proposed rule in its entirety, click here and contact HMS Healthcare Management Solutions to find out how we can help prepare you for meaningful use.

The Trouble With 5010

As the Medical Group Management Association (MGMA) and the American Medical Association (AMA) continue to call on the Centers for Medicare & Medicaid Services (CMS) to further delay enforcement of the HIPAA 5010 electronic transaction standards scheduled for April 1, physician practices that already have started using the new standards have reported several problems, most commonly:

• Issues with practice management and billing systems that had shown no problems during the testing.
• Issues with billing secondary payers.
• Claims rejections due to issues with billing and practice addresses.
• Crosswalks for national provider identifiers that are not being recognized.
• Claims lost by Medicare contractors.
• Certain “not otherwise specified” claims being denied due to not having descriptions on the claims.
• Sporadic payment of resubmitted claims.
• Call hold times of one to two hours when attempting to contact contractors for further explanation of unpaid and rejected claims.
• Unsuccessful claims processing, with no reasons cited for rejection, despite using submitters that were approved after successful 5010 testing.

HMS Healthcare Management Solutions information systems are currently compliant with the 5010 update to the HIPAA electronic transaction standards. Our systems are in place and have been tested to ensure you can continue to send claims and receive reimbursement without interruption.

Find out how we can assist you by contacting HMS today!

CMS Releases Stage 2 Meaningful Use Proposals

Officials with the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) announced the proposed requirements for Stage 2 Meaningful Use and 2014 certification of electronic health records at the Healthcare Information and Management Systems Society’s annual conference in Las Vegas.

The Stage 2 Meaningful Use rules and EHR certification standards largely reflect the recommendations made last year by the Health IT Policy Committee and the Health IT Standards Committee.  Notices of proposed rulemaking (NPRM) for the two sets of regulations should be published later this week in the Federal Register. Following a 60-day comment period, the final rule is scheduled for release this summer.

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California Medicaid Case Heads Back To Lower Court

The Supreme Court sent back to a lower court a case on whether Medicaid recipients and medical providers can sue California for cutting reimbursement rates in the healthcare program for low-income Americans.

The high court said after it heard oral arguments in the case on October 3, federal government officials approved the state’s statutes as consistent with federal law.

Justice Stephen Breyer said in the majority opinion the case was sent back to a U.S. appeals court based in California to determine whether the recipients and providers may sue in light of the changed circumstances of the federal government’s approval.  In sending the case back, the justices set aside a ruling by the appeals court that had blocked the cuts for violating federal law.

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Medicare Program Deadlines Approaching

Practices and eligible professionals (EPs) must complete any 2011 reporting by the end of February for Medicare programs including meaningful use, e-prescribing and Physician Quality Reporting System (PQRS).

For meaningful use, February 29 is the last day for EPs to register and attest to receive an incentive payment for calendar year 2011. E-prescribing and PQRS do not require EPs to register, but an EP’s claims must be processed in the National Claims History no later than two months after the end of the reporting period to be counted for that program year. Practices are encouraged to submit any Medicare claims with PQRS or e-prescribing information as soon as possible. The February 29 deadline does not impact e-prescribing payment adjustments, which began this year and were based on the first six months of 2011.