HHS Inspector General Revises Self-Disclosure Protocol
On April 17, the HHS Office of Inspector General (“OIG”) released a revised self-disclosure protocol (PDF) called the OIG Provider Self-Disclosure Protocol. The protocol describes what a hospital must confide to the government in order to avoid prosecution or get a possible reduction in penalties.
The protocol also discusses the three types of fraud most commonly disclosed by hospitals as: submission of false or inflated Medicare bills, employment of people whom the OIG has excluded from Medicare and payments to doctors to induce referrals of patients for treatment.
The OIG protocol is intended only for violations that involve intentional conduct on the part of the health system. Simple billing errors and civil matters that only involve the Stark law can be made through a Self-Referral Disclosure Protocol maintained by CMS.
Senate Republicans Release White Paper on Health IT Issues
On April 16, Senate Republicans released a 28-page white paper outlining problems identified in the Obama administration’s handling of the 2009 stimulus bill’s health information technology programs. The report said that the program is leading to increased health care costs and potential waste and abuse and that it threatens patient privacy, and called on the programs to be “recalibrated.”
The white paper alleged five key implementation deficiencies: a lack of a clear path toward interoperability; concerns about health IT increasing health care costs and not helping to control costs as previously estimated; a general lack of HIT program oversight, citing an HHS inspector general’s report from last December; patient privacy and security risks; and concerns about whether providers can afford to maintain their federally incentivized health care technology long-term.
Not included in the white paper was a separate letter addressed to health IT stakeholders and members of the public, asking for feedback on issues raised in the white paper and “any areas of concern and potential solutions” to improve implementation of the health IT provisions of the American Recovery and Reinvestment Act of 2009.
CMS to Discuss Appropriate EHR Coding with Hospitals
CMS and the Office of the National Coordinator (“ONC”) for Health Information Technology will hold a listening session May 3 to discuss why electronic health records (“EHRs”) are leading to increased coding intensity levels for some Medicare services. Interested stakeholders will discuss the effects of EHRs and coding trends, developing standards for coding with EHRs and coding challenges. Scheduled to speak will be Medicare Director Jonathan Blum and the major hospital associations.
Bipartisan Policy Center Releases Health Spending Cost-Containment Proposal
On April 18, the Bipartisan Policy Center released a plan for cutting waste from the health care system. The proposal claims to save $560 billion in health care spending over 10 years.
The largest share comes from Medicare savings, which total almost $300 billion after paying for fixing the Sustainable Growth Rate formula by freezing physician fee-for-service payments for 10 years.
The proposal would also introduce competitive bidding among Medicare Advantage plans and freeze physicians’ payments in traditional fee-for-service Medicare, while providing incentives both to providers and beneficiaries to enroll in the new Medicare networks.
Bills Introduced This Week
S. 739: On April 16, Sen. Barbara Boxer (D-CA) introduced legislation that would amend the Public Health Service Act to establish direct care registered nurse-to-patient ratio requirements in hospitals. The bill was referred to the Senate Health, Education, Labor and Pensions Committee.
H.R. 1531: On April 12, Rep. Rosa DeLauro (D-CT) introduced legislation that would require health plans to provide coverage for a minimum hospital stay for the treatment of breast cancer and coverage for secondary consultations.
For more information, please contact John F. Williams, III at 317-977-1462 or jwilliams@hallrender.com.
Please visit the Hall Render Blog at http://blogs.hallrender.com/ for more information on topics related to health care law.
