MedPAC considers site-neutral payment for acute, long-term care hospitals   04/05/2013
The Medicare Payment Advisory Commission today discussed potential site-neutral payment approaches for patients who are chronically critically ill, defined by MedPAC as patients who spend at least eight days in an intensive care or critical care unit. Currently, Medicare pays acute-care hospitals and long-term care hospitals differently to care for these patients. According to MedPAC staff, this can create financial incentives to provide services in higher paid LTCH settings and encourage transitions between care settings that may be disruptive or harmful for patients. The commission discussed three potential site-neutral options: paying for CCI patients under the inpatient prospective payment system, no matter the site of care, but with an expanded outlier policy; paying for CCI patients under the inpatient PPS, but creating new CCI payment groups with a larger outlier pool; and bundling post-acute costs into new CCI payment groups in the inpatient PPS.  The commission expects to resume discussion on the issue this fall.
HRSA issues final rule on National Practitioner Data Bank   04/05/2013
The Health Resources and Services Administration yesterday issued a final rule merging the Healthcare Integrity and Protection Data Bank into the National Practitioner Data Bank. Effective May 6, the final rule revises existing regulations governing the NPDB to incorporate statutory requirements under the Patient Protection and Affordable Care Act. The rule does not affect reporting requirements or query access under the Health Care Quality Improvement Act of 1986, so existing requirements for hospitals and other health care entities will not change. The regulation does require the Department of Health and Human Services to establish a transition period to transfer all data in the HIPDB to the NPDB, and to cease operations of the HIPDB once completed.
CDC issues recommendations for novel flu virus   04/05/2013
The Centers for Disease Control and Prevention today issued diagnostic, infection control and treatment recommendations for patients with suspected H7N9 flu, a new avian flu virus identified in China. Since April 1, the World Health Organization has reported 16 confirmed cases of the virus in China, including six deaths. No evidence of person-to-person transmission and no cases in other countries have been reported to date. According to the CDC advisory, clinicians should consider the possibility of H7N9 infection in people with respiratory illness and an appropriate travel or exposure history. Although the majority of Chinese cases have resulted in severe respiratory illness in adults, the virus may cause mild illness and illness in children as well.
CMS lowers RAC minimum record request limit for hospitals, other providers   04/05/2013
The Centers for Medicare & Medicaid Services has reduced the minimum number of medical records that Recovery Audit Contractors may request from Medicare providers other than physicians and suppliers. Effective April 15, RACs may issue a minimum request of 20 records in a 45-day period from hospital and other provider campuses, down from a previous minimum of 35 records. In addition, only 75% of a hospital’s record request limit may be used for a particular type of claim, such as inpatient, down from 100% previously. The AHA-supported Medicare Audit Improvement Act (H.R. 1250), introduced March 19, would limit RAC medical record requests by campus to 2% of the Medicare claims submitted for a particular care setting, such as inpatient, outpatient, skilled nursing facility or inpatient rehabilitation.
FBI investigating phone system attacks against hospitals, others   04/05/2013
The Federal Bureau of Investigation and National White Collar Crime Center are investigating ongoing attacks against telephone systems operated by public sector entities, including some hospitals. The telephony denial-of-service attacks, which are part of an extortion scheme, start with a phone call to an organization from an individual claiming to represent a collections company for payday loans. The caller usually has a strong accent and asks to speak with a current or former employee concerning an outstanding debt. Failing to get payment from an individual or organization, the perpetrator inundates the targeted telephone network with a continuous stream of calls for an unspecified but lengthy period of time, which can prevent incoming and outgoing calls from being completed. The Association of Public-Safety Communications Officials has published a checklist to help organizations plan for and respond to such attacks, which should be reported to the Internet Crime Complaint Center at Because the attacks have targeted numerous hospitals and public health entities, the departments of Health and Human Services and Homeland Security also have become involved in the federal response.
Hospitals add 7,900 jobs in March   04/05/2013
Employment at the nation's hospitals rose by 0.16% in March to a seasonally adjusted 4,837,600 people, the Bureau of Labor Statistics reported today. That's 7,900 more people than in February and 61,400 more than a year ago. Without the seasonal adjustment, which removes the effect of fluctuations due to seasonal events, hospitals employed 4,834,300 people in March – 12,400 more than in February and 61,300 more than a year ago. The nation's overall unemployment rate fell by 0.1 percentage point in March to 7.6%.
Monograph explores role of IT in creating accountable system of care   04/05/2013
The latest monograph from the AHA’s Center for Health Care Governance discusses the stages most health care organizations will go through to build or become part of an accountable system of care. Author Pam Arlotto, president and CEO of Center-affiliate member Maestro Strategies, explores the information technology needed to support the necessary care management platform at each stage. The monograph, “Consolidation, Clinical Integration & Transformation: Investing in Information Technology for an Accountable System of Care,” also explores the role boards can play as they gain an understanding of the technology investments required and how to evaluate their organization’s progress at each stage. To order any Center monograph, visit The Center is AHA’s resource for information, tools and counsel to promote excellence in health care governance.