Senate Finance Committee examines oversight of RACs   06/25/2013
Testifying before the Senate Committee on Finance today, representatives from Billings (MT) Clinic and Salt Lake City-based Intermountain Healthcare urged the government to do a better job overseeing Recovery Audit Contractors. J.J. Carmody, director of reimbursement at Billings Clinic, and Suzie Draper, vice president of business ethics and compliance at Intermountain Healthcare, said their organizations are very successful overturning RAC denials on appeal, but must spend significant financial and staff resources to manage the audit and appeals process, which might otherwise be applied to quality improvement and patient care. In a statement to the committee, AHA voiced its support for the Medicare Audit Improvement Act (S. 1012/H.R. 1250). Among other provisions, the bill would establish a consolidated limit for medical record requests, impose financial penalties on RACs that fail to comply with program requirements, make RAC performance evaluations publicly available and allow denied inpatient claims to be billed as outpatient claims when appropriate.
Preview period for hospital readmissions reports underway   06/25/2013
Hospitals can preview their hospital-specific reports for the fiscal year 2014 Hospital Readmissions Reduction Program through July 12 by downloading the reports at My QualityNet. Hospitals should notify the Centers for Medicare & Medicaid Services of any suspected errors in their Excess Readmission Ratio calculations or discharge-level data by sending an e-mail to CMS_readmissions_reduction@mathematica-mpr.com by July 12. The ratios are based on CMS fee-for-service claims from July 1, 2009 through June 30, 2012. Hospitals that were not open as of May 10, 2013 or did not have any qualifying data during the period may access a “mock” hospital-specific report on the QualityNet website. The ratios will be publicly reported on the Hospital Compare website in October. For more on the Hospital Readmissions Reduction Program, visit www.cms.gov.
AHA advertorial: Preparedness is a process   06/25/2013
Preparedness is not a one-time investment, AHA President and CEO Rich Umbdenstock notes in an advertorial today in the Wall Street Journal. “It’s a process that must be nurtured and grown over time. Let’s make certain the care is there when we need it by providing reasonable funding to ensure hospital emergency preparedness.” Funding for the federal Hospital Preparedness Program has declined by almost 30% over the past decade, the advertorial notes. “At a time when hospitals are facing lower Medicare and Medicaid reimbursements, any further cuts will strain hospitals’ ability to be prepared to care."
AHA NOVA Award winners announced   06/25/2013
Five hospital-led partnerships to improve community health will receive 2013 AHA NOVA Awards July 27 at the Health Forum/AHA Leadership Summit in San Diego. The winning programs are: Bangor Beacon Community in Bangor, ME; Hope Clinic and Pharmacy in Danville, KY; Free Preventive Screenings Program in Vincennes, IN; Chippewa Health Improvement Partnership in Chippewa Falls, WI; and Core Health Program of Healthier Communities in Grand Rapids, MI. “We are pleased to honor this year’s AHA NOVA winners for their collaborative efforts to improve health and wellness,” said AHA President and CEO Rich Umbdenstock.  “Working together, hospitals and like-minded community organizations are providing valued and compassionate programs and addressing vital health care needs.” For more on the programs and hospital participants, see the AHA news release.
Task force recommends all baby boomers get one-time test for hepatitis C   06/25/2013
The U.S. Preventive Services Task Force today issued a final recommendation that all U.S. baby boomers – the generation born between 1945 and 1965 – get a one-time test for the hepatitis C virus. The panel also recommended screening adults at high-risk of infection, such as people who ever injected drugs or received a blood transfusion before 1992, when the U.S. began checking blood donations for the virus. The panel assigned a "B" grade to the recommendation, which means all copays and deductibles for the screenings will be waived under the Patient Protection and Affordable Care Act.
Great Boards newsletter looks at how to enhance committees    06/25/2013
The summer edition of AHA's Great Boards newsletter focuses on frequently asked questions about board committees and practices for enhancing committee effectiveness. Administered by AHA's Center for Healthcare Governance, the free quarterly newsletter examines hospital and health system governance trends and effective practices. To subscribe, click here. For additional tools and resources for hospital boards of trustees, visit www.greatboards.org.