MedPAC urged to carefully weigh impact of expanding site neutral payment policy   10/04/2012
AHA today urged the Medicare Payment Advisory Commission to carefully consider the potential unintended consequences before expanding its "site neutral" payment policy for non-emergency evaluation and management services to other hospital outpatient services. "The AHA is extremely concerned that MedPAC is considering broadening the application of its 'site neutral' payment policy to other hospital outpatient services before we have had a chance to understand the impact of the Commission's previous recommendation to cut payments for 10 E&M services by $1 billion annually," Roslyne Schulman, AHA director of policy development, told the panel at its meeting today. "This proposal could result in beneficiary access problems and a reduced level of services for the public overall. Now MedPAC is talking about recommending even more cuts. These are deep cuts to routine outpatient services that are integral to the service mission of hospitals." The panel is expected to consider draft recommendations on the proposal next month.
AHA responds to New York Times editorial   10/04/2012
In a letter today to the New York Times, AHA President and CEO Rich Umbdenstock said America's hospitals strongly agree with the newspaper's call for the government to establish national guidelines on how to bill properly for services, and has repeatedly made the same request. "It's critically important to recognize that more accurate electronic documentation and coding do not necessarily equate with fraud," the letter adds, noting that government payment rules are highly complex. "No one questions the need to identify billing mistakes; but the flood of new auditors is deluging hospitals with redundant audits, unmanageable medical record requests and inappropriate payment denials. A recent American Hospital Association survey found that denials were appealed at a 75% success rate. What's needed is clearer guidance, not additional audits that divert resources from patient care." The newspaper recently alleged that electronic health records may be used by some hospitals and physicians to increase their Medicare reimbursements through "upcoding" and the "cloning" of records. The AHA has proposed a framework for national guidelines for reporting hospital emergency department or clinic visits on 11 occasions since 2001.
CMS selects contractors to support IPF, cancer quality programs   10/04/2012
The Centers for Medicare & Medicaid Services has contracted with Telligen to provide national outreach and education support to inpatient psychiatric facilities participating in the new IPF quality reporting program, the agency announced today. In addition, CMS announced contracts with Telligen and the American College of Surgeons to support hospitals participating in the new quality reporting program for cancer hospitals that are exempt from the prospective payment system. For the cancer program, Telligen will help the hospitals report data to the National Healthcare Safety Network and comply with QualityNet administrative requirements, while the College will help the hospitals collect data for three ACoS quality measures. Under the final inpatient prospective payment system rule for fiscal year 2013, IPFs must collect certain quality data for relevant patients admitted on or after Oct. 1, 2012 to avoid a payment penalty of 2 percentage points in FY 2014. The rule also requires PPS-exempt cancer hospitals to collect data on two infection measures and three cancer-specific measures beginning Jan. 1, 2013, but leaves the potential payment consequences of not participating to a future rulemaking.
Hospitals reminded to complete RACTrac survey   10/04/2012
The AHA encourages all hospitals to submit data to its quarterly RACTrac survey by Oct. 15. The free web-based survey helps AHA gauge the impact of Medicare's Recovery Audit Contractor program on hospitals and advocate for needed changes. To register for the survey or for technical assistance, participants should contact RACTrac support at (888) 722-8712 or For more on the survey, including the latest results, visit
Kaiser Permanente exec to retire in December 2013   10/04/2012
Kaiser Permanente Chairman and CEO George Halvorson will retire at the end of next year after leading the organization since 2002. He previously served nearly 18 years as president and CEO of HealthPartners in Minneapolis, and has held senior management positions with Blue Cross and Blue Shield of Minnesota and Health Accord International. "After leaving Kaiser Permanente, a major focus for me will be issues of diversity and intergroup interactions," Halvorson said. "We have done some very good things at Kaiser Permanente relative to diversity, and I am looking forward to helping people take advantage of the opportunities presented by diversity." AHA President and CEO Rich Umbdenstock commented, "George is a visionary leader who has contributed greatly to both Kaiser Permanente and the nation's efforts to improve health and health care. He has led Kaiser in its vision to deliver care that promotes health, high quality, and is patient centered."