If you follow health information technology and are interested in the future of health care take time and listen to this panel discussion on Innovation Opportunities for the Health Information Technology Market with Eric Schmidt, Chairman of Google, Aneesh Chopra, Federal CTO for the United States, Todd Park, CTO of HHS, and moderated by John Doerr, venture capitalist at Kleiner Perkins.
The panel discussion was part of the Annual J.P. Morgan Healthcare Conference held in January 2011.
To start off moderator, John Doerr has the audience rattle off a bunch of great questions for the panel to address. Just listening to the questions will make you want to listen to the panel discussion.
Thanks to Susannah Fox and Claudia Williams for tweeting the link. Thanks to Brian Ahier (@Ahier) for posting the Vimeo link to the panel discussion.
Sunday, June 12, 2011
Wednesday, June 08, 2011
OIG HEAT Provider Compliance Training Webcast
The Office of Inspector General (OIG) has made available the Health Care Fraud Prevention and Enforcement Team (HEAT) Provider Compliance Training webcast. OIG is making the training information available to help highlight and educate providers on the the federal government's effort to fight health care fraud and abuse.
More information about HEAT Task Force and its mission and efforts can be found on the StopMedicareFraud website. The training information includes 16 modules:
Welcome Remarks 4:37
Overview of OIG 9:56
Navigating the Fraud and Abuse Laws 26:26
Compliance Program Basics 17:01
Operating an Effective Compliance Program 15:59
Understanding Program Exclusions 10:26
Navigating the Government 5:10
Overview of Centers for Medicare and Medicaid Services 34:24
Importance of Documentation 17:06
OIG Subpoenas Audits Surveys and Self Disclosure Protocol 17:42
Health Care Fraud Enforcement Panel 6:08
Health Care Fraud Enforcement Panel with CMS Deputy Admin 13:43
Health Care Fraud Enforcement Panel with Special Agent 15:10
Health Care Fraud Enforcement Panel with Asst. US Attorney 17:08
Health Care Fraud Enforcement Panel - Fraud Control Unit 11:15
Adjournment 0:59
More information about HEAT Task Force and its mission and efforts can be found on the StopMedicareFraud website. The training information includes 16 modules:
Welcome Remarks 4:37
Overview of OIG 9:56
Navigating the Fraud and Abuse Laws 26:26
Compliance Program Basics 17:01
Operating an Effective Compliance Program 15:59
Understanding Program Exclusions 10:26
Navigating the Government 5:10
Overview of Centers for Medicare and Medicaid Services 34:24
Importance of Documentation 17:06
OIG Subpoenas Audits Surveys and Self Disclosure Protocol 17:42
Health Care Fraud Enforcement Panel 6:08
Health Care Fraud Enforcement Panel with CMS Deputy Admin 13:43
Health Care Fraud Enforcement Panel with Special Agent 15:10
Health Care Fraud Enforcement Panel with Asst. US Attorney 17:08
Health Care Fraud Enforcement Panel - Fraud Control Unit 11:15
Adjournment 0:59
Tuesday, May 31, 2011
HIPAA Privacy Rule Accounting of Disclosures under HITECH
Today's Federal Register includes the Office of Civil Rights (OCR) Notice of Proposed Rulemaking (NPRM) modifying the HIPAA Privacy Rule's Accounting of Disclosure requirements for protected health information. OCR was required to make these modifications to the HIPAA Privacy Rule to implement the requirements under the Health Information Technology for Economic and Clinical Health Act (HITECH) section of the ARRA.
The regulations outline new procedures for accounting of disclosures of health information held in an electronic health record and disclosed for treatment, payment, and health care operations (as defined under HIPAA). The accounting period under the proposed regulations is three years. The proposed regulations focus on two rights for individuals -- a right to an accounting of disclosure and a "new" right to an access report. The new access report does not distinguish between a use (think internal use by a health care provider) and disclosure (providing the information to a third party). Instead the new right to an access report focuses on whether someone "accessed" the information in the EHR.
Previously under HIPAA, uses and disclosures for treatment, payment, and health care operations (commonly referred to as "TPO") were exempt from the accounting of disclosures requirements. The requirement for accounting for some limited uses and disclosures has always been a part of the HIPAA Privacy Rule.
The rule proposes separate compliance dates for the changes to the accounting of disclosures requirements (180 days after the effective date of the final rule - 240 days after publication of the final rule) and for the right to receive an access report (beginning January 1, 2013, for any EHR system acquired after January 1, 2009 and January 1, 2014, for any EHR system acquired on or before January 1, 2009).
My initial comments above are based upon a quick review of the proposed regulations. Official comments on the NPRM must be submitted on or before August 1, 2011.
HIPAA Privacy Rule Accounting of Disclosures Under the Health Information Technology for Economic and Clinical Health Act, Office for Civil Rights, Notice of Proposed Rulemaking (76 FR 31426, May 31, 2011)The regulations greatly expand the responsibility for health care covered entities and business associates to document and track the use and disclosure of health information held in an electronic health record (EHR). Health care providers and business associates should plan to thoroughly review these new regulations to understand the impact on their existing policies and procedures.
The regulations outline new procedures for accounting of disclosures of health information held in an electronic health record and disclosed for treatment, payment, and health care operations (as defined under HIPAA). The accounting period under the proposed regulations is three years. The proposed regulations focus on two rights for individuals -- a right to an accounting of disclosure and a "new" right to an access report. The new access report does not distinguish between a use (think internal use by a health care provider) and disclosure (providing the information to a third party). Instead the new right to an access report focuses on whether someone "accessed" the information in the EHR.
Previously under HIPAA, uses and disclosures for treatment, payment, and health care operations (commonly referred to as "TPO") were exempt from the accounting of disclosures requirements. The requirement for accounting for some limited uses and disclosures has always been a part of the HIPAA Privacy Rule.
The rule proposes separate compliance dates for the changes to the accounting of disclosures requirements (180 days after the effective date of the final rule - 240 days after publication of the final rule) and for the right to receive an access report (beginning January 1, 2013, for any EHR system acquired after January 1, 2009 and January 1, 2014, for any EHR system acquired on or before January 1, 2009).
My initial comments above are based upon a quick review of the proposed regulations. Official comments on the NPRM must be submitted on or before August 1, 2011.
Tuesday, May 24, 2011
Practical Guidance on Medicare Physician Signature Requirements
I was recently researching the physician signature requirements under the Medicare program and found this resource outlining some of key questions and answers around the requirements.
The Centers for Medicare & Medicaid Services Medicare Learning Network has issued a fact sheet on Comprehensive Error Rate Testing (CERT) Signature Requirements with the Q and A. Also mentioned in the guidance as a resourceis the Medicare Learning Network's MLN Matters Article MM6698, "Signature Guidelines for Medical Review Purposes."
The Centers for Medicare & Medicaid Services Medicare Learning Network has issued a fact sheet on Comprehensive Error Rate Testing (CERT) Signature Requirements with the Q and A. Also mentioned in the guidance as a resourceis the Medicare Learning Network's MLN Matters Article MM6698, "Signature Guidelines for Medical Review Purposes."
Sunday, May 22, 2011
FSB Welcomes Tom Clark
Tom comes to FSB with over 10 years of experience in handling business organization and commercial transactions. Tom received his undergraduate degree from Virginia Tech in 1993 and his J.D. from the University of Pittsburgh in 1997.
Thursday, May 12, 2011
HITECH Final Regulations Update: Coming Soon!
Susan McAndrew, deputy director for health information privacy at the Office for Civil Rights (OCR) indicated this week that various final regulations modifying the HIPAA privacy and security rules required by the Health Information Technology for Economic and Clinical Health Act (HITECH) will be issued soon. Health lawyers have been waiting on these regulations to better understand the full impact of the HITECH changes to HIPAA, including whether the "harm standard" will remain a part of the Interim Final Rule on breach notification.
According to a Health Information Security News article, McAndrew made this announcement this week while speaking at the 2011 NIST HIPAA Conference, Safeguarding Health Information: Building Assurance through HIPAA Security, held in Washington.
The article also indicated that a separate NPRM will be issued announcing the approach OCR plans to take regarding the accounting for disclosure modifications under the HITECH Act. The HITECH Act modified the traditional rule regarding those types of uses and disclosures that must be accounted for by health care providers and covered entities. Under the traditional rule -- health care providers did not have to provide an accounting of disclosure for uses and disclosures for treatment, payment, and health care operations. However, the modification by the HITECH Act now requires health care providers who utilize an electronic health record system (EHR)to provide, upon request, an accounting of disclosure of all uses and disclosures including those for treatment, payment, and health care operations which occurred within the last three year period. Of further interest will be how the NPRM suggests how business associates who obtain PHI from health care providers must also track and maintain a list of uses and disclosures for accounting of disclosure requests.
According to a Health Information Security News article, McAndrew made this announcement this week while speaking at the 2011 NIST HIPAA Conference, Safeguarding Health Information: Building Assurance through HIPAA Security, held in Washington.
The article also indicated that a separate NPRM will be issued announcing the approach OCR plans to take regarding the accounting for disclosure modifications under the HITECH Act. The HITECH Act modified the traditional rule regarding those types of uses and disclosures that must be accounted for by health care providers and covered entities. Under the traditional rule -- health care providers did not have to provide an accounting of disclosure for uses and disclosures for treatment, payment, and health care operations. However, the modification by the HITECH Act now requires health care providers who utilize an electronic health record system (EHR)to provide, upon request, an accounting of disclosure of all uses and disclosures including those for treatment, payment, and health care operations which occurred within the last three year period. Of further interest will be how the NPRM suggests how business associates who obtain PHI from health care providers must also track and maintain a list of uses and disclosures for accounting of disclosure requests.
Tuesday, May 10, 2011
WVCLE: Health Care Law 2011 Seminar
The West Virginia Continuing Legal Education Section of WVU College of Law will be sponsoring Health Care Law 2011 Seminar on May 20, 2011, in Charleston, West Virginia at WVU Medical Center - CAMC.
The Health Care Law 2011 Seminar will cover a variety of topics of interest to West Virginia health care attorneys. Topics include: Medical Mapractice Update, Protecting Medicare's Interest Under Section 111 and Mandatory Reporting Requirments, Risk Management Topics for Hospitals, Development and Update on ACOs, HIPAA/HITECH Update and Anatomy of a Health Care Data Breach, Stark and Fraud Abuse Update, and Lawyers and Law Firms as Business Associates.
I will be speaking on the changes to HIPAA under HITECH. The title for my presentation is "Anatomy of a Breach: Practical Tools to Handle a Breach and HIPAA/HITECH Updates."
Learn more about the seminar and how to register here.
The Health Care Law 2011 Seminar will cover a variety of topics of interest to West Virginia health care attorneys. Topics include: Medical Mapractice Update, Protecting Medicare's Interest Under Section 111 and Mandatory Reporting Requirments, Risk Management Topics for Hospitals, Development and Update on ACOs, HIPAA/HITECH Update and Anatomy of a Health Care Data Breach, Stark and Fraud Abuse Update, and Lawyers and Law Firms as Business Associates.
I will be speaking on the changes to HIPAA under HITECH. The title for my presentation is "Anatomy of a Breach: Practical Tools to Handle a Breach and HIPAA/HITECH Updates."
Learn more about the seminar and how to register here.
Sunday, April 10, 2011
Leaves of 3 Let Them Be: Poison Ivy Advice from Dr. Coffield
Last week I was looking through some old printed emails and I ran across advice about poison ivy from my dad, LeMoyne Coffield. Since Spring is on the way and the poison ivy is starting to grow I thought I would share this with everyone (including some good advice for the golfers).
My dad was not only my dad but he was my (our) family doctor. He was a lot of peoples family doctor. He had a wonderful way of providing advice and recommendations to his patients. His medical advice wasn't always the easiest and quickest solution - but it was usually the best long term practical advice.
I wrote him an email back in the Spring of 2000. I had been cleaning up an area behind our house and had gotten a bad case of poison ivy on my arms, neck, and face. I started the email by saying, "Thought I would let you know that spring has arrived -- I got my first bout of poison ivy. Some lessons you taught me as a child (and adult) have never gotten through." As children he was always pointing out poison ivy, showing us what it looked like, and hoping that we would learn how to spot it from a distance. My email went on to say that I had gone to see my primary care doctor and he had prescribed an oral steroid (prednisone) and I said, "What do you think?" Like I often did - I was emailing him for his second opinion. Below is his advice back to me. Good advice for anyone who is starting their spring yard cleaning.
By the way - if you don't know what poison ivy looks like look at this and remember, "Leaves of 3 let them be."
My dad was not only my dad but he was my (our) family doctor. He was a lot of peoples family doctor. He had a wonderful way of providing advice and recommendations to his patients. His medical advice wasn't always the easiest and quickest solution - but it was usually the best long term practical advice.
I wrote him an email back in the Spring of 2000. I had been cleaning up an area behind our house and had gotten a bad case of poison ivy on my arms, neck, and face. I started the email by saying, "Thought I would let you know that spring has arrived -- I got my first bout of poison ivy. Some lessons you taught me as a child (and adult) have never gotten through." As children he was always pointing out poison ivy, showing us what it looked like, and hoping that we would learn how to spot it from a distance. My email went on to say that I had gone to see my primary care doctor and he had prescribed an oral steroid (prednisone) and I said, "What do you think?" Like I often did - I was emailing him for his second opinion. Below is his advice back to me. Good advice for anyone who is starting their spring yard cleaning.
By the way - if you don't know what poison ivy looks like look at this and remember, "Leaves of 3 let them be."
Thursday, March 17, 2011
OCR Seeks FY2012 Budget Increase of $5.6M for HIPAA Compliance and Enforcement
HealthLeaders reports that the Office of Civil Rights (OCR) is seeking an additional $5.6 million in its Fiscal Year 2012 budget proposal to fund its HIPAA compliance and enforcement activities.
The article also details the most current reported numbers on breaches reported to OCR. As of March 16 there have been 249 entities that have reported breaches affecting 500 or more individuals. To view the current data and details on reported breaches go to the OCR Breaches Affecting 500 or More Individuals.
The article also details the most current reported numbers on breaches reported to OCR. As of March 16 there have been 249 entities that have reported breaches affecting 500 or more individuals. To view the current data and details on reported breaches go to the OCR Breaches Affecting 500 or More Individuals.
Tuesday, February 22, 2011
OCR Imposes $4.3M Penalty for Violation of HIPAA/HITECH Privacy Rule
UNTIL TODAY, many health care providers questioned whether HHS and the Office of Civil Rights (OCR) would ever issue any significant penalties for violations of the HIPAA Privacy Rule. However, will OCR ever be able to collect the penalties.
Today, HHS Office of Civil Rights (OCR) announced a civil money penalty (CMP) of $4.3 million against Cignet Health of Prince George's County, MD for violating the HIPAA Privacy Rule. This is the first ever civil money penalty issued by OCR for a violation of the HIPAA Privacy Rule. It is significant not only because it is the first - but also because of the size of the penalty and the basis for the violation.
OCR issued a Notice of Final Determination on February 4, 2011, outlining the procedure for payment of the $4.3 million civil money penalty. The Notice of Final Determination also indicates that Cignet failed to request a hearing on the matter or reach settlement with OCR. Prior to the issuance of the final notice, OCR had issued a Notice of Proposed Determination on October 20, 2010, which details the basis for the penalty, details the findings of fact, grounds for violation of HIPAA, and calculation of the penalty amount.
The Notice of Proposed Determination indicates that Cignet violated HIPAA by failing to provide individuals access to their health information under 45 CFR 164.524 and failed to cooperate with an investigation under 45 CFR 160.310(b). The Notice states:
Read the HHS Press Release and OCR Press Release. More details via the OCR's Resolution Agreement page. For more background on Cignet Health check out David Harlow's post at HealthBlawg, HIPAA CMP's: What's the point?
Today, HHS Office of Civil Rights (OCR) announced a civil money penalty (CMP) of $4.3 million against Cignet Health of Prince George's County, MD for violating the HIPAA Privacy Rule. This is the first ever civil money penalty issued by OCR for a violation of the HIPAA Privacy Rule. It is significant not only because it is the first - but also because of the size of the penalty and the basis for the violation.
OCR issued a Notice of Final Determination on February 4, 2011, outlining the procedure for payment of the $4.3 million civil money penalty. The Notice of Final Determination also indicates that Cignet failed to request a hearing on the matter or reach settlement with OCR. Prior to the issuance of the final notice, OCR had issued a Notice of Proposed Determination on October 20, 2010, which details the basis for the penalty, details the findings of fact, grounds for violation of HIPAA, and calculation of the penalty amount.
The Notice of Proposed Determination indicates that Cignet violated HIPAA by failing to provide individuals access to their health information under 45 CFR 164.524 and failed to cooperate with an investigation under 45 CFR 160.310(b). The Notice states:
1. Failure to Provide Access (45 C.F.R. § 164.524). Cignet failed to provide 41 individuals listed in Attachment A timely access to obtain a copy of the protected health information about them in the designated record sets (medical records) maintained by Cignet. These failures constitute violations of 45 C.F.R. § 164.524. Cignet's failure to provide each individual with access constitutes a separate violation of 45 C.F.R. § 164.524, and each day that the violation continued (that is, from the date specified in column 5 of Attachment A until April 7,2010) counts as a separate violation of 45 C.F.R. § 164.524.The press release issued by HHS points out that the HIPAA Privacy Rule requires that health care providers must provide a patient with access and/or copy of their health information within 30 days (and no later than 60) days after the patient requests such information. Further, the press release indicates that covered entities and business associates must uphold their responsibility to provide patients with access to their own health information.
2. Failure to Cooperate with an Investigation (45 C.F.R. § I60.310(b)). Cignet failed to cooperate with OCR's investigation of 27 complaints regarding Cignet's noncompliance described in paragraph 1 above. These failures to cooperate with an investigation constitute violations of 45 C.F.R. § 160.310(b). Cignet's failure to cooperate with OCR's investigation of each complaint constitutes a separate violation of 45 C.F.R. § 160.310(b), and each day that the violation continued (that is, from the date specified in column 7 of Attachment A until April 7, 2010) counts as a separate violation of 45 C.F.R. § 160.310(b). Each violation of 45 C.F.R. § 160.310(b) was due to Cignet's willful neglect of its obligation to comply with 45 C.F.R. § 160.310(b). Willful neglect means the conscious, intentional failure or reckless indifference to the obligation to comply with the administrative simplification provision violated. See 45 C.F.R. § 160.401.
Read the HHS Press Release and OCR Press Release. More details via the OCR's Resolution Agreement page. For more background on Cignet Health check out David Harlow's post at HealthBlawg, HIPAA CMP's: What's the point?
Monday, January 31, 2011
WVDHHR Transfers OHFLAC Staff and Operations to OIG
According to the West Virginia Department of Health and Human Resources (DHHR), the West Virginia Office of Health Facility Licensure and Certification (OHFLAC) will be transferred to the West Virginia Office of Inspector General (OIG) effective February 1, 2010. OHFLAC oversees the state and federal licensure and certification process in West Virginia for hospitals, critical access hospitals, behavioral health facilities, home health agencies, hospice agencies, ESRD services, and other health care services.
All personnel and positions currently assigned to OHFLAC will be administratively transferred. DHHR has states that this action is to further enhance the integrity of the regulatory unit of the Department of Health and Human Resources.
All personnel and positions currently assigned to OHFLAC will be administratively transferred. DHHR has states that this action is to further enhance the integrity of the regulatory unit of the Department of Health and Human Resources.
Friday, December 17, 2010
Body Browser: Think Google Earth for the Human Body!
Body Browser is described as a 3-dimensional multi-layered anatomical model of the human body that you can rotate, zoom in on, and search. More information about Body Browser is available in Google Labs.
Great to see Google developing this new tool that should be useful for educators, physicians, and others in the health care field. I can't wait to show this new tool to my kids.
Thanks to Brian Klepper over at Care and Cost for blogging about this new Google health tool.
Very cool!
Sunday, December 12, 2010
West Virginia Connect
Today's Charleston Gazette features an article on a new health care demonstration project, West Virginia Connect, funded by a $36 million federal Health Resources and Services Administration (HRSA) grant.
The article indicates that the funding will be for eight West Virginia primary care clinics to provide preventative care services to eligible health consumers for a flat $35 per month. The services will include unlimited doctor visits, immunizations and screenings, chronic disease management, and minor surgical procedures.
To be eligible to particpate a person must have a job, be between 19 and 64, and make less than $43,320 for a single person or $88,200 for a family of four. In return, participants have to let the state fold their medical data - blood pressure, blood sugar, etc. - into an anonymous 10,000-person database the state plans to use to make more informed choices as health-care reform unfolds.
The article indicates that the primary care centers involved say the project is intended to:
This is the first I have heard about this demonstration project. Other than this Grantee Project Abstract at HRSA website, I was unable to find any additional information or links about the demonstration project online. The article indicates that the project is currently governed by a steering committee of the DHHR secretary, insurance commissioner, and director of the GO HELP office.
The article indicates that the funding will be for eight West Virginia primary care clinics to provide preventative care services to eligible health consumers for a flat $35 per month. The services will include unlimited doctor visits, immunizations and screenings, chronic disease management, and minor surgical procedures.
To be eligible to particpate a person must have a job, be between 19 and 64, and make less than $43,320 for a single person or $88,200 for a family of four. In return, participants have to let the state fold their medical data - blood pressure, blood sugar, etc. - into an anonymous 10,000-person database the state plans to use to make more informed choices as health-care reform unfolds.
The article indicates that the primary care centers involved say the project is intended to:
- generate useful information about uninsured West Virginians and cost-effective ways to treat chronic diseases;
- demonstrate lowered emergency room usage, hospital stays, and times when people don't show up for appointments;
- develop an electronic patient tracking system other centers can use;create a catalogue of best practices that help people take better care of their own health;
- help the health system get ready for 2014, when hundreds of thousands will be newly insured through federal reform.
Sunday, December 05, 2010
West Virginia PEIA: Innovative Steps to Improve Long Term Health of West Virginia
This past week the West Virginia Public Employees Insurance Agency (PEIA) announced a creative and proactive health initiative to improve the health of West Virginians and move toward keeping future health care costs down for state and public school employees and ultimately for West Virginia taxpayer. Charleston Gazette's Phil Kabler reports on the initiative in "PEIA insurees can offset premiums increase."
The Improve Your Score initiative is a part of PEIA's Pathways to Wellness. PEIA announced that state and public school employees will have no health care premium increase this year if they comply with two requirements.The two requirements:
The Improve Your Score initiative is a part of PEIA's Pathways to Wellness. PEIA announced that state and public school employees will have no health care premium increase this year if they comply with two requirements.The two requirements:
- Undergo a four-step wellness screening to measure waist circumference, total cholesterol, blood pressure, and blood glucose. Completion of the screening provides a $10-a-month premium discount.
- Submit an affidavit verifying they have filed an advanced directive for end-of-life care, sometimes called a "living will." That provides an additional $4-a-month discount.
Thursday, December 02, 2010
WVHIN: Public Comment Period on Proposed Privacy and Security Policies
The West Virginia Health Information Network (WVHIN), West Virginia's health information exchange, has issued proposed privacy and security policies and is seeking public comments on the proposed policies from December 3, 2010 through January 3, 2011. The WVHIN is a public/private partnership created in 2006 under W.Va. Code 16-29G-1 et seq. and is charged with building a secure electronic health information system for the exchange of patient data among physicians, hospitals, diagnostic laboratories, other care providers, and other stakeholders.
The proposed privacy and security policies that are available for review and comment are as follows:
The proposed privacy and security policies that are available for review and comment are as follows:
- Patient Consent - General
- Patient Consent - Permissible Purpose
- Patient Consent - Sensitive Health Information
- User Authorization
- User Authentication
- Patient Amendment of Protected Health Information
- Patient Access to Protected Health Information
- Minimum Necessary
- Breach Notification
“WVHIN has been developing our core privacy and security policies that will guide us in our initial health information exchange implementation and pilot for 2011. We expect to have changes to the policies as a result of learning how to improve our operations through testing in the pilot period.“Written comments on the proposed privacy and security policies may be submitted to Samantha Stamper, Business Development Manager by January 3, 2011 at sstamper@wvhin.org.
“The policies have been developed over the past few months by the WVHIN Privacy and Security Committee and legal counsel, and are based upon an established WVHIN Privacy Framework and national best practices recommendations in Health Information Exchange (HIE). The committee is made up of stakeholder organizations including provider groups, state government, and consumer groups. The committee followed a cycle of reviewing and vetting the policies that have resulted in our drafts.”
“We have established a public comment period for the draft policies and would like to invite any member of the public to comments on these policies. Thus, we would like to request your assistance in forwarding this e-mail to any parties you may feel would like to comment on the policies. We welcome all feedback”, according to Business Development Manager Samantha Stamper.
Thursday, November 25, 2010
Thanksgiving 2010: Will You Engage With Grace?
Will You Engage with Grace this Thanksgiving weekend? I hope so.
For the third year running I am participating in the Thanksgiving holiday Engage with Grace Blog Rally. A viral effort to communicate the importance of having a conversation with your family and loved ones around end of life care wishes. Would you prefer to die in a hospital, or at home? Can your family correctly describe how you would want to be treated in the case of a terminal illness or sudden traumatic accident? Does your family know where you keep your living will and advanced directive?
At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. They’re not easy questions, but they are important. The key is having the conversation before it’s too late. Throughout the year I continue to promote the Engage with Grace effort (and so can you) by using the One Slide (see the slide below) at the end of my power point presentations.
So in the spirit of the upcoming Thanksgiving weekend, take time after your dinner, turn off the TV, and take time with your family and friends to engage in the Engage with Grace conversation.
Thanks to Alexandra Drane, Paul Levy, and many other health care bloggers and professionals for continuing to inspire and share the Engage with Grace message. Learn more about Engage with Grace and the One Slide Project at http://www.engagewithgrace.org.
Some other resources you may want to read and explore:
For the third year running I am participating in the Thanksgiving holiday Engage with Grace Blog Rally. A viral effort to communicate the importance of having a conversation with your family and loved ones around end of life care wishes. Would you prefer to die in a hospital, or at home? Can your family correctly describe how you would want to be treated in the case of a terminal illness or sudden traumatic accident? Does your family know where you keep your living will and advanced directive?
At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. They’re not easy questions, but they are important. The key is having the conversation before it’s too late. Throughout the year I continue to promote the Engage with Grace effort (and so can you) by using the One Slide (see the slide below) at the end of my power point presentations.
So in the spirit of the upcoming Thanksgiving weekend, take time after your dinner, turn off the TV, and take time with your family and friends to engage in the Engage with Grace conversation.
Thanks to Alexandra Drane, Paul Levy, and many other health care bloggers and professionals for continuing to inspire and share the Engage with Grace message. Learn more about Engage with Grace and the One Slide Project at http://www.engagewithgrace.org.
Some other resources you may want to read and explore:
- Atul Gawande's thought provoking piece in the New Yorker, Letting Go: What should medicine do when it can't save your life?
- Alexandra Drane sharing the concept behind Engage with Grace at this year's TEDMED event. Read the full text of her presentation.
- CNN article, At Thanksgiving, the hardest conversation which features a video interview with Alexandra Drane and good advice from Jeffrey Asher, an elder-care attorney with Eaton & Van Winkle LLP in New York on how to get the end of life care conversation started.
- My 2008 Engage with Grace Blog post where I shared how Alexandra Drane's talk at the 2008 Health 2.0 Conference personally touched me because of my experience as a young 12 year old boy who lost his mother to cancer who was allowed to die at home surrounded by her husband and family.
- For my West Virginia readers who want to learn more about end of life care. Check out the resources provided by the West Virginia Center for End of Life Care. There is also valuable information for health care professionals. You can find forms for the standard West Virginia Living Will and Medical Power of Attorney. The site also includes information, FAQs, list of West Virginia palliative/hospice providers and other resources.
Tuesday, November 09, 2010
AMA Issues New Policy To Guide Physicians’ Use of Social Media
Today the American Medical Association announced that it has adopted and issued a new policy offering guidance to physicians on the use of social media. The new policy focuses on helping physicians to "maintain a positive online presence and preserve the integrity of the patient-physician relationship."
The press release indicates that the policy encourages physicians to:
The press release indicates that the policy encourages physicians to:
- Use privacy settings to safeguard personal information and content to the fullest extent possible on social networking sites.
- Routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and content posted about them by others, is accurate and appropriate.
- Maintain appropriate boundaries of the patient-physician relationship when interacting with patients online and ensure patient privacy and confidentiality is maintained.
- Consider separating personal and professional content online.
- Recognize that actions online and content posted can negatively affect their reputations among patients and colleagues, and may even have consequences for their medical careers.
AMA POLICY: PROFESSIONALISM IN THE USE OF SOCIAL MEDIA
The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:
(a) Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.
(b) When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate.
(c) If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context.
(d) To maintain appropriate professional boundaries physicians should consider separating personal and professional content online.
(e) When physicians see content posted by colleagues that appears unprofessional they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.
(f) Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.
NLRB: Employees Protected Concerted Activity Extends to Faceboook and Social Media
Out of Connecticut comes an interesting case involving the use of social media in the workplace and its collision with employee protected concerted activity and employee freedom to associate without fear of employer retaliation under the National Labor Relations Act. The New York Times article, Company Accused of Firing Over Facebook Post, provides good background and details of the facts involved in the case.
American Medical Response of Connecticut, Inc. and International Brotherhood of Teamsters, Local 443, Case No. 34-CA-12576 (NRLB - Region 34), involves a complaint filed against American Medical Response for firing an emergency medical technician for among other things violating the company's policy of negatively depicting the company on Facebook or other social media sites. American Medical Response had denied the labor board's allegations and claims that the employee was discharged on various other grounds. The complaint contains the full language of the employer social media policies involved in the matter.
For those unfamiliar with the National Labor Relations Act, "protected concerted activity" is an employee right under the National Labor Relations Act that protects employees from employer retaliation for discussing working conditions. The National Labor Relations Act provides employees the right to associate together to improve working conditions, self organize, assist labor organizations and bargain collectively. The Act applies to activities by union and non-union employees.
This will be a fascinating case to watch to see how the new world of social media communication, connection, and association will be applied in the context of existing employee rights under the National Labor Relations Act. Similar protections may also be provided to employees who report issues to the Occupational Safety and Health Administration.
Employers who have implemented social media policies that restrict the rights of employees to utilize social media tools and website should review their policies to assess whether or not the policy unnecessarily restricts the rights of employees to associate and discuss their rights to discuss union related issues, wages, working conditions, and other rights protected by the Act.
American Medical Response of Connecticut, Inc. and International Brotherhood of Teamsters, Local 443, Case No. 34-CA-12576 (NRLB - Region 34), involves a complaint filed against American Medical Response for firing an emergency medical technician for among other things violating the company's policy of negatively depicting the company on Facebook or other social media sites. American Medical Response had denied the labor board's allegations and claims that the employee was discharged on various other grounds. The complaint contains the full language of the employer social media policies involved in the matter.
For those unfamiliar with the National Labor Relations Act, "protected concerted activity" is an employee right under the National Labor Relations Act that protects employees from employer retaliation for discussing working conditions. The National Labor Relations Act provides employees the right to associate together to improve working conditions, self organize, assist labor organizations and bargain collectively. The Act applies to activities by union and non-union employees.
This will be a fascinating case to watch to see how the new world of social media communication, connection, and association will be applied in the context of existing employee rights under the National Labor Relations Act. Similar protections may also be provided to employees who report issues to the Occupational Safety and Health Administration.
Employers who have implemented social media policies that restrict the rights of employees to utilize social media tools and website should review their policies to assess whether or not the policy unnecessarily restricts the rights of employees to associate and discuss their rights to discuss union related issues, wages, working conditions, and other rights protected by the Act.
Friday, November 05, 2010
OIG Issues Roadmap on Avoiding Medicare and Medicaid Fraud and Abuse for New Physicians
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) has issued a resource and educational guide for new physicians to help them better understand the key Federal fraud and abuse laws.
As a health care attorney who often deals with physicians on fraud and abuse related matters, I applaud the OIG's effort to provide educational information to help raise the level of understanding on these issues and increase the transparency of these federal laws. This guide won't just be useful for "new" physician but for all physicians to gain a better understanding of the very complex legal/regulatory structure of fraud and abuse laws in the United States.
The new OIG document is titled, "Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse." The physician education roadmap document summarized the five main Federal fraud and abuse laws, including the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law. The roadmap document provides tips to physicians on how they should comply with these laws in their relationships with payers (like the Medicare and Medicaid programs), relationships with vendors (like drug, biologic, and medical device companies), and relationships with fellow providers (like hospitals, nursing homes, and physician colleagues).
The roadmap guide was developed as a result of a survey conducted by OIG of medical school deans and designated institutional officials at institutions that sponsor residencies and fellowships to learn what types of instruction medical students, residents, and fellows receive on Medicare and Medicaid fraud, waste, and abuse. Nearly all respondents (92% of deans and 90% of designated institutional officials) reported they would like OIG to provide educational materials they can use. The complete survey, "Medicare and Medicaid Fraud and Abuse Training in Medical Education," was recently issued in October, 2010.
You can view online or download a PDF version of the roadmap guidance materials. I plan to include a copy of this as a part of my hand out materials when I talk to physicians and other health care providers on fraud and abuse issues.
As a health care attorney who often deals with physicians on fraud and abuse related matters, I applaud the OIG's effort to provide educational information to help raise the level of understanding on these issues and increase the transparency of these federal laws. This guide won't just be useful for "new" physician but for all physicians to gain a better understanding of the very complex legal/regulatory structure of fraud and abuse laws in the United States.
The new OIG document is titled, "Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse." The physician education roadmap document summarized the five main Federal fraud and abuse laws, including the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law. The roadmap document provides tips to physicians on how they should comply with these laws in their relationships with payers (like the Medicare and Medicaid programs), relationships with vendors (like drug, biologic, and medical device companies), and relationships with fellow providers (like hospitals, nursing homes, and physician colleagues).
The roadmap guide was developed as a result of a survey conducted by OIG of medical school deans and designated institutional officials at institutions that sponsor residencies and fellowships to learn what types of instruction medical students, residents, and fellows receive on Medicare and Medicaid fraud, waste, and abuse. Nearly all respondents (92% of deans and 90% of designated institutional officials) reported they would like OIG to provide educational materials they can use. The complete survey, "Medicare and Medicaid Fraud and Abuse Training in Medical Education," was recently issued in October, 2010.
You can view online or download a PDF version of the roadmap guidance materials. I plan to include a copy of this as a part of my hand out materials when I talk to physicians and other health care providers on fraud and abuse issues.
Thursday, October 21, 2010
WV Medicaid Offering Cash Incentive Program to New ePrescribers
The West Virginia Regional Health Information Technology Extension Center (WVRHITEC) announced this week that West Virginia's Medicaid Program is now offering cash incentives to health care providers who become a part of a new e-prescribing system.
WVeScript, is a new web-based ePrescribing tool implemented by the West Virginia Bureau for Medical Services (BMS) and provided to all Medicaid program prescribers and pharmacies. It is located on the BMS MediWeb Clinical Web Portal. This tool can be used to ePrescribe for all patients, not just those with Medicaid insurance. FAQs with more information about the WVeScript and MediWeb Clinical Web Portal.
The announcement by WVRHITEC also indicates that as an added incentive, West Virginia Medicaid will provide cash assistance in the amount of $1,000.00 for the purchase of a computer or to pay toward web access when a provider enrolls in the ePrescribing program at www.WVeScript.com. At the end of March 31, 2011, if a provider has electronically prescribed at least 70% of his or her prescriptions for Medicaid members, she or he will receive an additional $1,000.00. In addition, training is available, and a provider can earn two CME credits for completing the on-line web-based training. The incentives are available to a limited number of providers, so please sign up today.
WVeScript, is a new web-based ePrescribing tool implemented by the West Virginia Bureau for Medical Services (BMS) and provided to all Medicaid program prescribers and pharmacies. It is located on the BMS MediWeb Clinical Web Portal. This tool can be used to ePrescribe for all patients, not just those with Medicaid insurance. FAQs with more information about the WVeScript and MediWeb Clinical Web Portal.
The announcement by WVRHITEC also indicates that as an added incentive, West Virginia Medicaid will provide cash assistance in the amount of $1,000.00 for the purchase of a computer or to pay toward web access when a provider enrolls in the ePrescribing program at www.WVeScript.com. At the end of March 31, 2011, if a provider has electronically prescribed at least 70% of his or her prescriptions for Medicaid members, she or he will receive an additional $1,000.00. In addition, training is available, and a provider can earn two CME credits for completing the on-line web-based training. The incentives are available to a limited number of providers, so please sign up today.
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