Monday, February 28, 2005

West Virginia Hospital Association Poll on HIPAA

Today I noticed a HIPAA related poll question being conducted by the West Virginia Hospital Association. The results to date suprised me.

The poll asks the question:
If you thought a person, agency or organization covered under the HIPAA Privacy Rule violated your health information rights, would you know how to file a complaint?

As of the time I took the poll only 12 people had responded. Suprisingly more people answered no (66.7%) than yes (33.3%). I suspect that most people typically accessing the WVHA website are in some fashion involved with or knowledgeable about the health care field. As such, I would have believed that they had a higher degree of understanding of the laws related to privacy under HIPAA and how to file a written complaint with the Office for Civl Rights under the U.S. Department of Health and Human Services.

For those who want to learn more about the process for filing a complaint you can access a a Fact Sheet issued by the Office for Civil Rights. You can also access the complaint form and file it by mail, fax or via email. You can also access more information pertaining to the medical privacy rule under the Health Insurance Portability Act of 1996 (HIPAA) at the medical privacy section of the Office for Civil Rights website.

RSS/XML and Atom Feed

I finally got around to adding an RSS/XML and Atom feed to my blog. See the orange XML
button in the right hand column below the Archives section.

I am relatively new to the use of news aggregators or readers and wasn't aware that this feature wasn't built into the Blogger blog template. Basically a news aggregator is a piece of software or a remotely hosted service that periodically reads a set of news sources, in one of several XML-based formats (primarily RSS), finds the new bits, and displays them in reverse-chronological order on a single page. By using a news aggregator the information you want to see and any updated information is "pushed" to you rather than requiring you to go to each and every website to see if there is any updated information. Everywhere on the web where you see the little orange XML
block means that you can add that particular website to your news aggregator.

Here is a good explanation of the difference between blogs and RSS from Bob Stepno's Other Journalism Weblog.

Here is a post from Dennis Kennedy's blog on RSS Reader Reviews and his recommendation to try the new FeedDemon aggregator.

Here is an additional article discussing RSS called "RSS: Your Gateway To News & Blog Content" by Danny Sullivan, Editor.

If you use My Yahoo you can also add my blog to by clicking on the "add to My Yahoo" button.

Governor Manchin Proposes Insurance Reform with Promise of Saving West Virginia's $100 Per Vehicle

On Friday Governor Manchin proposed legislation insurance reform, including eliminating "bad faith" litigation and joint and several liability, in return for the insurance industry agreeing to reduce insurance costs for all West Virginians.

The Governor's press release urged West Virginians to support his efforts on civil justice and insurance reform legislative proposal.

The press release stated:

CHARLESTON, W.Va. - Gov. Joe Manchin today urged West Virginians to support
civil justice and insurance reform legislative proposals that could immediately save drivers throughout West Virginia up to $100 per vehicle in premium savings.

“This proposal is not directed at any one specific segment of society – it is for the benefit of each and every West Virginian,” the governor said. “Whether rich or poor, young or old, working or unemployed, a student or a teacher, all West Virginians have at least one thing in common: under the reforms we are proposing, their insurance and the insurance of their family and friends will be reduced by up to $100 per car.”

The reforms, which the Governor presented to members of the legislature during a joint briefing Thursday, could provide an immediate cost savings to West Virginians of more than $50 million. “West Virginians are having to make so many difficult choices every day. We have the power to ease their burdens, and we will,” the governor said. “We are determined to give all of the citizens of West Virginia some relief. The people of West Virginia deserve some relief and I am confident our proposal will provide that relief.”

“The bottom line is these reforms will immediately put money in the pockets of our state’s hard working families,” the governor added.

To obtain more detailed information on the type of reform proposed check out Governor Manchin's 2005 legislative agenda detailing the proposed insurance reform for third party bad faith and joint and several liability reform. The West Virginia Chamber of Commerce published two interesting maps regarding states with/without third party bad faith and joint and several liability reform.

Thursday, February 10, 2005

Governor Manchin Announces During State of State His Committment to "West Virginia on the Move" Initiative

Governor Joe Manchin gave his state of the state address to the West Virginia Legislature on Wednesday night. During the state of the state Governor Manchin made a commitment to join the West Virginia Leaders on the Move initiative sponsored by the West Virginia on the Move project.

I have had the opportunity to be involved in the West Virginia on the Move project and think it is a great grassroots effort to increase healthly lifestyle changes in West Virginia. For more information on how to become involved in the project check out the West Virginia on the Move website.

Below is an excerpt from the written text of Governor Manchin's state of the state address where Governor Manchin announced his and his staff's committment to participate in the West Virginia on the Move initiative.

". . .The third promise: Every child should have a healthy start. Just like children must be taught to read in order to be successful, they must also be taught the skills that will help them stay healthy throughout their entire life. That is why I am proposing a three part Healthy Start Initiative that will give our children the skills they need to fight the growing epidemics of childhood obesity, Type II diabetes and heart disease.

And, to show my commitment to promoting a healthy lifestyle for our children, the Governor’s office has accepted a challenge by the House and Senate to participate in the West Virginia Leaders On The Move initiative. During the legislative session, my staff and I will wear pedometers and track our steps daily. The steps will then be averaged out and, as I understand it, a trophy will be awarded to the office that has walked the most at the conclusion of the session. We’re happy to be able to participate in this worthwhile project, and for the record, we plan on winning. . ."

Governor Manchin's State of State Mentions WV Electronic Health Record Initiative

Governor Joe Manchin gave his state of the state address to the West Virginia Legislature on Wednesday night. During the state of the state Governor Manchin highlighted the need for West Virginia to lead the way in the creation of a modern electronic health information system.

I was excited to see Governor Manchin announce this initiative and believe that our state could greately benefit by such an initiative and position itself at the forefront of the conversion of health information from paper to electronic.

Due to the size of the state, our health status (or the lack thereof) and the large portion of the public insured through goverrnmental payors (Medicare, Medicaid, PEIA, etc.) I think our state's citizens and health care providers would greatly benefit by a comprehensive and coordinated electronic health record initiative. We could certainly become a testing ground and model state for such a federal/state pilot project. These efforts would certainly complement West Virginia's growing biometric industry. Due to the evolution and sophistication of the medical and health fields, the rise of specialties upon specialties, the mobility of the public and the disjointed nature that the health care industry maintains health information we have lost a continuity of health information. Without continuity and organization of all of the information -- the usefulness of the information is lost. What I call the "country doctor" effect has been lost. In more simplier times, health information in West Virginia was locally stored at your family's physician office and your physician not only knew your medical history but also the history of your family, your parents, grandparents, etc. He or she was the one that delivered you, treated you as an adolescent, treated your children and grandchildren. If developed correctly I think an integrated health information system could bring much of this inforamtion back to the health care professionals who can then use this information not only to provide better treatment to you but also to treat others with similar symptoms, diagnosis, etc.

In addition, Governor Manchin introduced Dr. David Brailer, the National Coordinator of Health and Information Technology, and his mother Grace Brailer, who is a member of the board of directors at Preston Memorial Hospital. Although I have read numerous article and heard Dr. Brailer speak at some national health information conferences, I was not aware that he was a West Virginia native. Dr. Brailer grew up in Kingwood, West Virginia where his mother still lives and graduated from West Virginia University. If you want to find out more about the national Health IT Strategic Framework you may want to review the "The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care." Here is an exective summary of the framework.

Below is an excerpt from the written text of Governor Manchin's state of the state address where Governor Manchin announced his administration's goal thatWest Virginia become a model state and lead the way in the creation of a more integrated health information system.

". . . We also need to begin the process of modernizing West Virginia’s health care system and use the technology that already exists within our high tech consortium and biometrics industry to put critical health care information in the hands of doctors and caregivers at the time they need it most — when care is delivered. Why is it so easy to access our bank accounts using ATMs worldwide but we have trouble moving medical records from one health care provider to another?

Last year, the federal government laid out a plan to ensure that most Americans have personal electronic health records within 10 years. To help do this, they appointed a National Coordinator for Health and Information Technology, Dr. David Brailer. We are honored to have Dr. Brailer and his mother Grace with us tonight.

I believe that West Virginia can serve as a model for health records partnerships that will pave the way for other states. We will lead the nation in making health care information more readily available to consumers so that they can make not only informed choices about their doctors and treatment options but also become more involved and responsible in their own care.
Dr. Brailer, thank you for being here tonight. We look forward to working with you. By the way, did I mention that Dr. Brailer is a native West Virginian and a graduate of WVU and his mom still lives in Kingwood? We should all be very proud. . ."

To read the full text of Governor Manchin's state of the state address you can find it at the Charleston Gazette in two parts: part one and part two. The Charleston Gazette also published an article in its online edition highlighting Governor Manchin's state of the state address. If you want to hear the state of the state you can listen to the webcast.

Friday, February 04, 2005

New OIG Advisory Opinion: Hospital Sharing Percentage Cost Savings from Changes in the OR with Cardiac Surgery Group

Today the Office of Inspector General (OIG) posted Advisory Opinion 05-01 concerning a hospital's proposal to share with a cardiac surgery group a percentage of the hospital's cost savings arising from the cardic surgery group's implementation of varous cost reducting measures to its operating room practices aimed at curbing inappropriate use and waste of medical supplies. The cost savings were to be measured based on the surgeons' use of specific supplies during designated cardiac surgery procedures.

CMS Issues Transmittal 98 dealing with "Psychotherapy Notes" under HIPAA

On January 21, 2005, CMS released Transmittal 98 of the Program Integrity Manual, entitled "Psychotherapy Notes." CMS issued these instructions, which affect Community Mental Health Centers, Hospitals and Physicians, in order to remain consistent with the Privacy Rule in 45 CFR §164.501. The new policy instructs contractors not to request that a provider submit psychotherapy notes. It also states that physically integrating information excluded from the definition of psychotherapy notes and protected information into one document or record does not transform the non-protected information into protected psychotherapy notes. Finally, it indicates that the provider is responsible for extracting the information needed to support that the claim is reasonable and necessary.