Thursday, August 20, 2009

OCR Designates HIPAA Regional Office Privacy Advisors

The Acting Director and Principal Deputy Director for the Office for Civil Rights, Robinsue Frohboese, has designated Office for Civil Rights Regional Managers in each of the HHS Regional Offices to serve as the Regional Office Privacy Advisors. On July 27, 2009, Secretary Sebelius authorized the Director of the Office for Civil Rights to carry out the designation required under the Health Information Technology for Economic and Clinical Health (HITECH) Act (Title XIII of Division A and Title IV of Division B of the American Recovery and Reinvestment Act of 2009 (ARRA).

The designation of these Regional Office Privacy Advisors was mandated by the ARRA-HITECH provisions under Section 13403(a). The Regional Office Privacy Advisors will offer guidance and education to covered entities, business associates, and individuals on their rights and responsibilities related to the HIPAA Privacy and Security Rules

The names, addresses, and contact information for each of the Regional Managers are listed together with a list of the States for which each Regional Manager has responsibility are listed below:

Region I - Boston (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)
Peter Chan, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
Government Center
J.F. Kennedy Federal Building - Room 1875
Boston, MA 02203
Voice phone(617)565-1340
FAX (617)565-3809
TDD (617)565-1343

Region II - New York (New Jersey, New York, Puerto Rico, Virgin Islands)
Michael Carter, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
Jacob Javits Federal Building
26 Federal Plaza - Suite 3312
New York, NY 10278
Voice Phone (212)264-3313
FAX (212)264-3039
TDD (212)264-2355

Region III - Philadelphia (Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia)
Paul Cushing, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
150 S. Independence Mall West
Suite 372, Public Ledger Building
Philadelphia, PA 19106-9111
Main Line (215)861-4441
Hotline (800) 368-1019
FAX (215)861-4431
TDD (215)861-4440

Region IV - Atlanta (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee)
Roosevelt Freeman, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
Atlanta Federal Center, Suite 3B70
61 Forsyth Street, S.W.
Atlanta, GA 30303-8909
Voice Phone (404)562-7886
FAX (404)562-7881
TDD (404)331-2867

Region V - Chicago (Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin)
Valerie Morgan-Alston, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
233 N. Michigan Ave., Suite 240
Chicago, IL 60601
Voice Phone (312)886-2359
FAX (312)886-1807
TDD (312)353-5693

Region VI - Dallas (Arkansas, Louisiana, New Mexico, Oklahoma, Texas)
Ralph Rouse, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
1301 Young Street, Suite 1169
Dallas, TX 75202
Voice Phone (214)767-4056
FAX (214)767-0432
TDD (214)767-8940

Region VII - Kansas City (Iowa, Kansas, Missouri, Nebraska)
Frank Campbell, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
601 East 12th Street - Room 248
Kansas City, MO 64106
Voice Phone (816)426-7277
FAX (816)426-3686
TDD (816)426-7065

Region VIII - Denver (Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming)
Velveta Howell, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
1961 Stout Street -- Room 1426 FOB
Denver, CO 80294-3538
Voice Phone (303)844-2024
FAX (303)844-2025
TDD (303)844-3439

Region IX - San Francisco (American Samoa, Arizona, California, Guam, Hawaii, Nevada)
Michael Kruley, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
90 7th Street, Suite 4-100
San Francisco, CA 94103
Voice Phone (415)437-8310
FAX (415)437-8329
TDD (415)437-8311

Region X - Seattle(Alaska, Idaho, Oregon, Washington)
Linda Yuu Connor, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
2201 Sixth Avenue - M/S: RX-11
Seattle, WA 98121-1831
Voice Phone (206)615-2290
FAX (206)615-2297
TDD (206)615-2296

Sunday, August 16, 2009

Health Care Reform Explained from Back of the Napkin Blog

Dan Roam at the Back of the Napkin Blog sums up the current health care reform effort in this four part health care series, Healthcare Napkins All. Great back of the napkin summary of health reform (actually insurance reform).

Thanks to Jay Parkinson MD for the tip.

Monday, August 10, 2009

State Medicaid Fraud Control Units Annual Report FY 2008

The DHHS Office of Inspector General has issued the Fiscal Year 2008 State Medicaid Fraud Control Units Annual Report. The report covers FY 2008 (October 1, 2007 - September 30, 2008.

The summary of the report provides background on the Medicaid Fraud Control Unit (MFCU) grant program, the number of states participating, the amounts recovered and number of convictions obtained in FY 2008:
During this reporting period, 49 States and the District of Columbia participated in the Medicaid fraud control grant program through their established MFCUs. The mission of the MFCUs is to investigate and prosecute Medicaid provider fraud and patient abuse and neglect. MFCUs’ authority to investigate and prosecute cases varies from State to State.

Forty-three of the MFCUs are located within Offices of State Attorneys General. The remaining seven MFCUs are located in various other State agencies.

In FY 2008, MFCUs recovered more than $1.3 billion in court-ordered restitution, fines, civil settlements, and penalties. They also obtained 1,314 convictions. MFCUs reported a total of 971 instances in which civil settlements and/or judgments were achieved. Of the 3,129 OIG exclusions from participation in the Medicare, Medicaid, and other Federal health care programs in FY 2008, 755 exclusions were based on referrals made to OIG by the MFCUs.
The report also contains examples of Medicaid fraud and patient abuse and neglect case investigations and prosecutions undertaken during FY 2008.

Read the full report for more information on the role that state MFCUs play in the oversight of the Medicaid program.

Saturday, August 08, 2009

Viral Health Effort Via Twitter: Fit West Virginia (#FitWV)

Dawn Miller of the Charleston Gazette highlights the ongoing Fit West Virginia (#FitWV) effort ongoing via Twitter in her op-ed piece, West Virginians try to tip scales on obesity.

The idea was born back on West Virginia Day as a result of Jason Keeling asking his blog readers to discuss solutions to West Virginia's problems in a post, West Virginia: Using Social Media for the Mountain State's Betterment. In response, Skip Lineberg of Maple Creative responded with his post, A Fitter West Virginia.

As a result of that "healthy idea seed" being planted a core group of West Virginia tweeters have been regularly posting on Twitter using the hashtag #FitWV. The effort has created a viral movement of West Virginians supporting other West Virginians in making health choices, exercising regularly, etc. Hopefully, this positive discussion is bringing about positive change and support to those participating.

As the country discussed health care reform efforts like #FitWV should be made a part of the equation. As Jordan Shlain, MD says in his recent op-ed over at The Health Care Blog:
. . . Nowhere in this debate is the patient, the consumer, and the citizen: the American! We lack accountability, responsibility and civic sensibility. It is Joe Diabetic that snacks on ice cream, misses appointments and doesn't take his insulin that increases the cost of health care. This diabetic will be admitted to your local ER with diabetic ketoacidosis and have many subsequent hospital admissions at our (read: your) expense, not his. This is a fundamental collective action problem.

Our town square is so big that we can get away with malfeasance to our village (and our country) with no shame. Yet, the forces of economics do not defy gravity and the cost of health care is now affecting all of us. Those of us that are untethered from the reality of cost are driving our health care 'car' into the ground.
. .
If you use Twitter -- please join the effort.

Dawn Miller also provides a link to some great new information from the Centers for Disease Control. The CDC released last month "Recommended Community Strategies and Measurements to Prevent Obesity in the United States."

Ms. Miller writes:

The CDC did all the research and evaluation work, so individual communities don't have to. They assembled a group of people with experience in urban planning, nutrition, physical activity, obesity prevention and local government. The group reviewed a couple years' worth of research, evaluated various tactics and settled on 24 recommendations. For each one, the CDC summarizes the evidence behind it and suggests ways to measure progress. Communities should:

1. Make healthier food and drinks available in public places. Schools are key, but think also of after-school programs, child care centers, parks, playgrounds, swimming pools, city and county buildings, prisons and juvenile detention centers.

2. Make healthier food more affordable in those public venues. Lower prices, provide discount coupons or offer vouchers for healthy choices.

3. Improve the availability of full-service grocery stores in underserved areas. One study of 10,000 people showed that black residents in neighborhoods with at least one supermarket were more likely to consume the recommended amount of fruits and vegetables than those in neighborhoods without supermarkets. Residents consumed 32 percent more fruits and vegetables for each additional supermarket in their census tract.

More supermarkets also raised real estate values, economic activity and employment and lowered food prices.

4. Provide incentives to food retailers -- supermarkets, convenience stores, corner stores, street vendors -- to locate in underserved areas or to offer healthier food and drinks. Incentives can be tax benefits and discounts, loans, loan guarantees, start-up grants, investment grants for improved refrigeration, supportive zoning and technical assistance.

5. Make it easier to buy foods from farms.

6. Provide incentives for the production, distribution and procurement of foods from local farms.

Did you know that the United States does not produce enough fruits, vegetables and whole grains for every American to eat the recommended amount of these foods? Dispersing agricultural production throughout the country would increase the amount of available produce, improve economic development and contribute to environmental sustainability.

7. Restrict availability of less healthy foods and drinks in public places.

8. Offer smaller portion options in public places.

9. Limit advertisements of less healthy foods and drinks.

10. Discourage people from drinking sugar-sweetened beverages.

11. Support breastfeeding, which appears to provide some protection from obesity later in life.

12. Require physical education in schools.

13. Increase the amount of physical activity in school PE programs. Modify games so that more students are moving at all times, or switch to activities in which all students stay active. Improving phys ed improves aerobic fitness among students.

14. Increase opportunities for extracurricular physical activity.

15. Reduce screen time in public settings. TV and computer time displaces physical activity, lowers metabolism, increases snacking and exposes children to marketing of fattening foods.

16. Improve access to outdoor recreational facilities, such as parks, green spaces, outdoor sports fields, walking and biking trails, public pools and community playgrounds. Access also depends on how close such places are to homes and schools, cost and hours of operation.

17. Support bicycling. Create bike lanes, shared-use paths and routes on existing and new roads. Provide bike racks near commercial areas. Improving bicycling infrastructure can increase how often people bike for utilitarian purposes, such as going to work and school or running errands.

18. Support walking. Build sidewalks, footpaths, walking trails and pedestrian crossings. Improve street lighting, make crossings safer, use traffic calming approaches. Walking is a regular activity of moderate intensity that a large number of people can do.

19. Locate schools within easy walking distance of residential areas.

20. Improve access to public transportation to increase biking and walking to and from transit points.

21. Zone for mixed-use development, including residential, commercial, institutional and other uses. This cuts the distance between home and shopping, for example, and encourages people to make more trips by foot or bike.

22. Enhance personal safety in areas where people are or could be physically active.

23. Enhance traffic safety in areas where people are or could be physically active.

24. Participate in community coalitions or partnerships.

Friday, August 07, 2009

AHLA Public Interest Committee Publishes Stark Law White Paper

The American Health Lawyers Association's Public Interest Committee recently published a new white paper on on the federal self-referral law also known as the "Stark Law" which looks at and considers what, if any, changes to the Stark Law might be beneficial under the current health care system and the proposed reform efforts.

The white paper is entitled, A Public Policy Discussion: Taking the Measure of the Stark Law. The white paper was written as a result of the Committee's Convener on Stark Law, held in Washington, DC on April 24 and June 30, 2009.

Monday, August 03, 2009

HIPAA Security Rule Enforcement Delegated to OCR

Today HHS Secretary Kathleen Sebelius announced that enforcement of the Security Rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be delegated to the Office for Civil Rights (OCR).

The official delegation occurred on July 27, 2009. More information about the transition of authority for the administration and enforcement of the Security Rule can be found in the OCR press release. The official Delegation of Authority by the Office of the Secretary has been issued and will appear in the August 4, 2009 Federal Register.

Prior to today, administration and enforcement of the HIPAA Security Rule has been the responsibility of the Centers for Medicare & Medicaid Services (CMS).