Promoting the “Minimum Necessary” Rule

Understanding HIPAA Security Standards

By Richard J. Mata; MD, MS

www.HealthcareFinancials.com

One concept that is stressed by HIPAA is the “minimum necessary” rule, which states the minimum use of personal health information [PHI] that can be used to identify a person, such as a social security number, home address, or phone number. Only the essential elements are to be used in transferring information from the patient record to anyone else that needs this information. This is especially important when financial information is being addressed. Only the minimum codes necessary to determine the cost should be provided to the financial department. No other information should be accessed by that department. Many institutions have systems where a registration or accounting clerk can pull up as much information as a doctor or nurse, but this is now against HIPAA policy and subject to penalties.  The “minimum necessary” rule is also changing the way software is set up and vendor access is provided. 

Chain of Custody

Another challenging task is keeping up with the number of people who access PHI, because the privacy regulations allow a patient to receive an accounting of anyone who has accessed their information, both internally [within your hospital, Emerging Health Organization, or medical practice) and externally [such as through your business associates]. The patient has the right to know who in the lengthy data chain has seen their PHI. This sets up an audit challenge for the medical organization, especially if the accountability is programmed internally.  When other business associates use this PHI without documenting access to a specific patient’s PHI, no one would be accountable for a breach in privacy.

Enter the Designated Record Set

One way to track access is through a designated record set, which contains medical or mixed billing records, and any other information that a physician and/or medical practice utilizes for making decisions about a patient.  It is up to the hospital, EHO, medical practice, or healthcare organization to define which set of information comprises “protected health information” and which does not, though logically this should not differ from locale to locale. 

Assessment

Overlaps from the privacy regulations that are also addressed in the security regulations are access controls, audit trails, policies on e-mail and fax transmissions, contingency planning, configuration management, entity and personal authentication, and network controls.  For more information about the Security Standards final rule, reference the Federal Register.

Conclusion

In the age of Twitter, IMing, blogging and texting, some young doctors are forgetting the basic fundamentals of patient privacy. And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Diagnostic and Statistical Manual of Mental Disorders

Coding Classification

By Staff Reporters

The classification and coding systems used by mental health insurers both diagnosis-related groups (DRGs) and current procedural terminology (CPT®) are still being defined through historical methodologies and are vague compared to the medical classification coding structure.

As an example, mental health insurers classify Tourette Syndrome (TS) as a “mental disorder.” In fact, TS is an inherited, neurobiological disorder, and both neurologists and psychiatrists treat TS with the same medications. If TS were reclassified under the medical coding structure, TS would not only receive potentially a better reimbursement but public perception of TS as a “mental disorder” would be changed.

The DSM-IV

The Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision), also known as the DSM-IV-TR, is a manual published by the American Psychiatric Association (APA) that includes all currently recognized mental health disorders. The coding system utilized by the DSM-IV is designed to correspond with codes from the International Classification of Diseases, commonly referred to as the ICD. Since early versions of the DSM did not correspond with ICD codes and updates of the publications for the ICD and the DSM are not simultaneous, some distinctions in the coding systems may still be present.

Assessment

For this reason, it is recommended that users of these manuals consult the appropriate reference when accessing diagnostic codes. For more information, contact the APA at (800) 368-5777.

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Conclusion

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ME-P Holiday Publishing Schedule

“Bridging the Gap between Medical Mission and Profit Margin”

By Ann Miller; RN, MHA

[Executive Director]

The ME-P does not usually close for the Holidays. So, if you are in need of some informative reading material during your down-time, try our archives of past articles.

If that isn’t enough, on the middle left sidebar of our home page you’ll see a list of popular posts, and reader comments, ranked from the past.

Finally, scroll down and look at the lower left sidebar for another topic grid. Click on a tag-of-choice and start reading. Oh! Don’t forget to subscribe for fee and secure delivery direct to your e-mail box.

Have a happy and safe holiday season.

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Notice of Healthcare Privacy Practices Explained

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NPP “Game Changer” Replaced Use of Consents

Dr. Mata

[By Richard J. Mata; MD, MS]

In its most visible change, the privacy regulations of HIPAA require covered health entities to provide patients with a Notice of Privacy Practices (NPP).

The NPP replaces the use of consents, which are now optional, although they are recommended.

The NPP outlines how PHI is to be regulated, which gives the patient far-reaching authority and ownership of their PHI, and must describe, in general terms, how organizations will protect health information.

THE NPP Specifics

The NPP specifies the patient’s right to the following:

  • gain access to and, if desired, obtain a copy of his or her own health records;
  • request corrections of errors that the patient finds (or include the patient’s statement of disagreement if the institution believes the information is correct);
  • receive an accounting of how their information has been used (including a list of the persons and institutions to whom/which it has been disclosed);
  • request limits on access to, and additional protections for, particularly sensitive information;
  • request confidential communications (by alternative means or at alternative locations) of particularly sensitive information;
  • complain to the facility’s Privacy Officer if there are problems; and
  • pursue the complaint with DHHS’s Office of Civil Rights if the problems are not satisfactorily resolved.

A copy of the NPP must be provided the first time a patient sees a direct treatment medical provider, and any time thereafter when requested or when the NPP is changed. On that first visit, treatment providers must also make a good faith effort to obtain a written acknowledgement, confirming that a copy of the NPP was obtained. Health plans and insurers must also provide periodic Notices to their customers, but do not need to secure any acknowledgement. Most Health Information Management departments that oversee the clinical coding of medical records also manage the NPP documentations and deadlines, but this may vary from hospital to hospital, or office to office.

Assessment

HIPAA requires no other documentation from the patient in order for information to be used or disclosed for basic functions, like treatment and payment, or for a broad range of other core healthcare operations. State laws may nonetheless require some kind of consent/authorization form from the patient for these purposes [It is common for institutions to claim, incorrectly, that HIPAA does].

Conclusion

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Thanksgiving “Food-for-Thought” on “Money Driven Medicine”

View the “Money-Driven Medicine” Video [A Free Streaming Download]

By Staff Reporters

During the month of November, Money-Driven Medicine will stream for free as part of the Watch-In! for America’s Health.

Based on Maggie Mahar’s Book

“Money-Driven Medicine” provides the essential analysis Americans need if they are to become knowledgeable participants in healthcare reform during these crucial days and in the years to come.

Assessment

Link: http://moneydrivenmedicine.org/watch-in

If you find this film to be a valuable tool, consider screening the DVD at your conference or professional event or in your community, association, school, workplace or place of worship.

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Strategic Modern Portfolio Theory Considerations in Hospital Capital Formation

Understanding Risk for Doctors and Financial Advisors

By Calvin W. Wiese; MBA, CPA

www.HealthcareFinancials.com

Hospital capital investments financial create risk. Risk is the uncertainty of future events. When hospitals make capital investments, they commit to costs that affect future periods. Those costs are known and relatively fixed. What are unknown are the benefits to be realized by those capital investments. For capital investments, risk is the certainty of future costs coupled with the uncertainty of future benefits. In some cases, while the future benefits are uncertain, there is a high degree of certainty that the benefits will exceed the costs. In these cases, risk can be very low.

Risk Re-Defined

Risk may be better defined as the degree to which the uncertainty of unknown benefits will exceed the known and committed costs. For example, when capital assets are purchased, both the burdens and the benefits of ownership are transferred to the owner. The burdens are primarily the costs associated with acquisition and installation. The benefits are primarily the revenues generated by operating the capital assets. Risk of ownership is created to the degree that the benefits are uncertain.

Managing Risk

Hospital managers and physician executives need to be skilled at putting hospital assets at risk. Without clear knowledge and understanding of the benefits and the burdens, hospitals can quickly find themselves at unacceptably high levels of risk. Risk must be continually assessed and evaluated in order to successfully put hospital assets at risk. Hospitals require many varied capital investments; their capital investments represent a risk portfolio. An effective combination of risky assets can often create risk that is less than the sum of the risk of each asset.

About MPT

Of course, financial managers have know this for years as a basic principle of Modern Portfolio Theory (MPT), first introduced by Harry Markowitz, PhD, with the paper “Portfolio Selection,” which appeared in the 1952 Journal of Finance. Thirty-eight years later, he shared a Nobel Prize with Merton Miller, PhD, and William Sharpe, PhD, for what has become a broad theory for securities asset selection; and hospital assets may be viewed as little different. Prior to Markowitz’s work, investors focused on assessing the rewards and risks of individual securities in constructing a portfolio. Standard advice was to identify those that offered the best opportunities for gain with the least risk and then construct a portfolio from them.

Following this advice, a hospital administrator might conclude that a positron emission tomography (PET) scanning machine offered good risk-reward characteristics, and pursue a strategy to compile a network of them in a given geographic area. Intuitively, this would be foolish. Markowitz formalized this intuition. Detailing the mathematics of diversity, he proposed that investors focus on selecting portfolios based on their overall risk-reward characteristics instead of merely compiling portfolios of securities, or capital assets that each individually has attractive risk-reward characteristics. In a nutshell, just as investors should select portfolios not individual securities, so hospital administrators should select a wide spectrum of radiology services, not merely machines.

Assessment

Savvy hospital managers will mitigate ownership risk by constructing their portfolio of risky assets in a manner that lowers overall risk.

Conclusion

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Techno-philic versus Patient-phobic Medical Care

Medicine Needs to get Back to Hands-on Basics, Rather than Focusing on Technology

By Staff Reporters

According to Rahul Parikh MD, there is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about “death panels” and “rationing care.”

Technophilic Doctors, Legislators and Patients

Worse, our entire focus seems to be toward technology and away from hands-on basic patient-philic care; starting with a detailed history and careful physical examination [remember Barbara Bates MD?]. And, all stakeholders are partly at fault.

Assessment

Here are a few related posts from Kevin Pho, MD.

Channel Surfing

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Top Ten Signs the ADA is Hunkering Down

About the American Dental Association

By Darrell K. Pruitt; DDS

Today, I especially cherish my right as a dues-paying member of the ADA – and as an American – to share my blunt, un-requested opinion as if you were a colleague, a patient or disinterested lawmaker.

For by early 2011, such liberty could warrant official sanction by the yet to be revealed national enforcer of the 2010 ADA Code of Conduct … if by then they find someone in the ADA capable of publicly announcing my crimes with a straight face, just before I receive a good talking-to about professionalism. If the future Ethics Enforcer would like me to help burnish his or her brand new gunslinger reputation quickly and deeply, I will gladly link any ADA official’s name to mine, and we’ll be companions for as long as I feel our union helps bring even more transparency to my profession. I’ve been an SEO assist for several ADA leaders for a couple of years already. Just ask ADA President Dr. Ron Tankersley – or – just Google his name.

Getting Spanked? 

I’m not too worried about getting spanked. What can the ADA possibly do to me? Besides, officially, nobody will utter as much as a peep because of the transparency thing. Unofficially, ADA officials will privately send more attaboys because they trust me. They know by now that I never betray friends. I’m selectively transparent – which is my right but not yours, non-profit ADA. I think we both know, Dr. Tankersley, that I’m not the only one who thinks a minority of ADA leaders are playing naïve, childish and costly games.

Then again, it could just be my persistent, egocentric stage of emotional development that causes me to imagine that Resolution 82 is pointed directly at the nose of D. Kellus Pruitt; DDS.

“Patient rights, ethics considered” was posted on Nov 16 on the ADA News Online, and was written by Jennifer Garvin 

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3843

Garvin writes, “Res. 82 asks that the following principles be considered for an ADA member Code of Conduct:”

1. Members will maintain high standards of integrity and conduct their dealings as members of the Association in a professional manner.

2. Members will treat other members and Association officers, trustees and staff with courtesy and respect, and shall refrain from conduct that is unreasonably disruptive or is harassing.

3. Members will respect the decisions and polices of the Association and will not engage in conduct that is disruptive to Association staff or causes the Association to expend an unreasonable amount of time or effort to address.

4. Members are encouraged to use proper Association channels of communication to address differences.

5. Members will comply with all applicable laws and regulations, including but not limited to antitrust laws and regulations.

6. Members will respect and protect the intellectual property rights of the Association, including any trademarks, logos and copyrights.

7. Members will not use Association membership lists for personal solicitation purposes.

8. Members will not use all or part of Association lists, including membership directory, online member listings, conference attendees and education course participants for selling, prospecting or creating a directory or database.

9. Members will treat all information furnished by the Association as confidential and will not reproduce materials without the Association’s written approval.

10. Members will avoid conflicts of interest.

Assessment

Garvin concludes: “The resolution also states that a proposed member code of conduct, together with proposed sanction and enforcement procedures, be presented for consideration by the 2010 House of Delegates.”  It is probably earthly unprofessional to make light of authoritarian bluster, but this really reminds me of the John Landis film “Animal House” when Dean Wormer put John Belushi and other ΔΤΧ Fraternity misfits on double secret probation. ADA Trustees shouldn’t take themselves so seriously. It looks silly to those watching. Or then again, keep it up. After all, it looks silly to those watching.

Toga Party! Dentures 2 for 1! Just ask for Dr. Ron.

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Conclusion

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How Important is it for Doctors to have Computer Skills?

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Very … It’s Imperative

By Staff Reporters

Emergency physician Shadowfax is recruiting doctors for his hospital, and balances the typical choices one must make balancing clinical knowledge versus interpersonal skills.

Deal-Breaker

One deal-breaker is the lack of modern computer skills. Unfortunately, in this modern age, if an employee can’t use a computer effectively … read more! 

A lack of computer skills may make doctors unemployable 

Assessment

Additional related posts from Kevin Pho, MD:

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Conclusion

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Dear Doctor – “I’m from the Government and I’m Here to Help”

Only-in-America

By Staff ReportersGetting Squeezed

CMS Cuts Medicare 21% for Doctors Unless Congress Acts

The Centers for Medicare and Medicaid [CMS] just reported to the American Medical News that the final 2010 Medicare physician fee schedule confirms 21.2% pay cut starting Jan. 1, 2010, unless Congress adopts legislation to avert it.  

So, enter John Kerry to the Rescue

Kerry Bill Helps Physicians Borrow Money for eMRs

But to qualify for electronic health record government subsidies, to be paid in increments over five years starting in 2011, physicians must lay out a substantial sum, take a lease, or borrow the money. So, to make it easier for doctors to purchase eMR systems, Sen. John Kerry (D-Mass) has proposed legislation that would allow small practices to get loans backed by the Small Business Administration (SBA).

Moreover, a press release from Kerry’s office stated that the money could be spent on “computer hardware, software, and other technology that will assist in the use of electronic health records and prescriptions.” 

Link: Continued at BNet Healthcare.

Assessment

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Yet, health economist and ME-P Publisher-in-Chief Dr. David Edward Marcinko opined:

“Is this sleight-of-hand chicanery akin to stealing from Peter to pay Paul”?   

Conclusion

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Investment Returns Drop for Nonprofit Healthcare Organizations

A Commonfund Report

By Roy Chernus
SK Communication, LLC for Commonfund

Did you know that nonprofit healthcare organizations reported average investment returns which dropped [minus] -21.2% in fiscal year 2008, ending December 31st 2008?

Results

Attached below is a press release with findings from the 2009 Commonfund Benchmarks Study of Healthcare Organizations. The 143 participating healthcare organizations represented total investable and Defined Benefit plan assets of $113.8 billion, comprising investable assets of $81.6 billion and $32.2 billion in DB plan assets.

Assessment
www.commonfund.org/Commonfund/Archive/CF+Institute/2009+0921+CBS+Healthcare+Press+Release.htm

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Joe Flowers New Healthcare Reform Strategy

Selling Patients like Baseball Players – Seriously

By Staff ReportersFuture Physicians

Here is a health care reform strategy that we have not heard of before. It was formulated by healthcare futurist Joe Flowers, and is reposted below for your review.

It first posits this question, and then gives a plausible answer, with unique new operational strategy.

Question

Why aren’t health plans more aggressive in promoting the long-term health of their members, like getting them to eat better, stop smoking, get a little exercise, and all that?

Answer

Because of health insurance industry “churn”

Strategy

Give Joe’s idea a read and tell us what you think?

http://www.thehealthcareblog.com/the_health_care_blog/2009/11/sell-patients-like-baseball-players-seriously-.html

More: www.imaginewhatif.com

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Part D Payer Shares of Prescriptions Dispensed Rise

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Increase for Eight Major Drug Classes

[By Staff Reporters]

The shares of all prescriptions dispensed covered by Medicare Part D rose by at least three percentage points, between midyear 2007 and midyear 2009, in each of eight major drug classes profiled.

Assessment

The largest percentage increases over this period were in the osteoporosis (to 26.9% in 2009 from 20.5% in 2007) and anti-platelet (to 28.4% from 22.5%) markets as of September 9, 2009.

Source: Data source: SDI © 2009.

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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HCG Forecast: Fall/Winter 2009 Edition

The Health Care Group  

By Cheryl Sprows

Three new topics in this issue:

 

  1. New Regulations for Business Associates
  2. New Breach Notification Requirement under HIPAA
  3. Workplace Harassment – Did you hear the one about?

Link: https://www.thehealthcaregroup.com/Productdownloads/2009fallwinterforecast.pdf

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Recovery Asset Contractor Survey Poll

RAC RESULTS TO-DATE [Beta]

By Staff Reporters

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According to the Centers for Medicare and Medicaid Services [CMS], RACs collected about $1-B in improper payments during their recent beta testing period. Of these payments; 96% were over-payments, 4% were under-payments; and 77% of providers failed to appeal, 7% appealed successfully and 15% appealed unsuccessfully.

Going forward there will be a three year “look-back period”, and a 10% contingency payment level for the four regional RACs currently in the program:

  1. Connolly Consulting
  2. PRG-Schultz
  3. HealthDataInsights
  4. Diversified Collections Services

By 2010, the RAC program is scheduled to launch in all 50 states. And so, please cast your vote in our exlcusive ME-P RAC program survey poll.

Conclusion

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About the PriceDoc Patient Opportunity

Increasing Health 2.0 Financial Transparency

By Staff ReportersHealth 2.0 Opportunity

www.PriceDoc.com is a free online service that empowers consumers to take control of their healthcare costs. PriceDoc allows patients to search for medical providers in their local area and compare fee schedules for specific procedures.  

Assessment

With PriceDoc, healthcare providers are able to post their discounts in exchange for cash or credit card payment. The result is access to affordable healthcare for those with no insurance, high deductibles health plans or those seeking elective procedures.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Give em’ a click today, and tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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About the New Video-Launch of InvestorGov.com

Do You Trust Mary?

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]Dr. David E. Marcinko MBA

Did you know that according to this new website, the mission of the US Securities and Exchange Commission [SEC] is to protect investors, maintain fair, orderly and efficient markets, and facilitate capital formation?

Well, I did, but during the last two years you might surmise that the SEC didn’t.

So – What’s an Inept Government to Do?

Launch a new website, of course, with these tab menus:

1. Invest Wisely

2. Avoid Fraud

3. Plan for Your Future

4. How the SEC Helps

A FINRA Re-Deux

Much information on the site is from the Financial Industry Regulatory Authority [FINRA/NASD]. Of course, SEC Chairwoman Mary Schapiro is the former chief executive of that organization, and we all know how they protected us from Bernie Madoff and his ilk, don’t we.

Assessment

Nevertheless, take a look at this video from Mary Schapiro. She sure looks serious, doesn’t she?

Video Link: http://investor.gov/welcome-message-from-chairman-schapiro/

Conclusion

Click to play :

And so, your thoughts and comments on this Medical Executive-Post are appreciated. What do you think about the new site? Oh, by the way, my answer to the posed question is No! But, feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Don’t Hide a Security Breach if You Can’t Do the Time

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When Will Costs Outweigh Health Information Technololgy?

[By Darrell K. Pruitt; DDS]pruitt

At what point will security data breaches become so costly that dentists will abandon computerization and return to pegboards and ledger cards?

Senate Judiciary Committee

A week ago, the Senate Judiciary Committee approved two separate bills which would mandate that dentists who store digital PHI notify patients if their data is breached. Of course, that would be the ethical thing to do anyway, wouldn’t it?

Senate Bill 139, also known as the Data Breach Notification Act, was introduced by Dianne Feinstein of California and is similar to existing state notification bills – including California’s own landmark Bill 1386 which set the standard 7 years ago.

Two Hundred Ten Dollars Cost – Per Record – for Notification

Considering that in October, the Ponemon Institute reported that it costs an estimated $210 per record to notify patients of a breach, there are a lot of angry lawmakers who are missing the point. Mandated fines for a breach are meaningless. Simply notifying thousands of patients of a breach will bankrupt any dental practice, even if it is an insurance company employee who loses a laptop computer containing a dentists’ patients’ personal data – like a BCBS employee did recently with over 800,000 physicians’ personal information.

Personal Data Privacy and Security Act 

Even now, a dentist whose practice is a victim of a breach, whether it is from stolen computer, hacker or dishonest employee, might take a quick look at the notification path to certain bankruptcy and gamble that patients’ data won’t be used before hiding the incident. That is why Senator Patrick Leahy of Vermont has sponsored the other breach bill which reflects the prevailing attitude of frustrated constituents throughout the nation. It is known as the Personal Data Privacy and Security Act.

Leahy is more concerned with punishment than with breaches themselves. In addition to a fine, he would establish a jail term of up to five years for failing to disclose a breach when required.

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:s1490is.txt.pdf

§ 1041. Concealment of security breaches involving sensitive personally identifiable information 

‘‘Whoever, having knowledge of a security breach and of the obligation to provide notice of such breach to individuals under title III of the Personal Data Privacy and Security Act of 2009, and having not otherwise qualified for an exemption from providing notice under section 312 of such Act, intentionally and willfully conceals the fact of such security breach and which breach causes economic damage to 1 or more persons, shall be fined under this title or imprisoned not more than 5 years, or both.” 

If dentists want to continue to use computers in their practices, Leahy would have them put serious skin into the game. The bill was read twice and referred to the Committee on the Judiciary.

On the ADA Advocacy page, dental leaders still maintain that electronic dental records will lower the cost of dentistry. And as recently as last month, the ADA House of Delegates again publicly endorsed the adoption of eDRs, yet still neglect to adequately warn ADA members of their dangers, now including possible imprisonment.

Assessment

ADA President Dr. Ron Tankersley is already irrelevant.

Conclusion

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ME-P Advertising and Sales Opportunities

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How Much Do “Financial Advisors” Pay for Doctor [Any Client] Prospect Leads?

More Than you Think in this Murky Advertising World – but – Are Matching Services Effective? 

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Dr. David E. Marcinko MBA

Recently, I received the sixth telephone cold call from one Mr. Tim Smith [866 952 4065], in as many months, regarding a service called Prospect Match of Concord California. It purports to match financial advisors with pre-screened clients [like affluent doctors] in my area.

Of course, because of their high quality selection process, only three advisors are “needed” in my locale. I also received this email sales-service pitch.

The Introductory e-mail Sales Pitch

We are hosting a live presentation with Ilene Hirsch of ProspectMatch, and new agent Wayne Dunlap will show you a service that will prospect for you—even in a terrible economy. See How Wayne Dunlap invested $1,094 in his business to earn $39,560 and does it again and again. Join us for 30 minutes and learn how Wayne:

  • Outsources his prospecting, and was
  • Introduced to 73 new prospects; resulting in 23 appointments and in 9 sales. 

Thank you
Eric Palmer (800) 290-7226
www.Brokersalliance.com 

About Prospect Match

“ProspectMatch helps financial professionals who are wasting time and earning too little. If you are earning less than $100,000 a year, you’re either not serious, or doing the wrong things and we can show you what to do. If you are earning $100,000-$300,000 annually, you’ve figured some things out. But those who use our systems see their income top $500,000 annually because they spend their days doing marketing the right way, talking to motivated affluent prospects and they sell the right way.”

Link: www.ProspectMatch.com

Costs

The blog states that there is a one time non-refundable registration [fixed-cost] fee of $149; so that prospects meeting their selection criteria are assigned to me exclusively. For each prospect match, the charge is an additional $20 [variable-cost] fee. This is known as a hybrid business cost model.   

Assessment

Here are a few interesting thoughts and co-incidences for further ME-P subscriber consideration and commentary:

  • The site is a pre or post-retiree sales lead generator for the 45 +age market for annuities; typically the most commission loaded and profitable financial product in the industry today. The fear of Obama-care may be self-promoting for annuities. 
  • It appears to be geared more for insurance sales agents; not RIAs or fiduciaries.
  • The service appears to help mitigate the so-called national “do-not-call” prohibitions. 
  • Explanatory sales booklets and other customized self-promotional literature are available for an additional surcharge, along with other premium upgrade services.
  • We have been getting more than the usual number of contacts recently, either to buy our ME-P mailing list [not for sale-confidentially assured], or to purchase an AMA. APMA or ADA mailing list for doctors, podiatrists and dentists. These folks are apparently unaware of our medical affiliations.
  • How do you feel about being called a “prospect” or book-of-business?
  • I am not – and have never been – a member of the Financial Planning Association [FPA], and I haven’t been a certified financial planner for the last three years; having quit that organization in abject disgust after more than a decade [read related posts – why?]. So, how and why did they target me? Big mistake, too.

Disclosure

I am not a member of the AMA; 82% of eligible [cogent and modern] physicians are not. But, I am founder of the www.CertifiedMedicalPlanner.com for fiduciary advisors and medical management consultants.

ConclusionProspecting Advisors  

And so, your thoughts and comments on this Medical Executive-Post are appreciated. What are the good and bad points of this service? Has any FA used it and what is your experience with it? As a doctor, how do you feel about being targeted as a “prospect” by a third-party head-hunter? Be sure to give the website a click and tell us what you think? 

We will try to contact Tim, or other representative of this advertising/marketing program, for an email interview. Let’s be objective.

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Don’t Tread on Me – Obama

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Bite Me – CMS

[By D. Kellus Pruitt; DDS]pruitt

Shy but proud Texas Dental Association leaders still direct employees to encourage members to volunteer for permanent, mandated National Provider Identifier numbers. Why? “Just ‘cause.”

As part of an agreement the TDA made with the state to help politicians out of a lawsuit they brought upon themselves for not providing adequate dental care for the poor in the state, TDA leaders followed someone’s bad advice to encourage Texas dentists to accept CHIP (Medicaid) – which requires dentists to have arbitrary 10 digit NPI numbers to participate.

Don’t get me wrong. I have the highest respect for dentists who treat the poor for pay that doesn’t even cover overhead. That is compassion to a fault – even before CMS investigators arrive with subpoenas based on vague, nuisance complaints from disappointed patients, disgruntled employees and hungry competitors. Getting even with rich, greedy, or otherwise mouthy dentists has never been easier because I’ve heard that CMS intends to investigate all complaints.

Yes, low pay is only part of the nasty package that TDA officials are officially discouraged from discussing with membership – even as they beg for us to sign up for CHIP and “do our part to return our debt to society by helping those who cannot care for themselves.” So who would dare question the reason for the faux sentiment expressed by a long string of TDA Presidents? That would be me.

There are simply so many other charitable ways of publicly and privately returning help to the community that don’t add to the risk of donating one’s skill. Even if one does not help local free clinics, how hard can it be to quietly give away care, Doc, in these hard times? It’s just between you and God anyway, isn’t it? One simply enters N/C in the fee column. Confidentially I sometimes get hugs that so far can be neither controlled nor taxed.

It appears to me that CMS is arguably more influential with TDA leaders than common TDA members like me. If I am correct, this means that dentistry is at risk of being overrun by authoritarian bureaucrats hired by ambitious politicians who often promise more than they can deliver before ducking accountability for earthly bad decisions. The business model even reminds me of the TDA’s.

So now that the TDA played its hand with regard to its fondness for BCBSTX and the NPI number, what does it mean for Texas dentists if Obama’s imminent “Public Plan Option” turns into “Medicaid for All” – as some naively hope and others justifiably fear? This week, the AMA gave its support to the Public Option. Will the ADA be next? 

Dentistry unhurried is value-added service. One cannot get rich at it, but it’s an honorable living.

Regardless of whether you approve of my tactless vitriol or not, I have to say that when it comes down to feeding my family, even this special bastard could be silenced if there is no longer a market on the east side of Fort Worth for dentistry unhurried. Especially if it meant a monthly visit by CMS inspectors like Dr. Annie Bukacek is going through right now. Like me, she also gives her patients the time they deserve. But unlike me, she doesn’t have time to pick fights with shy bullies who hide behind employees.

I’ll get to the physician’s story in a moment. But first, just how important are secrets to the leaders of the nation’s preeminent non-profit dental organization? It’s important enough that many in the ADA House of Delegates want the power to mete out punishment to fellow officers who cannot keep their mouths shut. Some of those we elected even want to make the sanctions retroactive to deal with colleagues who have already broken the traditional unwritten good ol’ boy code of stoic conduct. At the same time, the TDA is begging dentists in the state to run for ADA office – starting on the local level. Why do you think dentists in Texas don’t want to get involved? Nobody accepts delivery from the cluetrain in Austin. It probably stops there at least a couple of times each week day.

I copied below three of the ADA Delegates’ referred resolutions from Judy Jakush’s November 2 ADANews article, “Delegates vote on Association business matters,”

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3821

1] Res. 70 states that if any member of the ADA, including delegation member, council, committee or task force member, or Board of Trustees member has been acknowledged as breaking the attorney-client privilege or executive session, that member is, at a minimum, barred from ever again participating in an attorney-client or executive session within the ADA. This shall include such acts which have been acknowledged as occurring prior to the enactment of this resolution.

2] Res. 67 would specify that candidates for elective or appointive officers may not have had any sanctions bestowed upon them by the Association. Also referred was Res. 67RC, which would direct that anyone found by the Committee on Credentials, Rules and Order to have violated his or her duties to the Association would be disqualified from holding elective or appointive office.

3] Res. 68 was referred to the Council on Ethics, Bylaws and Judicial Affairs for report to the 2010 House with recommendations for Bylaws changes. The proposal calls for CEBJA to review the Bylaws and craft language that would define the mechanism for sanctions up to and including removal from office of a delegation member or Board of Trustee member if there is found to be cause for removal as shall be defined. That cause, at a minimum, should include those causes as delineated currently for council members. Res. 68 also calls for a method for fair and impartial hearings to be recommended and the establishment of an authorized House committee that can be held on an ad interim basis between annual sessions of the House of Delegates with authority to determine and impose any such sanctions deemed appropriate. 

Remember, the ADA is a non-profit, professional organization whose only purpose for existence is to serve dental patients through dentist members who support it with dues. When one reads these and other resolutions in Jakush’s article, it looks like ADA President Dr. Ron Tankersley is running the Pentagon. We’re only dentists for crying out loud!

Dr. Annie Bukacek’s 6-month battle with CMS

This morning I read what has turned out to be a popular article titled “Investigators descend on doctor,” written by Candace Chase, writing for the Daily Inter Lake which serves northwest Montana.

http://www.dailyinterlake.com/news/local_montana/article_d8cde54e-cc2d-11de-9ddd-001cc4c03286.html

“Dr. Annie Bukacek of Hosanna Health Care in Kalispell was surprised when a 30- to 40-foot-long command-post vehicle pulled up unannounced last week, along with a posse of state and federal health-care fraud investigators.”

“Bukacek points out that anyone – a disgruntled ex-employee or patient or someone who doesn’t like a physician’s looks or politics – could trigger an investigation and cost a physician as well as the government thousands of dollars.” 

I wonder what would happen if a dentist openly taunts CMS leaders? As I previously mentioned, it is Dr. Bukacek who claims, “They said they have to followup every allegation made.” 

When all American dentists are required to volunteer for NPI numbers and can no longer be legally paid in cash at the time of service, we’ll all be hung by an ADA-approved mistake of historic proportions. I suggest that ADA members take time right now to jot down names so that when judgment day inevitably arrives, one will be prepared to hold accountable the ADA employees who recommended the numbers. After reading how ADA leaders are hunkering down, it looks like going through employees will probably be the only way to touch the bosses they bravely try to shield.

Oh yeah. I posted the 5th of almost 30 comments that so far follow Candace Chase’s provocative article:

“Dr. Annie Bukacek’s experience is why as a US citizen in the land of the free, I simply refuse to do business with the US government. Bite me, CMS. Did you hear me? I said bite me!”

Assessment

It’s not likely that I’ll regret those words because I am powerless to stop myself from typing them anyway.

Conclusion

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When to Change Portfolio Managers

Some Considerations for Medical Professionalsfp-book

By Clifton N. McIntire, Jr.; CIMA, CFP®

By Lisa Ellen McIntire; CIMA, CFP®

Sometimes even the best made physician financial plans just don’t work out. And, despite extensive time and energy spent on due diligence before hiring an investment or portfolio manager, it becomes evident that you must change managers.

Some Thoughts for Doctors

Here are a few thoughts when considering a portfolio manager change:

  • You should have initially hired the manager with a long-term relationship in mind. Realizing that styles go in and out of favor, we were not simply buying last quarter’s best numbers; in 2009.
  • Market statistics often mask “real” performance of money managers, both good and bad. The S&P 500’s 2007 performance can be attributed to a few very large companies.
  • Generally, a full market cycle would be required to assess money manager performance. Having said that, what could happen that would warrant changing managers? Here is a brief list:
  1. Style Drift: You have a growth manager and when growth stocks turn down, you begin to see the purchase of “value” stocks.
  2. Not Sticking to Previously Established Disciplines: If the process is to sell if the price declines 20 percent down from the original buy range and now they are holding because, “This time, it is different.”
  3. Personnel Changes: New analysts are hired with a different philosophy. Recent transactions seem 180 degrees off course.
  4. Principals Leave: Like professional sports figures, good money managers are in demand and sometimes change firms. The replacement may be a 29-year-old MBA with little experience.
  5. The Firm is Sold: This may be good new if it broadens ownership and helps retain good people.  Look for long-term incentive driven “staying” bonus plans.
  6. Loss of Major Accounts: Reduced revenues may force cut backs in personnel and services. Attention may shift from portfolio management to marketing.

Assessment

Finally, sometimes it is just not working. Misjudgments in asset allocation and poor stock selection over a reasonable period of time can be reason enough to change managers.

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FINANCE: Financial Planning for Physicians and Advisors
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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

More Health 2.0 Technologies

Become Privy to Some New Product Launchs

By Staff Reporters

Visit the virtual Health 2.0 Conference Exhibit Hall of piooner blogger Matthew Holt www.Health2con.com,  or click-on each individual product launch where you’ll see the introduction of  brand new technologies from the following vendors:

Disclaimer

The ME-P has no relationship with these products or vendors.

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Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. If you’ve ever used, seen or tried these products or services, do tell us what you think!

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Remembering the IOM Medical Quality Report

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Despite the IOM Warning, Medical Errors May Have Killed 1 Million Plus In Past Decade

[By Fard Johnmar: First posted May 20, 2009]

IOM Report

Much like remembering the fallen Berlin Wall, it is fitting during this time of political healthcare reform debate, to again consider the IOM report – now more than a decade old.

In a scathing report, Consumers Union estimates that more than 1 million people have died over the last decade due to preventable medical harm.  The newly released report, “To Err is Human — To Delay is Deadly,” suggests that since the Institute of Medicine’s influential 1999 report on medical errors, “98,000 people die each year needlessly because of preventable medical harm, including healthcare-acquired infections. Ten years after To Err is Human, we have no national entity comprehensively tracking patient safety events or progress.”

While some hospitals have made great strides in the effort to reduce medical errors and the U.S. government has taken steps to limit reimbursement for preventable medical events, the nation still has a long way to go.  Consumers Union is recommending that we develop a national system for tracking medical errors.  The organization suggests that concerns about malpractice lawsuits due to reports of medical harm may be overstated.

Assessment

To learn more about the Consumer Union report, please click here.

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About Carena In-Home Medical Care

In-Home Medical Care Services for the Modern Era

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Dr. David E. Marcinko MBA

We have written about the high cost, questionable quality and scheduling burden of emergency room visits on the Medical Executive-Post before. And, for some non-emergency or after-hours needs, the ER may possibly be one of the worst places to deliver medical care.   

Enter Carena, Inc

Seattle-based Carena Inc. was founded in 2000 on the principle that expanding access to medical care improves outcomes and reduces costs. By providing around-the-clock medical care and education at a patient-identified time of need, Carena patients, clients and health plans are reported to experience lower costs while patients receive the right care – at the right time [www.CarenaMD.com].

A New [Old] Business Model

Carena is not an emergency room, not an urgent care center and not someplace patients go. This medical group delivers 24/7 house-calls both to render care and provide education for urgent medical needs.

House calls last as long as needed—often an hour—to make sure patients have the care and education needed to take control of their health.

The Carena model also offers medical care at the workplace enabling corporate clients to offer on-site care without the cost and space requirements of a typical employer-sponsored health clinic.

Home Visits in the Modern Era

Carena medical group physicians treat a wide range of urgent concerns. They carry an updated version of the traditional “doctor bag” filled with state-of-the art and portable instruments. For example, physicians have the equipment to suture minor cuts, deliver nebulizer treatments for asthma, or obtain lab samples. They run in-home rapid diagnostic tests for influenza, strep throat, and other medical issues. If X-rays or tests are needed, physicians coordinate scheduling and share results with patient PCPs. Electronic medical records are used throughout.

Always Open 24/7

Carena is always open. No waiting in the ER while doctors treat true emergencies. No wondering if other waiting patients are contagious.  

Reduced Financial Shock.

Carena house calls are reported to costs about 30-35 percent less than a typical emergency room visit of about $1,500.

Another New Term

With apologies to my esteemed colleague Robert M. Wachter MD, the hospitalist guru at UCFS, Carena doctors are often called “housepitlists.”  

Assessment

Carena is a medical company that provides a new model of health care delivery for innovative, self-insured companies. Internist Frances Gough MD is the Vice President of Product Development at Carena, Ted Conklin MD is the founder and Ralph C. Derrickson is President and CEO. Corporate clients for both Carena business models are Costco and the Microsoft Corporation of Redmond, WA.

Disclaimer

I own shares of MSFT common stock and am a professional member of MS-HUG.

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Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Spotlight on the “Health Tech Today” Video Launch

Video Clip from Microsoft

By Staff ReportersConnected Doctor Health 2.0

Health Tech Today is a new monthly, on-line video series at the intersection of health and information technology.  The show premiers November 10th 2009, but you can view a video trailer of their first show on the link below, right now

HealthBog

HealthBlog includes thoughts, comments, news, and reflections about healthcare IT from Microsoft’s worldwide health senior director Bill Crounse MD, on how information technology can improve healthcare delivery and services around the world.

Link: http://blogs.msdn.com/healthblog/default.aspx

Assessment

Please help them spread the word. Blog about it. Tweet your friends. Post information about Health Tech Today on Facebook.  Health IT has a new voice. We think you’ll like what you see.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. So, give em’ a click and tell us what you think! Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Our Newest ME-P Milestone

Growing and Thriving – Thanks to You!

By Ann Miller; RN, MHA

[Executive Director]Congratulations

This month we passed the 145,000 reader mark. As you know, the ME-P was launched in 2007 and initially reached about a thousand Internet pioneers. It has grown exponentially, from our initial list-serve, to more than one hundred thousand readers and subscribers today.

A Thriving Community

The ME-P is now a thriving online and onground community that connects physicians with financial advisors and management consultants.

Our goal in the modern Health 2.0 era is to: “bridge the gap between medical mission and profit margin.”

Since inception, we have become one of the most popular and influential electronic networks in the healthcare administration, economics and financial planning space. 

Assessment

ME-P would like to thank all of our devoted readers, zealot subscribers, authors and participants as well as our advertisers for making this publication possible:

Channel Surfing

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A New Remote Patient Monitoring Device

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The Next Step in RPM Solutions  

[By Staff Reporters]Tele Doctor

Long-term medical conditions create many challenges—for patients who have them, as well as for their attending physicians. This gadget reports to address those challenges

What it Is

The Intel® Health Guide is a comprehensive, next-generation remote patient monitoring (RPM) solution that combines an in-home patient device [the Intel Health Guide PHS6000] with the Intel® Health Care Management Suite; an online interface that allows clinicians to monitor patients and remotely manage care.

Reported Benefits

The benefits of the Intel Health Guide include patients who feel empowered to take a more active and positive role in their own care. For doctors, it enables more informed and personalized care—which may lead to better patient satisfaction. And it helps healthcare organizations to face the challenges of chronic care, increase efficiency, and achieve organizational objectives.

Assessment

In short, Intel® technology hopes to fulfill the promise of RPM, where interactive, data-rich telehealth helps to create timely, personalized and cost-effective care.

Disclaimer

The Intel® Health Guide requires an internet connection to enable communications with the patient’s care team and back-end data hosting. The Intel Health Guide is intended for use by patients under the guidance of a healthcare professional and is not intended for emergency medical communications or real-time patient monitoring.

Conclusion

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  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

Update on HIPAA Administrative Simplification

New Enforcement Rules

Federal Register: October 30, 2009 [Volume 74, Number 209]

Rules and Regulations – Page 56123-56131

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

DOCID: fr30oc09-12typewriter

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

45 CFR Part-160 [RIN 0991-AB55]

HIPAA Administrative Simplification: Enforcement

AGENCY: Office of the Secretary, HHS.

ACTION: Interim final rule; request for comments

SUMMARY:

The Secretary of the Department of Health and Human Services (HHS) adopts this interim final rule to conform the enforcement regulations promulgated under the Health Insurance Portability and

Accountability Act of 1996 (HIPAA) to the effective statutory revisions made pursuant to the Health Information Technology for Economic and Clinical Health Act (the HITECH Act), which was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA).

More specifically, this interim final rule amends HIPAA’s enforcement regulations, as they relate to the imposition of civil money penalties, to incorporate the HITECH Act’s categories of violations, tiered ranges of civil money penalty amounts, and revised limitations on the Secretary’s authority to impose civil money penalties for established violations of HIPAA’s Administrative Simplification rules (HIPAA rules). This interim final rule does not make amendments with respect to those enforcement provisions of the HITECH Act that are not yet effective under the applicable statutory provisions. Such amendments will be subject to forthcoming rulemaking(s).

Assessment

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Link: http://edocket.access.gpo.gov/2009/E9-26203.htm

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Product DetailsProduct Details

RFID versus WiFi Hospital Inventory Tracking Systems

Understanding Competing Wireless Technologies

By Davd Piasecki, with

Hope Hetico; RN, MHA

www.HealthcareFinancials.comHOFMS

The two wireless technologies currently competing to provide hospitals with better systems for managing equipment inventories are (WiFi) and active RFID.

Wireless-Fidelity [WiFi]

WiFi is the name of the popular wireless networking technology that uses radio waves to provide wireless high-speed Internet connections. The WiFi Alliance is the non-profit organization that owns WiFi (registered trademark) and the term specifically defines WiFi as any “wireless local area network products that are based on the Institute of Electrical and Electronics Engineers’s 802.11 standards.”  Yet, less than 5 percent of North American healthcare facilities are equipped with these real-time locating systems, so the market is currently up for grabs.

WiFi Pros

The advantage of WiFi-based real time locating systems (RTLSs) is that most hospitals already have WiFi networks in place, and many medical devices are equipped with WiFi functionality. Moreover, WiFi vendors such as Aeroscout, Ekahau, and PanGo market their products based on a standards-based non-proprietary functionality. The downside of WiFi systems is that hospitals will need to install additional access points to bring the needed functionality to existing networks.

RFID Pros

On the other hand, RFID vendors such as RF Code and Radianse point to the wide application of RFID for asset tracking, and to the technology’s longevity in the industry. Still, RFID tags remain suspect because their ability to efficiently track DME may not be private or secure. Increasingly, WiFi seems more ubiquitous than RFID.

Finally, of the three WiFi major vendors, only Ekahau makes a point of stressing that its inventory system is based only on WiFi and not RFID, so the issue isn’t clear cut.  Perhaps it will take both technologies to deploy RTLSs for hospitals.

General Recommendations

As a general recommendation, RFID is not yet practical for most small to mid-sized healthcare entities or medical clinics looking to automate their inventory-related transactions (though it does work for other applications such as with returnable containers and asset tracking).

RFID Hype

Despite the hype over RFID, bar codes are not becoming obsolete and are still very effective at quickly and accurately identifying products, locations, and documents. Unless there exists an application where bar codes simply don’t work, or where RFID offers a significant advantage over bar codes, use bar codes. Even if an application that cries out for RFID exists, hospital material management administrators may want to consider waiting (if possible) as the cost of the technology comes down.

Both RFID and WFI Needed

According to Robert M. Wachter MD, Professor and Chief of the Division of Hospital Medicine and Associate Chairman of Department of Medicine, and Lynne and Marc Benioff Endowed Chair in Hospital Medicine, University of California at San Francisco, and Chief of the Medical Service at UCSF Medical Center [personal communication], both should be used.

Ultimately, of course, we do need both bar coding and RFIDs, and we need rigorous studies looking at what works and what doesn’t. But, you have to start somewhere. Even though the evidence continues to trail, based on what I know today, if I was a hospital ready to get into the IT game, I’d go with bar coding first. 

Assessment

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In the next few years, standards will be finalized, hardware prices will drop, software will become more readily available, and, more importantly, the bugs will be worked out of all these systems.   

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Sponsors Welcomed

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Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

How to Search the ME-P?

Efficient Information Seeking

By Ann Miller; RN, MHA

[Executive Director]ME-P Consulting

A simple query that demands a cogent answer!

First Explore our Archives

Let’s say that you’ve reached the ME-P archives. Use this feature to explore articles on a monthly basis; since inception in 2007. To surf through the current month, click the first entry on the list and start reading. If you want something specific, try searching by channel topic category.

Then Try Topical Channel Categories

Through the channel category menu you can explore posts on a topical basis; there are more than 50 of them. And if you’re looking for something really specific, try using the search button on the top-right of the home page.

Assessment

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To encourage ME-P users to participate in the ongoing community discussion, we’ve left commenting enabled, so feel free to speak your mind and leave all the comments you like! We are lightly moderated however, to prevent that annoying spam.  

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

ADA Opens a Facebook

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Perhaps too Early?

[By Darrell K. Pruitt; DDS]pruitt

Something strange has happened to www.DentalBlogs.com I think they have partially shut down their Facebook account. They no longer feature original articles such as those by Dr. Rhonda Savage and Ms. Linda Miles, and in the last couple of weeks, they eliminated their collection of photos. Now the site only features ads and press releases. Does anyone else wonder what happened? Sure you do! This is exciting.

Perhaps Re-Tooling 

Unless they are just re-tooling this weekend, I suspect that since their previous format was biased heavily in favor of advertising dollars in a tough economy, their funding simply dried up. Like so many other advertising-related careers, the dinosaur found it couldn’t compete in a 2.0 market.  Nevertheless, today I did learn something important from the DentalBlogs Wall: The ADA has opened a Facebook account.

http://www.facebook.com/home.php#/pages/American-Dental-Association/32252997166?ref=mf

Such transparency is inspirational

When I announced this news on Twitter a few hours ago (“Proots”), neither the ADA nor the TDA had yet told membership. Yea, I scooped them on their in-house news. It happens all the time.  Naturally, I became a fan of the ADA Facebook. When I joined, there were already 1205 fans, even though the site is yet operational. I found that intriguing because it usually takes a long time for most FBs to attain 1200 fans – especially when all one can gather is the mission statement of the ADA’s newest Internet site.

My View 

Here’s what I see: About the time DentalBlogs laid off employees from their fully active Facebook, the ADA opened theirs (Gasp)! The ADA was well known to DentalBlogs because the ADA once advertised with them regularly. That is where I found an article about the ADA-approved CareCredit/GE that ended up causing problems for some people and entertainment for others. Let’s face it, friends. I just know that I’m not the only dentist in the nation with at least two burning questions. I bet at least 4 others are wondering who were the first seven fans to sign up for the ADA Facebook and Has Kim Volk, CEO of DDPA signed up yet?

Because the number of fans is rapidly piling up, such information from a few weeks (?) ago could soon be just too difficult to uncover from the fans list on the ADA site. It took a long time for me to scroll down through 1200 names – looking for those I recognize (Gasp)!

Scrolling Quickly, but Carelessly

I could have easily missed several easily recognizable names in contemporary dentistry, but as far as I can tell, not only was Delta Dental Plans Association CEO Kim E. Volk’s name not present in the list of 1200 fans, but there were very few names I recognized … and I’m sorry if I insulted anyone. I also did not see “Ron Tankersley” and other ADA officials’ names on the fans list. Didn’t the ADA try partial transparency like this once before? I may be wrong, but I think I played a role in shutting it down a few years ago with my persistent and still unanswered questions about the NPI number.

More Semi-Reliable Information

Here’s another bolus of semi-reliable information: I also quickly scrolled through DentalBlog’s list of 400 fans and did not notice an unusual amount of matches with the ADA Facebook fans list.

Those who dare to do so, might just ask, “So if the ADA fans didn’t come from dentalblogs, where did they come from?” I think one possibility is that the ADA effort has been in Beta and limited to a select group of people up until now. Doesn’t it seem strange that nobody is able to post anything? Did someone open the doors a few hours early? So who were the first 7 fans? No, you don’t have to scroll down to find out for yourself. I’ll tell you.

Who is John Hergert?

The first person to become a fan of the ADA Facebook account is named John Hergert from Chicago, Illinois.

2nd – Laurie Rich

3rd – Amy Lund

4th – Kelsey Majors

5th – Jessica Stevens

6th – Samantha Campbell

7th – Lina Kulkormi

I don’t recognize any of the seven, and I have not searched anyone’s name other than John Hergert’s – the first person to become a fan of the ADA Facebook. I found someone named John Hergert in Chicago, Illinois who is Associate Vice President at Lipman Hearne Inc. – an advertising agency.

http://www.spoke.com/info/p6JVgPy/JohnHERGERT.

Here is the bio of the person I only suspect is the first to become a fan of the ADA Facebook.

John Hergert’s Biography

John Hergert Associate Vice President John Hergert has a keen understanding of what it takes to capture and hold the attention of marketing audiences via innovative marketing techniques. Formerly Associate Director of Marketing Communications at DePaul University in Chicago, John works with both traditional and interactive media to design and implement marketing strategies that build a client’s image, increase support, and grow enrollment or attendance. John’s experience includes developing ROI-based marketing strategies for a variety of nonprofit and for-profit clients. Prior to DePaul, John was an account executive overseeing marketing and advertising strategy, web development, direct mail, print production, and promotional development for clients including Disney, Marconi, Owens Corning, and Reynolds. John began his marketing career while at the University of Wisconsin, where he was hired by a Los Angeles firm to implement cutting-edge marketing programs for Saturn and Trek Bicycle Corporation. John received his B.A. in Journalism from the University of Wisconsin and his Master of Science in Information Systems from DePaul University.”

Assessment 

What do you want to bet that the ADA Facebook is Mr. Hergert’s baby?

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Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Product DetailsProduct DetailsProduct Details

Product Details  Product Details

   Product Details 

How MCOs Intensify Accounting IBNRs

Understanding the Uncertainty of Loss

By Staff ReportersHOFMS

 

Because of the high degree of uncertainty inherent in the estimates of ultimate losses underlying the liability for unpaid claims, the IRS will not allow a Managed Care Organization to deduct an IBNR because the financial statements are based on an estimate (IRS, 134-155).

Loss Based Deductions

Unless the taxpayer healthcare entity qualifies for the insurance company exclusion, the IRS does not allow any taxpayer entity to deduct losses based on estimates. However, the precedent has been set that the IRS will accept an amount for IBNR claims if the amount is supported by actuarial projections and/or valid receipts of claims that the company has in-house prior to the filing of the tax return.

Time Line Controversy

There has been some controversy as to how long a reporting time period the IRS will allow to include those estimates. The time period ranges from three to six months to file a claim (IRS, 137). The process by which these reserves are established requires reliance upon estimates based on known facts and on interpretations of circumstances, including the business’s experience with similar cases and historical trends involving claim payment patterns, claim payments, pending levels of unpaid claims, and product mix, as well as other factors such as court decisions, economic conditions, and public attitudes.

Assessment

There has been no clear indication from the IRS that it will accept an accrual for these losses and entities. Therefore, healthcare organizations deducting such losses may eventually find themselves in a position where the IRS may challenge the relating deductibility of those losses.

Conclusion

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Product DetailsProduct Details

   Product Details 

Tax Credits and Home Improvements for 2009-10

Income Tax Reduction Strategies

By Sean G. Todd; Esq, CPA, MTax, CFP® Sean G. Todd

Let’s take a look at how all ME-P readers can directly reduce income taxes in 2009. The use of tax credits are a very effective way to reduce how much you pay the IRS. A tax credit is a dollar for dollar reduction in your tax liability. So, anyone doing home improvements? 

Tax Credits Available

We always have to follow the rules to make sure our expenditures qualify: 

1)  The home improvement must be placed in service from January 1, 2009 through December 31, 2010
2)  The improvement must be for taxpayer’s principal residence, except for geothermal heat pumps, solar water heaters, solar panels, and small wind energy systems (where second homes qualify)
3)  $1,500 is the maximum total amount that can be claimed for all products placed in service in 2009 & 2010 for most home improvements, except for geothermal heat pumps, solar water heaters, solar panels, fuel cells, and small wind energy systems which are not subject to this cap, and are in effect through 2016
4) You must have a Manufacturer’s Certification Statement to qualify
5)  Improvements made in 2009 will be claimed on your 2009 taxes (filed by April 15, 2010) — use IRS Tax Form 5695 (2009 version) — it will be available late 2009 or early 2010

Assessment

Note: Recording keeping: put your receipt with certification statements.

Conclusion

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Grading the Public Options That Already Exist

Understanding Existing Healthcare Plans

By Sabrina Shankman, www.ProPublica.org

October 28, 2009 12:27 pm EDT

2007 Healthcare Costs

What might a public health option look like in practice? One way to find out is to look at what’s already out there.

Link: http://www.propublica.org/ion/health-care-reform/item/grading-the-public-options-that-already-exist-1028

Assessment

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Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Doctors versus Retail Bankers

Understanding Modern Reality

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Dr. David E. Marcinko MBA

Doctors often carry notoriously heavy debt loads. Beyond the costs of a medical education are substantial costs for equipping, launching and staffing a practice. Technology changes fast these days and capital is required frequently. And, the era of eMRs, ARRA, HI-TECH and Obama-Care is upon us!

“I‘m a Banker – I’m Here to Help”

Unfortunately, retail bankers are now very conservative by nature; and the liquidity squeeze and financial meltdown of 2008-2009 makes credit even more difficult to obtain. It may be increasingly difficult to borrow money, especially since modern bankers know that a medical degree is no longer the guarantee of a steady and high income that it once was in the past. As more than one banker has often opined to me,

“We don’t usually loan money to doctors who really need it.”

Nevertheless, the more business a physician does with a bank, the better the terms that can be obtained; even thought hey may also not have a clue about what the practitioner can do to better compete in the managed care arena.

Why Big-Banks Hate Customers

http://articles.moneycentral.msn.com/Investing/JubaksJournal/why-big-banks-hate-banking.aspx

Local Community

Some bankers do have a good concept of local community politics however, for those not familiar with a practice venue. They frequently can provide references to more focused advisors, and bankers generally do not charge a fee for their advice. But, banks selling products are doing so according to their governing regulations as “prudent experts” under ERISA, and are not necessarily held to a fiduciary standard in any broader sense.

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Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Events Planner: November 2009

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Events-Planner: NOVEMBER 2009

Staff WritersME-P Events Planner

“Keeping track of important health economics and financial industry meetings, conferences and summits”

Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement!  Watch for a new Events-Planner each month.

First, a little about us! The Medical Executive-Post is still a relative newcomer. But today, we have almost 25,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily.  And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention. And so, enjoy the Medical Executive-Post and our monthly Events-Planner with our compliments. 

A Look Ahead this Month

November 1: Print Edition Healthcare Journalism: If you would like to “step-up-your-game” and be considered as a peer-reviewed contributor to the third print edition of: The Business of Medical Practice [Health 2.0 Profit Maximizing Techniques for Savvy Doctors]; contact Ann at: MarcinkoAdvisors@msn.com. There are several chapter topics still available. Now, the important dates:

Nov 1-4: ASPPA Conference, National Harbor, Maryland.

Nov-5-6: Investment Decisions and Behavioral Finance, CFA Institute, Cambridge, MA.

Nov 16-17: Financial Behavior in Retirement, Source Media, Philadelphia, PA.

Nov 18: FINRA Small Firm Conference, San Francisco, CA

Please send in your meetings and dates for listing in the next issue of our ME-P Events-Planner.

MarcinkoAdvisors@msn.com

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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