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Should HHS Secretary Kathleen Sebelius be Replaced?

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A Voting and Opinion Poll

[By Ann Miller RN MHA]

We are all aware that critics are calling for the head of Kathleen Sebelius after the clumsy online rollout of the PP-ACA.

And so, we ask:

Assessment

After you vote; please leave a cogent opinion, too.

Conclusion

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The RAND Corporation’s Health IT Legacy‏

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Understanding ObamaCare and HIT Data Breaches

[By Darrell K. Pruitt DDS]

1-darrellpruittTwo current topics in the HIT industry: (1) A dishonest 2005 RAND study set up lawmakers for disappointment in electronic health records, which are essential to Obamacare, and (2) I told you so.

The Reports

Just the other day, there were reports of two data breaches of EHRs involving over 734,000 patients in Texas and California.

http://www.ihealthbeat.org/articles/2013/10/23/health-facilities-in-california-texas-report-health-data-breaches

For reasons like this, the wisdom of an ambitious mandate for paperless healthcare by 2014 is beginning to be questioned by the same lawmakers who were sucked in years ago by RAND’s tainted 2005 study.

According to the vendor-friendly results gleaned from vendor-friendly data supplied by vendors, EHRs should have started saving 100,000 lives and $77 billion a year, years ago. Predictably, that has not happened. Far from it!

The Findings 

The happy findings – discredited even by RAND in January of this year – were paid for by Cerner and GE, who profited immensely from their RAND investment. Since nationwide adoption of EHRs became a bi-partisan goal with bubbly beginnings and millions of campaign dollars, the costs and danger of healthcare IT didn’t appear to bother conservatives until three months after RAND admitted the study was garbage.

In April, six GOP senators, led by Sen. John Thune (R-S.D.), released a detailed report criticizing HHS Secretary Kathleen Sebelius’ execution of a $35 billion initiative to promote EHRs as part of the ARRA stimulus package. (See: “GOP senators raise concerns with push for electronic medical records,” by Sam Baker, April 16, 2013, The Hill).

http://thehill.com/blogs/healthwatch/medicare/294273-gop-senators-raise-concerns-with-push-for-electronic-medical-records

Wither ARRA?

Have you ever wondered why ARRA was passed as a jobs bill rather than as part of healthcare reform? Any ideas?

More recently, with the conservatives’ failure to stop Obamacare even by shutting down government, EHRs have become recognized as the ACA’s next best weakness. Yesterday, Greg Scandlen, writing for RightSideNews.com, posted “The Tyranny of Electronic Systems.” It goes downhill from there.

http://www.rightsidenews.com/2013102333379/life-and-science/health-and-education/the-tyranny-of-electronic-systems.html

Even More

Also yesterday, Michelle Mailkin writing for Townhall.com, an ultra-conservative website similar to RightSideNews, posted, “Don’t Forget Obamacare’s Electronic Medical Records Wreck.

http://townhall.com/columnists/michellemalkin/2013/10/23/dont-forget-obamacares-electronic-medical-records-wreck-n1730172?utm_source=TopBreakingNewsCarousel&utm_medium=story&utm_campaign=BreakingNewsCarousel

Assessment 

Conservatives found traction: Without the anticipated healthcare savings from EHRs, Obamacare will not survive. These times are not as happy for EHR stake-holders as RAND led them to expect.

Conclusion

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Doctors’ Use of For-Profit Algorithms Considered UnSportsManLike Conduct

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On Protecting Medical Coding Jobs

By Darrell K. Pruitt DDS

The US government moves quickly to protect tedious upcoding jobs from being taken over by upcoding software.

Medical Billing and Coding for Dummies

In coding expert Karen Smiley’s July 2012 book, “Medical Billing and Coding for Dummies,” she writes: “It really does pay to be a certified medical biller/coder, no matter what designation you choose to pursue. Surveys conducted by the AAPC [American Academy of Professional Coders] indicate that coder salaries have continued to increase despite economic downturns. One possible reason for this is that getting payers to pay claims is becoming increasingly difficult.”

Call me cynical, but to me, her defense of the coding profession confirms that healthcare’s increasing demand for highly-paid coders (who have nothing to do with directly providing care to patients) is artificial, and originates with an administration which complicates providers’ payments in order to create new, high-paying jobs in the HIT industry – quietly adding to the cost of healthcare to cosmetically boost employment figures before an election. Who ultimately pays the bill for all non-productive healthcare costs?

Amazon Morphs

Less than 3 months following the appearance of “Medical Billing and Coding for Dummies” on Amazon for under $25 (paperback), EMR software suddenly changed or morphed the entire game, and the administration reacts by changing the rules to protect political investments.

Similar to algorithmic trading’s proven advantage over low-tech investors on Wall Street, the computation capabilities of modern EMRs allegedly provide an unfair advantage to doctors and hospitals, and at taxpayers’ expense – according to HHS and Justice Department officials.

Enter Eric Holder and Kathleen Sebelius

“On Monday [September 24], Attorney General Eric Holder and HHS Secretary Kathleen Sebelius sent a strongly worded letter warning that the Obama administration will not tolerate hospitals’ attempts to ‘game the system’ by using EHR systems to boost Medicare and Medicaid payments.” – iHealthBeat, September 26, 2012.

http://www.ihealthbeat.org/articles/2012/9/26/stakeholders-react-to-warning-on-use-of-ehrs-for-upcoding.aspx#ixzz29fYzjPUH

This was followed by an article posted yesterday, also on iHealthBeat titled, “Mostashari To Launch Review of Using EHRs for ‘Upcoding,’”

http://www.ihealthbeat.org/articles/2012/10/17/mostashari-to-launch-review-of-using-ehrs-for-upcoding.aspx#ixzz29fDElIKL

Enter the NCHIT

“National Coordinator for Health IT Farzad Mostashari MD plans to launch an internal review to determine whether electronic health record systems are prompting some health care providers to overbill Medicare by selecting higher-paying treatment codes, a process known as ‘upcoding,’ the Center for Public Integrity reports.”

Apparently, it only recently occurred to lawmakers that the EMRs they promote greatly simplify Medicare’s intentionally tedious and time-consuming reimbursement requirements mentioned by Karen Smiley – making profits much easier for providers without having to hire even more staff just to get paid for work done long ago. In addition, the alleged upcoding software threatens to eliminate the need for recently-graduated coding professionals – whose education was backed by ARRA stimulus (taxpayer) money. While our nation’s leaders might wink at institutional investors’ highly-profitable algorithmic trading on the stock market, unemployed coding specialists with outstanding college loans would only increase the potential embarrassment for the administration should doctors and hospitals be permitted to computerize billing decisions – leading to payment for services previously given away because they weren’t worth the hassle and expense of documentation!

Assessment

Unlike investors playing the stock market, according to Medicare’s emerging rules, doctors’ use of algorithms to increase profits is considered unsportsmanlike conduct. With the election only days away, can you blame them?

Conclusion

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Update on Senior Donut Hole Rebate Checks

More Seniors to Receive One-Time Donut Hole Rebate Checks

By Staff Reports

Medicare Beneficiaries Whose High Prescription Drug Costs Have Put Them in the Medicare Part D Donut Hole to Receive $250 Rebate Checks as a Result of the Affordable Care Act

WASHINGTON – The next round of more than 300,000 eligible seniors who have entered the Medicare Part D “donut hole” this year have been mailed their tax-free, one time rebate check for $250, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced recently. These one-time rebate checks are the first step in closing the prescription drug coverage gap under the Affordable Care Act. The first round of checks were distributed in the middle of June. As qualifying Medicare recipients “fall into the donut hole,” they will be sent a rebate check by Medicare.

“Seniors and other Medicare recipients in the Medicare donut hole are struggling to afford the medications they need and their basic living expenses. Seventy percent of our first round of these $250 rebate checks were cashed within a week of eligible Medicare recipients receiving them; so, we know that folks really need some help,” said Secretary Sebelius. “The Affordable Care Act starts to close the donut hole this year, giving much-needed relief to millions of seniors. In 2011, the Affordable Care Act takes an additional step for Medicare beneficiaries in the donut hole by providing them with a 50 percent discount on their brand name medications. Every year from 2012 until 2020, the Affordable Care Act will take progressive steps to close the donut hole.” 

“Seniors also need to know that they will just receive their check at their usual address – they don’t have to take any extra steps,” said Centers for Medicare & Medicaid Services Deputy Administrator and Director for the Center for Medicare, Jonathan Blum. “And they should never give out their personal information. If someone asks for your personal Medicare information over the phone who isn’t a trusted resource like Medicare, please don’t provide it. Seniors or family members should contact us at 1-800-MEDICARE to report any of these types of calls or go to www.stopmedicarefraud.gov to learn more about efforts to fight fraud and scams against seniors.”

On Thursday, July 8th, at 2:00 p.m., HHS Secretary Kathleen Sebelius joined local officials in Manchester, N.H., for a forum with senior citizens to discuss the rebate checks and other benefits of the Affordable Care Act as well as efforts to fight Medicare fraud.

The $250 checks are being mailed to those Medicare beneficiaries who entered the Medicare Part D donut hole, also known as the coverage gap, in the second quarter of 2010 and are not eligible for Medicare Extra Help (also known as the low-income subsidy or LIS) or enrolled in a qualified retiree prescription drug plan. The donut hole is the period in the prescription drug benefit in which the beneficiary pays 100 percent of the cost of their drugs until they reach the catastrophic coverage phase.

About Medicare Extra Help

Medicare Extra Help provides assistance to seniors so they don’t face higher costs or a coverage gap in their prescription drug coverage. Qualifying Medicare beneficiaries who entered the donut hole in the first quarter of 2010 who were not eligible for Medicare Extra Help received a check in the first round of rebates mailed June 10th. Going forward, a check for qualifying beneficiaries newly reaching the donut hole in 2010 will be mailed monthly.

Assessment

More information about the “donut hole” rebate checks, please contact www.HealthCare.gov or 1-800-MEDICARE. For further questions about Extra Help (or the LIS) benefit under Part D, please contact the Social Security Administration at www.ssa.gov.

Conclusion

Doctors and FAs – how will this rebate assist your patients and clients? Feel free to comment and 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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Protected Health Information Data Breaches

Affecting 500 or More Individuals

[By Staff Reporters]

As required by section 13402(e)(4) of the HITECH Act, the Secretary must post a list of breaches of unsecured protected health information affecting 500 or more individuals.

The following breaches have been reported to the Secretary of the US Department of Health and Human Services [DHHS].

Full Report

This link was sent in by our own investigative reporter Darrell K. Pruitt, DDS.

Link: http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/postedbreaches.html

Assessment

Shall we await a response from Kathleen Sebelius, who was sworn in as the 21st Secretary of the Department of Health and Human Services (HHS) on April 28, 2009?

Currently, she leads the principal agency charged with keeping Americans healthy, ensuring they get the health care they need, and providing children, families, and seniors with the essential human services they depend on. She also oversees one of the largest civilian departments in the federal government, with nearly 80,000 employees.

Conclusion

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Dr. Mark Leavitt says “Trust me”

On eMRs – Just Go for IT

By Darrell K. Pruitt; DDS

Neil Versel, a frequent contributor to FierceEMR, posted an article titled “CCHIT’s Leavitt: Don’t wait for final rules to proceed with EHR.”

http://www.fierceemr.com/story/cchits-leavitt-dont-wait-final-rules-proceed-ehr/2010-02-18#comment-778

Half-Baked Ideas 

Even though many states are spending eHR stimulus bucks as fast as they can on half-baked, expensive ideas that enrich HIT stakeholders, most physicians and most all dentists are delaying investing tens of thousands of dollars in HIT fantasy until HHS Secretary Kathleen Sebelius gets her act together. Sebelius is in way over her head. She hasn’t even settled on the definition of “meaningful use” for crying out loud.

Soon to Be Former CCHIT Leader 

Foot-dragging upsets the soon to be former head of CCHIT Dr. Mark Leavitt. He says doctors should put caution aside and just go for it.

“We believe that it’s risky for providers to wait until all the federal rules are final. If you wait to purchase an eHR until the rules are final and the accreditation process for certifying bodies is complete, I will put my reputation on the line and say that you will not achieve meaningful use in 2011.”

Assessment 

So, Dr. Leavitt, even as you are no longer wanted at CCHIT and are leaving in less than six weeks, you promise American doctors that your reputation is like (stimulus) money in the bank. Will you co-sign loan agreements? Talk is cheap, Dude.

Conclusion

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The Time Costs of Internal HIPAA Complaints

On Hospital Compliance

By Staff Reporters

The privacy regulations of HIPAA require that each hospital have an internal process to allow an individual to file a complaint concerning the covered entity’s compliance with privacy policies and procedures. This requires hospitals to designate a contact person to be responsible for receiving and documenting the complaint as well as the disposition.

A formal response to the person is not required as part of this rule; therefore it is estimated that each complaint, even though rare, will take ten minutes to document.

Recent Data

Recent data reveals that the most frequent complaints received either by hospitals or ultimately by DHHS include the following:

  • impermissible use or disclosure of individual PHI (most occurrences were curiosity or accidental, yet were reported);
  • lack of safeguards to protect PHI;
  • refusal or failure to provide an individual with access to or a copy of his or her record;
  • disclosure of more information than is minimally necessary; and
  • failure to have the individual’s valid authorization for a disclosure that requires one.

Assessment

Most hospitals have documented and logged such complaints; have reviewed the situation; and have resolved the problem internally.

Conclusion

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