News Briefs

HHS: 450,000 health workers may get vaccine

A preliminary review of smallpox vaccination plans submitted by U.S. states and cities in mid-December indicates that close to 450,000 public health and health care personnel may be offered the vaccine when it becomes available, according to the Department of Health and Human Services (HHS).

It is expected that access personnel who work in the emergency department, if not those in other areas, will be among the first group to be offered the vaccine. The plan is voluntary, the HHS says, and eligible individuals will make their own decision on whether or not to receive the vaccine.

Plans submitted so far contain information on the number of people comprising each public health smallpox team and each health care smallpox response team, information on where vaccines would be administered, the number of health care facilities identified to participate, and the number of clinics needed to support the effort.

No two state plans are identical, Centers for Disease Control and Prevention (CDC) officials say. The CDC provided states with guidelines, but also offered the flexibility to design a plan to meet specific needs.

HHS has launched a web site ( that answers questions about smallpox and the president’s vaccination plan, which it recommends for those who will be receiving the vaccination or are debating getting the inoculation.

Additional information on steps being taken to prepare for terrorism emergencies that would impact public health is available at

The Chicago-based American Hospital Association (AHA), meanwhile has said that while it supports the Bush administration’s voluntary smallpox vaccination program, key unresolved issues remain. They include liability, employee testing, and implementation, according to Roslyne Schulman, AHA senior associate director for policy development.

Outlier payment scrutiny to be increased, CMS says

Hospitals receiving large proportions of Medicare revenues as outlier payments will face an increased probability of review, and fiscal intermediaries will be asked to carefully scrutinize all of their billing practices, according to an announcement by the Centers for Medicare & Medicaid Services (CMS).

CMS also said it would increase the outlier payment threshold in 2003 to $33,560, up from $21,052 in 2002.

The American Hospital Association (AHA), which has encouraged CMS to safeguard the integrity of the Medicare program, said the step — implementing what it calls appropriate scrutiny of billing practices — seems reasonable.

"We’re pleased to see CMS acknowledge that hospitals that treat very sick patients who are exceptionally costly to care for should be reimbursed for that care," said Carmela Coyle, AHA senior vice president for policy. For more information, go to

Hospitals can offer free rides despite gift limits

Provisions that limit gifts to Medicare and Medicaid beneficiaries will not be enforced in the context of complimentary local transportation, the Department of Health and Human Services’ Office of Inspector General (OIG) has said.

The position was stated in response to a hospital inquiry regarding free transportation to patients and their families to the hospital and hospital-owned ambulatory surgical centers. OIG has said it is considering a regulatory exception that would allow hospitals to provide some free local transportation valued higher than the current limits of $10 per incident and $50 in the aggregate per year.

The position, announced in a Dec. 10, 2002 letter, will be in force until the OIG makes a decision on whether to issue a new regulatory exception. In the letter, OIG specified that the free transportation may be provided only within the hospital or ambulatory surgical center’s primary service area. For more information, go to

HHS offers guidance on HIPAA privacy rule

A document to address frequently asked questions about the Health Insurance Portability and Accountability Act privacy regulation is available from the Department of Health and Human Services’ (HHS) Office of Civil Rights.

According to one section in the guidance document, hospitals are not prohibited from keeping patient charts at the bedside and displaying patient care signs, such as "diabetic diet," if reasonable precautions are taken to protect patient privacy, such as limiting access to patient areas.

Also in the document, the agency commits to continued monitoring of the "workability" of the minimum necessary requirements and to consider revisions where necessary to protect access to and quality of care.

HHS also says that marketing rules that permit communications with patients about products and services for treatment or case management purposes do not modify or otherwise pre-empt the anti-kickback laws. The document can be found at

HAM offers more with HIPAA insert

This month’s issue of Hospital Access Management includes a copy of HIPAA Regulatory Alert, an eight-page, bimonthly supplement that covers the complexities of remaining compliant with the Health Insurance Portability and Accountability Act (HIPAA). There have been many changes since the original regulations were released in 1996. This year brings even more changes with HIPAA privacy and security. This supplement will appear again in the March issue of HAM, and then will begin its regular schedule every other month. This insert will provide readers with the most up-to-date resource on changes to the regulations and how to implement convenient and painless change within your facility.