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The final rule related to recovery audit contractors (RACs) for Medicaid was released in mid-September (http://www.gpo.gov/fdsys/pkg/FR-2011-09-16/pdf/2011-23695.pdf), just over three months before it goes into effect. It provides a variety of guidance and opt-outs for states that have many compliance experts scratching their heads.
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Imagine the ongoing dismay of a high school math teacher who year in and year out has to teach students how to do the problems the right way, and year in and year out sees the same mistakes over and over again.
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Grena Porto, a principal consultant with QRS Healthcare Consulting in Delaware, has made a career out of advocating for patient safety and improved quality. It should not have surprised some people, then, when she posted on a patient listserv all the reasons why she believes peer review doesn't work and detailed a number of cases to illustrate why.
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One survey every three years is trying enough. But for Novant Health's Presbyterian Hospital in Charlotte, NC, that would have seemed like a vacation. Between June and August of this year, the hospital had a Joint Commission survey, a CMS survey, and the regular biannual visit from the local health department.
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While there is general agreement that temporary staff can threaten patient safety and increase malpractice risks, the question is not quite so clear with nurse practitioners (NPs) and physician assistants (PAs) in the emergency department (ED).
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E-mail practices and mobile e-mail cause the most concern for data protection and regulatory compliance, according to the 830 individuals whose responses were included in a study conducted by the Ponemon Institute and Zix Corp., an e-mail encryption service.
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The March of Dimes, based in White Plains, NY, recently began an initiative in New York, California, Florida, Texas, and Illinois to implement a "39-week toolkit" in hospitals to discourage C-sections or inductions before that minimum gestation.
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Brian A. Todd, CHAM, manager of patient access staff development and training at Lourdes Health System in Camden, NJ, is seeing additional restrictions coming from companies that are doing clinical necessity checking.
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After a registrar immediately blamed a clinic because she wasn't able to verify a patient's demographics, Nicole Marsoobian, supervisor of pre-registration at Tufts Medical Center in Boston, sent her to the clinic for an hour.
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At St. Joseph East/St. Joseph Jessamine in Lexington, KY, collections in a newly opened women's hospital went from only about $100 in March 2010 to $15,000 a year later, and preadmissions collections, which were just $1,300 monthly, now range from $15,000 to $40,000. Stanford (CA) Hospitals and Clinics expects to collect $1 million more at point-of-service in 2012.
