Reimbursement

Fifteen years after the Omnibus Budget Reconciliation Act (OBRA) directed the Centers for Medicare & Medicaid Services (CMS) to implement intermediate sanctions for noncompliant home health agencies (HHAs), the federal agency has finally complied.

The business of healthcare is complex and is often not clearly understood by the patient or even by the medical office staff. Here are five steps that medical practices should take to help patients understand medical bills and be better prepared to handle them.

The U.S. Department of Health and Human Services (HHS) on Aug. 7 released an interim final rule for making healthcare claim payments electronically and describing adjustments to claim payments. The department expects this next step in the adoption of operating rules to save up to $9 billion over the next 10 years.

For hospitals looking to transform into accountable care organizations (ACOs), the transition can be overwhelming. So much so, said Brent Dover, president at HIE technology company Medicity, that it's basically like becoming a mini insurance company.

Health and Human Services Secretary Kathleen Sebelius released a new rule she says will cut red tape for doctors, hospitals and health plans. In combination with a previously issued regulation, she estimates the rule will save up to $9 billion over the next 10 years.

According to a recent study published in the August issue of the American Journal of Infection Control, nurse burnout has been linked to higher rates of healthcare-associated infections (HAIs), which therefore costs hospitals millions of additional dollars each year.

Managing multiple chronic conditions is still elusive for most patients, according to a Kaiser Permanente Colorado Institute for Health Research study that found only "fleeting" success for a minority of MCC patients.

In fiscal year 2013, inpatient hospital payments will be increasing by 2.3 percent ($2.5 billion) under the final rule for the hospital inpatient and long-term care hospital prospective payment systems (PPS). The final rule was issued Wednesday night by the Centers for Medicare & Medicaid Services (CMS).

Humana, and dLife Healthcare Solutions have partnered to offer its diabetic Medicare Advantage members a new multimedia self-care and education program based on the success of a 2011 pilot project.

Several key dates are looming as the Affordable Care Act continues its steady transition from legislation to law. There's Jan. 1, when 10 major provisions are slated to go live. Or Nov. 6 -- Election Day -- when the ACA's fate may be decided yet again.