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The Final Rule that adopts changes to the HIPAA Electronic Transaction and Code Set Standards was released in the February 20, 2003 Federal Register. This Rule modifies some retail pharmacy transactions and standard transactions.
For example, the transaction standards for Health Care Claims:
- Health Care Provider Taxonomy Codes and "date last seen by physician" (for certain PT claims) now only must be provided when they impact claim adjudication
- Principal diagnosis and line level physician information is now not always required, instead their use is situational
- A HCPCS code is required only when one exists for the reported service.
The Rule also confirms that the NDC code set will not be the national standard for drugs and biologics (except for retail pharmacies). It states that it is expected that current coding practices for drugs and biologics will continue.
Referring to the October 2002 compliance date, the Rule states that "We will not invoke our authority to penalize noncompliance with standards that our own delay in issuing this final rule has made infeasible."
Click here to read the modifications to the Electronic Data Transaction and Code Sets documents.
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The Final Rule for the HIPAA Security Standards was published in the February 20, 2003 Federal Register. The compliance data for providers is April 20, 2005.
The HIPAA Security Rule defines safeguards to protect the confidentiality, integrity, and availability of electronic protected health information. Providers are required to protect electronic health information from unauthorized access, alteration, deletion, and transmission.
Entities covered by the HIPAA Security Rule are health plans, clearinghouses, and health care providers that maintain or transmit health information electronically. The Rule makes no distinction between internal corporate communications and communications external to the corporation.
The proposed Security Rule published in 1998 included electronic signatures. The 2003 Rule states that the standard for electronic signature will be published later.
Security vs. Privacy
The HIPAA Privacy and Security Rules are intended to work together. The HIPAA Privacy Rule sets forth what uses and disclosures are authorized or required; it also defines patients' rights with respect to their health information.
The Security Rule is concerned with protecting the data and applies only to health information in electronic form - the Privacy Rule applies to protected health information in any form.
Safeguards, Standards, Implementation Specifications
The Security Rule includes 18 Standards in three areas of safeguards: Administrative, Physical, and Technical.
To add flexibility in compliance, implementation specifications are labeled as "required" or "addressable". Providers must determine if an addressable specification is reasonable and appropriate given its security framework. If it is, then the provider must implement it.
Below are examples of the 18 Security Standards:
Administrative Safeguards
An example of a standard under this safeguard is Security Awareness and Training defined as implementing a security awareness and training program for all members of its work force (including management). Implementation specifications:
- Security reminders (addressable) - periodic security updates
- Protection from malicious software (addressable) - procedures for guarding against, detecting, and reporting malicious software
- Log-in monitoring (addressable) - procedures for monitoring log-in attempts and reporting discrepancies
- Password management (addressable) - procedures for creating, changing, and safeguarding passwords
Physical Safeguards
One of the standards, Device and Media Controls, addresses the receipt and removal of hardware and electronic media that contain electronic protected health information - in and out of the facility, and within the facility. Implementation specifications:
- Disposal (required) - policies and procedures
- Media re-use (required) - policies and procedures
- Accountability (addressable) - maintain a record of the movements of hardware and electronic media, and a responsible person
- Data backup and storage (addressable) - create a retrievable copy of data before moving equipment
Technical Safeguards
The Access Control standard is intended to allow access to information systems to only those persons or software programs that have been granted access rights. Implementation specifications:
- Unique User Identification (required) - assign a unique name or number for identifying and tracking users
- Emergency access procedure (required) - policies and procedures
- Automatic log off (addressable) - electronic procedures that terminate a session after a predetermined time of inactivity
- Encryption and decryption (addressable) - encoding data for storage and decoding data for retrieval
Click here to read the complete HIPAA Security Standards document.
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CMS updated the Quality Measure results for each long-term and post-acute care facility in the country on February 27, 2003. The Nursing Home Compare website will include facilities' results on the same ten Quality Measures posted in November 2002.
The results were calculated using MDS assessments from July 2002 through September 2002 for the long-term Quality Measures and April 2002 through September 2002 for the post-acute Measures.
A users' manual for providers was posted on the CMS Nursing Home Quality Initiative website. The manual includes definitions of each Quality Measure and the criteria used to select which MDS assessments are included in the calculations. Click here to download that document and other reference materials.
Click here to view your updated results at the Nursing Home Compare website.
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CMS published a proposed rule (68FR11234) for its annual update of payment rates for the Medicare Prospective Payment System (PPS) for inpatient hospital services provided by long-term care hospitals. The proposal
includes a potential change to the annual period covered by the update.
CMS would like to change from an October through September year to a July through June year. It is also proposing to change the publication schedule for these updates to allow for an effective date of July 1. The proposed payment amounts and factors
used to determine the proposed rates have been determined based on this revised update rate year.
In addition, CMS is proposing that the annual update of the long-term care diagnosis-related groups classifications and relative weights remain linked to the annual adjustments of the acute care hospital inpatient diagnosis-related group system effective
each October 1. Other changes to outliers and bed-number restrictions are also discussed in the proposed rule.
Click here to view the details of the proposed rule in the March 7, 2003 Federal Register.
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Effective January 1, 2003, surveyors must note whether Long Term Care facilities have posted the number of licensed and unlicensed nursing staff directly responsible for care that day, on each shift.
That information is instantly available from the Daily Staffing report generated from Intellicost Enterprise Staff Scheduling - software designed specifically for Long Term and Post-Acute Care.
Enterprise Staff Scheduling improves facility efficiency overall while it dramatically decreases time spent on scheduling and reduces staff costs. It helps you balance employee satisfaction, quality of care, and expenses by putting complete information at your fingertips.
Tools to Manage Staffing
Per Patient Day (PPD) analysis facilitates staffing at appropriate levels. Overtime and agency use are continually monitored. This one software product gives you both PPD data and the tools to manage staffing. It also provides instant access to actual and projected budget information.
Intellicost Enterprise Staff Scheduling is a web-enabled program that runs on the Internet and can be hosted locally or remotely. Because multi-facility organizations share a database, schedules and management information for all sites are instantly available to all staff who have access.
Key Features
- Reduces the amount of time spent on scheduling
- Calculates daily PPD hours and dollars
- Identifies opportunities to reduce overtime and agency use
- Provides a wide range of valuable reports for staffing management
- Maintains employee information
- Provides staff with their schedule: bi-weekly or monthly
- Tracks use of agency staff
- Provides a secure web-based solution that's available to authorized staff anywhere via the Internet
Intellicost Enterprise Staff Scheduling is a product of Broader Healthcare Solutions, LLC. For more information, contact your local sales representative or Kim Barth at 800.426.2675 or via e-mail at info.ltc@keane.com.
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2003 Client Conference
April 27-30, 2003
J.W. Marriott Las Vegas Resort
Las Vegas, Nevada
Technology is helping to shape the future of healthcare - by providing better patient care, improved access to data, and a healthy return on investment. But technology alone is not the answer. It takes teamwork to get the job done right.
All Keane Care clients are invited to join us at the 2003 Keane Client Conference and discover how technology and teamwork can help you meet your business and care delivery goals. Team up with colleagues, industry experts, Keane business partners, and Keane staff members and learn how to get the most out of information.
The conference provides the perfect forum to meet with your peers, brush up on industry issues, and gain some valuable insights on how to achieve top performance from your system. The agenda will include general sessions for all Keane clients - plus plenty of time dedicated to individual product lines and applications.
Registration is $395 per person. If you register four or more people, it is $350. Pre-conference training is $175 for a single class and $300 for two classes.
Additional details and registration information can be found on The Insider.
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The Keane LTC Users' Group invites staff from all facilities using the VistaKEANE system to participate in their organization.
The mission of the Keane LTC Users' Group is to provide input to ensure all the products used by Keane Long-Term Care clients meet the ongoing requirements of the post-acute care community. The Users' Group is a self-governing body, independent of Keane.
Membership in the Users' Group is free and individuals determine their level of involvement.
Sign Up Now
Keane Care customers can visit the VistaKEANE Insider for more information and to sign up for the Keane LTC Users' Group.
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