Wednesday, November 30, 2011

Smart Card Alliance Releases White Paper on Health ID

The Smart Card Alliance Healthcare Council released a white paper providing smart card guidance for the Workgroup for Electronic Data Interchange (WEDI) Health Identification Card Implementation Guide. The white paper provides WEDI-compliant smart card designs and includes a discussion of the features and benefits of smart ID cards for healthcare providers and payers.

“The Smart Card Alliance supports WEDI’s goal to enable automated and interoperable identification using standardized machine-readable health identification cards,” said Randy Vanderhoof, executive director of the Smart Card Alliance. “This white paper complements the WEDI guide by outlining how smart card technology provides a strong foundation for health ID cards. They enable improvement in healthcare processes and in patient identity verification, while securing patient information and protecting patient privacy.”

“The intent of the WEDI Guide and its underlying ANSI standard is to standardize present practice and bring uniformity of information, appearance, and machine-readable technology. It offers great benefit; yet it is a simple identification card. Smart card technology, with its far greater capacity and ability to be updated, brings opportunity for heightened security and new health applications,” said Peter Barry, co-chair, WEDI Health ID Card workgroup.

The white paper provides a thorough explanation of smart card technology, as well as the benefits of smart cards for healthcare applications for payers, healthcare delivery organizations, patients, healthcare providers, and healthcare employers. Some of these benefits include:
- Accurate identification of the patient
- Accurate information on patient health plan
- Reduction in medical fraud
- Reduction of duplicate tests and payments
- Streamlined patient registration
- HIPAA compliance
- Improved patient privacy and information security
- Support for meaningful use requirements
- Reduced costs

“The WEDI Health ID Implementation Guide specifically mentions smart cards as an appropriate card type, and this white paper expands on the idea. Smart cards are the only technology that can provide the security and privacy features that are fundamental to any patient identity management system,” said Michael Magrath, chairman of the Smart Card Alliance Healthcare Council and business development director for Gemalto.

Please click here for more information.

Source: Smart Card Alliance News Release

HHS Awards Affordable Insurance Exchange Funds to States

The Department of Health and Human Services (HHS) awarded nearly $220 million in Affordable Insurance Exchange grants to 13 states to help them create Exchanges, giving these states more flexibility and resources to implement the Affordable Care Act. The health care reform law gives states the freedom to design Affordable Insurance Exchanges – one-stop marketplaces where consumers can choose a private health insurance plan that fits their health needs and have the same kinds of insurance choices as members of Congress.

The Department also released several Frequently Asked Questions providing answers to key questions states need to know as they work to set up these new marketplaces. Critical among these are that states that run Exchanges have more options than originally proposed when it comes to determining eligibility for tax credits and Medicaid. And states have more time to apply for “Level One” Exchange grants.

The awards bring to 29 the number of states that are making significant progress in creating Affordable Insurance Exchanges. States receiving funding today include: Alabama, Arizona, Delaware, Hawaii, Idaho, Iowa, Maine, Michigan, Nebraska, New Mexico, Rhode Island, Tennessee, and Vermont.

“We are committed to giving states the flexibility to implement the Affordable Care Act in the way that works for them,” HHS Secretary Kathleen Sebelius said. “Exchanges will give consumers more choices and make it easy to compare and shop for insurance plans.”
In the new Exchanges, insurers will provide new information such as an easy-to-understand summary of benefits and costs to consumers. The level of detail will sharpen competition between carriers which will drive costs down.

HHS also released a set of Frequently Asked Questions (FAQs) in anticipation of state legislative sessions beginning in January. Answers will help advance state policy development for Exchanges. For example, they clarify that Exchange grants can be used to build a state Exchange that is operational after 2014; that state-based Exchanges will not be charged for accessing Federal data needed to run Exchanges in 2014; and that state insurance rules and operations will continue even if the Federal government is facilitating an Exchange in the state. HHS will also allow greater flexibility in eligibility determinations, allowing, for example, a state-based Exchange to permit the Federal government to determine eligibility for premium tax credits.

Of the 13 states awarded grants today, 12 are receiving Level One grants, which provide one year of funding to states that have already made progress using their Exchange planning grant. The 13th state, Rhode Island, is receiving the first Level Two grant, which provides multi-year funding to states further along in the planning process.

Forty-nine states and the District of Columbia have already received planning grants, and 45 states have consulted with consumer advocates and insurance companies. Thirteen states have passed legislation to create an Exchange.

States have many opportunities to apply for funding. To accommodate state legislative sessions and to give states more time to apply, HHS also announced a six-month extension for Level One establishment grant applications. Applications now will be accepted until June 29, 2012 (the original deadline was December 30, 2011).

For the FAQs, visit

For more information on Affordable Insurance Exchanges, visit

For more information on the states receiving grants, visit

Source: HHS News Release

HHS Releases Tool to Help Small Businesses Compare Insurance Plans

A greatly expanded website to give small business owners an unprecedented detailed review of their health insurance plan choices was announced by the U.S. Department of Health and Human Services (HHS).

Just in time for 2012, this powerful new tool allows small business owners to compare the benefits and costs of health plans and choose those that are best for their employees. For the first time ever, it will allow small businesses to research locally available products in an unbiased manner and foster a more transparent and competitive marketplace.

“This new information will help business owners navigate what has traditionally been a complicated and confusing decision,” said HHS Secretary Kathleen Sebelius. “Both owners and their employees can feel more confident that the plans offered will be the best to suit everyone’s needs.”

In addition to the market being difficult to analyze, small businesses do not fare as well large employers when negotiating health care prices, on average small businesses spend 18 percent more for the same health insurance coverage. This new tool brings needed transparency to the marketplace, which will help ensure insurance companies will compete for business on the basis of price and quality.

The tool is located on, which was created under requirements contained in the Affordable Care Act, the new health care law of 2010. The website is the first of its kind to bring information and links to health insurance plans to one place, and to make it easy for consumers to learn about and compare their insurance options. The Centers for Medicare & Medicaid Services worked to define and collect detailed benefits and premium rating information from insurers across the country to develop the site.

The new information added gives small business owners access to the following:
Insurance product choices for a given ZIP code, sorted by out-of-pocket limits, average cost per enrollee, or other factors.

A summary of cost and coverage for small group products that shows the available deductibles, range of co-pay options, included and excluded benefits, and benefits available for purchase at additional cost.

The ability to filter product selection based on whether the plans are Health Savings Account eligible, have prescription drug, mental health, or maternity coverage, or allow for domestic partner or same sex coverage.

More than 530 insurers have provided information for more than 2,700 coverage plans across all states and the District of Columbia.

“Tens of thousands of small businesses from across America have already logged-on to to see what health coverage options are available to them,” said Steve Larsen, director of the Center for Consumer Information and Insurance Oversight. “The new, unprecedented ability to search at this level of detail will bring the marketplace into better balance by giving insurance purchasers the power of information.”

In addition, the website provides extensive information about consumer rights, tips for how to navigate the market’s complexities, and details on how the Affordable Care Act provides new protections for beneficiaries.

To access the small business Insurance Finder, go to the home page of and click on the blue tab at the top of the page.

For more information, visit, or access the HHS Facebook page or Twitter account. To download a Insurance Finder widget visit

Source: HHS News Release

TJC To Launch Enhanced e-App

The Joint Commission announced that on December 28, 2011, it will launch an enhanced electronic application for accreditation (E-App) for all accreditation programs, except for the laboratory accreditation program and certification programs.

Source: TJC Release

NIH Undergraduate Design Challenge Focuses on Healthcare Tech Solutions

A competition for undergraduate students to foster the design and development of innovative diagnostic and therapeutic devices, and technologies to aid underserved populations and the disabled is being sponsored by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of the National Institutes of Health. The Design by Biomedical Undergraduate Teams (DEBUT) Challenge is part of NIBIB's efforts to build, strengthen, and prepare the future workforce of biomedical engineers.

One winning student team will be selected for each of three challenge categories: diagnostic devices/methods; therapeutic devices/methods; and technology to aid underserved populations and individuals with disabilities. Eligible team candidates must be full time undergraduate students and U.S. citizens or permanent residents. Each winning team will receive a $10,000 prize, to be distributed among the team members. Winners will be honored at an award ceremony during the 2012 Annual Meeting of the Biomedical Engineering Society (BMES) in Atlanta, Ga. Each winning team will also receive up to $2,000 towards travel and registration costs to attend the awards ceremony.

Dr. Zeynep Erim, the architect of the NIBIB challenge, said "At NIBIB, we aim to prepare the next generation of engineers working at the intersection of the biological and physical sciences to improve human health. This program challenges up-and-coming biomedical engineers to force the boundaries of their design skills and knowledge to develop innovative biomedical technology for health care."

"As a nation, we have reached a crossroads where there is a tremendous opportunity to harness the science, engineering, and mathematics talent within our universities to address challenges in health care," stated Dr. Roderic Pettigrew, NIBIB director. "NIBIB's DEBUT Challenge, authorized under the America Competes Act, seeks to promote competitiveness in these disciplines and to put American ingenuity to work to address some of the unmet medical needs that are most prevalent in our country. I look forward to seeing what technological innovations our best and brightest students can offer to improve health care in our nation."

Details on how to enter, requirements and general information about the challenge can be found at

For updates and additional information, visit

Source: NIH News Release

CMS Announces New Demonstrations to Help Curb Improper Medicare, Medicaid Payments

The Office of Management and Budget (OMB) announced that the Administration cut wasteful improper payments by $17.6 billion dollars in 2011 as part of the Obama Administration’s Campaign to Cut Waste, fueled by decreases in payment errors in Medicare, Medicaid, Pell Grants, and Food Stamps. Combined with the avoided improper payments in 2010, agencies have avoided making over $20 billion in improper payments in the two years since President Obama issued an Executive Order initiating an aggressive campaign against the wasteful payment errors.

To help cut improper payments, the Centers for Medicare & Medicaid Services (CMS) has announced it will launch demonstration programs beginning in January 2012 targeting some of the most common factors that lead to improper payments. The demonstration programs will help strengthen Medicare by aiming at eliminating fraud, waste, and abuse.

To see the OMB press release, please visit:

To learn more about CMS efforts to cut improper payments, please visit:

Source: HHS News Release

Monday, November 28, 2011

Patient Engagement Important to Success of Health Care Reform

Kenneth Bertka, MD, recently authored an article about the importance of patient engagement in the success of health care reform. In his article Patient Engagement's Critical Role in Post-Reform Success: 6 Steps to Improve Patient Centeredness, Dr. Bertka says that "[p]atient more than a nice thing to do. Engaged patients are more likely to comply with their treatment and prevention plans, which results in higher quality care, fewer medical errors and lower cost."

Read Dr. Bertka's article here.

Source: Becker's Hospital Review

Wednesday, November 9, 2011

OCR Launches Privacy and Security Audits

The American Recovery and Reinvestment Act of 2009, in Section 13411 of the HITECH Act, requires the U.S. Department of Health and Human Services (HHS) to provide for periodic audits to ensure covered entities and business associates are complying with the HIPAA Privacy and Security Rules and Breach Notification standards. To implement this mandate, the HHS Office for Civil Rights (OCR) is piloting a program to perform up to 150 audits of covered entities to assess privacy and security compliance. Audits conducted during the pilot phase will begin in November 2011 and conclude by December 2012.

More information regarding OCR’s Pilot Audit Program is available on the OCR website at

Source: OCR News Release

Monday, November 7, 2011

PCPAN Coalition Urges Opposition to Merger of Two Large Pharmacy Benefit Chains

More than 50 consumers, small business owners and community pharmacists with Preserve Community Pharmacy Access NOW! (PCPAN) Coalition gathered in Washington, D.C. on November 4 to urge Congress and the Federal Trade Commission (FTC) to support patient care and oppose the planned merger between Express Scripts Inc. and Medco Health Solutions Inc, two of the nation’s largest pharmacy benefit management (PBM) companies.

Several Members of Congress attended the press conference to express their opposition to the merger.

“If allowed to go forward, this merger would have devastating effects on consumers and small businesses, alike,” said Congressman Joe Courtney (D-CT). “In an industry that already offers few choices, further market concentration would squeeze out the community pharmacies many of us have come to trust the most.”

“Right now, there is not a level playing field which is why I feel we need to act now,” said Congressman Thomas Marino (R-PA). “I supported community pharmacies when I sponsored a bill that sets out to level that playing field – and that would not cost the federal government or anyone else a penny. As a matter of fact, it would actually lower the prices for independent pharmacies and they, in turn, would pass it on to the consumer. I continue to support community pharmacies now.”

Pharmacy benefit managers (PBMs) manage prescription drug benefit programs for employers, unions, health plans and others. PBMs control the drug benefits of more than 200 million patients nationwide. This number includes a diverse group of Americans such as Medicare Part D beneficiaries, servicemen and veterans that are TRICARE beneficiaries, and more.

"[Dr]ugstores are lobbying against the merger, arguing that the deal, in which Express Scripts would acquire Medco for $29 billion, would put drugstores out of business and lead to higher consumer prices," reports

The House Judiciary Subcommittee on Intellectual Property, Competition and the Internet held a hearing on the merger on September 20. The Senate Judiciary Subcommittee on Antitrust, Competition Policy and Consumer Rights plans to hold a hearing on the merger in December.

Thursday, November 3, 2011

TJC, SGS Form Alliance to Offer Coordinated Accreditation and ISO Certification Option

The Joint Commission (TJC) and SGS Group are joining forces to offer hospitals and critical access hospitals in the United States the option of pursuing both accreditation and certification to various ISO and industry best practice standards beginning in early 2012.

This program combines The Joint Commission’s modern health care quality and safety standards, survey process, and accountability performance measures with SGS management system audits including certification to the ISO 9001 quality management system standards. The combination of accreditation and ISO offers hospitals the tools to maintain best practices and lower costs across their entire operation while remaining focused on their core service – delivering quality health care to patients.

ISO standards articulate management systems to consistently meet established requirements. Joint Commission standards supply the valuable quality and safety enhancing requirements which can be integrated into an organization’s quality management system. By encouraging leadership commitment to maintaining focused, organized and dynamic processes, the coordinated option has the potential to deliver extra value by improving the operating performance of the organization.

SGS, a public company, is the world’s leading verification, inspection, certification, and testing company focused on providing independent certification and quality assurance services through its worldwide network of subsidiaries, branches and agencies. SGS operates a network of 1,250 offices around the world.

The Joint Commission, and its affiliate Joint Commission International, are the leading health care accrediting bodies, both in the United States and internationally, utilizing up-to-date standards they have developed working with the health care community to help improve the quality and safety of care.

“We are providing this option for hospitals and critical access hospitals in the United States that are interested in exploring the combination of ISO education and certification with Joint Commission accreditation as a mechanism to more precisely identify system vulnerabilities and inefficiencies. Future plans are to expand the option to organizations accredited under other Joint Commission accreditation programs,” says Ann Scott Blouin, RN, Ph.D., FACHE, executive vice president, Accreditation and Certification Operations, The Joint Commission.

“Providing this enhanced service to health care organizations through the alliance of SGS and The Joint Commission is a natural progression for health care performance improvement,” says Tony Perkins, senior vice president, SGS. “We are offering health care organizations an opportunity to take advantage of a number of ISO standards which complement Joint Commission accreditation requirements. This provides a method for hospitals to focus on improvements in quality and customer service in all departments, as well as their facility’s impact on the environment.”

Click here for more information.

Source: TJC News Release

EHNAC Requests Public Review of Program Accreditation Criteria

The Electronic Healthcare Network Accreditation Commission (EHNAC), a non-profit standards development organization and accrediting body, announced that it has posted new versions of program criteria for general public review. EHNAC seeks interested parties to provide opinions, comments and suggestions for the upgraded criteria versions that have been developed for each of EHNAC’s accreditation programs with regard to the necessity, appropriateness and workability of the criteria versions proposed for adoption.

Comments are due on Nov. 26, 2011.

Below is a listing of the eleven affected programs:
ePAP – e-Prescribing Accreditation Program
FSAP EHN – Financial Services Accreditation Program for Electronic Health Networks
FSAP Lockbox – Financial Services Accreditation Program for Lockbox Services
HIEAP – Health Information Exchange Accreditation Program
HNAP-70 – Healthcare Network Accreditation Plus Select SAS 70©1 Criteria Program
HNAP EHN – Healthcare Network Accreditation Program for Electronic Health Networks [Includes Payer]
HNAP Medical Biller – Healthcare Network Accreditation Program for Medical Billers
HNAP TPA – Healthcare Network Accreditation Program for Third Party Administrators
MSOAP – Management Service Organization Accreditation Program
OSAP – Outsourced Services Accreditation Program
OSAP HIE – Outsourced Services Accreditation Program for Health Information Exchange Services

Please click here for more information and to review the criteria.

Source: EHNAC News Release

Wednesday, November 2, 2011

ONC Seeks Opinions on Mobile Devices as Health Information Tools

The Office of the National Coordinator for Health Information Technology’s (ONC) Office of the Chief Privacy Officer plans to perform a project using a qualitative data collection approach to obtain in-depth information from mHealth users regarding privacy and security concerns with this technology and perspectives on potential safeguards.

mHealth refers to the use of mobile devices to communicate health information, and includes text messaging, email accessibility on the device, Skype, or the use of applications downloaded to the device.

ONC is conducting focus group research to identify and explore the attitudes and preferences of a diverse sample of consumers with respect to the communication of health related information on mobile phones and devices, including text messaging. Results from this focus group research are expected to be available in 2012. For more information on this and other mHealth initiatives at HHS, please visit

Source: ONC News Release