Yeah, I just found out how much the "wonderful world of health insurance" now costs. Every 2 weeks, I get to work one day... for health coverage alone.
Obama Nominee for Social Security Board Favors Rationing Health Care 4:17 PM, Nov 15, 2011 • By JEFFREY H. ANDERSON
Is it just a coincidence that the people that President Obama nominates to fill high-level governmental posts tend to favor government-directed health care rationing? Last year, Obama nominated Donald Berwick to head Medicare and Medicaid. Now he’s nominated Henry J. Aaron to head the Social Security Advisory Board. Henry J. Aaron
Berwick, to whom Obama issued a dubious recess appointment to circumvent the usual Senate confirmation, has become notorious for statements like, “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open” — and, in progressive-speak, “The social budget is limited.”
Aaron, a recent Obama nominee, has expressed similar views. He wrote a piece earlier this year called, “The Independent Payment Advisory Board — Congress's ‘Good Deed.’” The grisly IPAB, one of the most underreported of Obamacare’s myriad of liberty-sapping features, would have the power to cut Medicare spending each year — if Obamacare isn’t repealed first. The dictates of its 15 unelected members would effectively become law. In fact, Congress couldn’t even overturn the IPAB’s decrees with a majority vote in each house and the President’s signature.
Obama has since doubled-down on the IPAB, seeking to grant it even more power to cut Medicare spending than Obamacare would grant it. To be clear, this is in addition to the nearly $1 trillion that the Congressional Budget Office says would be siphoned out of Medicare and spent on Obamacare during the overhaul’s real first decade (2014 to 2023).
Aaron praises the IPAB, although he does admit to having a few problems with it. He thinks that its largely unchecked power isn’t unchecked enough, as the board should be able to order payment reductions for other aspects of medical care that have so far escaped its statutory grant of power. He writes,
“I admit that the provisions governing the IPAB are less than optimal. For example, recommendations regarding payments to acute and long-term care hospitals, hospices and inpatient rehabilitation and psychiatric facilities are off-limits until 2020; and those to clinical laboratories are off-limits until 2016. These politically motivated restrictions should be repealed as early as possible so the IPAB’s recommendations can comprehend the delivery system as a whole.”
Aaron says that “the survival and strengthening of the IPAB is of critical importance.” In a sense, this is unsurprising, given his earlier views, which were captured in a Washington Post story published during the Reagan administration (when Aaron was in his late 40s). The Post article reads,
“If Americans are serious about curbing medical costs, they’ll have to face up to a much tougher issue than merely cutting waste, says Brookings Institution economist Henry J. Aaron.
“They’ll have to do what the British have done: ration some types of costly medical care — which means turning away patients from proven treatments.
“Cutting billions worth of ‘pure waste’ — in needless hospitalization, surplus beds, Cadillac-model machinery and superfluous tests — would only temporarily slow the growth in health spending, which now tops 10 percent a year, Aaron told a symposium sponsored by the American Academy of Physician Assistants last week in Reston.
“Eventually the ‘cornucopia of technology’ and America’s aging population will combine to drive up health costs by 6 or 7 percent a year anyway unless something else is done, he said.
“That ‘something else’ is what Aaron calls the ‘second stage’ of cost control. It’s a much more complex step, requiring choices that no one — doctor, patient or politician — likes to make.
“Aaron and Dr. William B. Schwartz, professor of medicine at Tufts University School of Medicine, recently completed a study of how these choices are made in Britain, a country which spends half as much per person as the United States on health care.
A man from Nyköping in eastern Sweden has been denied a power wheelchair despite having had both of his legs amputated as the local health authority remained "uncertain if the impairment was permanent".
The man had his legs amputated after a long struggle with diabetes, but despite being unable get about, his application for a power wheelchair has been denied.
“I was bitterly disappointed in the local authorities. I don’t feel I got the support I deserve,” Evert Stefansson told The Local.
Evert Stefansson had struggled with his health for a long time. As a long-suffering diabetic his kidneys have taken a beating, as has his eyesight.
About a year ago, his condition took a turn for the worse when his toe suddenly went black.
He was rushed to hospital where they had no other choice than to amputate his leg. Within a year, they had to take his other leg too.
Since then Evert has experienced some difficulty in getting about.
He might be able to walk short distances again with prosthetic legs, but that will take up to a year, according to his wife Siv.
Siv, also on early retirement due to a bad back, told The Local how she is forced to help her husband with everything and how he remains completely dependent on her.
In order to regain some of his independence, Stefansson applied for a so-called Permobile, a power wheelchair, that he could manoeuvre himself.
“But I had my suspicions right from the start that it wouldn’t be easy, when the woman from the county visited. She sort of hinted that he could have an ordinary electric wheelchair,” Siv Stefansson said.
The electric wheelchair was less desirable as it would still need a carer operating it, and would therefore not allow Stefansson to get about by himself, without the constant help of his wife.
However, the motivation for the county council’s decision was allegedly that it was “uncertain if the impairment was permanent”, reported local media.
After the couple found out that Evert’s application would be rejected, Siv decided to take the matter into her own hands.
“I got angry. It just isn’t right that he has worked all his life but now can’t do anything that he loves anymore. Not even go fishing,” she told The Local.
“I decided to contact the papers and the broadcast media. And it was definitely what was needed.”
Through media’s reports, a woman in the nearby area caught wind of the couple’s plight and contacted her brother, who works with permobiles and has previously helped others in the same predicament.
“She told him ‘you better do something about this’ - and he did,” Siv Stefansson said.
Thanks to the woman's initiative, Evert’s new permobile will arrive next week, on loan from the company that manufactures them.
“I am overjoyed! It is by far the best Christmas present we could receive,” Siv Stefansson told The Local.
Rebecca Martin (news@thelocal.se)
I really hope that the Supreme Court sees how wonderfully the national healthcare is working in other countries along with the fact that it is UNCONSTITUTIONAL.
By Howard Anderson, July 11, 2011. Credit Eligible
The long-overdue HITECH-Act mandated HIPAA compliance audit program will begin soon, with about 150 on-site audits of covered entities and business associates anticipated by the end of 2012.
The Department of Health and Human Services has awarded a $9.2 million contract to the consulting firm KPMG to develop the protocols and conduct the HIPAA audits. "Site visits conducted as part of every audit would include interviews with leadership (e.g., CIO, privacy officer, legal counsel, health information management/medical records director); examination of physical features and operations; consistency of process to policy; and observation of compliance with regulatory requirements."
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Every site visit will result in a detailed audit report. The HHS Office for Civil Rights will oversee the audit program.
Time to Prepare Adam Greene, formerly of OCR and now a partner at the Washington law firm Davis Wright Tremaine LLP, notes, "In light of the large numbers of HIPAA covered entities and business associates, the likelihood of being audited will be small. Nevertheless, now is a good time for covered entities and business associates to review their HIPAA privacy and security programs, ensure that their documentation is up to date and assess whether their programs are effectively protecting protected health information." Greene notes that because the program is funded through the HITECH Act, "It is not clear whether the audit program will continue after HITECH Act funds expire in 2012."
The KPMG contract announcement "raises as many questions as it answers," Greene says. "We do not know the scope of the audits, such as whether KPMG will review general compliance with the privacy and security rules or whether the audits will be focused on specific issues." And although the contract says entities varying in size and scope will be audited, "we do not know how entities will be selected for audit," Greene adds. "Most importantly, we do not know whether the audit program will be used as an enforcement tool (leading to resolution agreements or civil monetary penalties), or whether it will be used strictly as an educational tool to improve general compliance."
Greene notes that HHS also awarded a $180,000 contract to Booz Allen Hamilton for "audit candidate identification." He adds, "While limited information has been released about this contract, it is presumably for the purpose of identifying the universe of covered entities and business associates. Especially with respect to business associates, it may prove impossible for Booz Allen to generate a truly comprehensive list of candidates."
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
Print this article Medical coding professionals are required to use standard coding systems as named by HIPAA.
The Health Care Insurance Portability and Accountability Act, or HIPAA, became law in 1996. Initially started to allow individuals to carry health insurance between employers, it later expanded to include issues like the privacy and security of patient health information, health care fraud and abuse and standard elements used when transmitting electronic patient health information, or e-PHI, for reimbursement. The e-PHI elements relate directly to medical coding.
Related Searches: HIPAA Privacy ICD 9 Coding
About Medical Coding
Medical coding assigns numerical and alphanumerical codes to patient diagnoses and procedures for reimbursement and reporting purposes. Medical codes provide a condensed way to report lengthy and detailed medical information. For example, 943.11 represents the code for a first-degree burn to the forearm. Converting medical diagnoses and treatments into numerical formats allows for the easy search, retrieval and submission of data.
Electronic Data Interchange
Before HIPAA, health care organizations were behind other businesses and technology in processing information. As industries like banking moved to electronic formats for information, the health care industry still processed much of its information via paper. Paper-based information exchange is costly, and health care needed a way to save money and provide a more efficient way of doing business. Electronic data interchange, or the electronic format of "data elements that assist in identifying the contents of a transaction," provided a way to work more effectively. According to the Centers for Medicare and Medicaid Services, EDI covers "claims and encounter information, payment and remittance advice, claims status, eligibility, enrollment and disenrollment, referrals and authorizations, and premium payment" information, which correlates with the medical coding process.
Transaction and Code Set Rule
As part of HIPAA's Administrative Simplification Title II, a "Transaction and Code Set Rule" exists. "Covered entities," or any health care organization falling under HIPAA law, are required to follow the standard set of coding. Under this portion, HIPAA also sets forth requirements for standard medical diagnosis and procedure codes.
HIPAA's Adoption of Coding Systems
The medical coding and billing industry had established coding systems prior to HIPAA. Because of this, HIPAA law named the well-known coding systems as the standard for reporting diagnoses, procedures and drugs. For physician office procedures, the Current Procedural Terminology, or CPT-4, system is used. ICD-9, or International Classification of Diseases-Ninth Revision, codes identify hospital diagnoses and inpatient procedures. Current Dental Terminology, or CDT, and National Drug Codes, or NDC, are standards for the dental and drug industries. Under HIPAA, any covered entity reporting e-PHI reimbursement information must adhere to the standard coding systems listed here.
HIPAA and ICD-10
In October 2013, the ICD-9 system updates to ICD-10. Foreseeing the change, HIPAA included terminology in the law to name the updated ICD-10 as one of the required standard code systems once implemented. The updated ICD-10 system provides better detail in codes for easier sharing and accessibility of patient health information.
what a JOKE.....so do you feel like a safer INDIVIDUAL????? currently the only way to FEEL like an individual would be to complain that the sheets are too rough and throw a tantrum and get a different set of sheets with a complimentary pizza brought by administration as an "I'm sorry we are such idiots".......
YOU ARE A NUMBER.....NOTHING MORE
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
'HIDING' your procedure/diagnosis does nothing for your 'security'.....people could care less what our diagnosis are......the ONLY thing hidden , is from you ,as to the definition of the code applied to YOU.....
anyone remember the stupid AIDS 'scare'......that was an F'EN joke......you cant count AIDS diagnosis if folks dont report it, not to mention who they 'party with'.....
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
'HIDING' your procedure/diagnosis does nothing for your 'security'.....people could care less what our diagnosis are......the ONLY thing hidden , is from you ,as to the definition of the code applied to YOU.....
anyone remember the stupid AIDS 'scare'......that was an F'EN joke......you cant count AIDS diagnosis if folks dont report it, not to mention who they 'party with'.....
Yes, you are just coded down to a number, both your identity and what your illness is. You better hope that you're V70.0, and not 042. I mean, if you have a 305.1, you could eventually come down with 162.3 and need 96408, 77427, or the combination of both.
Yes, you are just coded down to a number, both your identity and what your illness is. You better hope that you're V70.0, and not 042. I mean, if you have a 305.1, you could eventually come down with 162.3 and need 96408, 77427, or the combination of both.
HAHAHAHAHAHA.....ain't it crazy????
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
Social Security to hand out first raises since '09
WASHINGTON (AP) — Social Security recipients will get a raise in January — their first increase in benefits since 2009. It's expected to be about 3.5 percent.
Some 55 million beneficiaries will find out for sure Wednesday when a government inflation measure that determines the annual cost-of-living adjustment is released.
Congress adopted the measure in the 1970s, and since then it has resulted in annual benefit increases averaging 4.2 percent. But there was no COLA in 2010 or 2011 because inflation was too low. That was small comfort to the millions of retirees and disabled people who have seen retirement accounts dwindle and home values drop during the period of economic weakness, said David Certner, legislative policy director for the AARP.
"People certainly feel like they are falling behind, and these are modest income folks to begin with, so every dollar counts," Certner said. "I think sometimes people forget what seniors' incomes are."
Some of the increase in January will be lost to higher Medicare premiums, which are deducted from Social Security payments. Medicare Part B premiums for 2012 are expected to be announced next week, and the trustees who oversee the program are projecting an increase.
Monthly Social Security payments average $1,082, or about $13,000 a year. A 3.5 percent increase would amount to an additional $38 a month, or about $455 a year.
Most retirees rely on Social Security for a majority of their income, according to the Social Security Administration. Many rely on it for more than 90 percent of their income.
Mark Zandi, chief economist at Moody's Analytics, said the COLA would give a boost to consumer spending next year, amounting to about $25 billion in government support, or 0.2 percent more economic growth, if beneficiaries spend it all. For comparison, last year's 2 percentage point cut in Social Security payroll taxes was worth $115 billion to U.S. households.
"It is not a magic bullet for the economy, but it will certainly be a positive for households on fixed incomes," he said.
Federal law requires the program to base annual payment increases on the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). Officials compare inflation in the third quarter of each year — the months of July, August and September — with the same months in the previous year.
If consumer prices increases from year to year, Social Security recipients automatically get higher payments, starting the next January. If price changes are negative, the payments stay unchanged.
Only twice since 1975 — the past two years — has there been no COLA.
Wednesday's COLA announcement will come as a special joint committee of Congress weighs options to reduce the federal government's $1.3 trillion budget deficit. In talks this summer, President Barack Obama floated the idea of adopting a new measure of inflation to calculate the COLA, one that would reduce the annual increases.
Advocates for seniors mounted an aggressive campaign against the proposal, and it was scrapped. But it could resurface in the ongoing talks.
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
A. It's not EXPECTED to be ANYTHING. It IS 3.5%. The notices have already been getting mailed out to tell people for the past month that they're getting it. B. How many of the working people do you know who got a raise in '10? About the same number as got a raise on Social Insecurity. C. Many don't understand that a good portion of those who "get social security" don't even actually get it. It goes to pay for a portion of their mandated national healthcare, whether that be Medicare or Medicaid. The checks generally go directly to the establishments they are living in, if they are not independently wealthy or haven't been admitted long enough to have their bank accounts drained.
A. It's not EXPECTED to be ANYTHING. It IS 3.5%. The notices have already been getting mailed out to tell people for the past month that they're getting it. B. How many of the working people do you know who got a raise in '10? About the same number as got a raise on Social Insecurity. C. Many don't understand that a good portion of those who "get social security" don't even actually get it. It goes to pay for a portion of their mandated national healthcare, whether that be Medicare or Medicaid. The checks generally go directly to the establishments they are living in, if they are not independently wealthy or haven't been admitted long enough to have their bank accounts drained.
it's a tightly controled machine.....and big daddy tells you your worth
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
MDS Frequently Asked Questions (FAQ) • What is the MDS data? • Who is MDS data collected on? • How often is the MDS data collected? • What type of data are collected as part of the MDS? • What years of MDS data are available from CMS? • I'm interested in all MDS assessment data for a period of 6 months, how should I request the data? • How can the MDS data be extracted? • What is the output format and media type of the NH MDS?
-------------------------------------------------------------------------------- • What is the MDS data?
The Long Term Care Minimum Data Set (MDS) is a standardized, primary screening and assessment tool of health status which forms the foundation of the comprehensive assessment for all residents of long-term care facilities certified to participate in Medicare or Medicaid.
-------------------------------------------------------------------------------- • Who is MDS data collected on?
MDS data is collected on ALL residents of long-term care facilities certified to participate in Medicare or Medicaid. In other words, all residents are given MDS assessments regardless of payer type.
-------------------------------------------------------------------------------- • How often is the MDS data collected?
All residents in Medicare and/or Medicaid certified facilities are assessed at admission, annually, for a significant change in status assessment, significant correction of prior assessment, and a quarterly review assessment. Admission assessments must be completed by 14th day of resident's stay (unless Medicare which have more requirements). The annual reassessment must be within 12 months of the most recent full assessment. Significant change reassessments must be within 14 days following a change in status has occurred. Quarterlies must be no less frequently than once ever 3 months. This means that (at a minimum) 3 quarterly reviews and one full assessment is required in each 12 month period. Because subsequent assessments are based on timing of admission assessments or other full assessments quarterly assessments will not necessarily be in a specific quarter. According to the RAI Users Manual facilities may vary or stagger their schedules (all residents in Feb, May, August and November or stagger with some in January, some in February, remainder in March and first group again in April).
-------------------------------------------------------------------------------- • What type of data are collected as part of the MDS?
The MDS contains items that measure physical, psychological and psycho-social functioning characteristics of the resident. See the Chapter 3 of CMS's RAI Version 2.0 Manual for a description of the data elements collected in the MDS. Note, not all assessment types collect the same data. For example, questions relating to a living will or back pain are only reported on full assessments, not on quarterly assessments.
-------------------------------------------------------------------------------- • What years of MDS data are available from CMS?
MDS data from CMS is available starting in October 1998 through present. There is approximately a 3-month delay until the MDS data is available for research. The earliest data will have more mistakes in the data because of a learning curve so CMS recommends using data after October 1998. Facilities have a month to transmit data to their State but they are frequently late. Generally CMS extracts data from the State database to their National database for target dates after 2-3 months.
-------------------------------------------------------------------------------- • I'm interested in all MDS assessment data for a period of 6 months, how should I request the data?
As of September 2001, MDS assessment records are based on the date the nursing facility submitted the assessment, the "submission date." If you need an assessment based on a specific period of time (e.g, all assessments that given during 6 months) or "target" date range, you may need to request additional months of data depending on your needs. For example, 99% of original assessments, 99% re-entries and 96% of discharges are submitted within 90 days of the target date, however, only 77% of corrected annual/quarterly assessments, 71% of corrected re-entries, and 83% of corrected discharges are submitted within 90 days of the target date. If you're interested in capturing 90% of corrected assessments allow 6 months from the end of your target date.
-------------------------------------------------------------------------------- • How can the MDS data be extracted?
MDS data can be extracted based on disease status, type of assessment, state of the nursing facility, specific nursing facility, and known cohort (using a SSN or HIC finder file).
-------------------------------------------------------------------------------- • What is the output format and media type of the NH MDS?
The output file is a custom file containing the variables from the MDS that the researcher has selected and justified. Currently CMS only releases MDS data on DVD in ASCII format.
Last Modified August 11, 2011
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
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