May 23, 2013
The Medicare Shared Savings Program (MSSP) for accountable care organizations (ACOs) established under the Affordable Care Act is about to kick-off its second year with a new round of applications for the January 1, 2014 start date. As part of the application process, those seeking to apply into the ACO MSSP must first submit a notice of intent (NOI) to apply into the program on the CMS website by May 31, 2013 at 5:00 pm EST.
The goal of ACOs is to promote accountability of providers to patient populations and coordination of services under Medicare, and encourage investment in infrastructure and design care process for high-quality, efficient service delivery. ACOs include eligible providers and suppliers include group practice arrangements, networks of individual practices, joint ventures between physicians and hospitals, and physician employment models. In the first few rounds of applications, the accepted ACOs grew from 27 and 87 in the first two rounds of applications for the two 2012 start dates to 106 for the 2013 start date. Numbers are expected to grow in 2014.
CMS requests that ACOs seeking to apply complete the NOI as soon as they can because of the potential delay in response by CMS. CMS will send an email with the NOI Receipt Notice and ACO identification number and instructions on CMS User IDs for the application process. The CMS User ID and password are then used to submit an ACO application. In addition, ACOs will need to submit a Form CMS-20037 by June 6, 2013, as instructed on the NOI Receipt Notice from CMS.
In June, CMS will post the applications for the 2014 start date. Applications may be submitted starting July 1, 2013 and are due no later than July 31, 2013. Those who miss the deadlines will not be eligible to participate in the ACO MSSP until 2015.
Key Deadlines for January 1, 2014 Start Date
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Applications posted on CMS Web site
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June 2013
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NOIs accepted
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May 1, 2013 – May 31, 2013
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CMS User ID forms accepted
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May 3, 2013 – June 10, 2013
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Applications accepted
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July 1, 2013 – July 31, 2013
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Application approval or denial decision
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Fall 2013
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Reconsideration review deadline
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Fall 2013
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For more information about the ACO MSSP application and operations, see the article “So You Want to Be an ACO: 10 Lessons Learned for Forming and Operating an ACO.”
January 24, 2013
On January 17, 2013, the Department of Health and Human Services (HHS) posted Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules [PDF] (the Final Rule) under the authority of the HITECH Act and the Genetic Information Nondiscrimination Act (GINA), as well as under the general authority of HHS. The Final Rule, scheduled to be published in the Federal Register on January 25, 2013, will be effective on March 26, 2013. Thankfully, however, in general covered entities and business associates will have an additional six months, until September 23, 2013, to come into compliance. The Final Rule does not address the Proposed Rule on Accounting for Disclosures [PDF], published May 31, 2011.
This client alert provides an overview of the principal changes in the Final Rule. Look for a complete Ober|Kaler review and analysis of the Final Rule in the coming days.
Read More »
January 2, 2013
Today, HHS announced that it entered into the first breach settlement for less than 500 patients. HHS settled for $50,000 with Hospice of North Idaho for violations of the HIPAA Security Rule including a failure to maintain security policies and procedures and maintain secure mobile devices. In June 2010, an unencrypted Hospice of North Idaho laptop was stolen containing information of 441 patients. In the HHS press release, OCR Director Leon Rodriguez stated that “This action sends a strong message to the health care industry that, regardless of size, covered entities must take action and will be held accountable for safeguarding their patients’ health information.” For more information see: www.hhs.gov/news/press/2013pres/01/20130102a.html
July 26, 2012
Joshua Freemire was recently interviewed by BNA with regard to the Meaningful Use Audits. The resulting article is here: http://www.bna.com/meaningful-participants-begin-n12884910824/
July 26, 2012
I spoke today with an editor at EHR Intelligence regarding the hospital and professional audits of Meaningful Use program compliance being conducted by Figloiozzi & Company. You can read the full interview here: http://ehrintelligence.com/2012/07/26/meaningful-use-audits-qa-with-oberkalers-joshua-freeman/
July 26, 2012
A number of health care providers that attested to Meaningful Use for Stage 1 have received a letter from an Figloiozzi and Company, acting as CMS’s auditor for the EHR Incentive Program (the “Program” or “Meaningful Use Program”), requesting certain records related to the attestation. CMS has not, as of this writing, made any announcement of this audit initiative or of the engagement of Figloiozzi and Company. While it is always good policy to confirm the identity and authority of any entity claiming a right to review or audit records, these letters are legitimate. Citing its statutory authority under the American Recovery and Reinvestment Act (ARRA), and without any fanfare, CMS has begun to audit the attestation materials. Read More »
July 26, 2012
Covered Entities and Business Associates may be breathing a little easier lately, after the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) made public the detailed audit protocols used by KPMG during the first round of random audits. The protocols contain some surprises, but, at a minimum, their publication ends what had been a nonpublic process. Covered entities and business associates alike should review the protocols even if they were not selected for an audit during this past cycle; the protocols offer some surprising indications of government enforcement priorities and provide a fairly granular “road map” of HHS OCR’s interests. Read More »
July 26, 2012
A recent action by the Connecticut Medical Examining Board (a unit of that state’s Department of Public Health) should serve to remind covered entities and business associates that it is not only the federal government that can act to enforce HIPAA’s privacy requirements. In a consent order dated the 21st of March [PDF] but officially accepted in mid-June, Dr. Gerald Micalizzi accepted a $20,000 fine, six months probation, and additional education requirements for inappropriately accessing the records of patients at Connecticut’s Griffin Hospital. Read More »
