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The ergonomics rule didn’t make it very far into the Bush administration. The rule, which aimed to reduce the incidence of repetitive motion injuries in workers, was one of the last-minute legislative efforts by the Clinton administration. Health care and business groups opposed the rule, however, saying it was too costly and burdensome.
The House vote on the rule was 223-206. Sixteen Democrats joined majority Republicans in opposing the rule, while 13 Republicans voted to leave it in place. After a day-long debate, the Senate voted 56-44 to kill the rule, as six Democrats sided with all 50 Republicans. This was the first time such a safety rule had been repealed.
"Putting aside all the rhetoric and demagoguery, this debate was about whether OSHA’s [Occupational Safety and Health Administration’s] ergonomics regulation was the best way to ensure safety and health in the workplace," says Ed Gilroy, co-chairman of the National Coalition on Ergonomics in Washington, DC. "We are gratified that both chambers of Congress have agreed that the answer to this critical question is a resounding no.’"
Some Democratic members of Congress are up in arms over Health and Human Services Secretary Tommy Thompson’s decision to reopen the HIPAA privacy regulations for an additional 30 days.
The Democrats, which include Sens. Ted Kennedy, D-MA; Patrick Leahy, D-VT; and Tom Harkin, D-IA, along with Reps. John Dingell, D-MI; Ed Markey, D-MI; and Henry Waxman, D-CA, held a press conference in March to denounce the decision, the AHA News reports. The Congressmen said any delay in the HIPAA privacy regulations’ April 14, 2001, effective date, or in their full implementation date of April 14, 2003, would be a violation of campaign pledges made by President Bush. Also, the members said no hospital, health care organization, or corporation should be allowed to sell medical information for profit.
The Chicago-based American Hospital Association (AHA) holds a different opinion. "While we appreciate the members of Congress’ involvement on this important issue, we don’t agree with them," says AHA Vice President and Chief Washington Counsel Melinda Hatton. "Nationwide, hospitals are telling us that the privacy regulations in their current form are not workable. We have firmly concluded that they need to be fixed before they go into effect, not after."
Federal payment rates for Medicare+Choice managed care plans will increase by about 5.3% in most counties across the country, according to the Health Care Financing Administration (HCFA) in Baltimore. Payment rates in other counties will rise by the guaranteed minimum increase of 2%.
The expected payment rates reflect the law’s requirements, including recent changes included in the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), enacted last December. The new payment rates for 2001 and 2002 can be viewed on the HCFA Web site at www.hcfa.gov/stats/hmorates/aapccpg.htm.
For 2002, the floor amounts will be $553.04 for urban areas with populations of 250,000 or more. In other counties, the floor amount will be $500.37. For the months of March through December 2001, the rates are $525 and $475 respectively. All of these rates reflect increases mandated by BIPA.
The Department of Health and Human Services (HHS) reported in March that improper Medicare payments to doctors, hospitals, and other health care providers in fiscal year 2000 continued to show sustained decreases since the department’s Inspector General began tracking Medicare’s payment error rate five years ago. The error rate measures payments made by Medicare that are not "properly supported by health care providers’ documentation or which otherwise do not meet Medicare reimbursement requirements."
For the second straight year, HHS and the Health Care Financing Administration received "clean" audit opinions of their financial statements from the Office of Inspector General (OIG). The OIG serves as independent auditor as required under the Government Management Reform Act.
Medicare’s estimated error rate was 6.8% in fiscal year 2000, compared with nearly 8% the previous year, according to the OIG’s latest report. The error rate has fallen to roughly half of the 14% rate estimated in fiscal year 1996, the first year that the Inspector General conducted an audit to estimate Medicare’s overall error rate.
The fiscal year 2000 error rate represents an estimated $11.9 billion in improper payments out of the total $173.6 billion in fee-for-service Medicare payments, compared with $13.5 billion in fiscal year 1999 and $23.2 billion in fiscal year 1996. HCFA met its target for reducing the error rate to 7% in fiscal year 2000 and continues to take steps to meet its fiscal year 2002 goal of 5%.
The OIG calculated the improper payment rate by examining a valid statistical sample of 5,234 Medicare claims across the United States valued at $5.3 million. OIG auditors reviewed the medical records supporting the claims with the assistance of medical experts and then projected the sample findings over the universe of Medicare fee-for-service benefit payments, which totaled $173.6 billion during fiscal year 2000.
The Office of Inspector General (OIG) has posted a general information sheet for Corporate Integrity Agreements (CIAs) and Settlement Agreements with Integrity Provisions on its web site. The site offers the following links:
To see the CIA information, visit www.dhhs.gov/progorg/oig/cia/index.htm.
• The 2001 HIPAA Conference, sponsored by members of the Joint Healthcare Information Technology Alliance in Washington, DC, will be held May 23-25 in La Jolla, CA. The Department of Health and Human Services’ Bill Braithwaite, PhD, MD, will open the meeting with an update on the Health Insurance Portability and Accountability Act of 1996 administrative simplification regulations. Other industry experts also will address the participants.
For more information, call the American Health Information Management Association in Chicago at (312) 233-1100 or visit its web site at www.ahima.org.