Greenway Health, A Tampa-based electronic health record (EHR) company has falsely obtained EHR certification and incentivized clients in exchange for promoting or recommending its products to prospective new customers, and because of this act, the company will be dishing out $57.25 million.
Hospitals are beginning to follow in the footsteps of the American Hospital Association and are suing the Trump Administration for its decision to institute site-neutral payments.
Walgreens and Microsoft are teaming up to become the most efficient consumer health market available. The two powerhouse companies are going to bring new technology and retail innovations to alter the healthcare delivery space. This multi-year agreement is being aimed to lower the costs of medical supplies and improve patients’ wellbeing. Walgreens has been making impressive partnerships with companies over the last few months to bring their customers the best experience possible. Walgreens has also made agreements with Silicon Valley, Verily, Alphabet Inc. and LabCorp to bring both new technology and more effective healthcare resources to consumers.
Due to the passing of five major appropriation bills by Congress, the funding of the Department of Health and Human Services and the Department of Veterans Affairs has remained. This funding dampens immediate large-scale negative impacts because many government healthcare programs such as Obamacare, Medicare, and Medicaid are insulated and funded through September. Additionally, two other critical unaffected departments are the Center for Disease Control and Prevention and the National Institutes of Health, allowing for the continuation of public health surveillance and significant biomedical research respectively. Unfortunately, other government agencies such as the Food and Drug Administration are greatly affected. Due to the Department of Agriculture being completely shut down, the FDA is currently only operating at 60% of regular employees leading to potential problems regarding regulations and mandatory recalls of possible harmful goods.
Another detrimental effect of the government shutdown is an impact on the Indian Health Service (IHS). The IHS receives all of its funding from the recently shut down Department of the Interior, which has had widespread consequences to Native American tribes. The only services that can continue in these areas are “immediate needs of the patients, medical staff and medical facilities” and this lack of funding has been extended to suspending grants and other IHS health programs.
Well-known departments and agencies such as the Department of Homeland Security’s Office of Health Affairs and the Environmental Protection Agency have already been displaying negative aftermath of the government shutdown with all signs pointing to large detrimental effects if this continues for an extended period. Health inspectors at the United States borders and the Countering Weapons of Mass Destruction Office have already faced setbacks causing increased concern regarding possible decreased safety of US citizens. Furthermore, even the National Park Service has ceased all restroom maintenance and trash service due to funding leading to closures of popular parks such as Yosemite and Joshua Tree National Park due to unsanitary conditions.
People have been living in unimaginable conditions since Hurricane Michael hit on October 10th, 2018. We are now in 2019, and many are still unable to live in their homes. Without proper housing and the many hazardous conditions around the panhandle that extend farther than just at home, there has been an increased rate of injury and illness. This hurricane has provided us with a prime example of social determinants impacting health.
The healthcare system has avoided addressing the issue of social determinants for a long time. In 2018, newly launched initiatives, as well as studies showing the need for these initiatives, have caused the healthcare system to take a new look at social determinants and how to address them.
Factors such as housing, transportation, food assistance, and personal finances have been taken into account to begin the process of reassessing healthcare's take on social determinants. People with limited access to transportation and housing are at a higher risk of injury or illness, especially when they have limited ways to get to a physician. Medicaid plans on helping to offer affordable housing to those who need it. Patients without transportation often forego making an appointment or miss them when they do have them. Uber recently launched a “health dashboard” to provide free rides for those unable to get to a doctor when they need to.
In addition to this, Geisinger Health System started “Fresh Food Farmacy,” which cut costs among diabetic patients from anywhere between $48,000 to $240,000 per member. This caused the risk of serious complications or death for people with diabetes to drop to 40%, a great win for those working with diabetics. Cigna is also planning on offering financial planning services for their group members, as announced in December 2018. Financial stress can take a significant toll on a person’s physical and mental health.
With many physicians claiming social determinants “aren’t their problem,” there is still a long way to go with maintaining equity among Americans. However, now that the panhandle is experiencing even more of these social determinants than usual, we have been provided a new chance to tackle these determinants and make the panhandle a healthier place for everyone. These social determinants will continue to play a significant role in local health for everyone involved with the hurricane, but choosing to see the positive side of this great opportunity is best for our county's health.
Recently the Food and Drug Administration has been planning to make changes to its medical device clearance process. These changes they are planning on implementing would mean they would rely far less on older predicate devices so that they could offer a modernized pathway for high-tech medical innovations.
A recent uproar in the media was the National Rifle Association telling doctors in a tweet to “stay in their lane” when addressing the issue of gun violence. As you know, doctors see the aftermath of gun violence; you have to tell the family whether their loved one is alive or dead from this senseless act of violence. An immediate tweet back to the NRA from the Annals of Internal Medicine simply said: “Doctors are in our lane.” In addition to this, the AIM also decided to collaborate with the American Foundation for Firearm Injury Reduction in Medicine (AFFIRM) to fund new research supporting new practice recommendations.
Emerald Coast Medical Association aims to keep our members up to date on the newest legal changes. CMS listened to doctors and decided to delay any changes to codes for Medicare patient visits until 2021. According to the Centers for Medicare & Medicaid Services, doctors were worried that the plan would cut revenue for physicians who care for Medicare patients. Although CMS made changed to its plan, it did decide to continue with its plan to consolidate codes for Medicare patient visits.
Seema Verma, a CMS Administrator, said that they would consolidate codes for “evaluation and management” (E/M) visits to three, maintaining the level 5 code that is used for physicians who see the sickest patients who require more services. The agency will work with doctors to iron out the details, which will delay implementation to 2021. The E/M changes are part of a final rule that outlines the physician fee schedule for 2019. Along with that also come changes to the third year of the physician payment system implemented under MACRA.
The American Medical Association is on board with the revisions of the original proposed E/M policies. They are grateful that the administration is not moving forward with the payment collapse of E/M codes in 2019. The two-year window allows time for an AMA-convened workgroup to look over and make recommendations on this controversial topic.
Effective January 1, 2019, CMS will finalize several burden-reduction proposals that were supported by doctors. The final rule, though, will include revisions that preserve access to care for complex patients, equalize certain payments for primary and specialty care, and allow the delay in implementation of E/M coding reforms until 2021.
The original implementation would have been much sooner, but CMS received over 15,000 comments on a proposed rule that was released in July. Most of the 15,000 comments were in opposition to the change. This change would have collapsed payment rates for eight office visit services for new and established patients down to two each, a massive cut in the overall scheme of things. In addition to that, it also was said it could underpay doctors who treat the sickest patients, which more than 150 medical groups opposed and sent letters disputing the plan to consolidate E/M codes. CMS has released fact sheets with more details about the physician fee schedule, and one outlining changes to the quality payment program under MACRA.
Free Loaner Copy Machines
CPC Office Technologies is offering loaner copiers at no charge for 90 days to any companies affected by the hurricane. If your business or a business that you know of was affected, please let us know.
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Managing Traumatic Stress After the Hurricane
Time will tell whether Houston, the Caribbean, and Florida manage to recover from the trauma of recent hurricanes mentally but while the physical injuries will fade and the houses will be rebuilt, the psychological impact is likely to worsen. Implementing targeted psychosocial care is both a humanitarian need and an economic necessity—saving lives, jobs, and families.