The HIPAA clock is running: final HIPAA transactions and code sets standards published.
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The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a larger and more complex problem than Y2K ever was. According to the author, the costs associated with a project of such unending scope and in support of intrusion into both information and operational systems of every health care transaction will be incalculable. Some estimate that the administrative simplification policies implemented through HIPAA will save billions of dollars annually, but it remains to be seen whether the savings will outweigh implementation and ongoing expenses associated with systemwide application of the regulations. This article addresses the rules established for electronic data interchange, data set standards for diagnostic and procedure codes, unique identifiers, coordination of benefits, privacy of individual health care information, electronic signatures, and security requirements.
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Health & Human Services Secretary Tommy Thompson and others in Washington say that they are serious about easing the confusing and costly regulations that burden the health care field. It's a promise hospital executives have heard many times before. Is there any reason to believe that this time real help is finally on the horizon?
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Billions of dollars are paid improperly each year because of laboratory service billing errors that include services not covered, incorrect coding, lack of medical necessity, and unsupported services. An important part of a laboratory compliance program is the compliance audit. This article discusses barriers to a successful audit, audit skills for the laboratory, areas to cover in an audit, and writing the audit report. Intermountain Health Care (IHC) is an integrated health-care system consisting of 20 hospitals in Utah and Idaho, health plans with 450,000 directly covered lives and contracts to third-party insurance companies covering 500,000 additional lives, and 75 other facilities with 400 employed physicians. Approximately 1,000 of IHC's 23,000 employees work in laboratories.
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Reviews provide valuable information and insight about the overall status of community-wide emergency medical services. Specific areas of concern are readily identified and can be addressed within a reasonable time by the group responsible for instituting corrective actions.
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The Food and Drug Administration (FDA) is requiring human cell, tissue, and cellular and tissue-based product (HCT/P) establishments to follow current good tissue practice (CGTP), which governs the methods used in, and the facilities and controls used for, the manufacture of HCT/Ps; recordkeeping; and the establishment of a quality program. The agency is also issuing new regulations pertaining to labeling, reporting, inspections, and enforcement that will apply to manufacturers of those HCT/Ps regulated solely under the authority of the Public Health Service Act (PHS Act), and not as drugs, devices, and/or biological products. The agency's actions are intended to improve protection of the public health while keeping regulatory burden to a minimum, which in turn would encourage significant innovation.
DEA is amending its regulations to require additional recordkeeping and reporting requirements for drug products containing gamma-hydroxybutyric acid (GHB) for which an application has been approved under the Federal Food, Drug, and Cosmetic Act. DEA makes these changes under section 4 of the "Hillory J. Farias and Samantha Reid Date-Rape Drug Prohibition Act of 2000." These additional requirements are necessary to protect against the diversion of GHB for illicit purposes.
Tracking case outcomes helps improve care and create efficiency. But without universal reporting standards, the workload for hospitals is heavy and the data lacks uniformity.
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To achieve optimum productivity and regulatory compliance, manufacturers need solutions that address manufacturing, regulatory and business needs simultaneously. Ways to reduce the costs and achieve regulatory compliance are presented here.
Health care providers, purchasers, and insurers are struggling to manage the cost of health care while maintaining the quality of care. Alliant Health System has incorporated Total Quality Management (TQM) and the Critical Path Process throughout the corporation as a managed care strategy to deliver cost-effective quality care. Using the Critical Path Process has demonstrated a reduction in Length of Stay (LOS) and cost while maintaining quality. The success of this process depends upon an interdisciplinary and collaborative approach among health care providers in identifying practice patterns to assure appropriate and timely delivery of patient care.
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