meh. I read it. The main point seemed to be that someone might lose a laptop. That's a valid concern but it's not specific to the federal government. I'm not entirely sure that the Examiner reporter read the regulation. I have pretty high tolerance for wonkish stuff, and I have to say that my eyes glazed over...But here's what I got out of a skim:
There's a concern that insurers will have many new patients with deferred medical issues which will increase insurer risk for a few years, They are proposing a reinsurance program, how heinous ;) It also looks like they're suggesting that some insurers could use technical support for data analysis as well. And if they're going to spend money they want to be able to audit the programs that get it. I would too. The Examiner seems to be up in arms about the feds looking at data, but yanno... they already do have the very large datasets from Medicaid and Medicare. They are asking for comment on how best to handle this. The nerve of them ;) They also say that although HIPPA does not strictly apply they want to use it as a standard anyway. Like everyone else in the medical field does, or perhaps should would be a better word. What I don't see is any indication that they're proposing to go through patient charts and line by line require justification for each expenditure. You know. Like your current insurance does? On Fri, Sep 23, 2011 at 10:02 PM, Gruss Gott <[email protected]> wrote: > > All provider claims for risk adjusted Medicare advantage are currently > submitted to CMS's RAPS system, but it only requires 5 fields. Soon they > will be getting full 837 claims via the new EDPS system. > > It's very common to run analytics on this data for purposes of finding > under treated patients. You can even power campaigns by using the lack of > data. For example, no physical therapy claim after knee surgery, or no > vasodilator if the patient is HCC 16 (diabetes w vascular complications), or > even simply no PCP visit this year. > > In other words, seems like the government already has this data, however > given their historical expertise in manipulating it I wouldn't be too > worried. > > That said I didn't read the link :) > > > > On Sep 23, 2011, at 10:00 PM, Robert Munn <[email protected]> wrote: > > > > > cool, thanks! > > > > On Fri, Sep 23, 2011 at 7:49 PM, Judah McAuley <[email protected]> > wrote: > > > >> > >> I don't think this is accurate. I glanced at the rule when it was > >> proposed and there hasn't been any uproar in the medical world that > >> I've seen, so I'm dubious. But I don't know for certain. I'll do some > >> investigation and try to reply back here in a couple days. > >> > >> Judah > >> > > > > > > > > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| Order the Adobe Coldfusion Anthology now! http://www.amazon.com/Adobe-Coldfusion-Anthology/dp/1430272155/?tag=houseoffusion Archive: http://www.houseoffusion.com/groups/cf-community/message.cfm/messageid:343008 Subscription: http://www.houseoffusion.com/groups/cf-community/subscribe.cfm Unsubscribe: http://www.houseoffusion.com/groups/cf-community/unsubscribe.cfm
