This Week's Healthcare News
HealthDataManagement
Payers Work to Ease Coordination of Benefits Determinations
Mar,13,2013
by+Joseph Goedert
All 12 health insurer members of CAQH have pledged to adopt the new COB process when it’s complete, which should happen later this year. Covering a combined 165 million members, the members are Aetna, AultCare, Blue Cross Blue Shield of Michigan, Blue Cross and Blue Shield of North Carolina, BlueCross BlueShield of Tennessee, CareFirst BlueCross BlueShield, Cigna, Health Net, Horizon Healthcare Services, Kaiser Permanente, UnitedHealth Group, and WellPoint and its affiliated plans.
The payers are building a shared repository of patient demographic data to match and compare records from different health plans to identify patients with overlapping coverage from more than one insurer. The goal is to electronically identify and assess payer responsibilities, a primarily manual and often inaccurate process, when a patient has coverage from more than one insurer.
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Fierce EMR
IRS unlawfully seized 60M medical records
Mar,
by:+Susan D. Hall18,2013
An unnamed HIPAA-covered entity in Southern California is suing the U.S. Internal Revenue Service, alleging that agents executing a warrant stole medical records for 10 million Americans. Those affected could include every state judge in California, as well as "prominent citizens in the world of entertainment, business and government, from all walks of life," according to the complaint.
Fifteen IRS agents executed a search warrant on March 11, 2011, for financial data pertaining to a former employee of the company, however, "it did not authorize any seizure of any healthcare or medical record of any persons, least of all third parties completely unrelated to the matter."
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Fierce Health Payer
73% of consumers likely to use health exchanges
Mar,15,2013
By:+Dina Overland
Awareness of and interest in health insurance exchanges has been increasing, especially among consumers who purchase coverage on their own, according to a survey from J.D. Power and Associates.
In its 2013 Member Health Plan Study, J.D. Power analyzed responses from 33,000 members of 136 commercial health plans and found that 73 percent of consumers who don't have employer-based insurance say they "definitely will" or "probably will" shop for coverage using a state exchange.
That's well above J.D. Power's survey results from 2012 showing that 55 percent of health plan members with individual coverage likely would use a state-run exchange, Fierce Health Payer previously reported.
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Modern Healthcare.com
Featured Report:Most states earn 'F' in price transparency
Mar,18,2013
by:+Melanie Evans
Most states have limited laws or no laws at all to guarantee patient access to information on hospital and clinic prices, according a newly released report that found poor disclosure and incomplete information in three dozen states.
The report, released by the Catalyst for Payment Reform and the Health Care Incentives Improvement Institute, awarded an F to 29 states—including seven without any price laws whatsoever—and gave another seven states a D. State laws were graded on how easily disclosed prices could be seen by the public; whether laws required disclosure of prices or discounts paid by insurers; and how many providers and procedures were included.
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