‘Upcoding’ Running Rampant In Medicare Billing, Report Suggests
The number of inpatient stays billed at the highest severity codes increased almost 20% from fiscal years 2014-19, the Health and Human Services Department's Office of Inspector General says, as reported by Modern Healthcare.
Modern Healthcare:
Hospitals' Medicare Billing Practices Suggest Upcoding, OIG Says
Hospitals are increasingly billing Medicare for the most complex treatment even though data indicate that patients aren't sicker, according to a new government report. The number of inpatient stays billed at the highest severity codes increased nearly 20% from fiscal year 2014 through the 2019 fiscal year, an HHS' Office of Inspector General analysis of Medicare Part A claims revealed. The average length of stay decreased for those cases, which suggests that hospitals may be upcoding, the OIG said. "The implication is that the population being hospitalized hasn't changed very much—they're not actually sicker as the billing rate suggests," said Rachel Bryan, co-author of the study and program analyst at the OIG. (Kacik, 2/25)
Modern Healthcare:
Universal Health Services Lost $67 Million In Cyberattack Recovery
Universal Health Services said Thursday that the company lost $67 million in the second half of 2020 as a result of a September cyberattack. The Sept. 29 malware attack caused King of Prussia, Pa.-based UHS to temporarily take all of its U.S. information technology networks offline, including systems for medical records, laboratories and pharmacies. Servers weren't completely restored until October. That caused some ambulance traffic and elective procedures at UHS' acute-care hospitals to be sent to competitors, the company said. UHS also incurred labor costs to restore its IT operations quickly and had to delay some administrative functions like billing and coding until December, which affected fourth quarter cash flows. (Christ, 2/25)
Modern Healthcare:
Telehealth Company Sues HHS For Allegedly Excluding Overseas Physicians
A telemedicine physician group sued HHS and CMS for allegedly refusing to cover care provided by its critical-care physicians residing overseas. Regulators issued a waiver mandating that Medicare pay for critical-care services offered virtually during the COVID-19 pandemic even if the providers and beneficiaries are in different locations. But HHS said that it cannot pay for services that are administered outside the U.S., according to a lawsuit filed by RemoteICU (RICU) Monday in a Washington D.C. federal court. (Kacik, 2/25)
In news about health care workers —
CIDRAP:
Dental Hygienist Survey Suggests 3% Contracted COVID-19
A survey of US registered dental hygienists reported that 3.1% had been diagnosed as having COVID-19 as of October 2020, according to a Journal of Dental Hygiene study published yesterday. At the time, the study says an estimated 2.3% of the general US population had been infected. The researchers asked for survey responses from the American Dental Hygienists' Association database between Sep 29 and Oct 8, 2020. Of the 4,776 who answered, 35.4% had been tested for COVID-19 at least once, and 23 had been diagnosed by a physician, resulting in a 3.1% rate of infection. Only 55 of those who had COVID reported that contact tracing was performed, of which 14 (25.5%) said that workplace transmission was the most likely cause. (2/25)
Crain's Detroit Business:
Beaumont Nurse Anesthetists To Vote On Union In Wake Of Outsourcing
Nurse anesthetists at Southfield-based Beaumont Health's three northern hospitals are taking steps to form a union after being absorbed by Irving, Texas-based NorthStar Anesthesia on Jan. 1. About 180 certified registered nurse anesthetists, who were formerly employed at Beaumont's Royal Oak, Troy and Grosse Pointe hospitals, signed union petition cards on Jan. 4 indicating they support the idea of forming their own local union. It would be governed by them under the name Southeast Michigan CRNAs & Associates, or SEMCA. Two CRNAs told Crain's they are forming a union to gain a seat at the policy table at each of the three Beaumont hospitals to directly advocate for safe staffing ratios and greater patient safety measures. (Greene, 2/25)
GMA:
Black Health Care Workers Shine Spotlight On Issues Of Diversity In Medical Field
As the U.S. continues to celebrate Black History Month, Black medical workers are shining a spotlight on the lack of diversity in their profession. A biennial study conducted in 2018 by the Association of American Medical Colleges found that only 5% of physicians in the U.S. are Black or African American, compared to 56.2% of U.S. physicians who are white. (Bernabe, 2/26)
