FEDERAL REGISTER

HFMA staff review the Federal Register daily for information that affects healthcare financial managers, and post links to the Federal Register on HFMA's Regulatory Updates (www.hfma.org/news/reg).

... The secretary of the Department of Health and Human Services has issued a final rule (Federal

Register, June 4, 2007) establishing regulations required by section 506 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Those regulations require hospitals that furnish inpatient hospital services payable under Medicare to participate in the contract health services program of the Indian Health Service (IHS) operated by the IHS, tribes, and tribal organizations, and to participate in programs operated by urban Indian organizations that are funded by IHS for any medical care purchased by those programs. Section 506 also requires such participation to be in accordance with the admission practices, payment methodology, and payment rates set forth in regulations, including acceptance of no more than such payment rates as payment in full. Effective: July 5, 2007.

... CMS has issued a final rule with comment period (Federal Register, May 29, 2007) clarifying that entities involved in the financing of the nonfederal share of Medicaid payments must be a unit of government; clarifies the documentation required to support a Medicaid certified public expenditure; limits Medicaid payment for healthcare providers that are operated by units of government to an amount that does not exceed the provider's cost of delivering services to Medicaid individuals; requires all providers to receive and retain the lull amount of total computable payments for services furnished under the approved Medicaid state plan; and makes conforming changes to provisions governing the State Child Health Insurance Program (SCHIP) to make the same requirements applicable, with the exception of the cost limit on payment.

The Medicaid cost limit provision of this regulation does not apply to stand-alone SCHIP program payments made to governmentally operated providers; Indian Health Service (IHS) facilities and tribal 638 facilities that are paid at the all-inclusive IHS rate; Medicaid managed care organizations, prepaid inpatient health plans, and prepaid ambulatory health plans; and federally qualified health centers and rural health clinics. Moreover, disproportionate share hospital payments and payments authorized under sections 701(d) and 705 of the Benefits Improvement Protection Act of 2000 are not subject to the newly established Medicaid cost limit for governmentally operated healthcare providers.

Effective: July 30, 2007. Comments on issues related only to the "unit of government" definition are due by July 13, 2007.

...CMS has published a proposed rule (Federal Register, May 25, 2007) that would clarify the Medicare program provisions relating to contract determinations involving Medicare Advantage (MA) organizations and Medicare Part D prescription drug plan sponsors, including eliminating the reconsideration process for review of contract determinations, revising the provisions related to appeals of contract determinations, and clarifying the process for MA organizations and Part D plan sponsors to complete corrective action plans. This proposed rule would also clarify the intermediate sanction and civil money penalty provisions that apply to MA organizations and Medicare Part D prescription drug plan sponsors, modify elements of their compliance plans, and revise provisions to ensure HHS has access to the books and records of MA organizations and Part D plan sponsors' first-tier, downstream, and related entities. Comments are due by July 24, 2007.

SIDEBAR

YOU DO THE MATH: The Leapfrog Group's 2007 Hospital Quality and Safety Survey reports that only 96 U.S. hospitals have a lull computerized provider order entry system in place-out of 1,318 hospitals that responded. Another 85 say they are committed to implementing a system this year.

SIDEBAR

SO MAYBE THIS IS WHY CPOE IS SO SLOW IN COMING: The Bureau of Labor Statistics has estimated that 136,000 Americans were employed as health information management professionals in 2000; to meet the expected demand, there will need to be a 49% increase by 2010.