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Back Beat

April 1, 2008
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Ingenix Target of Attorney Subpoenas

New York State Attorney General Andrew Cuomo has issued 16 subpoenas to insurance companies — including Aetna Inc., Cigna Corp. and Empire BlueCross BlueShield — and plans to file suit against Ingenix Inc., its parent UnitedHealth Group, and three additional subsidiaries, as part of an industry-wide investigation into a scheme to defraud consumers by manipulating reimbursement rates.

The Attorney General's case contends that Ingenix operates a defective and manipulated database that most major health insurance companies use to set reimbursement rates for out-of-network medical expenses. The investigation also found that two subsidiaries of United dramatically underpaid members for out-of-network medical expenses by using data provided by Ingenix.

KLAS: CPOE Usage Almost Doubles

CPOE usage in hospitals with more than 200 beds has almost doubled, from 9.6 percent last year to 17.5 percent today, according to a report from Orem, Utah-based KLAS.

The jump represents significant progress since KLAS first began measuring CPOE adoption in 2003, when fewer than 3.5 percent of U.S. hospitals were participating in any form of the technology. At that time, nearly half of all pharmacy orders entered by physicians were reentered in the pharmacy, and only 45,000 physicians across the country used CPOE technology. Most of those providers using CPOE were in teaching hospitals.

The KLAS survey looks to answer such questions as: aside from continued growth, how is CPOE faring today? Is there a difference in deployment of CPOE in hospitals with 200 or fewer beds and those with more than 200 beds? Which vendors lead CPOE adoption, and how satisfied are their clients? Are physicians more accepting of the technology today than they have been in the past? What advice do providers offer from their experience with deployment and usage of CPOE?

Vendors covered in the report include Cerner, CPSI, Eclipsys, Epic, GE, McKesson, Meditech, QuadraMed and Siemens.

HIMSS Looks to School Pres Candidates

Chicago-based HIMSS has issued a Presidential Health Information Technology Briefing Book that outlines eight policy recommendations for the presidential candidates.

According to HIMSS, the recommendations include:

  • permanent status for the Office of the National Coordinator for Health IT;

  • full funding for all federal HIT initiatives;

  • adoption incentives and reimbursement methodologies;

  • interoperability standards and harmonization;

  • certification of EHR products;

  • privacy and security;

  • reform of physician self-referral and anti-kickback statutes;

  • and consumer empowerment.

The briefing book also includes an Executive Summary, a HIT 101 primer, current initiatives, resources and tools.

Report: States Making Progress in Protecting e-Health Data

Most states surveyed have made “substantial” progress in defining their privacy and security approaches for electronic health information exchange, according to a report released by the Office of the National Coordinator for Health Information Technology (ONC) and the Agency for Healthcare Research and Quality (AHRQ), both part of the U.S. Department of Health and Human Services.

The Impact Analysis Report provides an assessment of the progress made by states since the inception of the project by comparing the current landscape for privacy and security to the baseline as reported by the state teams in early 2006. The report discusses the impact of work among and between participants in five key areas: legislation, executive orders, leadership and governance, stakeholder education and knowledge, and development of health information exchange networks.

According to the report, progress made during the past two years includes:

  • 23 states cite increased awareness of privacy and security issues among stakeholders as a key component of success in the development and sustainability of statewide HIE plans;

  • 14 states indicated the Privacy and Security Solutions Project has served to increase support for planned HIEs;

  • 11 states reported legislative activities aimed at updating and aligning privacy and security statutes to prepare for electronic HIE, with four states having already passed some legislation; and

Seven collaborative work groups involving 43 states and two territories are now focused on implementing shared privacy and security solutions.