Physicians Exempted from Red Flags Rule
Congress has exempted some healthcare providers from the Red Flags Rule
with a clarification bill passed December 7.
After years of debate over their inclusion in the federal regulation, the bill
effectively exempts from the rule many
nonfinancial entities—including physician offices, law firms, and accountant offices. The bill awaited President
Obama’s signature into law at press
time.
Some hospitals could still be covered
by the rule if they use or report to credit
agencies.
Passed November 2007, the Red
Flags Rule required financial institu-
tions and other “creditors” to maintain
programs that identify, detect, and re-
spond to “red flags” patterns or activi-
ties that could indicate identity theft.
The Federal Trade Commission (FTC),
which Congress had tasked with writ-
ing the rule, interpreted “creditor” to
include entities that provide a service
up front and collect payment after in in-
stallments, such as a physician provid-
ing treatment to a patient.
The Red Flag Program Clarification
Act states that a creditor is someone
who loans funds to others and con-
ducts business with consumer report-
ing agencies for credit transactions. A
creditor is not an entity that “advances
funds on behalf of a person for expens-
es incidental to a service provided by
the creditor to that person.”
The FTC intends to begin enforcement of the rule once the clarification
act is signed into law. ¢
ED BENCHMARKS
www.mckesson.com
McKesson and the Emergency Nurses Asso-
ciation have launched the ED Bench-
marks Collaborative for hospitals
seeking to improve their emergency
department (ED) performance. This
Web-based subscription service en-
ables hospital leaders to identify trends
and compare their ED performance
with similar organizations nationwide.
CMS Introduces Innovation Center
In November the Centers for Medicare
and Medicaid Services (CMS) formally
established the new Center for Medicare and Medicaid Innovation.
Created by the Affordable Care Act,
the Innovation Center will examine new
ways of delivering healthcare and paying healthcare providers that can save
money for Medicare and Medicaid while
improving the quality of care. CMS also
announced the launch of new demonstration projects that will support efforts to better coordinate care and improve health outcomes for patients.
“The Center will identify and test care
models that provide beneficiaries with
a seamless care experience, better
health and lower costs,” said acting In-
novation Center director Richard Gilfil-
lan, MD, in a press release. “By working
together with innovative and committed
providers we can create a system that
works better for everyone. We want to
identify, validate, and scale models that
have been effective in achieving better
outcomes and improving the quality of
care, but may be relatively unknown.”
The Innovation Center will consult
stakeholders across the healthcare
sector including hospitals, doctors,
consumers, payers, states, employ-
ers, advocates, relevant federal agen-
cies, and others to obtain direct input
on its operations and to build partner-
ships with those interested in its work.
The center will work with stakeholders
to create learning communities that
help other providers rapidly implement
these new care models.
CMS also announced several new
initiatives to strengthen primary care
and better coordinate care for patients.
New initiatives will test health home
and medical home concepts.
The Innovation Center also announced upcoming award opportunities of up to $1 million for states to
support development of new models
aimed at improving care quality, care
coordination, cost-effectiveness, and
overall experience of beneficiaries who
are eligible for both Medicare and Medicaid, also known as “dual eligibles.”
For more information on the Innovation Center and these initiatives, visit
www.innovation.cms.gov. ¢
NETWORK MANAGEMENT SOLUTION
www.trizetto.com
The TriZetto Group announced the gen-
eral availability of its NetworX 4. 2 suite
of products. The suite, which includes
the NetworX Modeler and the patented
NetworX Pricer products, will support
healthcare payers as they work to
meet ICD- 10 compliance requirements
while improving administrative ef-
ficiency and preparing innovative plan
designs. It also includes expanded
pricing functionality for Medicare Pro-
spective Payment Systems.
DATA ANALYSIS SUITE
www.genego.com
GeneGo and Agilent Technologies have
integrated Agilent’s Genespring Bio-
informatics Solution with MetaCore.
GeneSpring GX 11. 5 is a multi-omics
microarray and mass spectrometry-
based analysis suite to handle tran-
scriptomics, genomics, metabolomics,
and proteomics data. It includes a
direct connection to the MetaCore
pathway analysis engine that allows
users to seamlessly upload expres-
sion data analyzed in GeneSpring for
pathway analysis in MetaCore.
DOCUMENTATION FOR MEDICAL PRACTICES
www.ahimastore.org
Ideal for classroom use and for all
levels of healthcare professionals in
medical practices, AHIMA’s Documenta-
tion for Medical Practices is the most
comprehensive documentation guide
available. It includes coverage for
physicians, advanced practice nurses,
physician assistants, and other clini-
cal staff. An accompanying CD-ROM
includes sample forms and electronic
resources. ¢
