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REGULATORY REVIEW


Plans (QHPs) in federally facilitated exchanges (FFEs). Parallel to the efforts of the Blue Button 2.0 initiative, CMS is proposing to require that the above listed entities make healthcare information available to patients/enrollees via openly pub- lished APIs. This would allow third- party developers to build programs that give patients access to their healthcare data in a user-friendly platform. Enti- ties also would be required to forward enrollee information to a different plan designated by the beneficiary even up to five years after a beneficiary has dis- enrolled. CMS states that these pro- posals could allow health information to follow up to 125 million enrollees, easing transitions of care and reduc- ing burden and redundancy. Although most if not all the entities in question


already have a requirement to pub- lish a provider and pharmacy direc- tory, CMS is proposing an additional requirement that both directories be made available through an API. The most controversial proposal in


the new rule regards an update to the hospital conditions of participation (CoP). CMS is interested in leveraging electronic patient event notifications as a tool for improving beneficiary care coordination. Therefore, CMS is pro- posing to revise the CoPs for Medicare and Medicaid hospitals to require them to send electronic patient event notifi- cations for admission, discharge or transfer to other facilities and commu- nity providers. The information sent could vary, but at a minimum, would include the patient’s demographic information, the treating practitioner


name and the sending institution. The patient would identify the facilities and providers that would receive automatic notices. Because this is a change to the CoP, hospitals that cannot demonstrate compliance with this proposal would lose the ability to receive reimburse- ment for treating Medicare enrollees. Upon release of the rule, several hospi- tal organizations expressed strong dis- approval for the proposal. Together, the Information Block- ing Rule and the Interoperability and Patient Access Rule represent sig- nificant expansions in the regulatory framework for EHI. For more infor- mation, write Alex Taira at ataira@ ascassociation.org.


Alex Taira is ASCA’s policy analyst. Write him at ataira@ascassociation.org.


IS CODING DRIVING


Then you need to visit The Coding Network’s booth # 714 and talk to us for all of your ambulatory surgery remote coding needs (permanent or temporary). Our coders are simply the best in the business. We also provide ASC coding audits and coding helpline services.


We have the largest team of ASC coders in the industry with 40+ ASC multispecialty coders and auditors. All of our coders/auditors are certified, based in the U.S., and have a minimum of 3 years of ASC coding experience (5 years for auditors).


Our contracts require no minimums which allows you to start and stop services at your discretion. We’ve handled the toughest cases and not a single client has ever paid a penny for recoupments, fines or penalties for a case coded by us. We provide services to 350 ASCs across the country.


For more information, contact Neal Green at : (310) 459-4186 or ngreen@codingnetwork.com


Remote Coding • Coding Accurancy Audits • Coding Helpline • Documentation Training Ask about our free 10 case ASC coding audit !


36 ASC FOCUS JUNE/JULY 2019 | ascfocus.org


YOU NUTS?


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