News You Can Use: Learn the New Take-Home-Drug Billing Guidelines That Take Effect in July

Are you part of the 61% of facilities that are not fully HIPAA-compliant?

• CMS instructs you how to bill for take-home drugs.
Effective July 3, 2006, hospitals should bill the appropriate durable medical equipment regional carrier (DMERC) for certain take-home drugs, the Centers for Medicare & Medicaid Services states in Transmittal 840, which was released in February. CMS includes multi-day supplies of oral anti-cancer drugs and immunosuppressive drugs in its list of affected drugs. You’ll also now be required to bill supplying fees, which must be billed on the same claim as the drug.
Hospitals that do not have a supplier number for billing the DMERC should complete a Form CMS-855S and obtain a supplier number from the National Supplier Clearinghouse, the transmittal says. See www.cms.hhs.gov/transmittals/downloads/R840CP.pdf for specific instructions on how to do so.

• AHIMA reports that the number of noncompliant facilities grew from 2005 to 2006.
The American Health Information Management Association (AHIMA) published a new study in April that shows the number of facilities that report they are fully or mostly compliant with the Health Insurance Portability and Accountability Act (HIPAA) is decreasing. While the survey showed that the majority of facilities are essentially compliant with HIPAA privacy and security regulations, AHIMA also found that the number of facilities that  believe they are more than 85 percent compliant has dropped since 2005. In 2005, 91 percent of facilities surveyed believed that they were more than 85 percent compliant. That number decreased to 85 percent in 2006. Only 39 percent of the survey respondents said that they are fully compliant.
Responses to other questions give insight into this slight decrease and show that while it is not a significant change, it is enough to raise concern. For example, 55 percent of respondents indicated that resources are their most significant barrier to full privacy compliance, states the AHIMA report. The survey also found that 64 percent of respondents had not received any patient requests for an accounting of disclosures and 29 percent of respondents felt that the government should modify this section of the privacy rule.
Visit www.ahima.org/emerging_issues/2006StateofHIPAACompliance.pdf to read the full report and see how your facility stacks up against the respondents.

- Published on 2006-06-14