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  • NCVHS Predictability Roadmap

    by Samantha Holvey | Oct 05, 2018

    From: Nick Coussoule and Alix Goss, Co-chairs, NCVHS Subcommittee on Standards

    The National Committee for Vital and Health Statistics (NCVHS) is requesting your assistance with the next step of the Predictability Roadmap initiative on updating and adopting administrative standards and operating rules under the Health Insurance and Portability Act of 1996 (HIPAA).  The attached draft recommendations for the Roadmap were developed after an 18-month industry engagement process which includes a set of 23 recommendations, calls to actions and measurements under 3 focus areas:1.  Improved education, outreach and enforcement from Health and Human Services (HHS), 2.  Policy levers to support process improvement changes from the standards organizations, and 3.  Regulatory levers to enable timely adoption, testing, and implementation of updated or new standards and operating rules.

    The recommendations have been incorporated into a narrative report and presentation.  The narrative report provides a history of standards development and adoption under the Health Insurance and Portability Act of 1996 (HIPAA) and the Affordable Care Act of 2010 (ACA), and the NCVHS Subcommittee on Standards engagement activities to date.  The power point summarizes our work and includes the list of recommendations, calls to action and measurements.  This information is also on the NCVHS website at https://ncvhs.hhs.gov/meetings/full-committee-meeting/

    The Subcommittee is interested in getting as much feedback as possible so that final recommendations can be developed for subsequent transmission to the Secretary of Health and Human Services (HHS) in 2019.  Please send comments to NCVHSmail@cdc.gov with the subject line “Predictability Roadmap” and include your name, email address, and organization.  A hearing will be held on December 12 – 13th in Washington, DC.

Featured Articles

WEDI Brief Outlines Challenges to Telehealth Reimbursement

Jan 13, 2017, 13:13 PM

Healthcare providers face many challenges in launching and sustaining a telehealth program – including finding the right CPT codes, if they exist, for reimbursement.

In many cases, a telehealth or telemedicine procedure is so new, a proper definition and guidelines haven’t been written for it yet, the Workgroup for Electronic Data Interchange (WEDI) reports in a new issue brief. Without those definitions, payers won’t reimburse for the service - and if health systems aren’t getting paid for it, they likely won’t use it.

CPT (Current Procedural Terminology) code sets, part of the Healthcare Common Procedure Coding System (HCPCS), are maintained by the American Medical Association’s CPT Editorial Panel and used by the Centers for Medicare & Medicaid Services (CMS) for definition and reimbursement. With terms like telemedicine and telehealth entering the healthcare lexicon over the past two decades, the AMA has been slowly working to refine the codes to include new services. The organization even launched a 50-member Telehealth Services Workgroup in late 2015.

To read more, visit MHealth Intelligence.

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