NYUMC Office of Compliance

If it concerns you, it concerns us.

NYUHC Regulatory Information Bulletin

Now we’re on a roll!  Previous issues of RIB are now available on the Compliance Website.  To expedite delivery the RIB is an e-newsletter.  Therefore, it was not designed to be printed.  If you would like a printed copy the easiest solution is to hit forward on the e-mail, scroll down to the JPEG of the newsletter, select it and click copy, open a new document in Word and click paste.   This will create a single page document that can be printed.  Happy reading!

Editor’s Corner!

Volume 1, Issue 4

Fascinating Additions & Proposals to Federal Law . . .

· CMS proposes changes to the Physician Fee Schedule effective 1st Jan 2007.  Proposed changes include a 5.1% reduction in fees, changes to Stark II Law changing the definitions of “centralized office building” and “physician in group practice,” and the reassignment rules.  Read the AMA’s response.

· CMS issues proposed 2007 Outpatient PPS.

· The Food and Drug Administration (FDA) is seeking comment on its draft guidance on the exception on informed consent for emergency research.  This guidance will be followed by a public hearing on October 11.

· The FDA is moving toward unique device identification requiring the medical device industry and hospitals to adopt a universal system to identify individual devices using bar codes & other technology.  Click the link to review and comment on the proposed rule in the Federal Register.

· Effective November 1, 2006, the DEA has changed its fee schedule for registering and re-registering as a manufacturer, distributor, or dispenser of controlled substances.  The new fee schedule requires an annual fee of $184 for dispensers like physicians, physician assistants, nurse practitioners, etc.

· Pres. Bush signed Executive Order directing federal agencies to provide healthcare price & quality info to consumers by 1/1/2007 by using IT.

The RIB is e-mailed monthly to managers and above.  To remove your name from our mailing list, or for questions or comments, please e-mail the Office of Compliance’s Regulatory Information & Education area or call (212) 404-4070.

►The House voted 270-148 to pass  the Health Information Technology Promotion Act of 2006 that would provide for the implementation of ICD-10, establish grants for IT implementation and create Stark relief for hospitals & physicians who share IT. The House bill now must be reconciled with a Senate version that passed earlier.  ►►The percent of Americans without health insurance hit 15.9%, or roughly 46.6 million people, in 2005, up from 15.6% of the population in 2004 (45.3 million people).

· In an emergency rule that was effective August 7th, the Department of Health expanded the Newborn Screening Panel to include Krabbe Disease.  This increases  the list of disorders/diseases on this panel to 45.

· The Department of Insurance promulgated an emergency rule effective August 2nd that amends the manner in which surgical claims are processed.  It requires that denials for surgical services that are considered cosmetic are subject to the utilization review and external appeal requirements of Article 49 of the Insurance Law or Public Health Law. Part 56 further provides that a request for coverage of surgery, other than a request for pre-authorization, that is solely identified by a code on a designated list, and is submitted without medical information, may be denied by a health plan without subjecting the request to Title I and Title II of Article 49 of the Insurance Law or Public Health Law if certain conditions are met.

· The Department of Education adopted new requirements for Certification as a Nurse Practitioner making it more difficult to be certified in additional specialties.  The DOE also adopted an emergency rule regarding the requirements for Licensure as a Clinical Laboratory Technologist that explains the licensure application process and deadlines for those qualifying under the grandparent provisions.

Notable New York Laws & Regulations . . .

Dr. DeAngelis, Editor of JAMA, is calling for further efforts to obtain transparency in medical research by urging employers of scientists to probe the scientists who do not comply with disclosure requirements for possible conflicts of interest. "It is important to discern the necessary & honest interests of for-profit companies from the potentially corrupting influence of commercial interests," she stated.

· Updates to ICD-9-CM Code Sets. Effective 10/1/2006.

· Struggling with E/M Service Coding & Documentation?  Check out CMS’  recently updated E/M guide.

· MM5060:  Implementing the revised CMS-1500 for NPIs.

· Final 2007 Inpatient PPS

· Public Comments posted on NCA for Clinical Trial Policy.

· LCD3084:  Updated Audiologic/Vestibular Function Tests

· Final 2007 Inpatient Rehab Facilities PPS.

August 31, 2006