The use of telehealth technology is increasing as more insurers and employers begin to cover virtual physician consultation services. Proponents say such services could help ease the primary care physician shortage and are less costly than other in-person visits. Wall Street Journal.
A new report from CMS finds that Medicare has saved about $115 million since it implemented new fraud prevention technology in the summer of 2011. The system uses predictive analytics to identify suspicious billing patterns and prevent payments. According to officials, much of the estimated savings are a result of removing fraudulent providers from the program. AP/Boston Globe, Forbes.
HealthTrio, a health IT vendor, has filed a lawsuit claiming that Aetna and two of its technology subsidiaries infringed on 10 of HealthTrio's software patents. Aetna said it is reviewing the suit and will "defend the case vigorously." Modern Healthcare, Health Data Management.
Sen. Chuck Grassley and Rep. Fred Upton are raising concerns about a potential conflict of interest involving a UnitedHealth Group subsidiary contracted to build a database hub for a federal health insurance exchange. The lawmakers said the contractor is in a position to tailor the system to favor the interests of UnitedHealth Group. The Hill's "Healthwatch," St. Paul Pioneer Press.
A Government Accountability Office report finds that CMS is behind schedule on implementing a $90 million predictive-modeling system to combat Medicare and Medicaid fraud. The system would use data analytics to find suspicious claims and immediately stop payments. According to GAO, many details of CMS' transition to the new system remain unclear. Modern Healthcare, Politico's "Pulse."
Most insurers participating in state health insurance exchanges will use an electronic system to submit their policies for review. Observers say the system has yet to be updated because officials are waiting on regulations from the Obama administration. Kaiser Health News.
HHS has announced that states now have until Dec. 14 to submit detailed plans for establishing online health insurance exchanges under the Affordable Care Act. The extended deadline aims to help states obtain the technical support necessary to pursue their own exchanges. The deadline extension will not affect the anticipated January 2014 launch of the exchanges. Washington Post's "Wonkblog" et al.
UnitedHealth Group recently bought Quality Software Services, which has received a contract to complete IT work for a federally run health insurance exchange. The deal has raised concerns that UnitedHealthcare might benefit from the acquisition. The Hill's "Healthwatch."
A new policy brief from the Robert Wood Johnson Foundation's Maximizing Enrollment project suggests that many states could better measure outreach and track enrollment trends if they upgraded their IT systems for Medicaid enrollment and eligibility. Government Health IT.
A new iPad application from America's Health Insurance Plans uses federal data to provide charts about health spending. Users can view historical and projected spending data on a national level or by state. Healthcare IT News, National Journal's "Influence Alley."
Connecticut officials are comparing two databases to determine whether state workers and retirees improperly kept former spouses on their health insurance plans. Officials say it is too early to tell whether the computer-assisted audit will be successful. Hartford Courant.
A new report by the Government Accountability Office finds that CMS has improved the operations of its HIPAA Eligibility Transaction System in part by implementing a series of upgrades to the hardware, software and operating system for HETS. Health Data Management, FierceHealthIT.
Black Book Rankings predicts that 302 developing and planned U.S. accountable care organizations will spend a total of $500 million on health IT in their first year. The report notes that ACOs could face between $1 million and $4 million in initial technology costs. FierceHealthIT et al.
Several health care organizations have responded to the Obama administration's warning that it will not tolerate hospitals' use of electronic health record systems to inflate medical bills. Many stakeholders said that they agree that such "upcoding" is unacceptable but added that federal officials should provide more guidance on using EHR systems in medical billing. Politico et al.
Utah's Department of Health is working to launch a database on medical and prescription drug claims to help consumers make informed health care decisions. However, the project has faced numerous problems related to staffing, contractors and funding. Salt Lake Tribune.