CMS Delays Enforcement of 5010 Standards

Monday, March 19th, 2012
This post was written by Cheryl Miller

CMS has postponed enforcement of its regulations requiring the use of the 5010 standards in all electronic healthcare transactions until June 30, 2012. It is two weeks before all healthcare providers and payors could have been penalized if they failed to comply and were not yet using the 5010 transaction set. Reaction to the news will be mixed, but there seems to be consensus that the delay is a welcome one.

In other CMS-related news, a new demonstration program to expand access to emergency psychiatric care for Medicaid beneficiaries could significantly cut state and hospital healthcare costs, reduce general acute care ED visits and help vulnerable patients get proper care. Federal law has prohibited Medicaid from paying for mental health services provided to Medicaid enrollees between the ages of 21 and 64. As a result, these patients have had to seek services in general hospital ERs, where they may not get the right care, or go to psychiatric hospitals where the care is appropriate but reimbursement is not provided, which has been a continued drain on healthcare resources.

Medicaid patients are the focus of another story, which details the barriers they face seeking treatment in primary care, making them twice as likely to visit the ED as their privately insured counterparts, according to a study published in the Annals of Emergency Medicine. Even those Medicaid enrollees who have primary care report significant barriers to seeing their doctor, and given that many of them are in poor health, they tend to visit the ER more. Researchers hope their study will bring about change in this area.

Changes in the rates of hospital-acquired infections could be imminent, given a new study that found that hospitals with board-certified infection prevention and control directors have significantly lower rates of bloodstream infections (BSI) than those that are not led by a certified professional. It is the first such report to study the association between certified program directors and rates of healthcare-associated infections, researchers say.

And lastly, location plays an important role when it comes to healthcare quality, cost, accessibility and outcomes, says a new, extensive study from the Commonwealth Fund. But these factors vary greatly not only from one community to the next, but within and across states, depending on the performance of the healthcare system available to residents.

These stories and more in this week’s issue of Healthcare Business Weekly Update.

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