In an effort to cut $33 million from its budget, Washington state has recently passed a law that limits Medicaid patients to three non-emergent ED visits per year. It will not cover visits beyond the initial three, even if the visit constitutes a true emergency. To determine...
Over the past several years, healthcare quality has come under increased scrutiny. In 2001, the Institute of Medicine's (IOM) report Crossing the Quality Chasm highlighted the lack of consistency in the quality of care in the American healthcare system. The IOM report showed...
The Health Care Quality Improvement Act of 1986 (HCQIA) was created to provide immunity from monetary damages to hospitals and individual practitioners participating on medical peer review committees. HCQIA also created the National Practitioner Data Bank.
Although patient safety organizations (PSO) have been around for a couple of years, for many medical staffs, questions still linger. Hospitals aren't required to participate in a PSO, but many are considering doing so to reap the legal protections that PSOs offer.
Many clients have asked me about appropriate privileging for telemedicine providers. This is a regulatory issue, and the most common regulatory agencies, The Joint Commission and Centers for Medicare & Medicaid Services (CMS), have not been in sync with their requirements....
The term "accountable care organization" (ACO) has been nebulous since it first became part of the healthcare vocabulary in 2009 with the introduction of the Patient Protection and Affordable Care Act. Since then, the industry has been waiting for the Centers for Medicare...
