HIMSS 2014 Keynote – Marilyn Tavenner Speaks about ICD-10, Meaningful Use, Healthcare.gov and Quality in Healthcare

Marilyn Tavenner, Administrator of the Centers for Medicare and Medicaid Services spoke at HIMSS 2014 in Orlando Florida about interoperability, and “reduced spending in healthcare,”  she said.  “We want to continue to reward programs that provide value and quality. Linking quality data, reporting, and cost of care to outcomes, patient quality for all care settings and tie that to payments.”  She also spoke about ICD-10, Meaningful Use Stage 2, Healthcare.gov, interoperability and details about several quality and privacy initiatives.

Ms. Tavenner then commented on important 2014 programs

  • Physician Payments Sunshine Act Payment transparency program requires reporting of any transfer of value between covered drugs, devices, biologicals, and medical supplies and physicians is in the early stages in file exchange, operational in fall 2014. Requires
  • ICD-10 deadline – “…no more delays, system going live October 1, 2014.”  There will be no change in the deadline.  International Classification of Diseases (ICD-10) is required for all HIPAA Covered Entities.
  • ICD-10 testing, four prong approach Healthcare.gov – “substantial progress has been made” and we will continue to make improvements to the site to improve usability and reliability for Americans who want to purchase insurance via the federal web site.
    • Internal testing
    • March beta testing and Medicare testing week
    • Tools for providers to test
    • July testing – volunteers will be accepted starting in March, totaling 500 total
    • Stage 2 Meaningful Use of Electronic Health Records – “we have to have the ability to exchange data among systems and patients so interoperability is key.”   Now is not the time to stop moving forward.  There will be flexibility in receiving hardship exemptions.  “However we expect providers to comply with Stage 2 MU.”   Meaningful Use is specified under Title IV, Division B of the HITECH Act specifying Meaningful Use of Electronic Health Records in 2009.
    • Accountable Care Organization (ACO) providers will benefit from data interoperability in these initiatives including uniform transactions.

Michael F. Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. His vision for the firm is to continue acquisition of skills and technology that support the intersection of clinical data and administrative health data where the eligibility for medically necessary care is determined. He leads a team that provides litigation consulting as well as advisory regarding medical coding, medical billing, medical bill review and HIPAA Privacy and Security best practices for healthcare clients, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, physician compensation, Insurance bad faith, payor-provider disputes, ERISA plan-third-party administrator disputes, third-party liability, and the Medicare Secondary Payer Act (MSPA) MMSEA Section 111 reporting. He uses these skills in disputes regarding the valuation of pharmaceuticals and drug costs and in the review and audit of pain management and opioid prescribers under state Standards and the Controlled Substances Act. He consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises ERISA self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, studies at Harvard Medical School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims). Mr. Arrigo has been interviewed quoted in the Wall Street Journal, New York Times, and National Public Radio, Fortune, KNX 1070 Radio, Kaiser Health News, NBC Television News, The Capitol Forum and other media outlets. See https://www.noworldborders.com/news/ and https://www.noworldborders.com/clients/ for more about the company.

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