Thursday, April 28, 2011

HIPAA Regulations as it relates to New Technology

We have written about HIPAA on several occassions on this blog (and even when we aren't writing about it, we are staying abreast on the subject). In the course of our recent research, we have found a number of articles discussing ideas on how new (and growing) technologies can fit into HIPAA regulations. We feel that, while this isn't the start, the fact that more consistent reporting is happening in this capacity will help bring the industry together to work towards a solution.

The risk of fines (or worse) is still a major concern for those reluctant to convert to EHR, so the idea of a transition to developing mobile sites and apps is beyond most physicians' range of thought. However, Diversenet, a company focused on strengthening mobile health technology capabilities, recently developed a whitepaper with nine mobile security best practices, such as encrypting PHI on mobile devices, authentication of users prior to transmitting PHI and automatic session timeout, logoff and device locking. Additionally, it lists 10 questions about mobile health data that healthcare organizations should ask when evaluating mobile technology.

The problems with mobile devices are obvious. Once information leaves a server, there are any number of complications that can result in breaches, and mobile technology has not proven itself to be anywhere near consistently secure. However, according to the article, a number of small mobile health companies are providing targeted wireless personal health monitoring devices and services that collect and transmit health data, while others have developed mHealth apps for patient monitoring, scheduling medical appointments and medication reminders, all of which work. And, at the security end, global technology service providers are adapting existing security products for the healthcare sector.

This just leaves the actual mobile device as the key problem, but Diversinet has a solution for that as well.

The advent of cloud computing, as it relates to HIPAA, is allowing certain organizations to reconsider certain security protocols and, according to a recent article in Tech News World. The story addresses how organizations are typically confused as how to meet the addressable requirements of the Security Rule, causing a refrain from full implementation, leaving the institution in the precarious position of not fully complying with the law -- at least not in the manner intended by HHS.

However, with cloud computing scenario, most security activities occur in partnership between vendor and client. So, while the onus still resides with the covered entity, components of the implementation can be handled by the business associate cloud provider. An organization that could commit, at some level, to helping maintain the HIPAA security requirements, would have a significant leg up.

"HIPAA is a well-intentioned, but poorly implemented law that is unnecessarily scaring doctors and keeping them in an unrealistic 'technology lockdown'."
This is a quote from Mark Britton, Founder and CEO of Avvo, a company that helps physicians deal with the legalities of new technology, such as social media. While Avvo has the ability to deal with specific issues, they do offer these five basic pieces of advice for managing their career online in relationship to HIPAA:
  1. Use email, SMS and social media messaging
  2. Feel free to share information with other providers
  3. Feel free to answer general patient questions
  4. Keep family members in the loop
  5. Exercise common sense and reasonable practices in all instances
For more details on these tips and other potential issues, click here...


Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at

Friday, April 22, 2011

CMS 2011 Spring Conference Wrap-Up

The CMS 2011 Spring Conference has officially wrapped up, and once again a large amount of information came directly from CMS on the state of the market, what their expectations are and what plans need to do to succeed in the new world of healthcare. As is customary, Jonathan Blum, Deputy Administrator and Director of CMS, had the keynote speech. 

Mr. Blum spoke about the 2012 CMS Priorities for the Medicare Part C and Part D Programs and beyond. CMS’s focus is on the following three items:
  1. Consistency
  2. Quality Improvement
  3. Continued focus on Compliance

CMS’s view of consistency means policy consistency. Simplifying programs, benefits and plan choices for beneficiaries; making navigation of the Part C & D programs easier for beneficiaries overall. CMS has a great deal of policy to implement via the Affordable Care Act, so they are seeking to allow systems and plans time to catch up by holding steady with policy issuance.

Quality Improvement
The 5 Star Bonus Payment System signals that CMS cares about quality, improving scores and rewarding good plans.  Ratings are provided as a consumer tool and payment mechanism.  As such, in 2012, 5 Star Plans will be allowed to market enrollment year round; while plans with 2 Stars consistently for 3 or more years will not be allowed to offer products to beneficiaries. Overall growth of 7% has been recognized in Medicare Advantage for 2011; this growth is even faster for 4 Star and higher plans. Plans are focused on improving ratings so beneficiaries gravitate to their plans.

Continued focus on ComplianceCMS has a heightened focus on compliance, audits, and performance. This can be seen in the way 2010 audits were conducted. Several overall trends appeared during the audits that all plans should take note of. The areas consisted of Part D Formularies, Coverage Determinations, Grievances, and Enrollment & Disenrollment Processes.

In addition, Mr. Blum stated that plans should understand their business better than CMS.  They should see and identify trends and issues before CMS. Understanding why their beneficiaries are calling is critical to correcting issues immediately. The top area of concern noted in the audit findings centered on oversight of a plan’s Pharmacy Benefits Manager (PBM). While CMS understands this is a delegated role the plan must remember they are ultimately responsible to the member and CMS to ensure their enrollees receive their medications. The oversight of the PBM must be conducted on a daily basis to avoid issues and ensure beneficiaries receive their medications at point of sale. Special attention should be paid to protected classes and transition of medications; multiple problems were cited in these areas. Proper and timely processing of coverage determinations and grievances is critical to remain in compliance. Also, plans must ensure their enrollment and disenrollment processes are working fluently. Take the time to build internal controls and workflow processes to avoid issues later down the road.

Overall, CMS is focusing on becoming more forthright. Compliance is of utmost importance.  Better Compliance + Better Performance = Higher Plan Reimbursement.  As the Medicare program continues to grow and expand the plans that do well will receive more members.


Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at

Friday, April 15, 2011

2011 Xplor Conference Recap

Merrill Corp. receiving the 2011 Technology Innovation of the Year Award
Last week, Merrill Corp. had the honor of receiving the 2011 Technology Innovation of the Year Award at the Xplor Conference. Before we attended, we had written a short post about the announcement of Merrill receiving the award. However, we would be remiss if we didn't follow-up to share how impressive the entire conference was.

Some of you who follow the Merrill Corp. Twitter page (@merrillconnect) read some real-time thoughts and updates from the event in general. Obviously, the highlight was the award luncheon where we received the award with our partner InfoPrint, but just as enjoyable and fruitful was the ability to network and catch up with colleagues in the industry that we normally don't get to meet with face-to-face.

Additionally, the amount of education that was available in both the general and breakout sessions was excellent. Personally, I participated in a panel discussing the future of Automated Document Factories (ADF) and its links to CRM tools and other electronic media, but also attended others, including discussions of Meware, which could be the next generation of mobile techonogy; and the evolution of Hybrid Cloud Computing which could have a direct link to the regulatory compliance issues that the healthcare industry is dealing with..

Finally, Tampa offered a great atmosphere for the conference and was a great place to visit (especially with the weather we have had up north). Thank you to everyone who help make this award possible, and next time you visit the Merrill Corp. offices, be sure to check out our plaque. 


Robert Cook is Digital Print & Fulfillment Director for Merrill Corporation.

Friday, April 8, 2011

Census Says Life Expectancy is Up, But Why?

Recent census data shows that the US average life expectancy has increased to a record-breaking 78 years. The immediate thought that most people have when presented with this information is that improving medical technology and increased health is leading to longer lives. To some extent, that is true. While there is a clear correlation between life expectancy and medical advances, this number does not really mean that the average person is living a longer life.

In reality, average life expectancy is determined almost entirely by infant mortality rate. In this most recent report, the CDC listed “a record low of 6.42 deaths per 1,000 live births, a drop of nearly 3% from 2008.” This number was 100 out of 1000 as recently as 1920, creating a statistic that implies that most people are living up to twenty years longer than they have in the past. This is simply not true.

Death rates are likely to continue dropping over the next decades as medical advances remove the threat of curable disease. The increasing unpopularity of smoking adds to this number as well.  This ratio of infant-mortality and death rate will continue to influence life expectancy, but we do not need to start worrying about running out of retirement homes any time soon.

Friday, April 1, 2011

Did you have Merrill winning your "Technology Innovation of the Year" Bracket?

Why should the University of Connecticut, the University of Kentucky, Butler University and Virginia Commonwealth University all hope to be like Merrill Corporation? Because next week, the leading global provider of technology-enabled services will be the only one of the five guaranteed to be holding a trophy.

While the trophy won't be presented in Houston or broadcast on national television, what it represents is nearly as highly regarded, as Xplor International, a worldwide, not-for-profit professional association that recognizes document technology solutions, has named Merrill Corporation as the recipient of their Technology Innovation of the Year Award.

Merrill was nominated for this award due to their record, page and piece level tracking and compliance-driven production environment that enables the company's healthcare clients to effectively communicate with their members. Merrill has successfully implemented an innovative, unmatched and proven Chain of Custody workflow resulting in the production of complex member communications that are accurate, timely and compliant – reducing member confusion and increasing member satisfaction.

The award will be presented at a luncheon on the final day Xplor International's 2011 Conference. Receiving the award will be Robert Cook, Director, Digital Print & Fulfillment for Merrill Corporation (who will also a panelist at the conference and reporting on it via Merrill's Twitter page).

Merrill strives to hit specific benchmarks in the healthcare communications industry - specifically in personalization and compliance – and by being recognized by Xplor International with the Technology Innovation of the Year Award, clearly we are reaching this goal,” said Cook. “Our focus on integrating 'integrity manufacturing' and its ability to support the reporting requirements of the industries we serve was key to this award. To win this with InfoPrint Solutions, and to be listed alongside previous winners such as Adobe Systems, Inc., ADP Investor Communications and GMC Software, is truly a great honor for Merrill Corporation.”

For more information on the award, please read the press release announcement.