HHS Seeks Public Input on Improving Care Coordination and Reducing the Regulatory Burdens of the HIPAA Rules

December 14, 2018 by matray

The U.S. Department of Health & Human Services (HHS), Office for Civil Rights (OCR), issued a Request for Information (RFI) seeking input from the public on how the Health Insurance Portability & Accountability Act (HIPAA) Rules, especially the HIPAA Privacy Rule, could be modified to further the HHS Secretary’s goal of promoting coordinated, value-based healthcare. This RFI is a part of the Regulatory Sprint to Coordinated Care, an initiative led by Deputy Secretary Eric Hargan.     HHS developed the HIPAA Rules to protect individuals’ health information privacy and security interests, while permitting information sharing needed for important purposes. However, in recent years, OCR has heard calls to revisit aspects of the Rules that may limit or discourage information sharing needed for coordinated care or to facilitate the transformation to value-based health care. The RFI requests information on any provisions of the HIPAA Rules that may present obstacles to these goals without meaningfully contributing to the privacy and security of protected health information (PHI) and/or patients’ ability to exercise their rights with respect to their PHI.     “This RFI is another crucial step in our Regulatory Sprint to Coordinated Care, which is taking a close look at how regulations like HIPAA can be fine-tuned to incentivize care coordination and improve patient care, while ensuring that we fulfill HIPAA’s promise to protect privacy and security,” said deputy secretary Hargan. “In addressing the opioid crisis, we’ve heard stories about how the Privacy Rule can get in the way of patients and families getting the help they need. We’ve also heard how the Rule may impede other forms of care coordination that can drive value. I look forward to hearing from the public on potential improvements to HIPAA, while maintaining the important safeguards for patients’ health information.”     “We are looking for candid feedback about how the existing HIPAA regulations are working in the real world and how we can improve them,” said OCR director Roger Severino. “We are committed to pursuing the changes needed to improve quality of care and eliminate undue burdens on covered entities while maintaining robust privacy and security protections for individuals’ health information.”     In addition to requesting broad input on the HIPAA Rules, the RFI also seeks comments on specific areas of the HIPAA Privacy Rule, including:

  • Encouraging information-sharing for treatment and care coordination
  • Facilitating parental involvement in care
  • Addressing the opioid crisis and serious mental illness
  • Accounting for disclosures of PHI for treatment, payment, and health care operations as required by the HITECH Act
  • Changing the current requirement for certain providers to make a good faith effort to obtain an acknowledgment of receipt of the Notice of Privacy Practices
  Public comments on the RFI will be due by February 11, 2019.  The RFI may be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/

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Hub International Acquires the Assets of Pennsylvania-Based Nolen Associates, Inc.

December 13, 2018 by matray

Hub International Limited, a global insurance brokerage, announced that it has acquired the assets of Nolen Associates, Inc. Terms of the transaction were not disclosed. Located in Springfield, Penn., Nolen Associates is a full-service medical malpractice insurance agency that represents more than 1,000 healthcare professionals throughout PennsylvaniaNew YorkNew JerseyDelaware and Maryland. Further strengthening Hub's Healthcare practice, Ray Nolen, president of Nolen Associates, and vice presidents Patrick Nolen and Michael Nolen will report to Shawn McLaughlin, national practice leader of Hub Healthcare and CSO for Hub New England. "We are excited to add the expertise of Ray, Pat and Mike to Hub's expanding Healthcare practice," McLaughlin said. "We look forward to enhancing the great, personalized service their clients are accustomed to with the resources of Hub's Healthcare Specialty."

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Physicians Insurance teams with Milliman Datalytics-Defense to Apply Machine-Learning to Claims Management Strategies

December 6, 2018 by matray

Milliman, Inc., a global consulting and actuarial firm, recently announced that Physicians Insurance A Mutual Company has selected Milliman Datalytics-Defense as its advanced analytics legal management platform for processing defense cost invoices. Milliman Datalytics-Defense employs data mining algorithms and machine learning to help insurers and self-insureds detect patterns in attorney billing practices, delivering a better understanding of both costs and defense strategies.

“At Physicians Insurance we seek out forward-thinking solutions that provide value to our members,”says John Domeika, Physicians Insurance A Mutual senior vice president. “With Milliman Datalytics-Defense, we’ve gained an innovative claims handling process that will improve strategies and help us best steward our member resources.”

Milliman Datalytics-Defense is designed specifically for the insurance industry and has subject matter expertise built into the technology and reporting. The tool’s predictive analytic engine is fueled by a powerful and proprietary data-mining algorithm for greater accuracy and the ability to turn text into structured data.

“To manage and mitigate risk effectively today, it’s necessary to employ tools that take advantage of advanced analytics techniques like data mining and machine learning,” saidChad C. Karls, principal and consulting actuary with Milliman. “We look forward to working with Physicians Insurance to help reduce costs and increase transparency in the claims handling process.” 

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Constellation Announces Strategic Partnership with Health Care IT Security Company Imprivata

December 5, 2018 by matray

Constellation, Inc., recently announced a strategic partnership with Imprivata, a healthcare IT security company offering technology that addresses two critical needs: safeguarding electronic systems and healthcare data as well as improving efficiency in the way clinical work is done.

Imprivata OneSign sin

gle sign-on technology can save typical care providers up to 45 minutes per shift by allowing them to log into electronic health systems just once and eliminating the need to remember and enter their usernames and passwords countless additional times. The technology’s advanced authentication ensures that those who sign in to the system are authorized to do so, a key protection for system and data security.

“Our agreement with Imprivata marks a significant milestone in Constellation’s strategy to offer solutions that support the success of physicians, hospitals and senior-living and long-term care communities beyond medical professional liability insurance,” said Bill McDonough, Constellation CEO. “Our partnership will enable us to help healthcare organizations and clinicians reduce time spent on administrative tasks and regain time for patient care. Optimizing care team time provides both business and personal benefits, including improved satisfaction for both patients and clinicians.”

“Constellation is a trusted organization with an excellent reputation,” said Wes Wright, chief technology officer at Imprivata. “Through Constellation, we’ll be able to deliver the benefits of our platform to a broader network of providers – and help them better leverage both talent and time to deliver care more efficiently and securely.”

Under the agreement, Constellation’s medical professional liability companies – MMIC, UMIA and Arkansas Mutual Insurance Co. – will exclusively market Imprivata’s portfolio of healthcare IT security solutions in the 16 states where they serve customers. Those states include Arkansas, Colorado, Idaho, Indiana, Iowa, Kansas, Minnesota, Missouri, Montana, Nebraska, North Dakota, Oregon, South Dakota, Utah, Wisconsin and Wyoming.

Constellation’s collaboration with Imprivata marks its third expansion of services beyond medical professional liability insurance. Earlier, it introduced the Physician Empowerment Suite, an online platform designed to help healthcare providers deliver a better patient experience and improve operational performance and effectiveness. And in January 2018, it established a strategic collaboration with CliftonLarsonAllen (CLA), a leading healthcare professional services, consulting and advisory firm.

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KAMMCO Releases Opioid/Controlled Substances Dashboard for Physicians, Hospitals in its Health Information Exchange

December 5, 2018 by matray

KAMMCO released a new Opioid/Controlled Substances dashboard for physicians, hospitals and behavioral health providers participating in the KAMMCO network of health information exchanges. The tool supplements the existing Prescription Drug Monitoring Program (PDMP) currently available in most states.

“The KAMMCO tool builds upon a more comprehensive set of data than the PDMP, which only captures filled prescription data, and does not include medications which are administered to patients in healthcare facilities,” said Laura McCrary, Ed.D, KAMMCO senior vice president. “The new dashboard provides participating clinicians with the list of opioids/controlled substances prescribed or administered to a clinician’s patients even before a prescription is filled at the pharmacy.”

The tool utilizes data from the physician-led KAMMCO network of health information exchanges and is available to prescribing providers and their designated delegates.

To develop this advanced analytics tool, the KAMMCO Analytics and Business Intelligence team worked with a multi-disciplinary group of practicing physicians to assess how health information exchange data could better inform physicians regarding their patients’ history of opioid/controlled substance use. The tool allows clinicians to identify individuals in their patient population who received at least one prescription/administration of opioids/controlled substances, by facility and date range up to 12 months, and also displays the top five opioid medications prescribed/administered to their patients.

KAMMCO provides physicians with access to aggregate clinical data from itshealth information exchange through secure web-based dashboards. Additional analytic dashboards available to KAMMCO network participants include: High Risk Patients, 30 Day Readmissions, Disease Registries, Health Care Utilization, Behavioral Health, Preventive Care Quality Reporting and Polychronic Conditions. Participants may also request custom ad-hoc reports.

The Opioid/Controlled Substances dashboard is available to participating physicians and health systems as a part of the KAMMCO physician-led health information exchanges in Kansas, Georgia, South Carolina, Connecticut, New Jersey, Missouri, and Louisiana. All exchanges are delivered in partnership with the state medical societies.

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Willow Risk Advisors Partners with the American Society Interventional Pain Management to Launch Medical Malpractice Insurance Program Exclusively for Its Members

November 16, 2018 by matray

Willow Risk Advisors announced a partnership with American Society of Interventional Pain Physicians (ASIPP) for an exclusive medical professional liability insurance program available to its members. In an effort to further increase value to its physician members, The American Society of Interventional Pain Physicians (ASIPP) endorsed Willow Risk Advisors as their professional liability insurance broker. Teaming up with The NORCAL Group, Willow Risk has developed an exclusive Medical Malpractice Insurance Program tailored specifically to serve interventional pain physicians. This new program will offer necessary benefits including risk management, premium discounts, consent to settle, aggressive claims handling and administrative defense. In this new partnership with Willow Risk Advisors, ASIPP's focus on risk management and patient safety will be further solidified. Included in the program is risk management CME activities. All ASIPP members will receive access to a mobile app that offers on-demand webcasts and articles. Not only will the program continue to uphold the original mission of ASIPP, but also further enhance the educational opportunities and mobility towards professional growth. "In the modern era of regulatory tsunami and exploding practice costs with declining reimbursement, the creation of an exclusive medical liability program for members of the American Society of Interventional Pain Physicians (ASIPP) is one of the pivotal achievements of the organization," said Laxmaiah Manchikanti, MD, ASIPP chairman of the board and chief executive officer. "There are many important benefits of this program in addition to a savings on average of 15- to 40-percent, exclusively for ASIPP members, with an additional discount for ABIPP board certification (*ABIPP Certification discount pending approval). As many practices are now forced to undergo three and four audits a year, another benefit is the administrative defense coverage for audits. Coverage limits can be extended up to $1 million. "We are confident this program will propel the importance of ASIPP and the importance of ASIPP guidelines We're proud to offer this new program on the heels of another successful ASIPP program, the National Interventional Pain Management Qualified Clinical Data Registry (NIPM-QCDR) which saves physicians 9 percent in penalties, and provides outcomes for interventional techniques we perform daily."

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ISMIE Mutual Announces New Osteopathic Partnerships

November 13, 2018 by matray

ISMIE Mutual Insurance Co. has partnered with the Indiana Osteopathic Association (IOA) and the Pennsylvania Osteopathic Medical Association (POMA). Through the program, IOA and POMA members will receive access to ISMIE’s risk management program, discount credits and other benefits that come with ISMIE coverage. New physicians coming out of residency will also be eligible for special discounted coverage. “We are enthusiastic about entering into these new partnerships,” said ISMIE Chairman Paul H. DeHaan, MD. “We expect osteopaths will be drawn by our favorable pricing, but it’s our customer service, superior claims support and topnotch risk management program that will help ISMIE build loyalty with osteopaths.” ISMIE provides medical professional liability insurance, offering products that maximize protection and minimize worry. Founded by physicians in 1976, ISMIE remains physician-led. ISMIE Mutual is an admitted carrier in 11 states and the District of Columbia, and protects professionals and facilities in all 50 states through its subsidiary ISMIE Indemnity.

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Cooperative of American Physicians Announces Hire of Thomas Mortimer

November 7, 2018 by matray

The Cooperative of American Physicians, Inc. (CAP) today announced the new hire of Thomas Mortimer in the role of senior account executive, adding a depth of industry knowledge and experience to the CAP sales team. Mortimer will report to Daniel Cavanaugh, CAP vice president of membership development. 

A well-known figure in the medical malpractice coverage space, Mortimer is trusted by members of both the physician and insurance industries and brings considerable expertise to his new role. He served as assistant vice president of SCPIE from 1991 to 1995 before becoming vice president of the MMI Insurance Agency through 2000. Two years as sales director of St. Paul Global Health Care followed, before starting Thomas Mortimer Insurance Services, Inc. in 2002.

“Our mission at CAP is to provide an outstanding level of guidance and service to our members, and we’ve developed an exceptional team to fulfill that promise,” said Sarah Pacini, CAP chief executive officer. “Thomas Mortimer brings a wealth of knowledge to the CAP sales team, and has long been a trusted partner to both the physician and insurance industries.”

“Over the past 30 years, I’ve had the good fortune to work with talented, passionate individuals in both the insurance and health care industries,” said Mortimer. “My position at CAP offers a fantastic opportunity to pull from both skill sets to provide the highest level of guidance and care for CAP physicians, and by extension, countless patients.”

Mortimer entered his new role on November 1.  

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ISMIE Mutual Adds Brad Ash to Medical Liability Executive Leadership Team

November 6, 2018 by matray

ISMIE Mutual Insurance Co. announced Charles Bradley (Brad) Ash has joined the company’s management team as a senior vice president, reporting to Wayne de Nazarie, executive vice president.

Ash brings extensive experience within the medical liability insurance industry, most recently serving as chief executive officer of Aon Affinity Healthcare in Pennsylvania. Prior to that, he was a senior vice president with responsibilities including underwriting and business development for The Doctors Company, where he also served on its executive review and high exposure (claims) committees. In addition, Ash held positions at COPIC in Colorado for many years, working on operational and strategic initiatives, including geographic expansion and new product lines and platforms.

In his new position, Ash will have senior management oversight for ISMIE’s Sales and Underwriting Divisions.

“We are pleased to welcome Brad, an experienced medical liability insurance executive with a track record that supports all aspects of ISMIE’s continuing expansion throughout the United States,” said ISMIE chairman Paul H. DeHaan, MD. “Brad will play a central role in building new business opportunities and helping lead ISMIE’s strategic direction.”

Ash is a graduate of The University of Texas at Austin and earned an MBA from the University of Colorado. He holds the professional designations of Chartered Property Casualty Underwriter (CPCU) and Registered Professional Liability Underwriter (RPLU).

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