Tuesday Tidbits (plus)

On Friday January 9, 2009, the Office of Management and Budget cleared the final HHS 5010 transaction
standards and ICD-10 code set rules for publication in the Federal Register.
I expect that the rules will be published on Thursday or Friday of this week (in other words before Inauguration Day as HHS has projected.) We won’t know whether the implementation deadlines have been extended until the rules are published. I’ll be keeping an eye out here

While the first point was a tidbit the next one is not. Today, Ingenix and United Healthcare announced a UCR rate settlement with New York attorney general Andrew Cuomo. (Health plans generally pay out of network providers based on usual reasonable and customary (UCR) rates.) Under this agreement, Ingenix and UHC will pay $50 million to a qualified university selected by Mr. Cuomo. According to Mr. Cuomo, the selected university will create a new database.”to help determine fair and accurate reimbursement rates. The university will also develop a website where for the first time consumers will be able to learn in advance how much they are likely to be reimbursed if they go out of network.” Replacement of the current widely used Ingenix databases with this “independent” database is bound to reduce the incentive for plan members to use in-network providers.Finally, Govexec.com confirms a Washington Post report that the chief Washington, D.C., zookeeper, John Berry, is expected to become the OPM Director in the Obama administration. (I couldn’t resist that sentence. Mr. Berry is a skilled executive who is strongly endorsed by the federal employee unions.)