Proposed Regulation Changes

The State Board of Health will hold a public hearing to consider amendments to Chapter 449 of Nevada Administrative Code (NAC) on March 8, 2013.   The notice of public hearing,  proposed regulations and proposed changes that will allow podiatrists to conduct pre-surgical evaluations for podiatric patients can be found at the following link:

http://health.nv.gov/HCQC_HealthFacilities_WShops.htm

The long awaited HIPAA “Omnibus Rules”

The Omibus rules "Modify the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, and Enforcement Rules to implement statutory amendments under the Health Information Technology for Economic and Clinical Health Act (“the HITECH Act” or “the Act”) to strengthen the privacy and security protection for individuals’ health information; modify the rule for Breach Notification for Unsecured Protected Health Information (Breach Notification Rule) under the HITECH Act to address public comment received on the interim final rule; modify the HIPAA Privacy Rule to strengthen the privacy protections for genetic information by implementing section 105 of Title I of the Genetic Information Nondiscrimination Act of 2008 (GINA); and make certain other modifications to the HIPAA Privacy, Security, Breach Notification, and Enforcement Rules (the HIPAA Rules) to improve their workability and effectiveness and to increase flexibility for and decrease burden on the regulated entities.

DATES: Effective date: This final rule is effective on March 26, 2013.

Compliance date: Covered entities and business associates must comply with the
applicable requirements of this final rule by September 23, 2013.

The Rulemaking announced today may be viewed in the Federal Register at https://www.federalregister.gov/public-inspection. 

The Rules are at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2013-01073.pdf.   

The HHS Press Release can be found on the HHS News page: http://www.hhs.gov/news/.  

Executives say health reform may spur collaboration for hospitals, doctors

From Las Vegas Business Press

Good articles about how hospitals and the health care industry are transitioning given the state of the economy and the Affordable Care Act. Read more: http://www.lvbusinesspress.com/articles/2013/01/15/news/iq_59248738.txt

Lowest Annual Rate in National Health Expediture

The rate of increase in health spending, 3.9 percent in 2011, was the same as in 2009 and 2010 — the lowest annual rates recorded in the 52 years the government has been collecting such data.

Read the full article:
http://www.nytimes.com/2013/01/08/us/health-spending-growth-stays-low-for-third-straight-year.html?smid=pl-share

HHS announces first HIPAA breach settlement involving less than 500 patients

The Hospice of North Idaho (HONI) has agreed to pay the U.S. Department of Health and Human Services’ (HHS) $50,000 to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule. This is the first settlement involving a breach of unprotected electronic protected health information (ePHI) affecting fewer than 500 individuals.
The HHS Office for Civil Rights (OCR) began its investigation after HONI reported to HHS that an unencrypted laptop computer containing the electronic protected health information (ePHI) of 441 patients had been stolen in June 2010. Laptops containing ePHI are regularly used by the organization as part of their field work. Over the course of the investigation, OCR discovered that HONI had not conducted a risk analysis to safeguard ePHI. Further, HONI did not have in place policies or procedures to address mobile device security as required by the HIPAA Security Rule. Since the June 2010 theft, HONI has taken extensive additional steps to improve their HIPAA Privacy and Security compliance program.

“This action sends a strong message to the health care industry that, regardless of size, covered entities must take action and will be held accountable for safeguarding their patients’ health information.” said OCR Director Leon Rodriguez. “Encryption is an easy method for making lost information unusable, unreadable and undecipherable.”

The Health Information Technology for Economic and Clinical Health (HITECH) Breach Notification Rule requires covered entities to report an impermissible use or disclosure of protected health information, or a “breach,” of 500 individuals or more to the Secretary of HHS and the media within 60 days after the discovery of the breach. Smaller breaches affecting less than 500 individuals must be reported to the Secretary on an annual basis.

Read full article at HHS.gov: http://alturl.com/cqo6z http://preview.alturl.com/cqo6z

Fiscal Cliff Deal Includes "Doc Fix" Averting 27% Medicare Payment Cut.

American Health Lawyers Association News Bulletin:

Late Tuesday night, the House approved the Senate bill to avert the fiscal cliff. The deal, while raising taxes on the wealthy, has little in the way of spending cuts or entitlement reform. However, an important piece of the legislation is the inclusion of a "doc fix," a short-term patch that will prevent a 26.5% cut in Medicare reimbursement payments to physicians scheduled to start with the new year. Many outlets covering the doc fix focus on what will be included in the deal to offset the cost of the patch.

Medical real estate development expected to boom soon in valley - Business - ReviewJournal.com

Good article about Medical Real Estate and the state of health care in Las Vegas in general:
Medical real estate development expected to boom soon in valley - Business - ReviewJournal.com

Southern Nevada is poised to experience a major surge in medical real estate development in the next few years, an expert at Colliers International said.

The surge will be driven by 79 million baby boomers headed into retirement and millions of Americans covered under President Barack Obama's health care plan, said Stacy Scheer, who specializes in medical real estate properties at Colliers.

She expects to see a wealth of new development and expansion in Southern Nevada's medical office market as the health care industry shifts toward patient-centered accountable care organizations, or ACOs. Small practices and sole practitioners are joining larger ACOs, and the need for skilled nursing and assisted-living facilities is rising, Scheer said.

This massive influx of patients will create demand for more doctors' offices, hospitals, outpatient clinics and long-term care facilities. About 60 million square feet of medical real estate will be developed nationwide.

Colliers formed a specialty group led by Scheer and Andrew Kilduff focusing solely on real estate needs of next-generation health care providers in a rapidly changing market.

There's also a growing trend toward building off the hospital campus as physician groups look for ways to expand while curbing costs, Scheer said.

"The basic premise is you're seeing a migration to off-campus locations and the reason is just higher costs to be in a full-blown hospital," she said. "They're not restricted in construction, and beyond the cost is patient accessibility and convenience. So you're seeing medical facilities like quick-care centers popping up in Walgreens, even Wal-Mart. They're migrating more towards the retail setting."
Las Vegas hospitals are responding to the expected medical boom by expanding facilities. MountainView Hospital has a $68 million expansion project under construction that will add a new emergency room and 12-bed intensive care unit, and St. Rose Dominican Hospital is planning a new five-story, 326-bed tower at its Siena campus.

The $1.5 billion, 150-acre Union Village medical and senior-living complex in Henderson is expected to break ground in 2013.

"Medical is on everybody's radar screen," Southern Nevada Medical Industry Coalition Chief Executive Doug Geinzer said. "Not just medical, but health and wellness. It's a cottage industry and we're already killing it with spa treatments on the Strip. The MGM (Grand) built stay-well suites, totally rehabilitated for wellness fanatics. They've got vitamin C-infused showerheads."
It's all part of the "medical tourism" industry emerging in Las Vegas, he said. The Las Vegas Convention and Visitors Authority hired a full-time employee to focus on medical tourism, and the newly formed Las Vegas Regional Economic Development Council put health care at No. 2 on its priority list.

Las Vegas has some of the best cosmetic surgery facilities in the country and does a great job of protecting patients' anonymity, Geinzer said. And it's relatively cheap to fly here and stay here.
Tom Weniger, business development manager for Crovetti Orthopaedics, said patients are coming from as far as Alaska and China to have surgery performed in Las Vegas. Hip and knee replacement surgery for the 45- to 65-year-old age group is expected to increase 17 times by 2030, he said.
"People are more active now. Exercise used to be a walk, then it was aerobics with Jane Fonda, and now it's gyms and fitness centers," Weniger said. "I know we have tremendous potential for growth."
Dr. Michael Crovetti has performed nearly 350 outpatient surgeries and his patients are usually up and walking the same day, Weniger said.

Scheer said downtown Las Vegas will see new medical development to meet the needs of 1,500 Zappos employees working at their new headquarters, employees of startup technology companies and a growing population of condominium residents.

Research firm Applied Analysis reported 8.3 million square feet of medical office space in the Las Vegas Valley with a vacancy rate of 24.5 percent as of the third quarter, slightly below the 27.6 percent overall office vacancy.

The vacancy rate has been trending downward as demand has outpaced new inventory, Applied Analysis principal Brian Gordon said. He showed 171,209 square feet of positive net absorption, or more space taken than vacated, year to date. Only 44,000 square feet of medical office is under construction.

Contact reporter Hubble Smith at hsmith@reviewjournal.com or 702-383-0491.