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Here's where you can find out about what CHS is up to, what's coming in the future and events. Keep up to date with CHS happenings and find out what's on our calendar.

RBS (REGULATORY BUDGET SENTINEL)

HHS DECIDES TO POSTPONE ICD-10 DEADLINE INDEFINITELY

By: Nicola Crean, CHS Marketing Coordinator

In a surprising announcement last month, the Department of Health and Human Services (HHS) has decided to delay the compliance deadline for implementing the International Classification of Diseases, 10th Edition (ICD-10). In January 2009, the final rule adopting ICD-10 was published with the intended date of October 1, 2013 to be the deadline for industry wide compliance.

The department’s decision comes in the wake of the Centers for Medicare and Medicaid Services (CMS) postponing the adoption of the 5010 transaction. Initially intended to be completed by January 2012, this deadline has now been extended twice, and at this time, is set for June 30, 2012.  

In order to successfully implement ICD-10 into the health care system, it was required that 5010 go into effect. While HHS has not directly attributed the delay to other deadlines being pushed back, it may certainly be a consideration.

According to the news release on the HHS’ website, HHS secretary Kathleen Seblius appears optimistic about the decision, in hopes that delaying the deadline will reduce stress among those throughout the industry who are struggling to meet the 2013 deadline.

“We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead,” said Seblius. “We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”

The press release provides little information on what the industry should expect. In fact, the HHS has yet to even set a new compliance date. The only direction provided to the public was the timeline has been extended and a new date would be set in the future.

The abrupt change in the ICD timeline has left industry professionals wondering what they should anticipate in the future. The general thought seems to be: where do we go from here?

An article in Information Week (ICD-10 Delay Worries Grow Among Health Leaders) reports on a survey that was completed by Edifecs, which was one of the first companies to attempt to gain an understanding of industry feelings on HHS’ announcement.

Overall, the survey demonstrated that healthcare professionals were frustrated by the lack of uncertainty that came from postponing the ICD-10 deadline. Since the HHS provided limited information and no new deadline, individuals are unsure of what their next steps should be.

In fact, 64 percent of respondents felt that this delay would not ensure readiness in the future. Instead, they anticipated that it would ultimately results in a loss of money and time due to current efforts being underway to meet the preexisting deadline.

In addition, those who believed that implementation of ICD-10 will overall do more harm than good was reported to be 76 percent of those surveyed. Some even went on to suggest that HHS look at other alternatives prior to setting a new deadline.

Although HHS may have had positive intentions, the survey demonstrates that there is lingering frustration throughout industry professionals. A similar sentiment was expressed by the College of Health Information Management Executives (CHIME), a foundation that advocates enhanced information management within in the healthcare industry, according to their website.

CHIME wrote a letter directly to Sebelius last month. The letter described their support for the implementation of ICD-10 and went on to state that prolonging this transition will only create uncertainly and frustration within the industry. The organization strongly recommended a timeframe be put in place as soon as possible. In addition, they also suggested breaking up sections of the industry into different deadlines.

At this time, the deadline remains undetermined, and healthcare professionals continue to wait for answers. With a lack of timeframe for more information from the HHS, it is uncertain when the industry will receive directions on what their next steps should be. The hope, however, is that in the long term more good comes from the HHS’ decision.

NEW STUDY: STRESS IN THE WORKPLACE LEADS TO OVEREATING

By: Nicola Crean, CHS Marketing Coordinator

It comes as no surprise that work can create a feeling of stress in individuals. Feeling under pressure can be difficult to deal with, and potentially can lead to feeling burnt out from work in general. Every individual is different in how they suppress feelings of anxiety, and there is no specific remedy to cure these feelings.  

A new study published in the American Journal of Clinical Nutrition reports that feelings of stress can often lead to individuals coping by overeating. The experiment, which monitored 230 working women aged 30 to 55 years old, examined the group’s behavior for a 12-month period.

The study found that when the participants felt overwhelmed with work, many would take comfort in food as a way to attempt to console themselves. An article discussing this study in CNN (Stress at Work May Cause Overeating) goes on to say that particularly women who had a sense of burnout were more likely to overeat then those without burnout.

The participants were required to complete surveys throughout the study to demonstrate how they were feeling emotionally towards their job and what their current eating habits were. The Indo-Asian News Service (Bored with Jobs, Women Find Solace in Eating) reports that 22 percent of the group claimed to have a degree of burnout. Although those who did not have similar feelings cut down on overeating throughout the course of the experiment, this group was unable to change their habits.

The CNN article went on to cite the study stating that “among overweight and obese subjects, failure to make changes due to burnout and reduced resources may impair self-esteem and self-efficacy, which are important for achieving success in weight maintenance.”  

Results also implied that participants who were overweight prior to the experiment, combined with feeling burnout, had the greatest risk of emotional eating. However, the study did not make any specific claims on a direct link between weight and burnout.

Although this study may be the first of many to research this phenomenon, the results could become a realistic concern for both employees and employers. As hard economic times have resulted in smaller staff sizes, employees may be more likely encounter stress in the workplace. If overeating is individuals coping method than this could eventually result in other health issues.

An article published in the Asbury Park Press (Simple Ways to Reduce Stress, Increase Happiness) has some tips on how to ward of stress.

  • Take small, frequent breaks throughout the workday.
  • Avoid working through lunch.
  • Step away from the computer and other electronics at some point in your day, possibly at lunch.
  • Take control and set limits at work
  • Avoid internalizing stress. Connect and socialize with others.
  • Be aware of what you listen to at work so it doesn’t contribute to stress.

Although the articles suggestions on how to avoid stress may be just a start, it is important for employees to begin to be aware of their behaviors when work becomes stressful. Avoiding stress altogether is the ideal situation; however, learning to handle it in a healthy way is more realistic.

Wellness Article

THERE ARE SOME BEHAVIORS YOU JUST CAN'T REGULATE.

By: Chacko Kurian

Regulations depend on carrots and sticks. If you don’t pay your taxes, there will be serious consequences – the stick. If you buy a home with a home loan, we’ll let you take the interest payment deduction on your taxes – the carrot. The HITECH Act has a number of sticks associated with the security of Protected Health Information (PHI). We at CHS will be addressing the issue of security of PHI in forthcoming articles. There is, under some circumstances, one link in the security chain that no regulation can affect -the uninformed behavior of the user. This article addresses one method where cyber criminals make unwitting users partners in a security breach.

Prior to founding Apple Computers, the Steves (Wozniak and Jobs) could be found ripping off Ma Bell using a blue box to make long distance phone calls (domestic and international) for free. The subculture that reveled in this activity called “phreaking” was probably the progenitor of the subculture of hackers who, today, like to hack computer systems just because they’re there. There is the story of Steve Woz(niak) actually making a “phreak” phone call to the Vatican and asking to speak to the Pope while pretending to be Henry Kissinger with a think German accent. These are the guys who later found legal ways to take your money.

Before the age of digital telephone switching systems, telephone switches reset trunk (long distance) lines with a tone at a specific frequency – 2600Hz. This meant that the trunk line was disconnected at one end and available for dialing at the other end. The dialing was also accomplished by tones at preset multiple frequencies. How did one get those frequencies? Legend has it that the 2600Hz frequency was discovered by accident by Joe Engressia, known among phreakers as ‘Joybubbles’, at the age of 7! He was apparently able to whistle at that frequency and so attach himself to the dialing end of an available long distance line.

But how does one progress from knowing that you could get a trunk line to using it to make free long distance calls. In 1954, the then undivided Bell System published an article in the Bell System Technical Journal about the basics of signaling using multi-frequency tones. This piece of information by itself was of little use. The second and final piece of the puzzle was published, again courtesy of Ma Bell, in the November 1960. Bell System Technical Journal in an article called “Signaling systems for control of telephone switching”. This article published the actual multi-frequency tones used to control the switches. From that information to the creation of the reputed “Blue Box” that became a clandestine product was a short step. With one of these boxes, anybody was able pick up a phone and make free long distance calls.

To be able to win this questionable prize, the phreaker required two pieces of information and they were found in two locations, but once they were combined, the information became quite powerful. Today – cybercriminals put two pieces of information discovered from different locations together to achieve their nefarious goals..

Spear Phishing is the technique by which pieces of information stolen from different locations are put together, by cybercriminals, to steal your identity, your money and anything of value. How does this work? Unlike the shot gun approach taken by those Nigerian scam artists who send out millions of emails, the Spear Phisher is looking for prey with a small email blast to very targeted prospects. All they need to start the process is one piece of information – your email address and sometimes your name. They don’t need anything like a credit card number, the password to your on-line bank account or your social security number– well, not yet. The attack is quick and over in less than a day, before security and software companies have an opportunity to react.

A typical Spear Phishing attack starts with an email that comes to you and looks something like this, courtesy of the Microsoft Safety and Security center

Remember they already have your email address and sometimes your name so the “Hello” salutation is not so innocuous. It looks very familiar but the highlighted items should make you suspicious. If you examine the links you will find that they link to unsecured and unfamiliar sites as shown below:

Once you click on the link and enter the information they’re asking for, they’ve got you.

Another variation of this technique is to send you an email making you an offer that sounds reasonable on the surface, but requires you to open an attachment with the details of the offer. Again, once you open that attachment, they’ve got you. What happens behind the scenes is that the attachment has a robot program that can do almost anything that they want it to do. It can install a keystroke logger and send your internet banking or credit card passwords to the cybercriminal. It can give control of your computer over to the cybercriminal and so enable more of these schemes to be run from your computer. The possibilities are endless.

Sometimes the Spear Phisher makes the email look like its coming from your boss – again remember he has email addresses and names. The email may require you to give up password and other authentication information in order to perform a “security audit” or an “account verification”.

Key to making this criminal endeavor work is that it requires your participation to either provide the missing information or open the attachment. So the best defense it to verify the email by contacting the sender by phone or alternate method if the email looks suspicious. A good antivirus program installed on your computer can help too.Remember for the scheme to work it requires your participation.

We might as well brace for a number of these email attacks. Recently Epsilon, a division of Alliance Data suffered an illegal entry on its client’s email databases. This is the company that processes marketing communications for loyalty programs like Marriott Rewards, Citibank Advantage and many other large organizations. Imagine the rich information for cybercriminals that email addresses, names and loyalty program associations can provide. If you belong to the Marriott Rewards program like I do, expect an incredibly valuable offer to come to you via email. Do not open the attachment even though the logo looks almost right and the text has only one or two spelling mistakes.

There’s lots of regulations coming from Washington DC these days, but I don’t think they can think one up for this.

CHS SOFTWARE UPDATE

CHS Software you may want to use

Often, we at CHS, are guilty of not informing you of products or features that we have implemented over the past year that you may want to use. This year we have rounded out our individual enrollment, billing and administration offering with a full cycle product. If you sell individual policies or sell voluntary products in addition to your regular employer sponsored group health offerings, this may interest you.

"Full Cycle" in this context means the following:
i) taking the application for enrollment of the individual/family on the web, after getting their responses to qualifying/underwriting questions,
ii) enrolling them in the plan of choice,,
iii) billing their credit card or bank account at the appropriate frequency, i.e. monthly, quarterly, semi-annually or annually,
iv) applying the payments received against the appropriate invoices
v) disbursing premium/commission and other payments to carriers, brokers/agents and other suppliers
vi) updates to Accounts Receivable, Accounts Payable and General Ledger without manual intervention after set-up.

We would like to say that all of the above happens "automatically" (a grossly over-used word) but it doesn't. It happens with minimal, but appropriate, human intervention. For example, there are checks and balances in place to make sure that premium billing adjustments owing to changes in family composition or product choices are made accurately. The web enrollment product, CHS iCoverNow, has to be customized with your logo, color palette, questions and response logic. Users of our product like it. It has allowed them to grow into areas where they couldn't before. We believe that this will interest administrators of individual health plans who sell to the public at large and may become a valuable tool in the context of health care reform.