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MSHIMA Speaks to Legislators in Jackson at Hill Day

Representatives from the Mississippi Health Information Management Association visited with legislators in Jackson last Thursday as part of its 2017 Hill Day. MSHIMA members educated select lawmakers on the HIM profession and the benefits of being an HIP as well as the concerns of the industry. Representatives from MSHIMA included Laura Little, president; Lorie Mills, program chair; Candice Kittrell, legislative committee; Ryan Kelly, administrator; and Lorrie Davis, membership/sponsorship coordinator.

SAMHSA Final Rule Will Ease Sharing of Substance Abuse Treatment Records

The Substance Abuse Mental Health Services Administration (SAMHSA) issued a final rule last week that eases sharing of substance abuse treatment records among providers, as well as access to Medicare and Medicaid data for research, while still protecting the privacy of patients seeking treatment. These rules had not been updated since 1987.


New SHRP Faculty Digs Big Data

With only a few weeks left in her premed undergraduate degree program at the University of California, Davis, Shamsi Berry decided she'd rather have a degree in physical anthropology. Little did she know that she had taken the first step on the road to becoming a leader in one of the fastest-growing fields in health care: informatics. Berry joined the faculty of the Health Informatics and Information Management Department at the University of Mississippi School of Health Related Professions in July. The department's Master of Health Informatics program is one of only seven in the country accredited by the Commission on Accreditation for Health Informatics and Information Management Education.


OCR Issues New Guidance on Permitted Disclosures to Loved Ones

The Office of Civil Rights (OCR) has issued an FAQ clarifying that the HIPAA Privacy Rule permits disclosures to loved ones regardless of whether they are recognized as relatives under applicable law. The FAQ was developed to address confusion following the 2016 Orlando nightclub shooting about whether and when hospitals may share protected health information with patients' loved ones.  OCR also updated guidance that makes clear that the terms marriage, spouse, and family member include all lawful marriages (whether same-sex or opposite-sex), lawfully married spouses and the dependents of all lawful marriages, and clarifies certain rights of individuals under the Privacy Rule.


Cahaba Issue with RHC Claims

Cahaba has identified an issue with some Rural Health Clinic (RHC) facility claims and we are reaching out to you for assistance in getting this information to your provider community.  The problem we have identified is Independent RHC claims with the Type of Bill 71X, containing Revenue Code 0780 and HCPCS Code Q3014 are receiving the Common Working File (CWF) reason code edit E9903 in error.  This reason code states: No Clinic Visit shown for Independent RHC.  The Centers for Medicare and Medicaid Services (CMS) has been made aware of this issue and has instructed Cahaba to hold these claims until a new Change Request (CR) is implemented to correct the CWF.  This information has also been added to our claims issue log as an open issue.  We will notify you once we have received further instruction from CMS.


DOM Announces RFP for MSCAN

When the Mississippi Division of Medicaid (DOM) launched its coordinated care program in January of 2011, two coordinated care organizations (CCOs) were selected after an extensive procurement process to offer beneficiaries the choice between two health-coverage plans. Since then, the Mississippi Coordinated Access Network (MississippiCAN) has grown, and currently approximately 70 percent of Medicaid beneficiaries in Mississippi receive services under the umbrella of coordinated care. With those original contracts set to expire in 2017, DOM will release a request for proposals (RFP) in an open, competitive process to bid on the new contracts early this year. Through the procurement process, DOM is expected to select at least three entities to participate in the program, offering more choice for a larger population of coordinated care beneficiaries. Currently, MississippiCAN includes two plans offered by Magnolia Health Plan and UnitedHealthcare Community Plan. While those contracts expire on June 30, 2017, their agreements include an optional one-year renewal to ensure a smooth transition and implementation period for whichever entities are awarded the new contracts. Winners of the new contracts are expected to be announced by summer 2017.


EHR Incentive Program: Attest to 2016 Program Requirements by February 28

The Registration and Attestation System is now open. Providers participating in the Medicare Electronic Health Record (EHR) Incentive Program must attest to the 2016 program requirements by February 28 to avoid a 2018 payment adjustment. The EHR reporting period is any continuous 90 days between January 1 and December 31, 2016. If you are participating in the Medicaid EHR Incentive Program, please refer to your state’s deadlines for attestation information. If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you must demonstrate meaningful use to avoid the Medicare payment adjustment. You may demonstrate meaningful use under either Medicare or Medicaid.


OPPS Hospital Claim Issues

Due to errors in the Medicare Claims Processing System, some Outpatient Prospective Payment System (OPPS) hospital claims with dates of service on or after January 1, 2017, may be overpaid. Claims with the following HCPCS codes may be impacted: 0253T, 0335T, 24361, 25420, 25444, 25445, 27442, 27871, 28715, 28730, 37229, 43266, 45389, 62360, 64580, 69717, and 75898.


ICD-10 Glitch Leads CMS to Relax Physician Quality Penalties

The CMS issued something of a get-out-of-Medicare-penalties-free-card for two years to physicians and group practices due to a glitch with quality reporting measures based on a recent update to the ICD-10 diagnosis and procedure codes. The CMS pointed its finger at updates that went into use Oct. 1, 2016, to the ICD-CM (Clinical Modification) and ICD-PCS (Procedural Coding System) and their impact on the Physician Quality Reporting System. The updates “will impact CMS's ability to process data reported on certain quality measures for the 4th quarter of CY 2016,” the agency said in a statement posted on its website. The CMS said it will not apply the 2017 or 2018 PQRS payment adjustments to any “eligible professional” or “group practice that fails to satisfactorily report for (calendar year) 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for the 4th quarter of (CY) 2016."  Normally under the PQRS program, penalties are 2% of the Medicare fee schedule. According to a page of frequently asked questions, problem areas concentrated in certain medical specialties, notes Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association. “It says the majority of the codes are for diabetes, pregnancy, cardiovascular, oncology, mental health and eye diseases,” Bowman said. So, when will the ICD-10 code update itself be updated? Bowman said that's not specified. But at least the CMS acknowledged the problem and is taking steps to correct it and mitigate its impact, she said.


Medicare Overpayments and Underpayments

The Notice of New Interest Rate for Medicare Overpayments and Underpayments - 2nd Qtr Notification for FY 2017 is now available. The Department of the Treasury has notified the Department of Health and Human Services that the private consumer rate has been changed to 9.50 percent: Transmittal R280FM


Chronic Care Management Services Changes for 2017

CMS recently approved a number of changes to the payment rules for Chronic Care Management (CCM) services under Medicare Part B for CY 2017 to reduce administrative burden and improve payment accuracy. See the CCM Services Changes for 2017 fact sheet, FAQs, and the Care Management webpage for more information.

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