March 28, 2018
CHIA Opposes California Senate Bill No. 1238
A bill introduced in the California State Legislature last month on February 15 by State Senator Richard Roth from Riverside regarding the maintenance, storage and destruction of patient records has raised a number of concerns in the California health care community regarding the ability of providers to realistically comply with the bill’s provisions should it become law.

A primary concern regarding the bill is the administrative burden placed on providers prior to the destruction of patient records. The bill requires certain health care providers to provide a statement to be signed by all new patients informing them, among other things, of the intended retention period of their records. If a provider plans to destroy any patient records the provider must subsequently notify patients at least 60 days in advance by first-class mail, electronic mail, or both of the proposed destruction. The bill requires that patients be given their “original medical record” if they request it prior to the proposed destruction date and also allows patients to designate the method of delivery of the records, “either by personal pickup, mail, overnight delivery, or other delivery means.” 


The CHIA Board of Directors is preparing a formal response in opposition to the bill. CHIA will be represented at the Senate Health Committee hearing in Sacramento on April 4, 2018. For more information about the hearing visit: http://shea.senate.ca.gov/agenda
Many Medicare Claims for Outpatient Physical Therapy Services Did Not Comply With Medicare Requirements
OIG News Update

Sixty-one percent of Medicare claims for outpatient physical therapy services that we reviewed did not comply with Medicare medical necessity, coding, or documentation requirements. Specifically, of the 300 claims in our stratified random sample, therapists claimed $12,741 in Medicare reimbursement on 184 claims that did not comply with Medicare requirements. Therapists properly claimed Medicare reimbursement on the remaining 116 claims. On the basis of our sample results, we estimated that during the 6-month audit period, Medicare paid $367 million for outpatient physical therapy services that did not comply with Medicare requirements. These overpayments occurred because the Centers for Medicare & Medicaid Services' controls were not effective in preventing unallowable payments for outpatient physical therapy services.

By eliminating improper payments, Medicare could have saved an estimated $367 million on services provided by outpatient physical therapists from July 1 through December 31, 2013. Therefore, we recommended that CMS (1) instruct the Medicare Administrative Contractors to notify providers of potential overpayments so that those providers can exercise reasonable diligence to investigate and return any identified overpayments, in accordance with Medicare guidelines, (2) establish mechanisms to better monitor the appropriateness of outpatient physical therapy claims, and (3) educate providers about Medicare requirements for submitting outpatient physical therapy claims for reimbursement.

Join us in San Diego for the CHIA Convention & Exhibit 
June 2 - 6, 2018 | Town & Country, San Diego CA

With more than 30 educational sessions, learn from top industry experts who will explore innovations that drive success in HIM best practices. Topics include: information governance, EHR challenges and opportunities, health informatics, coding, audit/review, compliance, cybersecurity, privacy, workforce development and more. The Exhibit Hall will feature state-of-the-art solutions to help health care organizations gain a competitive advantage. Invest in your professional career and register today.

  • Network and engage with professional colleagues from a variety of health care roles and settings.
  • Expand health information management knowledge and expertise with inspiring innovative and informative educational sessions.
  • Spark action by acquiring essential skills and energized intention.
For full program schedule and descriptions, presenter details, and exhibitor listing, visit the CHIA Convention Program webpage or view the Convention Preliminary Flyer (PDF).

Register by May 2 and Save!
Learn more and register at Californiahia.org/convention-exhibit
Latest HIM News Updates
CMS Proposes Regulation to Alleviate State Burden
Centers for Medicare & Medicaid Services; Mar 22, 2018

The Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking (NPRM) that would provide state flexibility from certain regulatory access to care requirements within the Medicaid program. Specifically, the NPRM would exempt states from requirements to analyze certain data and monitor access when the vast majority of their covered lives receive services through managed care plans. CMS regulations separately provide for access requirements in managed care programs. Additionally, the NPRM would provide similar flexibility to all states when they make nominal rate reductions to fee-for-service payment rates.

States have raised concerns over undue administrative burden associated with meeting the requirements of the final rule, Medicaid Program; Methods for Assuring Access to Covered Medicaid Services (published in November 2015). Specifically, states with few Medicaid members enrolled in their fee-for-service program or when members are only temporarily enrolled, and states making small reductions to fee-for-service payment rates, have urged CMS to consider whether analyzing data and monitoring access in that program is a beneficial use of state resources. 

HIPAA Social Media Rules
HIPAA Journal; Mar 12, 2018

HIPAA was enacted several years before social media networks such as Facebook were launched, so there are no specific HIPAA social media rules; however, there are HIPAA laws and standards that apply to social media use by healthcare organizations and their employees. Healthcare organizations must therefore implement a HIPAA social media policy to reduce the risk of privacy violations.

There are many benefits to be gained from using social media. Social media channels allow healthcare organizations to interact with patients and get them more involved in their own healthcare. Healthcare organizations can quickly and easily communicate important messages or provide information about new services. Healthcare providers can attract new patients via social media websites. However, there is also considerable potential for HIPAA Rules and patient privacy to be violated on social media networks. So how can healthcare organizations and their employees use social media without violating HIPAA Rules?

CHIA Events Calendar
What is a Legal Health Record?
Wednesday, April 4 - Live Webinar

Tuesday, April 10 - Sacramento
Wednesday, April 11 - Ontario

Leveraging Data Analytics for Risk Adjustment Success
Wednesday, April 25 - Live Webinar

NCHIA Student Night
Thursday, April 26 - Live Webinar

IG Web Series Part 2: Making the Case for Information Governance
Friday, April 27 - Live Webinar

What is the OIG Saying About Kwashiorkor and Malnutrition Coding
Wednesday, May 16 - Live Webinar

CHIA Pre-convention Tutorials
Saturday, June 2 - Sunday June 3 - San Diego

CHIA Convention & Exhibit
Sunday, June 2 - Wednesday, June 6, San Diego