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• CMS continues shift to value over volume in 2016 IPPS final rule

  CMS finalized changes to multiple quality measures in the fiscal year 2016 IPPS final rule, released July 31.

• What should I do if I take on a patient with a diagnosis that fits within one of the six clinical groups under PDGM?

  The 2019 proposed PPS rule references this concern in several areas.

• Two-Midnight Rule: Initial Reviews to Resume

  Having taken time out for retraining and internal audits, contractors may resume initial-phase reviews of Medicare reimbursement claims for short-stay inpatient hospital care, CMS says.

• AHIMA: HHS must standardize minimum necessary definition

  HHS must provide a clearer definition of the HIPAA minimum necessary standard, AHIMA president Melissa Martin, RHIA, CCS, CHTS-IM, testified at a subcommittee hearing.
  
  The National Committee on Vital and Health Statistics’ subcommittee on privacy, confidentiality, and security held a hearing June 16 to determine how HHS can improve its guidance on the HIPAA minimum necessary standard. The minimum necessary standard requires covered entities (CE) to use, request, and disclose only the minimum amount of protected health information (PHI) necessary for a given transaction. CEs cannot use, request, or disclose an individual’s entire medical record unless it can justify that the whole record is reasonably needed for a specific purpose.

• OIG Recovers More Than $2 Billion in Civil Monetary Penalties This Year

  The Office of Inspector General (OIG) recovered more than $2.77 billion in civil monetary penalties (CMP) during the first half of the year, according to the office’s Semiannual Report to Congress, released May 31. The OIG expects that figure to continue to rise through the second half of the year.

• Patients unable to access medical records after clinics close

  A chain of health clinics in New Mexico closed after filing for bankruptcy and left patients without access to their medical records, KRQE News 13 reported.
  
  Atrinea Health operated urgent care and family practice clinics in Albuquerque, Rio Rancho, Santa Fe, Los Lunas, and Ruidoso. The company filed for bankruptcy in 2015 and in March a federal judge ordered the company to shut down all its clinics and sell its assets.
  
  A patient advocate was appointed by the court to coordinate patients’ transition to other clinics and physicians. However, many patients said they have not received their medical records. Their new physicians have had to reorder tests that were recently performed by Atrinea Health clinics and complete new exams to document pre-existing conditions. In some cases, patients were left without access to prescriptions. Other former Atrinea Health patients reported that they received little or no advance warning that the clinics were closing and that it’s difficult to find physicians who are accepting new patients.

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