New Law Requires Hospitals to Retain Medi-Cal Records for 10 Years
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A new state law, effective Jan. 1, 2018, requires hospitals and other providers of health care services rendered under Medi-Cal or any other California Department of Health Care Services (DHCS) health care program to keep records for at least 10 years. Specifically,
AB 1688 (Chapter 511, Statutes of 2017) requires providers to keep a record of each service rendered, the beneficiary or person to whom rendered, the date of service, and any additional information that DHCS may by regulation require. These records must be maintained for 10 years from the final date of the contract period between the plan and the provider (for Medi-Cal managed care enrollees), from the date of completion of any audit, or from the date the service was rendered, whichever is later. AB 1688 thus effectively changes the length of time a provider must keep medical records of Medi-Cal patients. Currently, state law requires medical records of adults or emancipated minors to be retained for 7 years, and for unemancipated minors, until the minor reaches age 19 but in no case less than 7 years.
The new, longer retention period is consistent with federal
Medicaid and CHIP final rule governing managed care organizations and their subcontractors. It is also consistent with previously-existing federal laws requiring that providers that contract with a Medicare Advantage (MA) or Medicare Part D plan maintain records for a minimum of 10 years from the last contracting period or completion of audit, whichever is later. For MA and Part D plans, the retention period applies to books, contracts, medical records, patient care documentation, and other records that pertain to any aspect of services performed, reconciliation of benefit liabilities, and determination of amounts payable under the contract.
Hospitals should read their contracts with MA and Part D plans to ensure they are complying with their specific contract requirements. Hospitals should also anticipate receiving contract amendments from their contracted Medi-Cal managed care plans addressing the new retention period.
CHA will update its Record & Data Retention Schedule in 2018 to reflect the new requirements. For more information about the Record & Data Retention Schedule, please visit
calhospital.org/record-retention.
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CHIA Confidentiality & Security Publication - Revised 2017
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Confidentiality & Security: Protecting and Releasing Health Information in California 2017 - Now available for purchase
CHIA Members $85 / CHIA Non-Members $95
This publication is designed to inform HIM and other health care professionals about the HIPAA privacy and security rules, and reviews situations where providers are called upon to disclose information -- including releases pursuant to court orders, subpoenas, reporting requirements, patient treatment regimens, and billing and payment activities.
2017 Additions:
- New DHHS guidelines concerning patient rights of access to PHI
- Attorneys as “patient representatives” accessing patient records on the patient's behalf
- Revisions to California Evidence Code, Section 1158
- HIPAA Phase 2 audits
- New HIPAA enforcement initiatives
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Transforming Health Care with Telehealth: Policy Trends & Issues
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Provided are excerpts from the Nov/Dec CHIA Journal. CHIA members receive a mailed hard copy, and all CHIA and AHIMA members can
access the digital version online
to view, read, and enjoy now!
Transforming Health Care with Telehealth: Policy Trends & Issues
by Mei Wa Kwong, JD
Policy Advisor and Project Director, Center for Connected Health Policy
The use of telehealth has accelerated since 2000, but has struggled with several complex barriers to widespread adoption. While it has been in existence for decades and despite the benefits shown, utilization continues to be low. A major part of this can be attributed to the existing policy environment. While telehealth technology has developed rapidly, the policy that impacts it has been slower to evolve. With a key role in information governance, it will be important for health information management (HIM) professionals to stay abreast of the telehealth landscape.
As telehealth practices continue to grow and emerge, HIM professionals will be wrangling with how these encounters should be documented, coded and included with the electronic health record, as well as managing release of information processes. It is important to know that policy around telehealth is continuing to evolve and change. Additionally, telehealth is being increasingly looked at as policymakers hunt for innovative solutions to the emerging issues we face in health care, such as the opioid epidemic. The table is set for the next steps to be taken to address the aforementioned factors to ensure that telehealth is used to its fullest ability to provide services to those who need them.
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Telehealth is being employed throughout the country to expand access to quality affordable health care, yet California and Medicare policies have created unnecessary barriers to widespread adoption. This on demand presentation will provide basic knowledge on this relevant and important emerging topic.
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Are you ready for the next stage in your health information career? Make the
CHIA Job Board
your first stop.
Job Seekers
- Discover HIM opportunities
- Create job alerts
- Anonymously post resumes
- Professional resume evaluation
- And more
Employers
- Manage online recruiting
- Post jobs efficiently & affordably
- Search the Resume Bank
- Setup pre-screen filters
- And more
Position yourself ahead of the crowd. Start your HIM search today!
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AHIMA Convention 2018 Call for Abstracts
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AHIMA is searching for industry experts like you to speak at the 89th Convention and Exhibit. The deadline to submit an abstract is December 16, 2017. Visit
ahima.org/speakingopportunities to learn more.
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CMS Issues Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System and Quality Reporting Programs Changes for 2018
Centers for Medicare & Medicaid Services; Nov 3, 2017
On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule with comment period (CMS-1678-FC), which includes updates to the 2018 rates and quality provisions, and other policy changes. CMS adopted a number of policies that will support care delivery; reduce burdens for health care providers, especially in rural areas; lower beneficiary out of pocket drug costs for certain drugs; enhance the patient-doctor relationship; and promote flexibility in healthcare.
CMS is committed to transforming the healthcare delivery system – and the Medicare program – by putting a strong focus on patient-centered care, so health care providers can direct their time and resources to patients and improve outcomes. In the final rule, CMS is adjusting the amount Medicare pays hospitals for drugs that are acquired under the 340B Drug Discount Program. In addition, the final rule includes a provision that would alleviate some of the burdens rural hospitals experience in recruiting physicians by placing a two-year moratorium on enforcement of the direct supervision requirement currently in place at rural hospitals and critical access hospitals.
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ICD-10-CM/PCS the Next Generation of Coding Booklet — Revised
CMS MLN Matters; Nov 2, 2017
- International Classification of Diseases, 10th Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS), an improved classification system
- Examples
- Similarities and differences from ICD-9
- Current Procedural Terminology and HCPCS codes
- Use of external cause and unspecified codes; new features; and changes in ICD-10-CM
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CMS Hospital Value-Based Purchasing Program Results for Fiscal Year 2018
Centers for Medicare & Medicaid Services; Nov 3, 2017
The Hospital Value-Based Purchasing (VBP) Program adjusts what Medicare pays hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of inpatient care they provide to patients. For fiscal year (FY) 2018, the law requires that the applicable percent reduction, which is the portion of Medicare payments available to fund the program’s value-based incentive payments, remain at 2 percent of the base operating Medicare Severity Diagnosis-Related Group (MS-DRG) payment amounts for all participating hospitals. We estimate that the total amount available for value-based incentive payments for FY 2018 discharges will be approximately $1.9 billion.
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CDPH Issues Guidance for Hospitals on Submitting Plans of Correction
California Hospital Association; Nov 6, 2017
The California Department of Public Health (CDPH) has released the attached All Facilities Letter with new guidance for submitting plans of correction. Earlier this year, the Centers for Medicare & Medicaid Services (CMS) expanded the ways in which providers may submit plans. While previously required to submit plans of correction written on on the right side of CMS Form 2567, providers now have the option of instead including their plan as a separate attachment. CDPH has extended this practice to state-issued 2567 forms.
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Making Sense of the Changes: An Overview of FY2018 IPPS
Tuesday, November 14 - Live Webinar
Confidentiality: Protecting & Releasing Health Information in California
Wednesday, November 15 - Garden Grove
Thursday, November 16 - Dublin
Best Practices for Coding Audits and Compliance Strategies
Thursday, November 30 - Live Webinar
Unbundling the Madness: CPT Updates, E&M Codes and OP CDI Processes
Tuesday, December 5 – Irvine
Wednesday, December 6 – Sacramento
CHIA Student Chat
Thursday, December 7 - Live Webinar
CDI Application in Renal Disease
Wednesday, December 13 - Live Webinar
HIPAA Compliance on a Shoe String Budget
Tuesday, December 19 - Live Webinar
HIM Professionals Role in MACRA
Wednesday, January 10 - Live Webinar
A Respiratory System A&P and Coding Review
Wednesday, January 21 - Live Webinar
Advanced ICD-10 Coding Workshop - Day 1 PCS
Friday, February 9 - Garden Grove
Advanced ICD-10 Coding Workshop - Day 2 CM
Saturday, February 10 - Garden Grove
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