KPAMA Journal
Keystone Chapter of AAHAM
October 2016
Editorial Prelude
Richard Olmstead and Chad Wallace are taking over the newsletter responsibilities from Kristy Piper Richmond. We have big shoes to fill, but we will do our best to produce a newsletter you will want to read. Chad and I wish to make the content interesting to the membership. Two $25 gift cards will be given to the members who come up with the best creative ideas for the newsletter. Please have your ideas to us by Nov. 30th. Get those creative juices flowing!
FYI, content has to be printable. Good luck!Send your suggestions to Richard Olmstead at
A Word from Our President
Wasn’t that a great regional meeting with the Philadelphia Chapter on September 20th at the Desmond Hotel in Malvern? We had such a great line up of speakers, with Jeff Hinkle leading us through the process of an EPIC conversion and Jolene Calla providing many of the ever increasing state updates. And of course, Howard Forman warning us of the current problems with cyber fraud. But who can ever forget, Steve McClatchy providing two great sessions about stress reduction and leadership. Besides being very insightful, Steve was one of the funniest speakers we have ever heard at an AAHAM event. And judging from the laughter filling the room, everyone really enjoyed his life lessons. A great thank you to all our vendors who participated in the vendor fair with greatgiveaways and drawings.
Just a few weeks later, we joined with all the other national chapters at the annual AAHAM ANI at Caesar’s Palace in Las Vegas. If you have ever been to Caesar’s, you know what a challenge it is just tomaneuver your way through the maze of Caesar’s that occupies an entire block on the Las Vegas Strip. But we managed to find our way to the conferencecenter to accept two prestigious awards for Keystone. We came in 3rd place within the AlanTabas Division for ChapterExcellence. Remember when we are always asking you to hand in the speakers’ surveys? That is a small part of the qualifications for our Chapter Excellence submissions. We then came in 1st place in the Alan Tabas Division for National Membership Retention Award. Thank you to all our Keystone members who renewed their national membership for the 2015 to 2016 year.
And something new to make your life easier with the CEU process, AAHAM has switched to an online CEU reporting form. Click on the certification tab on the national website and then click the recertification tab. In the recertification tab you will be able to either check your CEU status or report CEUs. To report CEUs, click the Online CEU Reporting Form and you will be able to add 5 different activities for which you earned CEUs and any accompanying attachments.
Hope everyone is having a great year and make sure you fill out your AAHAM renewals for next year so that we can once again earn 1st place for National Membership Retention.
Bill Major
Keystone Chapter President
Friendly Reminder
Our next meeting will be December 7th at the Harrisburg Hershey Holiday Inn. There will be excellent educational opportunities along with the traditional Holiday festivities. This is the do not miss meeting of the year. Our keynote speaker will be Dan Angel from Hershey Medical Center.
Mark Your Calendars!!!!!!!!!
21st ANNUAL KEYSTONE CHAPTER SILENT AUCTION
It’s not too early to start thinking about the upcoming Holiday Meeting!!
We are planning another spectacular Silent Auction in conjunction with our December 7 holiday meeting taking place at the Harrisburg/Hershey Holiday Inn. Thank you all for your past participation in the Auction—either through bidding or through donation. Please consider contributing a donation this year. It is the proceeds from this event that help keep our meeting fees remarkably low! Please mark this event on your calendar.
PLEASE BE PART OF THIS MAJOR FUNDRAISER FOR YOUR CHAPTER.
All items accepted!
Past items have included:
Beer/Alcohol Basket Jewelry, Sunglasses Floral Arrangements
HandbagsCrafts Artwork, Quilts
Sporting Event Tickets Sports Memorabilia Spa Treatments
Homemade Goodies Electronics Gift Cards
Coffee Makers Candles Holiday Decorations
CALL, MAIL, EMAIL OR FAX WITH YOUR ITEM TODAY!!!
Kristy Pipher Richmond
Commercial Acceptance Company
2300 Gettysburg Rd, Suite 102
Camp Hill, PA 17011
(717) 216-5028 (direct line) (866) 678-6855, x.214 (toll free) (717) 901-5565 (fax)
Name______
Company______
ItemName/Description______
Estimated Value______
______I will bring item to Auction on the day of the December 7 meeting.
______I will make arrangements to deliver my donation to Kristy prior to the December 7 meeting
______
The Keystone AAHAM Certification CornerFall 2016
Recent Events and Challenges/Promotions
2016 ANI – AAHAM’s Annual National Institute, Caesar’s Palace, Las Vegas
After just returning from ANI, I reflect on how wonderful it is to be a certified member of AAHAM. The ANI kicks off with a special CRCE and CRCP luncheon and awards presentation. It is a great time to connect, or re-connect, with colleagues who have reached the highest levels of certification offered by AAHAM. The luncheon is followed by the Annual Business Meeting and overall Awards Ceremony. It is always a great experience to cheer on others who you know have worked hard to achieve greatness in their chapters. However, nothing can compare to the feeling of having your chapter recognized by National AAHAM for achieving one of the top honors. Keystone has a history of being a strong chapter; we received two awards this year (in Chapter Excellence and Member retention). It is up to all of us to continue this tradition. Thank you for all you do for our chapter, and for looking for ways to improve!
The Main Event – Education (Education = CEUs!!!): there are so many top-notch educational sessions to choose from to earn CEUs to maintain your certification. The Keystone chapter is also looking out for you if you were unable to attend ANI. We have attended different educational sessions in search of presentations that we can bring back to our local chapter. We don’t want you to miss out on some of the best education offered in our industry. If you attended a great presentation, please share that information with a board member. Look for future presentations to come from ANI…
RAISE THE LEVEL! – This is the challenge posed to us by our AAHAM National President, John Currier.
Keystone currently has 30 CRCEs, 14 CRCPs, 0 CRIPs, 80 CRCSs, and 0 CCTs – Let’s Raise the Levels by 2017!!
As we all look to raise the level on certifications, you may decide to “Certify Up a level”, as members have done in recent months. If you are certified at any level, you may decide to pursue the distinction of “Dual certification”.
Congratulations to Keystone AAHAM Members who recently earned their certifications!
Awesome job by everyone!!!
March 2016 / July 2016Mary Beth McMenamin, CRCE-I
Ted Grozio, CRCP-I
Mary Collins, CRCS-I
MarlynKeffer, CRCS-P
Morgan Gale, CRCS-I
Lisa Schaeberle, CRCS-I
Emilee Tomco, CRCS-I / Eric Baines, CRCP-I
Barbara Lingg, CRCP-I
Kathleen Bair, CRCS-I
BonelBorrelli, CRCS-I
Lynn Capwell, CRCS-I
Kim Good, CRCS-I
Laurie Herman, CRCS-I
Danna Houseknecht, CRCS-P
Emily Mathias, CRCS-I
Laura Vaeth, CRCS-I
Brenda Valentine CRCS-I
Spotlight on Members “Raising the Level!” Congratulations on your Fantastic achievements!!!
Members who “Certified Up in 2016” / Members who earned “Dual Certification in 2016”Mary Beth McMenamin CRCS-I to CRCE-I
Ted Grozio CRCS-I to CRCP-I / Eric Baines, CRCP, I/P
2016-2017 Certification Calendar
November 7-18, 2016 / November 2016 exam periodDecember 15, 2016 / Registration deadline for March 2017 certification exams
March 13-24, 2017 / March 2017 exam period
April 17, 2017 / Registration deadline for July 2017 certification exams
July 10-21, 2017 / July 2017 exam period
August 15, 2017 / Registration deadline for November 2017 certification exams
November 6-17, 2017 / November 2017 exam period
December 15, 2017 / Registration deadline for March 2018 certification exams
Study Sessions
Individual and Group Study Sessions are available upon request. NOTE: they can be scheduled on Saturdays, if desired. Call or email me if interested (info below). Allow plenty of time to prepare; i.e. – six months is recommended for the higher level certification exams (CRCE, CRCP, and CRIP).
Warm Regards and Blessings during the upcoming Holiday Season,
Carolyn Brown, CRCE-I
Keystone AAHAM
Certification Chairperson
717-270-2460 (Direct Line)
717-926-3570 (Cell)
Email:
From the Maestro of Medicaid … Stan Slipakoff
What’s New With MA
I have been asked to write a short article that sets out what is new with MA. That is like asking me to explain the legal requirements and operational impact of HIPAA in 25 words or less. It can’t be done. So, I will focus on just two items.
Provider Revalidation is the first subject. This is the requirement that all MA providers, who became providers 5 or more years ago, were required to up-date their provider enrollment information by 9/25/16. Those who failed to do so were supposed to be terminated as MA providers on 9/26/16. Needless to say, this isn’t exactly what happened. As of 9/10/16, there were 70,700 provider locations that hadn’t revalidated. MA made some generous assumptions and was able to justify lowering the number of un-revalidated locations. It also terminated provider locations that hadn’t billed in the last 2 yrs. They also terminated provider locations where revalidation notification letters were undeliverable. That brought the number of un-revalidated down to 48,480. Of those un-revalidated provider locations, 37,503 were terminated. Thus, we had a total termination of 59,403 provider locations. That left 10,977 provider locations as un-revalidated, but not terminated. This group, for the time being, can treat and bill for their services. However, their payments will be pended until they revalidate. Also, how long the grace period will be in existence has not been revealed. At the end, MA actually terminated 37,503 locations
Unfortunately, revalidation is not a completed project. In 2017, all MA providers, who became providers less than 5 years ago, will have to revalidate. Also, all MA MCO providers will have to be revalidated next year.
The second issue is Community HealthChoices (CHC). We all know HealthChoices (HC) as MA’s MCO program. The MCOs currently provide all healthcare services except behavioral health. Well, the times are changing. CHC will roll all behavioral health services into the current HC Program. At this point, I don’t have enough information to have an opinion if this idea is good for either providers or beneficiaries. I do know it is good for MA. There are 2 concerns that I have about the CHC concept. First, when HC was initially designed, it did include behavioral health. Behavioral health was ultimately removed as being too costly and ineffective. So, what has changed that will allow us to believe that the cost and effectiveness issues won’t exist under CHC? MA has given assurances, but I have seen nothing that tells me exactly how the old concerns have been addressed.
My other concern is related to how CHC is being implemented. The good news is that the state will be divided into zones and those zones will be the same as the current HC zones. That should lessen the confusion of beneficiaries when CHC goes operational. Another piece of good news is the roll out schedule. It will be done in phases. The first zone to go active is Southwest on 7/1/17. That makes sense because it is a zone that contains a big urban area (Pittsburgh) and many rural areas and small towns. The next zone is Southeast on 1/1/18. This zone contains Philadelphia and the 4 surrounding counties. It goes live 1/1/18. Why would you do your second rollout in a zone that has more the 50% of your beneficiaries? The other 3 zones go live 1/1/19. That is when the Southeast zone should go live. By 1/1/19, providers and MA will have more experience and hopefully worked out all of the implementation kinks.
Why I say the timelines for readiness reviews and implementation are rushed can be seen in the “CHC Roll-out Phases …” document issued by MA. Southwest’s readiness period is 8/16/16 – 5/5/17 and its implementation period is 5/6/17 – 12/31/17. East’s readiness period is 2/6/17 – 11/3/17 and its implementation period is 11/6/17 – 3/1/18. This all means that the readiness periods for the 2 zones will overlap. The rest of the zones have similar schedules.
The preceding is my way of saying the CHC implementation schedule is too aggressive and that neither the providers nor MA have the staff/time to do all that has to be done. Even MA says this by having 9 separate items that it lists as “Priorities with Extended Timeline.” That means these areas may not be fully ready before the CHC’s live date and/or they will have to have staff work on these issues beyond the live date. These priorities are: information systems, network adequacy, member materials and services, communications with stakeholders and providers and the public, training, coordination between MA offices and general information
As always, the only guarantee I can give is that MA will keep things interesting.
A Cerebral Intervention from our own Chad Wallace….
GUIDE TO AVOID TCPA VIOLATIONS AND FINES
By Richard A. Lovich, Esquire, Partner-Managing Litigation Attorney, Stephenson, Acquisto & Colman, AAHAM Legal Counsel
Background on the Telephone Consumer Protection Act (TCPA)
In 1991, Congress responded to consumer complaints about telemarketing calls to their mobile phones by enacting the TCPA. The TCPA restricts the use of automatic dialing systems (ATDS), prerecorded voice messages, and text messages to a person’s mobile phone without “prior express consent,” even though identical messages to land-based telephone lines are allowed. The enactment of the TCPA addressed legitimate issues prevalent at the time, but with the advances in technology, the act became obsolete. The Federal Communications Commission (FCC), the governmental department responsible for enforcement of the TCPA at the administrative level, did not take action to update it.
AAHAM Takes Action
The need, and under certain circumstances, the legal obligation to send vital information to patients, in an economically viable manner, requires the use of the current cellular technology and some level of automated calling. In the summer of 2015, AAHAM asked the FCC to clarify the TCPA in the hopes of obtaining more flexibility for the healthcare industry as a whole. Thankfully, AAHAM with the backing of other industry leaders was successful in persuading the FCC in granting AAHAM’s petition to exempt calls from the limitations and penalties of the TCPA, if the nature of the call fit within certain criteria.
While AAHAM was successful in this regard, there are still limitations on the scope of the exemption. The FCC did not extend the right of healthcare providers to make automatic calls or send text messages that involve accounting, billing, debt collection, or other financial content. Further, even in the event that a provider receives “prior express consent” to use a particular number, violation of the TCPA may still occur if that number has been re-assigned or the patient revokes consent.
Penalties for TCPA Violations
The cost of violations of the TCPA can quickly become devastating. TCPA carries statutory damages of $500 per violation and up to $1,500 if the violation is deemed “willful or knowing.” Violations can quickly accumulate if the provider is unaware of how to comply with the TCPA, and hospitals are now facing multi-million dollar settlements by failing to comply with the TCPA.
How to Avoid Violating the TCPA
In an effort to assist in navigating the treacherous road of TCPA compliance, AAHAM has provided a “5 rule” guidance:
(1) Know the TCPA Rules
Providers can contact patients regarding:
oAppointment and exam confirmations and reminders
oWellness checkups
oHospital pre-registration instructions
oPre-operative instructions
oLab results
oPost-discharge follow-up intended to prevent readmission
oPrescription notifications
oHome healthcare instructions
BUT only if the contact meets the following criteria:
oBe without charge to the patient (including not being charged against any calling plan limits that may apply)
oBe made only to the number provided by the patient
oInclude the name and contact number of the healthcare provider
oBe limited to the authorized purposes and not include any advertising, telemarketing, debt collection, billing, accounting, or other financial content
oBe concise, generally one minute or less for voice calls and 160 characters or less for texts
oBe limited to no more than one message per day, up to a maximum of three per week, for each healthcare provider
oOffer an easy method to opt out of receiving future messages, including an interactive method for voice calls and a “STOP” reply for texts; and immediately honor an opt-out request
(2) Be safe, always get written consent
Providers should incorporate receiving written consent in their regular admissions process. This can be achieved by adding a clause to the admission forms, allowing the provider to contact the patient via their personal mobile phone number. The statement should clearly and explicitly state that the permission includes the use of ATDS.
(3) Consent isn’t always enough
Episode of Care
oConsent is limited to each episode of care. If a patient gives written permission for the provider to contact him or her regarding MRI results, written consent does not pass to their emergency admission six months later. For each admission and visit, it is paramount to obtain written consent.
Revoke Consent
oRemember that a patient may always revoke consent. Revocation of consent can be provided in any “reasonable manner;” including verbal notification to hospital staff. It is imperative staff maintain notes regarding each correspondence with the patient and notate each account where the patient has revoked consent.