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News |
Highlights from 2/5/10 NHIMA Board of
Directors meeting
"The
Physician Quality Reporting Initiative" by Sally Roland
“Early Testing” Option on Certification
Exams
Major Provisions of the Health Care Bill to Be Offered on Senate Floor
Highlights from 2/5/10 NHIMA Board of Directors Meeting:
The NHIMA Board meeting was held via
teleconference this quarter, the virtual sites were Hastings, Lincoln and Omaha.
The Board is considering using a virtual meeting platform for other committees
and meetings to accommodate those who want to be involved from across the entire
state. This will reduce or eliminate travel and be respectful of time.
LB702 was brought before the Nebraska
Legislators for discussion this month. LB702 would eliminate the 180 day
limit on authorizations for the release of health information. The
amendment made to LB702 during the legislative debate stated: "If an
authorization does not contain an expiration date or specify an event for the
occurrence of which causes the authorization to expire, the authorization shall
expire twelve months after the date the authorization was executed by the
patient.”
Monica Seeland, NHIMA Advocacy Liaison and
Angie Gage, NHIMA President-Elect will be attending AHIMA Winter Team Talks and
Hill Day in Washington DC this year and we are excited that Nebraska will be
represented at Hill Day.
The AHIMA Apportionment Amendment continues to
be a hot topic for debate. The House of Delegates workgroup voted to bring
back the same amendment that was sent back to committee at the House of
Delegates last October. It will again be up for discussion at Winter Team
Talks and then for electronic vote in July, 2010. The NHIMA Board does not
support the percentage model as Nebraska will lose 3 of 5 delegates with this
model. We will keep you posted – look for discussion on the Nebraska COP
soon.
NHIMA Election of Officers will be held via
electronic vote in March. Thank you to those who have volunteered for an
office this year.
The new AHIMA COP will be deployed the first
week of March. I encourage you to use the COP – there is a lot of great
information and networking opportunities.
The NHIMA Coding Roundtable held a very
successful event in January. The topic was “Auditing your RAC results”
and it was very well attended and had great information. Michelle Ilsley
coordinated the event and did a great job!
We were very pleased to hear that CIMRO was
awarded the Regional Extension Center grant from the Federal Government. I
am sure they will do a great job and we look forward to collaborating with them
on the HITECH and ARRA initiatives.
See you all in Kearney April 21st!
Respectfully submitted,
Ranae Race, RHIT, President
"The Physician Quality Reporting Initiative: Secrets to Success" in the January/February issue of Family Practice Management was authored by NHIMA's Sally Roland. Click here to read the article.
“Early Testing” Option on Certification
Exams by Carla Dirkschneider, MS, RHIA
Click the “News” button at Getting
students to register and take their certification exams is an extremely
difficult task facing educators today. This has been a hot topic the last
few years at AHIMA’s Assembly on Education Conferences. Many educators
across the country report having decreasing numbers of students taking the RHIT
and RHIA examinations. It is difficult to pinpoint the exact reason for
this decrease, but the possibilities include: employers not requiring
credentials, cost of the exam, lack of knowledge of AHIMA’s member benefits,
etc.
With the decreasing number of students taking
the exams, AHIMA has enacted an “early testing” option for students.
This “early testing” option allows students in CAHIIM accredited programs to
apply and take their certification exams during their final semester of study.
The “early testing” option has been in progress for one year and the results
are alarmingly favorable. From October 08 – March 09, the pass rates for
the traditional testing option were as follows: RHIA – 69.2% and RHIT
– 86.1%. From October 08 – March 09, the pass rates for the early
testing option were as follows: RHIA – 83.3% and RHIT – 96%.
Due to the availability of the “early
testing” option and the overwhelming results of the data, some schools have
decided to require students to take the exam as part of the curriculum.
Clarkson College is currently in the process of making this change. All
HIM students at Clarkson College will be required to take the certification exam
as part of the curriculum. During the last semester of study, students
will be required to apply and take the certification exam prior to graduation.
Student will be given grades for each step of the process to ensure completion
of the certification exam. Students will not be graded on the
passing or failing of the certification exam itself. Clarkson College is
still working out the semantics of the cost for the exam. Ideally, the
cost of the exam will be bundled into the tuition of the course, therefore
allowing students to use their financial aid to cover the cost of the exam
instead of paying for it out of pocket.
Clarkson College hopes to have this change
implemented for the Fall 2010 Academic Year. Requiring the exam as part of
the curriculum will allow the student to take the exam when he/she is best
prepared rather than delaying testing. It has been found that the earlier
a student tests, the more likely he/she is to perform well on the respective
exam.
CQ TODAY PRINT EDITION
Nov. 22, 2009 - 10:09 p.m.
Major Provisions of the Health Care Bill to Be Offered on Senate Floor
By CQ Staff
Senate Majority Leader Harry Reid, D-Nev., unveiled a version of the health care overhaul bill (HR 3590) Nov. 18 that will be debated after the Thanksgiving recess. The measure would expand Medicaid coverage, create state-run insurance exchanges, establish a public health care option to compete with private insurers and cost an estimated $848 billion over 10 years. The bill would:
Coverage Requirements:
Individual Mandate
- Require most individuals to obtain minimum essential coverage, beginning in 2014.
- Exempt those who cannot afford coverage, including taxpayers with incomes less than 100 percent of the federal poverty level.
- Allow individuals and groups to keep their current health plans.
- Require those who do not obtain coverage to pay a penalty of $95 in 2014, rising to $750 in 2016 and indexed for inflation thereafter.
Employer Mandate
- Require businesses with 200 or more employees to automatically enroll employees into health insurance plans offered by the employer. Employees could opt out if they had other coverage.
- Require employers that have more than 50 employees and do not offer coverage to pay a $750 fee for each employee who gets a tax credit for health insurance through a state exchange.
Insurance Options:
State Exchanges
- Require states to establish government-run insurance marketplaces, or exchanges, by 2014. All legal state residents could enroll in a plan through the exchange. If a state exchange is not operational by 2014, the Health and Human Services (HHS) secretary would establish and operate one.
- Allow insurers to offer one of four types of health plans. The plans would provide increasing levels of service and out-of-pocket costs.
Consumer Cooperatives
- Establish and appropriate $6 billion for a federal program to assist nonprofit, member-run health insurance issuers, known as the Consumer Operated and Oriented Plan (CO-OP) program.
Public Option
- Require the establishment of a public health insurance option within the exchanges by 2014. States could opt out if they provide health care coverage as comprehensive as required under the bill.
- Require the public option to cover essential health benefits, as defined by HHS. States could require additional benefits if they defray the costs.
- Require HHS to negotiate provider reimbursement rates for the public option. The rates could be no higher than average rates paid by private qualified health plans.
Tax Credits and Subsidies
- Provide tax credits to help low-income individuals and families to buy coverage on the exchange.
- Make most employees offered insurance by their employers ineligible for federal subsidies.
- Provide tax credits for certain small businesses that purchase health insurance for employees.
Insurance Requirements
- Bar insurance companies from denying coverage for pre-existing conditions or dropping coverage of those who become ill.
- Bar plans from imposing lifetime limits or creating plans that effectively discriminate in favor of higher-wage employees.
- Require all plans to cover preventive services and immunizations.
- Prohibit out-of-pocket expenses greater than those for health savings accounts.
- Cap deductibles at $2,000 for individuals and $4,000 for families for the small-group market.
- Provide that no individual, company or issuer would be required to participate in a federal health insurance program.
Abortion Restrictions
- Specify that abortion coverage could not be a mandated benefit as part of a minimum benefits package.
- Allow qualified health plans to decide whether to cover abortions, and if so, whether to limit coverage to pregnancies that result from rape or incest or that would endanger the woman's life, or to provide broader coverage.
- Allow the public option to cover elective abortion only if it uses money collected as premiums - not subsidies or federal funds - to pay for the procedure.
- Permit states to require coverage of abortions beyond those in cases of rape or incest or danger to the woman's life only if no federal funds are used for the coverage.
- Require each state exchange to offer at least one plan that covers abortion beyond the limits of rape, incest or danger to the woman's life and one that does not. Exchange plans that cover abortion would have to segregate revenue collected as private premiums from federal subsidy revenue and use only money from private premiums to pay for the procedure.
- State that the bill would not pre-empt state laws regarding the prohibition or requirement of funding or coverage for abortions.
Medicaid and Medicare:
Medicaid Expansion
- Expand eligibility for Medicaid in 2014 to cover all children, parents and childless adults who are not eligible for Medicare and who have incomes up to 133 percent of the federal poverty level. States could expand eligibility as early as Jan. 1, 2011.
- Provide federal payments that would cover 100 percent of the cost of insuring newly eligible people under Medicaid through 2016, with additional aid available in subsequent years.
- Allow states to amend their state Medicaid plans to cover all non-elderly individuals with incomes above 133 percent of the federal poverty level.
- Require states to maintain the same income eligibility levels for adults through 2013, and the same levels for children currently in Medicaid through Sept. 30, 2019.
- Reduce Medicaid disproportionate-share hospital allotments, which are made to hospitals that treat a higher-than-average share of low-income patients.
Medicare Changes
- Repeal a scheduled 21 percent reduction in the Medicare physician pay rates scheduled for January and instead provide a 0.5 percent increase.
- Require Medicare to cover 100 percent of the cost of preventive services and waive beneficiary co-insurance requirements.
- Freeze the income thresholds from 2011 through 2019 for higher- income individuals who pay higher Part B premiums.
Prescription Drug Coverage
- Provide a $500 increase in 2010 for the onset of the coverage gap, or "doughnut hole," under the Medicare prescription drug program. Drug manufacturers would have to give a 50 percent discount on drugs that beneficiaries buy while in the coverage gap.
Medicare Advantage
- Make rates for Medicare Advantage the same as those for traditional Medicare fee-for-service plans.
- Base Medicare Advantage payments on the average of bids from Medicare Advantage plans participating in a market.
Children's Health Insurance Program
- Require states to maintain their current income eligibility levels for the Children's Health Insurance Program (CHIP) through fiscal 2019.
- Provide a 23 percentage point increase in the CHIP match rate from fiscal 2014 to 2019, but cap the rate at 100 percent.
Medical Malpractice
- Express the sense of the Senate that states should be encouraged to develop and test alternatives to the existing civil litigation system and that Congress should consider establishing a state demonstration program to evaluate alternatives to the existing civil litigation system for medical malpractice claims.
Revenue Provisions:
Excise Taxes
- Impose a 40 percent excise tax on insurance companies that offer plans costing more than $8,500 a year for individuals and $23,000 a year for families, starting in 2013.
- Increase the hospital insurance tax rate for high-income taxpayers, including individuals who earn more than $200,000 and couples who file a joint return and earn more than $250,000.
- Impose a 5 percent tax on the amount paid for voluntary cosmetic surgery.
Flexible Spending Accounts
- Limit contributions to health care flexible spending accounts to $2,500 per year, beginning in 2011, and allow reimbursement only for prescribed drugs or insulin, not over-the-counter drugs.
Fees
- Raise $2.3 billion per year from fees on manufacturers and importers of prescription drugs that are sold in the United States.
- Raise $2 billion per year from fees on manufacturers and importers of medical devices that are sold in the United States.
- Raise $6.7 billion per year from fees on U.S. health insurance providers.
Itemized Deductions
- Increase to 10 percent, from 7.5 percent, the adjusted gross income threshold used for claiming the itemized deduction for medical expenses, except for those 65 and older, effective for taxable years beginning after Dec. 31, 2012.
Source: CQ Today Print Edition
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