May. 14, 2014

MAC reviews of 2-midnight compliance make strong case
for documentation

Hospitals are starting to get results from Medicare reviews of compliance with the two-midnight rule, and it's clear that documentation is once again their best defense from claim denials. That doesn't always mean Medicare administrative contractors (MACs) are consistent in their findings in the "probe and educate" program, which at the moment is CMS's main vehicle for gauging the medical necessity of admissions under the two-midnight rule.More

Calling all innovators:
Share your experiences, models and successes

ACMA is now accepting presentation proposals for the 2015 ACMA National Conference, April 26-29, 2015, in Phoenix, and we are searching for practitioners with innovative solutions, which have been tested in daily practice.

What makes a valuable presentation?

Speakers receive a 50 percent discount on main conference pricing.

Do you fit the bill? Then submit your presentation today — click here. Presentations must be submitted by June 2.

1 day remains to apply for the ACM Certification
Apply by May 15 to earn your case management credential!

May 15, 2014, is the ACM Certification application deadline for the third quarter of 2014. Applications and payment must be received by the ACMA National Office by this date in order to take the exam during July, August or September.

If you are not yet ACM certified, we encourage you to apply now at and put the ACM credential after your name.More

Do you have a question about case management? We have an answer!
If you have a question about regulatory issues, denials, handoffs, or any other issue pertaining to case management, send your question to the "Since You Asked" committee for a thorough explanation that will be published in an upcoming issue of briefCASE.

To get your question answered, email Nancy Loeffler, chair of the committee, at

Forbes opinion piece: 'RACs are reckless bounty hunters'
A recent Forbes opinion piece condemns the high volume of denials by recovery audit contractors. The piece cites three studies by the OIG and by Medicare whose findings show the need for a systemic overhaul of RACs. The piece concludes by calling for the elimination of "fraud and abuse both within medicine and within the government."More

Complete your 2014 National Conference evaluations for up to 24 CEUs
Evaluation forms for the 2014 ACMA National Conference in Chicago are available online at If you have not yet done so, please complete your conference evaluation forms now to receive you CE certificate(s).More

Tiny coils help COPD patients to breathe easier
Cleveland Clinic
Doctors and researchers are testing a new procedure that doesn't involve surgery to help patients with a devastating lung disease called chronic obstructive pulmonary disease (COPD). COPD, which encompasses a group of conditions, is permanent lung damage that gets worse over time. The two most prevalent forms of COPD are chronic bronchitis and emphysema. People with COPD cannot catch their breath and may feel as though they are suffocating.More

Helping patients with dementia live well
Medical News Today
British Care Services Minister Paul Burstow unveiled a range of new design prototypes at the Design Council that can help people with dementia live well. The prototypes included a fragrance-release system designed to stimulate appetite, specially-trained 'guide dogs for the mind' and an intelligent wristband that supports people with dementia to stay active safely. The innovative designs will be a large step forward in achieving some of the commitments the Prime Minister recently announced in his challenge on dementia.More

Nursing and the critical art of being present
By Keith Carlson
During the celebration of Nurses Week 2014, I have been giving a great deal of thought regarding what it means to be present when engaging in the delivery of nursing care. Having said that, what exactly is presence? And how do we nurses actively cultivate it while performing the tasks associated with our work? While we may frequently say that nursing care is all about the patient, the truth is that your ability to be present is where it all begins. A nurse who is present brings so much more intrinsic value to the act of nursing and patient care, whereas a nurse who is on autopilot may as well be a robot.More