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Clinical Support Regulatory Specialist — Case Management
MD Anderson Cancer Center
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Director, Transition Management Operations — 1408616
Vanderbilt University Medical Center
Nashville, Tennessee
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Bi-lingual (Spanish/English) Case Manager
Inhealth MD Alliance
Davenport, Florida
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CMS announces limited restart of RAC reviews
AHA News Now
The Centers for Medicare and Medicaid Services will allow current Recovery Audit Contractors to restart a limited number of claim reviews beginning this month, CMS announced. The agency said most reviews will be done on an automated basis. However, a limited number will be complex reviews on certain claims, including spinal fusions, outpatient therapy services, durable medical equipment, prosthetics, orthotics and supplies, and cosmetic procedures.
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Last chance for certification in 2014
The ACM Certification application deadline for the fourth quarter of 2014 is a little more than one week away — Aug. 15, 2014. Applications and payment must be received by the ACMA National Office by this date in order to take the exam during October, November or December.

What are you waiting for? If you are not yet ACM certified, apply now at and put the ACM credential after your name.

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Court urged to deny government's request to dismiss 2-midnight challenge
The AHA, four hospital associations and a number of hospitals urged a federal court to deny the government's motion to dismiss their challenge to the Centers for Medicare & Medicaid Services' two-midnight rule, and to instead grant them an immediate favorable ruling. "Rather than defend any of these policies on their merits, the Secretary has moved to dismiss, claiming that this Court lacks jurisdiction because the hospital Plaintiffs have not exhausted their administrative remedies," the hospital groups said in a motion for summary judgment. Though the requirement that plaintiffs exhaust those remedies is waivable, the secretary's brief "conspicuously ignores the waiver doctrine" and "this is a textbook waiver case," the motion adds. The hospital groups filed the lawsuit in April, challenging the various requirements of the rule as "arbitrary" and "capricious" and therefore invalid under federal law and regulation. Under the two-midnight rule, physicians admitting Medicare beneficiaries to the hospital must expect the patient to stay at least two midnights for the hospital to receive payment for inpatient care.
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  Join Excellence and Innovation

• Are you a Case Manager looking for opportunities to develop your career?
• Are you a Case management leader committed to helping change the future of healthcare?
You belong here!

Begin the journey of a lifetime with a Pioneer ACO who is participating in the Bundled Payments initiative.

The same Learning Link you love, now easier to update
As part of our ongoing efforts to enhance ACMA member benefits, we have made some changes to the Learning Link email listserv — one of ACMA's top-rated member benefits. While the process for posting to Learning Link has not changed and the postings you receive in your inbox will look the same, you will now be able to easily change the email at which you receive Learning Link postings and the format in which they are delivered — either "digest" (a daily summary of the day's postings) or "regular" (individual postings delivered in real time as they occur).
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Post your case management position with ACMA and save $50
Special Labor Day Offer: Through Sept. 1, save $50 on one job posting on ACMA's Career Link job board with promo code: 50cloff.

For more information, or to post your position now, go to

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A leader in clinical consulting
McBee Associates, Inc. delivers case management, medical necessity review, and appeals services to hospitals across the country. Call 800.767.6203 for case management shift coverage. MORE

Our unique blend of expertise and experience makes PhoenixMed the premier choice as your hospital case management partner offering solutions for contemporary case management redesign and education.

'Since You Asked' Committee update
Q: What are the requirements for a patient to be admitted to an Inpatient Rehabilitation Facility (IRF)?
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20th Annual Case Management Conference
Join Contemporary Forums for the 20th Annual Case Management Conference: The Impact of ACA on the Continuum of Care in Las Vegas, September 14 - 17, 2014, or via Live Webcast!
Advertise here!

To find out how to feature your company in the ACMA briefCASE and other advertising opportunities, Contact Geoffrey Forneret at 469-420-2618.

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 it to the "Since You Asked" committee for a thorough explanation that will be published in an upcoming issue of briefCASE.

What is the Since You Asked Committee?
The committee is charged with writing short articles for ACMA's briefCASE e-newsletter that answer your case management questions. Pose a question and the committee does the research to get the best information on the subject and writes an article on the findings. Topics are researched thoroughly and articles include references to allow the reader to seek out more information from the sources.

What issues are you facing in your daily practice? What regulations or requirements are unclear or confusing? Past articles have focused on regulatory issues, how to have a crucial conversation, what is an LCD versus an NCD, MAC pre-payment review, and the 13 items required for the conditions of participation for discharge planning for Medicare patients. To view past articles, click here.

To get your question answered, submit suggestions to Nancy Loeffler, the committee chair, via email at She and the committee will then consider the request and how best to approach the subject.

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Study: Not all 30-day readmissions indicate problems
Modern Healthcare
Are all 30-day readmissions really a bad thing? Not necessarily, according to researchers comparing readmission rates among California hospitals. The study found safety net hospitals in the state often had better outcomes on 30-day mortality measures, but were still more likely to face readmission penalties. The research adds to a growing body of data delving into the penalties' effect on hospitals in economically disadvantaged communities.
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Feds stop public disclosure of many serious hospital errors
The federal government this month quietly stopped publicly reporting when hospitals leave foreign objects in patients' bodies or make a host of other life-threatening mistakes. The change, which the Centers for Medicare and Medicaid Services denied last year that it was making, means people are out of luck if they want to search which hospitals cause high rates of problems such as air embolisms — air bubbles that can kill patients when they enter veins and hearts — or giving people the wrong blood type.
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Date Event Location More Info
Aug. 23 MO/IL Gateway Chapter Conference St. Louis Details
Sept. 6 Kentucky/Tennessee Chapter Conference Nashville, Tenn. Details
Sept. 11-12 South Carolina Chapter Conference Columbia, S.C. Details
Sept. 18 Missouri-Kansas Chapter Conference Kansas City, Mo. Details
Sept. 29 North Carolina Chapter Conference Winston-Salem, N.C. Details
Sept. 27 Maryland Chapter Conference Baltimore Details
Oct. 3 Great Lakes Chapter Conference Novi, Mich. Details
Oct. 4 Western Pennsylvania Chapter Conference Pittsburgh Details
Oct. 11 Virginia Chapter Conference Richmond, Va. Details
Oct. 14 Wisconsin Chapter Conference Waukesha, Wis. Details
Oct. 25 Connecticut Chapter Conference Uncasville, Conn. Details
Oct. 28 Illinois Chapter Conference Rosemont, Ill. Details
Nov. 19-22 Leadership Conference and Medical Director Forum Orlando, Fla. Details

  For the full ACMA event map, click here.



Tyler Neese, ACMA Director of Communications and Public Policy, 501.907.2262
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Colby Horton, Vice President of Publishing, 469.420.2601

Ryan Clark, Content Editor, 202.684.7160  
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