Volume 63 Issue 4 April 7, 2017

In This Issue President's

Message

CMS Data on

MIPS

Exemptions Late

Committee Chair

Spotlight

Upcoming

Events

TidBits

Net Revenue

Procedure Is

Here To Stay

President's Message

The HFMA year is soon coming to a close and that means our new

officers, board members, and committee chairs will officially begin

their new roles June 1st. It has been an absolute pleasure to serve the last four years as an officer of this wonderful HFMA EMC

community. The journey this past year as the President has been so humbling and personally fulfilling. Thank you once again for allowing

me this amazing opportunity.

HFMA consistently provides excellent educational and networking

opportunities. Our chapter would not be able to do that without the generous financial support of our chapter sponsors. At every event

this year I have done my best to stress the importance of our sponsors and want to personally thank you again for prioritizing HFMA

sponsorship. I also want to take thank our approximately 550

members of the chapter for supporting HFMA and entrusting us to fulfill your professional educational and networking needs. I will not

be able to thank all chapter leaders for going above and beyond in making this past year a success and at a minimum I feel compelled to

personally thank Susan Stokes, Sharon Bayliss, and Sara McGlynn. Your leadership and efforts this past year were invaluable.

The value of HFMA

There are many reasons I am so proud to be part of our chapter's leadership. Two of my favorite include the following:

• HFMA consistently listens to the feedback provided by our

members in our surveys to meet current needs and to shape future events. One of the best examples of this was our

February 16th educational event on MACRA. We were asked by our members through surveys to provide a standalone

educational event on MACRA and its sweeping changes. We

were able to put together a comprehensive event that included many strategic considerations with timely

perspectives from our panelists that included a physician, a

HFMA Final Rule

Summary

HFMA Bowling

Night

Pass on the

Value

Thank you to our

Sponsors

senior financial leader from a large health system, and a

reimbursement consultant from a large firm.

• HFMA educational content provides our members necessary

tools that can be leveraged immediately in our day to day roles. A great example was our March 23rd annual Insurance

and Reimbursement update. The reason this timing was impeccable was later that night the House of Representatives

planned to vote on the American Health Care Act (AHCA) bill that would have fundamentally reformed the Affordable Care

Act. Although that vote was temporarily tabled until the next

day before ultimately not going to an official vote, conference attendees received a timely policy overview of this bill that

helped all attendees understand key provisions. Gaining such an understanding is crucial in helping our members determine

institutional impacts and empower each of us to better

services our customers. Although the AHCA is not as pressing at this time, these skills are transferable and will be helpful

when a later healthcare bill resurfaces that will likely contain similar principles.

Upcoming Events

Below is a listing of upcoming educational and networking events in

our chapter. I hope to see you there.

• HFMA/MICPA Health Care Conference April 26 (Laurel Manor, Livonia)

• HFMA EMC May 12 Program Committee Meeting (Trinity

Health, Livonia)

• Michigan HFMA Spring Conference May 24- 26 (Soaring Eagle Casino & Resort, Mount Pleasant)

• Annual HFMA Tigers game June 13

• Annual HFMA Golf Outing July 13 (Lakewood Country Club, Commerce Township)

Thank you once again for allowing me the opportunity to serve as chapter president. Please let us know if you would like to be more

involved in the chapter as we can always use volunteers. Our chapter is run by leaders that graciously volunteer their times and

talents. Thank you to all of you that make HFMA EMC so successful.

CMS Data on MIPS Exemptions Late: MGMA

By: Andis Robeznieks, freelance writer based in Chicago.

@AndisRobeznieks

CMS says they will send out MIPS Status Information - Promised in

December - in the Spring. The move from volume- to value-based physician payment has

started. But federal regulators have yet to provide critical information to physicians.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed Medicare's sustainable growth-rate (SGR) payment formula

and created the new value-based Medicare Part B payment systems, including the Merit-Based Incentive Payment System (MIPS) and

designated advanced alternative payment models (APMs).

MACRA requires physicians to file this year quality reports, which

affect payment for 2019. But many physicians and group practices are still unsure of how to get

started as at least a third of physicians may be exempt from MIPS reporting. The Centers for Medicare & Medicaid Services (CMS)

promised that they would notify physicians about their MIPS status by

December but the agency has yet to fulfill that promise.

The Medical Group Management Association (MGMA) wrote a letter to CMS Administrator Seema Verma asking that the agency

"expeditiously release" the eligibility notices. The MGMA also requested the agency do the same with a promised list of approved

vendors operating qualified registries and qualified clinical data

registries with whom physicians can partner with to meet data-reporting requirements.

"Group practices planning to utilize these reporting mechanisms must

either delay engagement or partner with vendors without a guarantee

they meet CMS's qualifications," Anders Gilberg, MGMA senior vice president for government affairs, wrote in the letter to Verma.

Full article

Committee Chair Spotlight - Josh Richards - Program Committee

Organization where employed: Plante Moran

Title: Assurance Associate

HFMA Member Since: 2013 Years in current position: 3 years

Why I chose this career/position: When I started my career, I had a few healthcare clients early on. Through these, I found that I

really enjoyed the work and the staff I worked with. Eight years later,

that has snowballed into me devoting 100% of my time to serving clients in the industry.

What I like most about my job/field: Developing staff, networking with peers, and expanding my knowledge of the industry.

What I like least: Detail reviewing tedious projects.

I Joined HFMA because: I wanted to get to know more folks in the industry and attend events to soak up every piece of knowledge I

could. What I'm most excited about for the future of healthcare: I

am excited about the future of healthcare because nobody knows what care delivery, payment and technology will look like, 10 years

from now. The opportunities are endless.

"Getting to Know You" questions.

Top 3 songs on your iPod?

a) Luke Combs - Hurricane

b) Stolen Silver - Prefontaine

c) A Little More Summertime - Jason Aldean

If I had time, I would like to: learn to play acoustic guitar and

become better at golf Some places I've traveled to: Hawaii (Islands of Maui and Kauai),

Playa Del Carmen, Mexico Some places I'd like to travel to: Scotland, France, British Virgin

Islands, Fiji Three things you'll always find in my fridge: Milk, fruit and diet

pop

You would be surprised to know this about me: I am religious about keeping very few items in my email inbox. Current total is 5

items. In case of fire, I would: Save as many people as I could until I

physically could not.

Proudest moment: Becoming a Dad Most famous person I've ever met: This was tough to answer, as

that list is not very long, besides the President (Mike Klett, that is), Tom Izzo would have to be it.

Person I would like to meet: Warren Buffet Last book read: (I'm a big Audible fan so I've actually listened to the

last book) Outliers: The Story of Success, by Malcolm Gladwell

Dream automobile: For now, that would have to be a blue 2017 Chevrolet Corvette Z06 with 0 miles on it.

Upcoming Spring Programs

HFMA Region 6 Webiars April 12, 2017 - Navigating Self-Pay Collections in 2017

Speaker: Don Wright, Senior Vice President of Self-Pay Operations, Revenue Cycle, Parallon

Click here for more details and to register

April 27, 2017 - Healthcare Trends and Issues for 2017

Speaker: Phil Solomon, Vice President of Marketing Strategy, MiraMed Click here for more details and to register

HFMA National Webinars

April 11, 2017 - Revenue Cycle Panel Discussion: Motivations and

Impact of Investing in Patient Financial Care Initiatives

April 20, 2017 - Transforming Operational Chaos Into a High-

Performing Physician Network

May 4 - HFMA's Spring Virtual Conference (Free for Members/ $175 for Non-Members)- What's in Store for Health Care and You?

May 9, 2017 - Delivering Effective Pre-Service Cost Estimates to Patients to Maximize Point-Of-Service Collections

May 11, 2017 - Incorporating a Positive Patient Experience

Throughout the Revenue Cycle

May 16 2017 - Strategies for Unifying Your Clinical and Non-Clinical

Payments to Enhance the Patient Financial Experience

May 17, 2017 - Creating Success Pre- and Point-of-Service Collections Strategies

May 18, 2017 - Improving Patient Satisfaction Through Data Analytics and Aggregation

Save the Dates (registration will open about 6 weeks before

the program date)

April 26, 2017 Annual HFMA/MICPA Conference Time: 8 a.m. to 5 p.m. (Earn up to 8 CPEs)

Download the brochure

Link to Register

May 12, 2017 - May Member Meeting -Topic coming soon Speakers: Coming Soon

Trinity Health, Livonia, MI

May 18, 2017 - Joint Meeting with MCACHE - Becoming a

Model System: How Intermountain Healthcare Leverages Transformational Strategies to Achieve Greater Systemness

Speaker: Bert Zimmerli, CPA, Chief Financial Officer & Executive Vice President,

Intermountain Health Panelists: Anthony J. Tedeschi, M.D., Chief Executive Officer, Detroit Medical

Center Kevin Webb, Ph.D., FACHE, Chief Acute Care Officer, Promedica Carolyn Wilson, MBA, RN, Executive Vice President & Chief Operating Officer, Beaumont Health Moderator: Dan Riina, FACHE, Partner, TRG Healthcare

Inn at St. John's, Plymouth, MI Time: 5:15 p.m. - 8:15 p.m. Link to register (registration open now)

TidBits

(The TidBits column is interesting personal information you would like

to share with our HFMA family! It could be a story, a favorite restaurant or recipe, an accomplishment, or something you do for

entertainment. Please submit article to Susan Stokes at susan-

stokes@comcast.net.)

News from the Ken Marcus Family

Andee and Ken Marcus were thrilled with the birth of their second grandchild, Max Henry Borkin, who was born at Beaumont Royal Oak

on March 11, 2017. He weighed 6 pounds, 12 ounces and was 20.25 inches.

Ken is a partner in the Health Practice of the law firm of Honigman

Miller Schwartz and Cohn LLP and a long-time member of the Eastern

Michigan Chapter of HFMA. Ken said, "having grandchildren is a wonderful experience which provides perspective on the long view of

life. With good fortune these children may see the year 2100! One can only wonder what marvels they will see, but at the same time

hope that there is peace in the world."

His parents are Stephanie Marcus Borkin, M.D. and Michael Steven Borkin, M.D. Stephanie is a board certified pediatrician (Merrillwood

Pediatricians, Royal Oak) and Michael is a board certified dermatologist (Dermatology Associates, Birmingham). They reside

in Royal Oak and are both members of the medical staff of Beaumont

Royal Oak.

Stephanie and Michael met in NYC where she was attending Albert Einstein College of Medicine and he was in a dermatology residency at

St. Luke's - Roosevelt Hospital. As every mother will agree it was

against all odds that they actually were "set up" through Andee, who is a nurse practitioner in ENT at Henry Ford West Bloomfield. A

resident mentioned to her a resident friend of his in NYC, Andee got his email address and sent it to Stephanie, and when they met "to

study together" they hit it off. They were married in April of 2015.

Max is Andee and Ken Marcus' second grandchild. Maya Arielle

Mikinberg was born on March 15, 2016 to their daughter and son-in law Melissa and Eddie Mikinberg, who live in Long Island City, New

York. Andee and Ken Managed to have two grandchildren in fewer

than 12 months! Melissa is a motion graphic artist for Gas Station

TV. Eddie is a VP in the fraud unit of a major NY bank. Max is also

the nephew of Laura Marcus, who resides in NYC and is professionally employed by a nonprofit educational fund raising organization.

Below is a photo of Ken explaining the PRRB appeals process to Max.

Below is a photo of Maya on her first birthday.

_______________________________________________________________________________________

Congratulations to Mike Klett! He completed the Executive MBA through MSU while going through the 4 HFMA Officer positions and started a new position at Michigan Medicine.

New Revenue Procedure Is Here To Stay

By: Andrew Kloeckner, partner, Baird Holm Attorneys at Law akloeckner@bairdholm.com and

Bill Wilson, Senior Vice President & Regional Manager of

Central States, Lancaster Pollard bwilson@lancasterpollard.com

Out with the old and in with the new? A recent revenue procedure change is catching the attention of health care providers with facilities

financed through tax-exempt bonds. The good news is, the changes allow for greater flexibility and revised safe harbor guidelines.

The Internal Revenue Code (IRC) provides that interest on bonds

issued by governmental or 501(c)(3) organizations may be exempt

from tax if, in addition to satisfying other requirements, not more than 10% of the proceeds of the debt issuance for governmental entities

(5% for 501(c)(3) organizations) are utilized in a private business use (a private party such as a medical practice or for-profit service

provider may qualify as a private business use). As a result, traditional

service agreements between hospitals and medical practices and other arrangements to manage segments of hospitals' businesses may be

considered management agreements and could cause financings to fail the private business use test. This would result in interest on

bonds being taxable.

In order to prevent such a result, hospitals with outstanding tax-

exempt debt historically sought to fit management and service agreements into one of a multitude of complex and often burdensome

private use safe harbors under the Internal Revenue Service (IRS) Revenue Procedure 97-13 (Rev. Proc. 97-13). These safe harbors

were tied to the length of the agreement and the type of

compensation provided to the service provider. If a safe harbor was

satisfied, then the agreement would not qualify as a private business

use.

Because the safe harbors were extremely technical and complex, on August 22, 2016, the IRS issued Revenue Procedure 2016-44 (Rev.

Proc. 2016-44) as a replacement to Rev. Proc. 97-13. Rev. Proc. 2016-44 has been lauded in the industry as providing greater flexibility

for management and service agreements to qualify for private use

safe harbors. Gone are the rigorous tests of the past that tie modes and forms of compensation to the length of agreements.

Full Article

HFMA Final Rule Summary: Advancing Care Coordination Through Episodic Payment Models (EPMs)

In order to shorten this comprehensive summary of the final rule

implementing three new Mdicare Part A and B episode payment models (EPMs), modification to the existing Comprehensive Care for

Joint Replacement (CJR) model, and the Cardiac Rehabilitation (CR) Incentive Payment model, we have broken it into three sections.

Section I - Final Rule: Medicare Program; Advancing Care Coordination Through Episode Payment Models (EPMs)

Section II - Comprehensive Care for Joint Replacement (CJR) Model

Section III - Cardiac Rehabilitation (CR) Incentive PaymentModel

HFMA Bowling Night

Pictured L to R: Josh Richards, Steve Fehlinger, Corey Kosch, Aaron Moore, Amy Vandecar, Pete Stewart, Elyse Berry, Abby Vandecar,

Sharon Foley, M. Jane Hardy, Mitchell Apliner, Dianne Alpiner, Bob Alpiner, Rob Carlesimo. Pictures by Bill Bollinger. Thanks Bill!

The annual HFMA Bowling night took place on March 15, at Langan's

Nor-West Lanes in Farmington Hills. There was a chance to win prizes for pins dropped. Strike = $20 or $1 per pin. Pizza, salad and cold

drinks were shared. A great time was had by all attendees

Dinner of Pizza and Salad was enjoyed by all.

Thank you Abby Vandecar for helping with the drawing!

Congratulations Sharon Foley for an awesome strike!

Pass on the value of HFMA

When you share your HFMA experience, you make our organization -

and your network - stronger. Referring your colleagues is as simple as

sending an email. We'll even help you articulate the value of membership.

When you use our online referral form, we'll send a message on your

behalf explaining the benefits of HFMA membership. Using these

forms also makes it easier for us to track which members you sponsor. That means we can make sure you receive all the prizes you

deserve for sharing your experience.

Win these prizes when someone joins HFMA based on your

recommendation.

• HFMA apparel item, duffel bag, or smartphone accessory

• $25, $100, or $150 Visa Gift Cards

• Cash prizes of $1,000 or $2,500

• Apple Watch Sport

Grand Prize of $5,000*

Learn more about the Member-Get-A-Member Program and prizes. *Grand prize of $5,000 will be paid as follows: $3,000 for the winner and $2,000 donated to a charity of their choice.

Thank you to our 2016-17

Corporate Chapter Partners

Platinum Sponsor

Advomas Baker Tilly Virchow Krause, LLP

Beaumont Health HELP Financial

Henry Ford Health System

Trinity Health

Gold Sponsors Baker Healthcare Consulting, Inc.

Craneware

Detroit Medical Center HealthFirst Financial

L & S Associates, A Human Arc Company McLaren Macomb

PricewaterhouseCoopers LLP

Priority Health St. John Providence Health System

Silver Sponsors

Bank of America Merrill Lynch Bottom Line Systems, Inc.

Capio Partners

Commerce Bank Credit Adjustments, Inc.

Healthcare Payment Specialists HealthRise Solutions

Huntington Bank

Lubaway Masten & Company, LTD Molina Healthcare of Michigan

OnPlan Plante Moran, PLLC

PNC Bank ProAssurance

The Rybar Group, Inc.

TLM Consulting, Inc. University of Michigan Health System

Walgreens

Bronze Sponsors

Blue Cross Blue Shield of Michigan Dykema Gossett, PLLC

Experian Health Honigman Miller Schwartz and Cohn LLP

Hurley Medical Center

King & Spalding, LLP Kitch Attorneys & Counselors

Money Recovery Nationwide

Velo Law Office

Whittaker Group Healthcare Recruiting & Executive Search, LLC

Henry Ford Health System

Trinity Health

HealthFirst Financial

PricewaterhouseCoopers LLP

St. John Providence Health System

Healthcare Payment Specialists

Huntington Bank

Molina Healthcare of Michigan

PNC Bank

Walgreens