MHA Today | May 10, 2016

May 10, 2016
MHA Today: News for Healthcare Leaders

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet. Connect with us on LinkedIn.

In This Issue
General Assembly Enacts Medicaid Eligibility Change
Legislators Enact Physician Licensure Bill
MHD Reinstates Adult Dental Services Coverage
Issue Brief Describes Drivers Of 2017 Health Insurance Premium Changes
CMS Releases Additional RHC Billing Guidance
AHRQ Releases Updated 2015 Beers Criteria


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General Assembly Enacts Medicaid Eligibility Change

Staff Contact: Daniel Landon

The General Assembly has completed its enactment of House Bill 1565. The measure changes a decades-old standard governing the value of assets that can be held by an aged, blind or disabled person without jeopardizing his or her eligibility for Medicaid coverage. The increase in the asset limit will be phased-in throughout several years. The bill now moves to the governor for review.

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Legislators Enact Physician Licensure Bill

Staff Contact: Daniel Landon

State legislators have completed their enactment of House Bill 1682. The bill now goes to the governor for review. The original bill was dubbed the “Medical Practice Freedom Act,” and would prevent the state’s licensure of physicians from being contingent on participation in a particular plan of coverage or public service initiative or compliance with “meaningful use” of electronic medical records. The bill was amended to prevent state licensure of physicians from being tied to more rigorous medical specialty board certification, as well as create a palliative care advisory council, authorize newborn blood tests to screen for an additional rare disease, permit physician assistants and assistant physicians to order restraints or seclusion under certain circumstances in mental health treatment settings, and restrict a provider’s liability or administrative or criminal penalty for prescribing or using hemp extract as authorized by state law for the treatment of seizure disorders.

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MHD Reinstates Adult Dental Services Coverage

Staff Contact: Steve Renne

In compliance with House Bill 11, passed by the 98th Missouri General Assembly, the MO HealthNet Division has reinstated adult dental coverage effective for services on or after Jan. 1.

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Issue Brief Describes Drivers Of 2017 Health Insurance Premium Changes

Staff Contact: Andrew Wheeler

The American Academy of Actuaries published an issue brief describing the major contributors of 2017 health insurance premium changes. The brief primarily focused on the individual market with some factors unique to the small group market. Key drivers include growth in health care costs, the sunset of reinsurance program funds, differing risk-pool assumptions between 2016 and 2017, and the one-year moratorium on health insurance provider fee. The brief also provides a look at premium changes from a consumer perspective, siting changes in age, use of tobacco products, geographic location, benefit design, family status and marketplace tax credits.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Releases Additional RHC Billing Guidance

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services previously announced billing requirement changes for services provided at rural health clinics. CMS now has released additional guidance effective Saturday, Oct. 1. The guidance includes the use of the CG modifier. The CG modifier should be used in conjunction with revenue code 052x and/or 0900, which also should include all charges subject to coinsurance and deductible for the visit.

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Quality and Population Health


AHRQ Releases Updated 2015 Beers Criteria

Staff Contacts: Alison Williams or Jessica Rowden

The Agency for Healthcare Research and Quality has updated the 2015 Beers Criteria for medications to avoid in the elderly due to their high risk for adverse reactions. The guideline details the criteria, along with the strengths of each recommendation and supporting evidence.

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Consider This ...

This week is National Hospital Week. In Missouri, there are 24,127 licensed practical nurses and 8,266 advanced practice registered nurses.

Source: Missouri State Board of Nursing