MHA Today | May 13, 2016

May 13, 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.


Insights


Herb Kuhn, MHA President & CEO

The 2016 session of the Missouri General Assembly concludes today. As you receive this, they are rushing toward their constitutional deadline to conclude this session’s business by 6 p.m.

This year, more than 2,000 bills and hundreds of resolutions were filed by Missouri’s representatives and senators. Based on past experience, about 150 of these will reach the governor for his signature. A few of those may not survive the veto and veto override process. MHA’s work includes not only promoting the legislation that serves hospitals and the communities they serve, but halting legislation that harms hospitals. The latter takes as much time or more than the former.

In keeping with tradition, and for the purpose of utility, the final days of session have witnessed the advance of a series of large “omnibus” bills related to broad subjects. This is true for health care legislation, where in the past 48 hours, several bills with numerous health care and hospital subjects have been finalized. Although this year’s health legislation does not make sweeping changes in the health care system — for example, Medicaid expansion wasn’t on the legislative docket this year — there are meaningful improvements in the way state government interacts with hospital operations.

A few notable examples of those improvements include a new law to upgrade and eliminate duplication in the infection control reporting system, as well as a revamp of the process of designating and regulating stroke centers. Also, some hospitals will be freed from the burden of reporting brain and spinal injury data to the state health department. MHA worked closely with the Missouri Society of Hospital Engineers to revise state law to improve the process of applying hospital life safety and building code standards. Finally, ill-considered state regulations that promoted hazard and liability on medical helicopter landing areas are eliminated.

The most essential health care bill in 2016 — for the state, hospitals and other providers — is an extension of the state’s provider taxes. Provider taxes, like the hospital federal reimbursement allowance, fund a significant portion of the state’s existing Medicaid program. This year, lawmakers are poised to approve a two-year extension of the provider taxes. An extension means more time to educate newly-elected lawmakers throughout 2017 about the necessity of the program.

While the legislative process is yielding positive benefits, the prevalence of omnibus legislation has its drawbacks. First, it’s a package deal. That means that the components we like are hooked to things not related — amendments with their own constituencies, for and against. Second, the state constitution requires a bill’s title to match the subject. In the past, this has created an opportunity for the courts to throw out the entire bill. Finally, there’s more room for errors in drafting that could increase the likelihood of veto.

In the weeks ahead, we’ll have a better sense of the bills’ trajectories. In several cases, legislation we support is expected to be enacted in multiple bills. This increases the likelihood of success. Although there are several hours left, and a gubernatorial vetting period for signature or veto, we are nearing the finish line.

There’s an election between today’s close of business and the next legislative session’s kickoff in January 2017. As we end this year’s state legislative advocacy, we do so with an eye toward the next session of the General Assembly.

Hospitals are essential to Missouri and Missourians. To succeed, we need a partnership with lawmakers and the state’s agencies. We’re already developing a plan to shape the legislative agenda to strengthen that partnership in 2017.

A summary of the 2016 legislative session will be available next week.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO



Herb B. Kuhn
MHA President and CEO

In This Issue
New State Enactment Addresses Public Safety
General Assembly Enacts Various Health Changes
Legislature Endorses Eligibility Verification
Report Criticizes 340B Hospitals
Legislators Approve Backup Enactment
Legislators Limit Mental Health Practitioner Liability
New Enactment Focuses On Emergency Care Regulations
Legislators Enact Health Bill
HIDI Posts Hospital Profile Report
HIDI Releases Management And Productivity Report
CMS Extends HCP Measure Data Submission Deadline

Advocate
state and federal health policy developments


New State Enactment Addresses Public Safety

Staff Contact: Daniel Landon

Senate Bill 732 is a newly-enacted bill with a variety of topics relating loosely to public safety. It revises standards for certain professionals to volunteer their services and equipment in responding to a disaster under the auspices of the State Emergency Management Agency. Regional EMS advisory committees will advise regarding community and regional time critical diagnosis plans. The bill revises licensure standards for emergency medical technicians. It also provides for liability protections for the use of patient restraints by EMTs in transporting patients detained for substance abuse or mental disorders. Hospitals and nursing homes will have policies for notifying EMS personnel before they transport at-risk behavioral patients. The bill authorizes an alternative process for designating stroke treatment centers. The state medical licensure board will have exclusive authority to set continuing education requirements for emergency department physicians in designated stroke, ST-segment elevation myocardial infarction and trauma centers. The bill also repeals the law authorizing the Department of Health’s brain and spinal cord injury registry. It also bars the Missouri Department of Health and Senior Services from requiring fencing or other barriers around a hospital helipad or otherwise regulating hospital helipad construction or operation. Hospitals must ensure their helipads are free of obstruction and safe for use while a medical helicopter is approaching, taking off from or on the helipad. First responders will be required to report elder abuse and incidents of bullying. Also, intergovernmental transfers may be used to fund Medicaid ambulance payments.

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General Assembly Enacts Various Health Changes

Staff Contact: Daniel Landon

The General Assembly has enacted Senate Bill 635. The bill addresses a variety of topics concerning health care, including the creation of a state database regarding the health care workforce. Of particular relevance to hospitals, the legislation revises hospital licensure standards to streamline and smooth compliance with life safety and construction codes. It also streamlines duplicative regulation of, and reporting by, trauma, ST-segment elevation myocardial infarction, and stroke centers. In addition, it gives the state physician licensure board exclusive authority to set continuing education requirements for physicians practicing in the emergency department of a hospital designated as a trauma, STEMI or stroke center. It makes state facilities other than Department of Mental Health hospitals subject to certificate of need review. It also bars the Missouri Department of Health and Senior Services from requiring fencing or other barriers around a hospital helipad or otherwise regulating hospital helipad construction or operation. Hospitals must ensure their helipads are free of obstruction and safe for use while a medical helicopter is approaching, taking off from or on the helipad.

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Legislature Endorses Eligibility Verification

Staff Contact: Daniel Landon

The newly-enacted Senate Bill 607 directs the Department of Social Services to use a contractor to verify recipients’ eligibility for public assistance programs, including Medicaid. The bill was amended to authorize Medicaid coverage of specified behavioral health services to manage physical health problems, create a legislative committee to monitor and investigate state public assistance programs, and allow Medicaid payments for ambulance services to be funded by intergovernmental transfers.

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Report Criticizes 340B Hospitals

Staff Contact: Daniel Landon

A new report criticizes the amount and distribution of charity care provided by hospitals participating in the 340B drug discount program. The report was prepared by Avalere Health on behalf of the Alliance for Integrity and Reform of 340B (AIR 340B), which is affiliated with pharmaceutical manufacturers. The group also issued a press release.

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Legislators Approve Backup Enactment

Staff Contact: Daniel Landon

The General Assembly has enacted House Bill 1816. It includes no new laws, as its components have previously been enacted this session. Duplicative enactments occur because of the uncertainties of the legislative process and because vetoes and court challenges can waylay enacted legislation. Components of particular interest to hospitals include authorization of a health workforce data center and for physician assistants to order patient restraints in behavioral health treatment settings.

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Legislators Limit Mental Health Practitioner Liability

Staff Contact: Daniel Landon

Current law has a two-year statute of limitations to file medical malpractice liability lawsuits. The newly-enacted House Bill 1765 applies this statute of limitations to lawsuits against various types of mental health practitioners, including psychologists, behavior analysts, professional counselors, marital and family therapists, and social workers.

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New Enactment Focuses On Emergency Care Regulations

Staff Contact: Daniel Landon

Senate Bill 988 has been enacted by the General Assembly. The base bill bars the Missouri Department of Health and Senior Services from requiring fencing or other barriers around a hospital helipad or otherwise regulating hospital helipad construction or operation. Hospitals must ensure their helipads are free of obstruction and safe for use while a medical helicopter is approaching, taking off from or on the helipad. The bill also streamlines duplicative regulations on trauma, ST-segment elevation myocardial infarction, and stroke centers, as well as gives the state physician licensure board exclusive authority to set continuing education requirements for physicians practicing in the emergency department of a hospital designated as a trauma, STEMI or stroke center. It gives two local governmental hospitals greater flexibility in investing their assets and makes state-owned health facilities other than Department of Mental Health state psychiatric hospitals subject to certificate of need review.

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Legislators Enact Health Bill

Staff Contact: Daniel Landon

The newly-enacted Senate Bill 973 would revise hospital licensure standards to streamline and smooth compliance with life safety and construction codes. It was developed in consultation with the Missouri Society of Hospital Engineers. It also creates an interstate compact for physical therapy licensure, provides more flexibility in dispensing maintenance medications and makes state facilities other than Department of Mental Health hospitals subject to certificate of need review.

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HIDI Tech Connect


HIDI Posts Hospital Profile Report

Staff Contact: Shane VanOverschelde

The Hospital Profile Report is derived from several data sources that displays a comprehensive set of key hospital metrics in an Excel-based tabular display. Data from 120 Missouri hospitals, including acute care, critical access, children’s and cancer hospitals, appear side-by-side in the report. This report is available to subscribers of the HIDI Premier Reporting Package and is located on HIDI Analytic Advantage® in the Strategic Planning/Premier Reports folder with the following file name: MO0000_2016 Hospital Profiles_(2016.05.13).xls. Hospitals interested in subscribing to the HIDI Premier Report Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.

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HIDI Releases Management And Productivity Report

Staff Contact: Cerise Seifert

MHA-member hospitals that submitted first quarter data for the “Management & Productivity Report” can access their completed reports online through a secure, password-protected website. Access to the report is limited to hospitals that participate in HIDI’s voluntary management and productivity program. The reports are located on HIDI Analytic Advantage® in the “Management & Productivity” folder under the “Finance and Policy” tab. Contacts from the participating hospitals have been notified by email. Staff may download and save the reports to a secure location on their networks or PCs. The data are encrypted on the site and also during the transmission from HIDI. Once the data have been transferred, they must be secured according to the hospital’s security procedures.

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Quality and Population Health


CMS Extends HCP Measure Data Submission Deadline

Staff Contact: Sherry Buschjost

The influenza vaccination health care personnel measure data submission deadline has been extended to Wednesday, June 15, for inpatient psychiatric facilities that participate in the Inpatient Psychiatric Facility Quality Reporting Program. The extension applies only to the HCP measure for the IPFQR Program. All other IPFQR and Hospital Inpatient Quality Reporting Program deadlines have not changed. IPFs that have not completed enrollment with the National Healthcare Safety Network at the Centers for Disease Control and Prevention may be at risk of failing to meet the new submission deadline. Failure to complete the HCP measure data submission prior to the deadline may result in a 2 percentage point reduction in an IPF’s fiscal year 2017 annual payment update from the Centers for Medicare & Medicaid Services.

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Did You Miss An Issue Of MHA Today?


May 12, 2016
American College Of Surgeons Releases New Statement On Principles
MO HealthNet Allows Separate Payment For Long-Term Contraceptive Devices
CMS Releases RHC Billing Requirements
MLN Connects Provider eNews Available
CMS Announces OQR Webinar
Chicago Real Estate Investment Group Sues Illinois Hospitals Over Tax-Exemptions

May 11, 2016
State Legislators Expand Access To Opioid Overdose Antidote
New Enactment Affects Pharmacy And Insurance Regulation
MHA Develops Acute Care And Critical Access QAPI Guide
CMS Hosts Health Care Fraud Awareness Symposium
Region 7 Releases “The Pulse of CMS” Newsletter
Trajectories — Hospital Preparedness
FDA Panel: Physician Opioid Training Should Be Mandatory

May 10, 2016
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

May 9, 2016
Medicaid Updates Restorative Dental Services Provisions
MHA Comments On Medicare Part B Drug Payment Rule
CMS Updates RAC ADR Limits
CMS Posts Preview Reports
CDC Reports On State Health Care Utilization



Consider This ...

This week is Women’s Health Week. Breast cancer affects 1 in 8 women, and is the second-leading cause of cancer death in women in the U.S.

Source: WomensHealth.gov