MHA Today | May 19, 2016

May 19, 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
Congressional Committee Creates Hospital Legislation
MHD Posts Provider Spenddown Form Bulletin
DOL Finalizes Overtime Pay Rule
CMS Issues Change Request Regarding Reporting Of Drugs
MLN Connects Provider eNews Available

Advocate
state and federal health policy developments


Congressional Committee Creates Hospital Legislation

Staff Contact: Daniel Landon

The Committee on Ways and Means of the U. S. House of Representatives has announced its new “Helping Hospitals Improve Patient Care Act of 2016,” along with a summary and section-by-section analysis. Its components include an exemption from Medicare payment caps for off-site hospital outpatient departments that were being developed when Congress passed a payment restriction in November 2015. The bill also revises Medicare readmission payment standards to include an adjustment for differences in patients’ sociodemographic characteristics. MHA is assessing the proposal.

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MHD Posts Provider Spenddown Form Bulletin

Staff Contact: Steve Renne

Spenddown eligibility and the effective coverage dates are determined by the Family Services Division. The MO HealthNet Division is responsible for administering the health care coverage and processing claims. The spenddown program is designed for people whose income is higher than the allowable amount for MO HealthNet coverage.

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Regulatory News
the latest actions of agencies monitoring health care


DOL Finalizes Overtime Pay Rule

Staff Contact: Andrew Wheeler

The U.S. Department of Labor issued a final rule that will nearly double the wage threshold that identifies who qualifies for overtime compensation. The final rule will become effective Dec. 1 and raises the salary threshold from $455 to $913 per week or $47,476 per year. The threshold also will automatically be updated every three years based on wage growth over time. The highly-compensated employee level is increasing from $100,000 to $134,004 per year. The duties test will remain unchanged. In addition, there is a time-limited non-enforcement policy for providers of Medicaid-funded services for individuals with intellectual or developmental disabilities in residential homes and facilities with 15 or fewer beds. The DOL has issued an overview of the final rule as it relates to the non-profit sector. DOL is offering several webinars about the final rule.

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CMS Issues Change Request Regarding Reporting Of Drugs

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services previously provided guidance about the use of the JW modifier when Medicare Part B drugs and biologicals were not completely used while treating a patient. The current policy allows the Medicare Administrative Contractor to determine whether to require the JW modifier. Currently, the Wisconsin Physicians Service Insurance Company, which serves as the MAC for most Missouri providers, does not require the use of the JW modifier. CMS now has provided a change request, mandating the use of the JW modifier effective Friday, July 1.

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MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issues updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • skilled nursing facility value-based purchasing program: specifications for new measure
  • 2014 physician quality reporting system experience report
  • comparative billing report on psychotherapy and evaluation and management services webinar


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Consider This ...

The cost of caring for patients with mental health disorders topped $201 billion in 2013. That's more than any other medical condition, including cancer and heart disease.

Source: Health Affairs