MHA Today | June 20, 2016

June 20, 2016
MHA Today: News for Healthcare Leaders



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In This Issue
Congressional Committee To Assess National Trauma System
CMS Issues Final Rule Setting Lab Test Payment Rates
CMS Proposes Changes To Payment Error Rate And Eligibility Determination Standards
HIDI HealthStats — Mental Health In Missouri

What You Need To Know This Week

  • Today is the deadline for submitting regulatory comments on proposed federal rules for Medicare skilled nursing facility, hospice and rehabilitation hospital perspective payment systems. Comments can be electronically submitted until 4 p.m.   
  • Comments for the Medicare Access and CHIP Reauthorization Act proposed rule are due Monday, June 27. MHA will post comments this week. 
  • Friday is the deadline for Aetna to submit a plan to remedy the specific anticompetitive impacts of the proposed merger between Aetna and Humana. 

Advocate
state and federal health policy developments


Congressional Committee To Assess National Trauma System

Staff Contact: Daniel Landon

The Subcommittee on Health of the U.S. House of Representatives’ Energy and Commerce Committee has scheduled a hearing, titled “Strengthening Our National Trauma System,” on Friday, June 24. Congressman Billy Long (R-Mo.) is a member of the subcommittee and the Energy and Commerce Committee. A webcast of the hearing will be available.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Issues Final Rule Setting Lab Test Payment Rates

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issued a final rule that will significantly change the Medicare clinical laboratory payment system. The new rule implements Section 216 of the Protecting Access to Medicare Act of 2014 and uses private payer rates for laboratory tests from applicable laboratories to set the payment rates in the clinical laboratory fee schedule. The transition would decrease the amount of expenditures by 5.6 percent or $390 million in fiscal year 2018. CMS further estimates that the five-year reduction will amount to 4.9 percent or $1.71 billion. The final rule provides clarification and definitions for private payers, a schedule for implementation, and a definition of applicable laboratory and reporting requirements. MHA has published an issue brief with additional information.

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CMS Proposes Changes To Payment Error Rate And Eligibility Determination Standards

Staff Contacts: Daniel Landon or Steve Renne

The Centers for Medicare & Medicaid Services has issued a proposed rule regarding its Payment Error Rate Measurement and Medicaid Eligibility Quality Control programs. Public comments regarding the proposed rule are due by 4 p.m. Monday, August 22.

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HIDI Tech Connect


HIDI HealthStats — Mental Health In Missouri

Staff Contacts: Mat Reidhead or Sarah Willson

June 2016 HealthStats Mental Health The June issue of HIDI HealthStats discusses the limited access, increasing demand and tragic consequences of mental health in Missouri. In 2011, the Centers for Medicare & Medicaid Services accepted applications from states for an Institution for Mental Disease waiver program for emergency mental health services. With a total award of $75 million, Missouri was one of 12 demonstration projects funded in 2012. Focused on freestanding inpatient psychiatric facilities, the three-year project resulted in the admission of 2,060 patients for a total of 13,243 inpatient days. These admissions brought in Medicaid billings of $11,313,300 to the state of Missouri. In the absence of the waiver, the majority of these admissions would have resulted in protracted searches for treatment and uncompensated care. The budget neutral demonstration resulted in significant indirect benefits for the patients and throughput at acute care hospitals. The project ended in early 2015 when funding was exhausted. However, in response to the effectiveness of the demonstration project, President Obama signed into law the Improving Access to Emergency Psychiatric Services Act in December 2015. The act reauthorizes the IMD waiver demonstration through September 2016 and allows the U.S. Department of Health & Human Services to extend the program for three more years and to other states. Missouri currently is waiting on a federal appropriation to reinstate the demonstration.

Another driver of access to mental health care is public investment in services. At $99.40 per capita, Missouri’s spending on public mental health services is well below the national average of $119.62 per capita. Reimbursement rates for the Department of Mental Health’s community health care providers have fallen far behind inflation making it harder for providers to maintain proper staffing and services. According to a 2016 commentary from The Missouri Budget Project, Missouri has cut state general revenue funding for mental health services by as much as 35 percent since 2009.

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Consider This ...

About 79 million Americans are infected with human papillomavirus, and 14 million become newly infected each year. While the body’s immune system clears most of the infections, high-risk strains are directly linked to 27,000 new cancers a year.

Source: The Washington Post