MHA Today | July 5, 2016

July 5, 2016
MHA Today: News for Healthcare Leaders




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In This Issue
DOJ Hikes Civil False Claim Penalties
CMS And TJC Release National Inpatient Quality Measures Specifications Manual
CMS Announces PC-01 First Quarter 2016 Data Submission Period Delay

What You Need To Know This Week

  • Look for two regulations that may be published by CMS — the Hospital Outpatient Prospective Payment and the Physician Fee Schedule.
  • As Missouri’s new fiscal year begins, review materials sent by MHA on Medicaid payment updates.
  • Gov. Nixon must sign or veto all legislation passed by the Missouri General Assembly this session by Thursday, July 14. A number of health bills are pending.

Regulatory News
the latest actions of agencies monitoring health care


DOJ Hikes Civil False Claim Penalties

Staff Contact: Daniel Landon

The U.S. Department of Justice has issued an interim final rule that revises its schedules of civil monetary penalties to reflect inflation adjustments. It revises the minimum and maximum penalties for claims submitted in violation of the federal Civil False Claim Act. Penalties nearly double, with the minimum per claim penalty increasing to $10,781 from $5,500, and the maximum penalty increasing to $21,563 from $11,000. The maximum civil monetary penalty for violating federal anti-kickback laws also increases to $21,563. The new penalties take effect Monday, Aug. 1, and will apply to violations occurring after Nov. 2, 2015. The department is soliciting comments until Monday, Aug. 29, regarding the inflation adjustments, which were authorized by Congress in 2015.

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Quality and Population Health


CMS And TJC Release National Inpatient Quality Measures Specifications Manual

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services and The Joint Commission Specifications Manual for National Inpatient Quality Measures, Version 5.2, has been posted to QualityNet. This version of the manual is for hospitals participating in the Hospital Inpatient Quality Reporting Program and covers acute inpatient discharges from Jan. 1, 2017, to Dec. 31, 2017. A complete list of changes is available in the manual’s release notes. Items of special interest include the following.

  • updates to the Early Management Bundle, Severe Sepsis/Septic Shock, Venous Thromboembolism, Stroke, Immunization, Substance Use and Tobacco measure sets
  • revised Data Dictionary
  • updated tables in Appendices A and C
  • removal of definitions from Appendix D
  • updated Appendix G


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CMS Announces PC-01 First Quarter 2016 Data Submission Period Delay

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has announced that the submission period for hospitals participating in the Inpatient Quality Reporting Program to submit first quarter 2016 Perinatal Care Elective Delivery Measure (PC-01) data will be delayed. Data submission is expected to be available on or before Thursday, July 21, and will end Monday, Aug. 15. CMS acknowledges that the delay from the historical July 1 start date will result in a shortened data submission period and encourages hospitals to plan accordingly.

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Consider This ...

July is Juvenile Arthritis Awareness Month. Juvenile arthritis affects nearly 300,000 children in the U.S.

Source: Arthritis.org