MHA Today | September 15, 2016

September 15, 2016
MHA Today: News for Healthcare Leaders


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In This Issue
Legislators Override Veto Of Transparency, Medicaid Fee Legislation
MHA Distributes Analysis For The Update Notice To FY 2017 IPF PPS
CMS Posts Proposed Revisions To CJR Model Slide Deck
MO HealthNet Approves Provider Rate Increases
MLN Connects Provider eNews Available
Practitioner Licensure Board Releases Plan For Refunding Fees
CMS Announces OQR Webinar
HIDI Releases Third Quarter FFY 2016 Inpatient, Outpatient, Missouri Databases

Advocate
state and federal health policy developments


Legislators Override Veto Of Transparency, Medicaid Fee Legislation

Staff Contacts: Daniel Landon or Rob Monsees

At its annual veto session, the Missouri General Assembly voted to override Gov. Jay Nixon’s veto of Senate Bill 608. Since all but two of the legislation’s components were included in other bills that were signed into law, the effect of the override is twofold. First, it restores the enactment of laws described under “Health Care Price Transparency” on Page 2 of MHA’s end-of-session summary. Second, it imposes fees on Medicaid recipients for missing scheduled medical appointments or repeated unnecessary use of hospital emergency departments, as described on Page 3 of the summary.

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MHA Distributes Analysis For The Update Notice To FY 2017 IPF PPS

Staff Contact: Andrew Wheeler

An analysis from MHA illustrates the financial effect of the update notice to the inpatient psychiatric facility PPS for federal fiscal year 2017. In aggregate, Missouri will see an estimated increase of 1.8 percent for services paid through the inpatient psychiatric facility PPS. Although footnoted, the analysis does not take into consideration the 2 percent Medicare sequestration. The report, which is available online for authorized users of HIDI Analytic Advantage,® includes a summary for the nation, state, health systems and individual hospitals. Contacts for each IPF have been notified by email with the location of the reports on HIDI Analytic Advantage.®

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Regulatory News
the latest actions of agencies monitoring health care


CMS Posts Proposed Revisions To CJR Model Slide Deck

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services has made available a slide deck with details about the proposed changes to the comprehensive care for joint replacement model. These changes were proposed as part of the “Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model (CJR).” Some of the proposed changes include the following.

  • allow accountable care organizations and critical access hospitals to be CJR collaborators
  • include reconciliation and repayment amounts in the target prices
  • the “target price” discount will be referred to as “quality-adjustment target price” to reflect linkages to quality
  • beginning July 1, 2017, CJR episodes for beneficiaries that are prospectively aligned to a next generation ACO or end-stage renal disease seamless care organization in a downside risk track, no longer will be initiated in the program
  • revise the quality-adjustment target price scoring thresholds


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MO HealthNet Approves Provider Rate Increases

Staff Contacts: Steve Renne or Sarah Willson

MO HealthNet Division recently released a provider bulletin on physician fee increases. The fee-for-service provider program maximum allowable fees schedule has been revised to include rate increases for approximately 40,000 procedure codes. The effective date of the rate change was July 1. MO HealthNet will reprocess claims paid for dates of service on or after 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.

  • track ICD-10 progress and manage your revenue cycle
  • ICD-10 coordination and maintenance committee meeting materials available
  • skilled nursing facility value-based purchasing program call
  • plans for the quality payment program in 2017


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Practitioner Licensure Board Releases Plan For Refunding Fees

Staff Contact: Daniel Landon

The Missouri State Board of Registration for the Healing Arts recently filed emergency state regulations to reduce many of its occupational and professional licensure fees charged to physicians, physical therapists, physical therapy assistants, anesthesiology assistants, physician assistants, perfusionists, athletic trainers, speech language pathologists and audiologists. The regulations took effect Sept. 11. The board plans to issue refunds for the overpayments in the middle of the month for the next several months for licensees who previously had paid their fees at the higher rate.

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Quality and Population Health


CMS Announces OQR Webinar

Staff Contact: Sherry Buschjost

The next outreach and education webinar for hospitals participating in the Hospital Outpatient Quality Reporting Program is scheduled for Wednesday, Sept. 21. The webinar, titled “Unlocking the Secrets of the Question and Answer (Q&A) Site,” is offered at 9 a.m. and 1 p.m. Registration is required.

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HIDI Tech Connect


HIDI Releases Third Quarter FFY 2016 Inpatient, Outpatient, Missouri Databases

Staff Contact: Shane VanOverschelde

The third quarter federal fiscal year 2016 inpatient and outpatient databases, including HIDI-reporting hospitals in Missouri, Illinois (but excluding hospitals in Kansas City, Kan. for the third quarter), are available for download to subscribers of the Premier Data Package on HIDI Analytic Advantage®. These databases will be updated to include the Kansas City, Kan., hospital data for the third quarter in the coming weeks. The databases consist of a patient-level limited dataset, including all HIDI-reported discharges and visits to hospitals. Files are delivered as both text files and ready-to-query Microsoft Access database files. The files are located in the “Strategic Planning/Premier Data” section and are organized in the following categories.

  • Q1-Q3 FFY2016, Inpatient
  • Q1-Q3 FFY2016, Outpatient Classified
  • Q1-Q3 FFY2016, Outpatient Unclassified


Hospitals interested in subscribing to the 2016 HIDI Premier Data Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.

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Consider This ...

The average age at diagnosis of prostate cancer is 66 in the U.S., and the disease rarely occurs in men under 40.

Source: The New York Times