MHA Today | January 12, 2017

January 12, 2017
MHA Today: News for Healthcare Leaders

twitter linkedin MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.

In This Issue
Senate Passes And Advances Budget Resolution
CMS Proposes Requirements For Qualified Practitioners And Suppliers Of Prosthetics
CMS Issues Preliminary Guidance On HOPD And Site-Neutral Provisions
MLN Connects Provider eNews Available

Advocate
state and federal health policy developments


Senate Passes And Advances Budget Resolution

Staff Contact: Andrew Wheeler

The U.S. Senate passed a budget resolution by a vote of 51-48. Most notable is that the budget resolution can serve as a mechanism to dismantle the Affordable Care Act. A budget resolution is expected to be brought to a vote in the House of Representatives on Friday. In conjunction with the budget resolution, the Senate also conducted a “vote-a-rama,” which is a series of amendments that are not binding. A listing and vote tally of these amendments are available.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Proposes Requirements For Qualified Practitioners And Suppliers Of Prosthetics

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released a proposed rule which would implement statutory requirements for qualified practitioners and qualified suppliers of prosthetics and custom-fabricated orthotics. Comments about the proposed rule will be accepted until Monday, March 13.

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CMS Issues Preliminary Guidance On HOPD And Site-Neutral Provisions

Staff Contacts: Andrew Wheeler or Jane Drummond

Recently, the Centers for Medicare & Medicaid Services released preliminary guidance about off-campus hospital outpatient departments that had plans for construction as of Nov. 2, 2015. The Bipartisan Budget Act of 2015 included language which would stop paying outpatient departments of the hospital under the Medicare outpatient PPS if services were not being billed as of Nov. 2, 2015. Since then, the 21st Century Cures Act provided additional criteria that would allow certain off-campus departments of a provider to be considered “excepted” from payment under Section 1833(t)(21)(C), meaning the off-campus department is allowed to receive hospital outpatient department payments for services provided in an outpatient department of a hospital. CMS now has released preliminary guidance incorporating the 21st Century Cures Act provisions. In 2017, if CMS received before Dec. 2, 2015, an attestation that a department was a department of a provider, that department was deemed to be “excepted.” In addition, for calendar year 2017, all other off-campus departments of a provider that did not meet the attestation requirement to be deemed excepted for 2017 must use modifier ‘PN’ as described in the CY 2017 OPPS final rule. For 2018, a department that met the mid-build requirement and submitted the required certification and attestation no later than Monday, Feb. 13, will be considered excepted and may receive payment under the outpatient PPS. The mid-build requirement is defined as the main provider had a “binding written agreement with an outside unrelated party for the actual construction of such department” as of Nov. 2, 2015. CMS also released guidance on how hospitals can request a relocation exception for an excepted off-campus department because of an extraordinary circumstance. The deadline for applying for such exception is Tuesday, Jan. 31.

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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.

  • CMS finalizes new Medicare and Medicaid home health care rules and beneficiary protections
  • chronic care management services changes for 2017
  • addressing the opioid epidemic: keeping Medicare and Medicaid beneficiaries healthy
  • end-stage renal disease quality incentive program: payment year 2020 final rule call Tuesday, Jan. 17
  • how to use the Medicare coverage database booklet revisions
  • post-acute care transfer of health information and care preferences quality measures pilot study: respond by Jan. 17


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Consider This ...

Gluten is a protein found in wheat, rye, barley and foods containing these grains. For the 1 percent of the population with celiac disease and the 5 percent with gluten intolerance, restricting gluten is the key treatment for the condition.

Source: February 2017 edition of TopHealth®