MHA Today | May 4, 2017

May 4, 2017
MHA Today: News for Healthcare Leaders

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

In This Issue
U.S. House Approves American Health Care Act
Budget Conference Committee Completes Work On State FY 2018 Budget
House Passes Omnibus Appropriations Bill
Department Of Insurance Urges Missouri Insurers To Provide Assistance
MLN Connects Provider eNews Available
NHSN Revises Enrollment And HCP Measure Data Submission Checklist
MHA Launches Complimentary Culture Of Safety Survey
Six Missouri Colleges And Universities Receive Nursing Education Grants
Kindred Hospital St. Louis Names New Permanent And Interim CEOs

Advocate
state and federal health policy developments


U.S. House Approves American Health Care Act

Staff Contact: Daniel Landon

The U.S. House of Representatives has passed the American Health Care Act, which would repeal and replace various components of the Affordable Care Act. The vote was 217-213. The House legislation includes the “MacArthur” and “Upton-Long” amendments previously described.

MHA President and CEO, Herb B. Kuhn released the following statement.

“The American Health Care Act, if enacted in the form adopted in the House, would reduce access to health insurance for more than 200,000 Missourians by 2020. In addition, the 19 states that didn’t expand Medicaid through the Affordable Care Act — including Missouri — will be harmed disproportionately as the Act takes effect. The legislation is grossly inequitable. The AHCA includes funding enhancements and losses targeted directly to states that expanded Medicaid and those that did not. On a per-capita basis, those AHCA changes give the residents of expansion states 61 percent more than the residents of nonexpansion states, including Missouri.

Although the Act rolls back some of the cuts to hospital payments included in the ACA, it does not roll them all back. Between 2017 and 2026, Missouri hospitals will continue to bear the $5.7 billion in Medicare payment reductions that were included in the ACA, and not repealed in the AHCA. This will occur at the same time as hundreds of thousands of Missourians will be priced out of their health insurance. Hospital uncompensated care — already more than $1.2 billion annually — could skyrocket as hospitals continue to provide care to the newly uninsured in communities throughout the state.”


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Budget Conference Committee Completes Work On State FY 2018 Budget

Staff Contacts: Daniel Landon, Rob Monsees or Brian Kinkade

Yesterday evening, a budget conference committee met to resolve the differences in state fiscal year 2018 budget bills previously passed by the House and Senate. The outcomes of differences that were of significance to hospitals include the following.

  • FRA estimated appropriation. Conferees agreed to add $155 million to the FRA appropriation and not to make it an adjustable “estimated” appropriation. MHA expects this appropriation to be sufficient although the loss of the estimated status means a loss of flexibility.
  • Continuation of FY 2017 supplemental funding. Conferees agreed not to add funding to the FY 2018 budget for costs budgeted in FY 2017 supplemental appropriations. Rather, funds will be held on the state’s balance sheet for the FY 2018 supplemental budget that will be considered next spring.
  • Point count for nursing facility and in-home services eligibility. Conferees agreed to reduce the point count from 21 to 24 for participants to qualify for in-home care and nursing facility care. They also agreed to provide appropriation authority to maintain the point count at 21 (current level), but this funding is contingent on the House and Senate passing a bill that ends the circuit breaker tax credit for low-income elderly and certain disabled renters.
  • Medicaid managed care. Managed care expansion is funded in the budget adopted by the conferees. 

The House and Senate must each pass the budget bills that emerged from these negotiations by 6 p.m. Friday, May 5. They remain at work seeking final approval.

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House Passes Omnibus Appropriations Bill

Staff Contact: Andrew Wheeler

The U.S. House of Representatives and U.S. Senate have both passed a fiscal year 2017 omnibus appropriations bill which would fund the federal government through Saturday, Sept. 30. Specifically, the bill includes an increase of $3.8 billion for the U.S. Department of Health & Human Services, for a total of $73.5 billion. The bill also provides an increase of $3.7 billion to the Centers for Medicare & Medicaid Services program management and operations, which is equal to the fiscal year 2016 enacted level. The bill now will be sent to President Trump for his approval.

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Department Of Insurance Urges Missouri Insurers To Provide Assistance

Staff Contacts: Daniel Landon or Sarah Willson

The State of Emergency Executive Order signed by the governor because of recent flooding has spurred the Missouri Department of Insurance to urge payers licensed in Missouri to make exceptions for coverage for those living in affected flood areas. A Department of Insurance bulletin addresses continuance of coverage and out-of-network benefits. Missourians who have questions or concerns about their insurance coverage should contact the department’s insurance consumer hotline at 800/726-7390 or visit insurance.mo.gov.


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Regulatory News
the latest actions of agencies monitoring health care


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.

  • durable medical equipment, prosthetics/orthotics and supplies revised blended fee schedule amounts
  • cochlear devices replaced without cost: bill correctly
  • hospice item set V2.00.0 receives Office of Management and Budget approval
  • merit-based incentive payment system: submit measures for the advancing care information performance category by Friday, June 30
  • MIPS group reporting 101 webinar – Thursday, May 11

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Quality and Population Health


NHSN Revises Enrollment And HCP Measure Data Submission Checklist

Staff Contact: Sherry Buschjost

The National Health Safety Network’s “Enrollment and Influenza Vaccination Among Healthcare Personnel Measure Data Submission Checklist” has been revised to include a correction to STEP 3: Perform Data Verification in NHSN. The checklist provides new guidance on running the Centers for Medicare & Medicaid Services’ line listing report which shows the exact data that will be submitted from NHSN to CMS for a facility. The HCP measure checklist is available on the Quality Reporting Center’s website. Its purpose is to help inpatient psychiatric facilities in the NHSN enrollment process and subsequent submission of the Influenza Vaccination Among HCP measure data. 

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MHA Launches Complimentary Culture Of Safety Survey

Staff Contacts: Alison Williams or Mary Shackelford

MHA is launching the SafeCulture Accelerator Project which kicks off early June 2017. The complimentary two-phase project allows Hospital Improvement Innovation Network participating hospitals to access and use the Agency for Healthcare Research and Quality Culture of Safety Survey and improvement activities through the use of HIIN project funding. MHA has partnered with Beterra Health, Inc., a patient safety and quality improvement consulting firm, to administer the survey and provide data analytics. An informational webinar about the SafeCulture Accelerator Project is scheduled at 10 a.m. Tuesday, May 9. Register online.

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Workforce News


Six Missouri Colleges And Universities Receive Nursing Education Grants

Staff Contact: Meredith Kenyon

The Department of Higher Education and the Missouri State Board of Nursing have awarded $800,000 in grant funding to six Missouri colleges and universities to expand their nursing education programs. The goal is to increase the number of nurses in Missouri, especially in areas where a shortage of health care professionals exists. “These grants will provide valuable educational opportunities for many students and help meet Missouri’s growing need for highly trained health care professionals,” said Zora Mulligan, Missouri Commissioner of Higher Education. The 2017 grant recipients are as follows.

  • Columbia College – $150,000
  • Crowder College, Neosho – $98,478
  • Jefferson College, Hillsboro – $150,000
  • State Fair Community College, Sedalia – $149,730
  • University of Missouri-Kansas City – $150,000
  • Webster University, St. Louis – $112,013


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CEO Announcements


Kindred Hospital St. Louis Names New Permanent And Interim CEOs

Staff Contact: Carol Boessen

Jan Turk was appointed Interim CEO of Kindred Hospital St. Louis, effective April 11. Angela Green will take over as CEO of Kindred Hospital St. Louis – St. Anthony’s, effective Monday, May 15. Green previously served as Senior Director of Clinical Operations before her CEO appointment. Both succeed Stephanie Bridges, who resigned in February. A list of CEO changes is available online.

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Consider This ...

In the U.S., 63.5 percent of adults ages 65 and older have received a pneumococcal vaccination.

Source: Centers for Disease Control and Prevention