MHA Today | March 18, 2016

March 18, 2016
MHA Today: News for Healthcare Leaders

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


Herb Kuhn, MHA President & CEO

This week, the U.S. House of Representatives’ Energy and Commerce Committee passed HR 4725. Among other changes, it would lower the cap on state provider tax rates to 5.5 percent from the current rate of 6 percent. Missouri’s hospital and nursing home provider tax rate is 5.95 percent. The proceeds fund the Medicaid program.

Congressman Billy Long, of Missouri’s 7th Congressional District in Southwest Missouri, serves on the committee. MHA and hospitals in his district contacted Rep. Long in advance of the vote to underscore the importance of provider taxes — especially the hospital federal reimbursement allowance. Nonetheless, Long voted with the Republican majority in party-line votes to reject an amendment to maintain the current tax cap and to advance the bill. The vote reflects the bill’s role as part of the framework of the House majority’s budget proposal.

This isn’t the first attack on the provider tax system. President Obama has recommended limits on the system in his past budgets. However, the president’s budget was submitted to a Republican congressional majority that was generally loath to use his recommendations as a baseline. This attack poses a new danger to the system.

The importance of provider taxes to Missouri’s Medicaid funding system cannot be overstated. The FRA is the third largest source of state revenue in Missouri — behind the individual income tax and the state sales tax. It produces twice as much revenue as the state’s corporate income tax and corporate franchise tax combined.

A lowered federal cap on provider tax rates nationally will harm states’ finances. It will harm Missouri disproportionately. Historically, Missouri has maximized the use of provider taxes, and the state’s budget could not support a significant shift from FRA funds to general revenue. To reinforce this point, MHA and the Missouri Health Care Association asked Missouri Senate President Pro Tem Ron Richard and Speaker of the House Todd Richardson to send letters to the Republican members of the U.S. House of Representatives. Each has done so.

FRA Assessment Compared to state Sources of GRAny loss or diversion of provider tax funding will increase cost shifting in health care. This is a message we are delivering to Missouri lawmakers. Losses to the state’s Medicaid funding system through a reduced cap would make the shifting more prevalent and the costs more profound.

Missouri’s congressional delegation have, in the past, unanimously supported the FRA — including Rep. Long. As the bill moves forward, we will be working with the entire delegation to ensure they remain supportive of provider taxes and the FRA.

Conversely, Missouri lawmakers are making good progress in reauthorizing the FRA and the state’s other provider taxes this year. Since last year’s FRA reauthorization was for a single year, state lawmakers must pass an extension this session. The Missouri House of Representatives and Missouri Senate both have bills that reauthorize the program. One bill is a two-year extension; the other, three years.

The FRA is essential to the state’s safety net. Every dollar counts. And, the fewer dollars that pass through the FRA, the more dollars that will be needed from general revenue or through the cost-shift to maintain the safety net.

We’re delivering that message to Congress and the Missouri General Assembly.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Legislative Leaders Oppose Federal Provider Tax Cuts
Senate Committee Reviews Medicaid Managed Care Reform Legislation
Committee Reverses Tort Reform Defeat
CMS Releases Interactive Mapping Medicare Disparities Tool
MLN Connects Provider eNews Available
Federal Office Of Rural Health Policy Hosts Webinar
CMS Updates Abstraction And Reporting Tool
RWJF Updates 2016 County Health Rankings Report

state and federal health policy developments

Legislative Leaders Oppose Federal Provider Tax Cuts

Staff Contact: Daniel Landon

As described previously, the U.S. House Energy and Commerce Committee has approved legislation to lower the federal cap on state provider tax rates when the proceeds are used to fund state Medicaid programs. Missouri would be significantly harmed by the proposal. It would reduce federal funding generated by hospital and nursing home provider tax revenues by hundreds of millions of dollars annually. To bolster their efforts to block the legislation, MHA and the Missouri Health Care Association invited Missouri Senate President Pro Tem Ron Richard and Speaker of the House Todd Richardson to send letters of concern to the Republican members of the U.S. House of Representatives. Each of the legislative leaders has done so.

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Senate Committee Reviews Medicaid Managed Care Reform Legislation

Staff Contact: Rob Monsees

Senate Bill 1111, sponsored by Sen. Dan Brown (R-Rolla), received a hearing by the Senate Veterans’ Affairs and Health Committee, which he chairs. SB 1111 would enact a series of Medicaid managed care reforms that mirror the managed care reform principles approved by MHA’s Board of Trustees. Proponents testifying in support included MHA, the Missouri State Medical Association, the Coalition for Community Behavioral Healthcare, BJC Healthcare, SSM Health, Saint Luke's Health System, CoxHealth, the Missouri Psychological Association and Missouri Mental Health Advocacy. The hearing was cut short before opponents could testify. The hearing will resume after the legislative break.

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Committee Reverses Tort Reform Defeat

Staff Contact: Daniel Landon

A state House committee has reconsidered its earlier defeat of Senate Bill 847 and approved the measure. The legislation would change the “collateral source rule” governing how medical costs are considered in calculating potential damages in liability lawsuits. MHA, other provider and business organizations, insurers, and other tort reform proponents support the bill, which was the subject of an extended filibuster before its earlier passage by the Missouri Senate. It now is eligible for debate by the House of Representatives, which is expected to enact it into law by ratifying the bill without changes.

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CMS Releases Interactive Mapping Medicare Disparities Tool

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services Office of Minority Health released a new interactive map to increase understanding of geographic disparities in chronic disease among Medicare beneficiaries. The Mapping Medicare Disparities tool illustrates disparities in health outcomes, utilization and spending by race, ethnicity and geographic location. CMS Acting Administrator Andy Slavitt stated, “Our commitment to health equity begins with properly measuring the care people get and having an honest dialogue on how and where we need to improve. Today’s tool aims to make it harder for disparities to go unaddressed.”

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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.

  • comparative billing report
    • modifier 25: internal medicine webinar
    • noninvasive vascular studies webinar
  • Medicare skilled nursing facility transparency data for calendar year 2013
  • eligible professionals and hospitals: submitting quality reporting document architecture files in the 2016 reporting period
  • hospital consumer assessment of health care providers and systems: measurement of the patient experience in hospitals

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Federal Office Of Rural Health Policy Hosts Webinar

Staff Contact: Jim Mikes

The Federal Office of Rural Health Policy is hosting a webinar at 12:30 p.m. Tuesday, March 29, to discuss new rural health clinic coding requirements that take effect Friday, April 1. The Centers for Medicare & Medicaid Services has provided an MLN Matters article that provides examples of the new coding procedures. Dial 800/779-1416 and enter passcode 4343459 to participate.

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Quality And Population Health

CMS Updates Abstraction And Reporting Tool

Staff Contact: Dana Downing

The Centers for Medicare & Medicaid Services’ Abstraction and Reporting Tools Outpatient 1.13 and Inpatient 4.17 have been released and are available on QualityNet. The release supports the collection of outpatient measures for the Oct. 1, 2015, to Dec. 31, 2015, timeframe. Inpatient measures for the Oct. 1, 2015, to June 30, 2016, timeframe include support for ICD-10. Some outpatient quality reporting measures may be unavailable in CART for abstraction until early April 2016, which include OP-1, OP-2, OP-3, OP-4, OP-5, OP-18, OP-21 and OP-23. The Healthcare Quality Information System will have extended system maintenance until 10:59 p.m. Monday, March 21.

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RWJF Updates 2016 County Health Rankings Report

Staff Contacts: Leslie Porth or Mat Reidhead

On March 16, the Robert Wood Johnson Foundation updated the 2016 County Health Rankings report. In this seventh year, new measures — including frequent physical and mental distress, drug overdose deaths, insufficient sleep, and residential segregation — were added. The website, sponsored by RWJF and the University of Wisconsin Madison, provides current publicly-available, county-level data about overall U.S. health, such as rates on smoking, obesity, teen births, impoverished children, high school graduations and premature death.

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Did You Miss An Issue Of MHA Today?

March 17, 2016
U.S. Senate Committee Approves Mental Health Bills
House Completes Work On Supplemental Budget
Local Government Bill Includes Hospital Tax Levy Change
Ransomware Virus Infects Hospital Computer Systems
AHRQ Chartbook Shows 17 Percent Decline In HACs
CMS Provides Additional Information Regarding OP-33
CMS Extends Fourth Quarter 2015 OQR Submission Deadline

March 16, 2016
Committee Defeats Bill To Restrict Covenants Not To Compete
House Advances Hospital Construction Regulatory Relief Bill
Committee Reviews Bills On Deceased Patients
House Releases Budget Plan
CMS Announces DMEPOS Competitive Bidding
HIDI Releases Fourth Quarter 2015 VBP Payments Model
Trajectories — Opioids: A Population Health Dilemma
MHA HEN Participants Convene
AHRQ Releases TeamSTEPPS® Training
General Leonard Wood Army Community Hospital Names New Commander

March 15, 2016
U.S. House Committee Advances Provider Tax Rate Cut
MedPAC And MACPAC Issue March 2016 Reports To Congress
CMS Issues New Guidance For Organ Transplant Centers
HPOE Releases New Triple Aim Strategies Guide
CMS Announces IQR Education Session
CDC Issues Recommendations For Prescribing Opioids For Pain
Moberly Regional Medical Center Names New CEO

March 14, 2016
Hospital And Physician Groups Convey Quality Data Burden
CMS Releases New Survey And Certification Memo

Consider This ...

This week is Patient Safety Awareness Week. Hospital-acquired conditions declined 17 percent from 2010 to 2014 saving 87,000 lives and nearly $20 billion in unnecessary costs.

Source: Center for Patient Safety