MHA Today | April 29, 2016

April 29, 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

Today and over the weekend, hospital leaders from throughout the state are traveling to Washington, D.C., to visit with congressional staff about federal issues that affect their communities. Most also will attend the American Hospital Association Annual Meeting that begins on Sunday. The AHA’s annual meeting always serves as a strong focal point for discussions on national issues facing hospitals.

An important part of our message will be to thank lawmakers and their staff for their high level of engagement on issues that affect hospitals. Missouri’s congressional delegation continues to provide an important voice for hospitals and has been leading on health care issues that are both significant to the state and national in scope. Their level of responsiveness is reflective of our ongoing federal advocacy efforts through the association, and at the hospital and hospital system levels.

Earlier this month, most of Missouri’s delegation supported efforts to stall the Hospital Compare “star rating” system rollout. They’ve been ongoing partners in blocking attacks on Medicaid provider tax programs, which if implemented would disproportionately harm Missouri and the state’s hospitals. In the U.S. House of Representatives and U.S. Senate, members of Missouri’s delegation have been key sponsors of bills to reform the Recovery Audit Contractor Program, fix the wage index manipulation that was included in the Affordable Care Act, and strengthen the rural health delivery system.

Our delegation’s leadership will be needed all the more as we address the ongoing challenges and potential opportunities of the changing health care system. RAC reform will need to progress, the 340B prescription drug program will need to be improved, and the health care workforce challenges of today and the future will require action.

Medicare and Medicaid are significant influencers of hospital financial and operational direction, and changes in these programs are driving transformation of the health care system. Missouri has 64 different participant groups engaged in innovative care models. Hospitals are working to adopt the Centers for Medicare & Medicaid Services’ Better Care, Smarter Spending, Healthier People Initiative, but the transition is more than just structural — it requires a paradigm shift. As such, hospitals are taking on additional risk and responsibility, while simultaneously redesigning the delivery model. Hospitals will need Congress as a referee as these efforts advance.

We’ll also need Congress to pay close attention to the cost of the uninsured. In Missouri, even two years after implementation of the ACA’s health insurance marketplace, hospitals’ uncompensated care costs continue to increase. As CMS moves to a new DSH model, and the amounts of, and access to, disproportionate share hospital payments change, hospital finances could be jeopardized.

These are among the issues we’ll be discussing with congressional staff while in D.C. It’s a broad set of issues that reflect the diversity of Missouri’s hospitals.

Success isn’t a matter of luck. It’s the result of regular engagement with lawmakers and detailed explanations about how congressional action and administration policies affect Missourians. We all want the same thing — a health care system that delivers value.

* * *

Speaking of advocacy, MHA’s Missouri Health Matters advocacy campaign was recently awarded five “Pollie” awards — three gold and two bronze — by the American Association of Political Consultants. The awards recognize MHA’s highly-targeted campaign program designed to engage Missourians in contacting their lawmaker on behalf of Medicaid reform.

We’re preparing to bring the same level of commitment and precision to our Medicaid reform and expansion efforts in the 2017 legislative session. Have a great weekend! Send me an email to let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Prisoners Released To Halfway Houses To Get Medicaid Coverage
State Issues Medicaid Managed Care RFP
CMS Awards DMEPOS Recompete Contracts
CMS Releases MACRA Proposed Rule
CMS Releases Expanded QVL And FAQ Document For RHCs


state and federal health policy developments

Prisoners Released To Halfway Houses To Get Medicaid Coverage

Staff Contacts: Daniel Landon or Steve Renne

The Centers for Medicare & Medicaid Services has issued policy guidance stating that Medicaid coverage will be extended to prisoners housed in halfway houses immediately prior to and following incarceration. The document projects that 96,000 will gain access nationally. The U.S. Department of Health & Human Services also released an issue brief on coverage of the “justice-involved population,” including those recently released from prison.

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State Issues Medicaid Managed Care RFP

Staff Contacts: Steve Renne or Daniel Landon

Today, the state released a request for proposal seeking bids for statewide managed care for adults and children on Medicaid. Elders and the disabled will continue to receive Medicaid through the fee-for-service program. There will be a pre-proposal conference regarding the RFP on Wednesday, June 1. Services provided under the new contracts will begin May 2017.

Sen. Dan Brown (R-Rolla) had written the MO HealthNet Division asking for a delay in issuing the RFP. Sen. Brown cited the need to absorb the Centers for Medicare & Medicaid Services’ recent release of 1,425 pages of federal regulations governing Medicaid managed care. Sen. Brown is the sponsor of Senate Bill 1111, an MHA-backed bill to reform the Medicaid managed care system.

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Regulatory News
the latest actions of agencies monitoring health care

CMS Awards DMEPOS Recompete Contracts

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services announced the Round 2 Recompete and national mail-order recompete contract suppliers for Medicare’s Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program, both effective July 1, 2016. Under the DMEPOS competitive bidding program, suppliers compete to become Medicare contract suppliers. After the first two years of Round 2 and national mail-order programs, Medicare saved approximately $3.6 billion. A listing of Round 2 Recompete and mail-order contract suppliers can be found online.

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CMS Releases MACRA Proposed Rule

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services recently released a proposed rule which would implement provisions of the Medicare Access and Children's Health Insurance Program Reauthorization Act related to the physician payment system. The proposed rule is lengthy and complex with many pages focused on the reporting of quality measures. CMS estimates that the total annual burden of MIPS will be 12,493,654 hours with a cost of $1,327,177,683. Included in this amount is up to 5,325,208 hours and $387,252,730 of eligible clinician cost for quality performance category reporting. MHA has published an issue brief with additional information. Comments must be received by 4 p.m. Monday, June 27.

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CMS Releases Expanded QVL And FAQ Document For RHCs

Staff Contact: Jim Mikes

The Centers for Medicare & Medicaid Services released an updated document that expands the qualifying visit list that rural health clinics can bill to Medicare. All of the procedures listed in the document in red cannot be billed until Oct. 1. CMS also released an FAQ document that gives timely information on various aspects of the QVL implementation.

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Did You Miss An Issue Of MHA Today?

April 28, 2016
New Tort Reform Law Concerns Expert Witnesses
State House Repeats Amendment Barrage
TJC Releases New Fire Protection Standard Module
TJC To Delete 131 Accreditation Standards
CMS Releases MACRA Proposed Rule
MLN Connects Provider eNews Available
National Prescription Drug Take-Back Day Set For April 30
USPSTF Posts Final Research On Screening Prostate Cancer

April 27, 2016
HHS Awards $5 Million To Puerto Rico To Combat Zika
NHSN Identifies Central Line Insertion Practices Analysis Defect
DHSS Releases Health In Rural Missouri Biennial Report
Report Assesses National Health Security And Preparedness Levels

April 26, 2016
General Assembly Enacts New Infection Control And Telemedicine Laws
State Legislators Enact Tort Reform Law
CMS Issues Final Rule On Medicaid Managed Care
CMS Clarifies Computed Tomography Compliance
CMS Releases Policy Clarification On Acceptable Control Materials
Missouri Hospitals’ Safety Scores Improve
CMS Announces IQR Education Session

April 25, 2016
HIDI HealthStats — Diabetes And Health Equity
CMS Releases Supplement To IQR Specifications Manual
CMS Announces IPFQR Webinar
NHSN Updates 2016 Training Materials
MHA Publishes Quality Resource Brief
MHA Award Reminder: Trustee Of The Year
Vlosich To Leave Harry S. Truman Memorial Veterans’ Hospital

Consider This ...

The birthrate among American teenagers has fallen to an all-time low. Teen births cost taxpayers $9 billion each year.

Source: The Washington Post