MHA Today | March 3, 2017

March 3, 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.


Herb Kuhn, MHA President & CEO

It’s been a very interesting week.

On Monday, in a meeting with the nation’s governors, President Trump said of the health care overhaul effort, “I have to tell you, it’s an unbelievably complex subject. Nobody knew that health care could be so complicated.”

On Tuesday, Trump outlined his principles for health care in a speech before a joint session of Congress. His five principles were similar to those espoused by the House in their policy framework and in the draft legislation, although less detailed.

Last Friday, a draft of the U.S. House Republicans’ plan to overhaul the Affordable Care Act “leaked.” Conservatives in Congress quickly voiced opposition. And, the nation’s governors, not to be left behind, “leaked” their own proposal for reforming Medicaid.

Yesterday, a draft of the bill — which is expected to be considered in the U.S. House Energy and Commerce Committee on Wednesday — became available to Republican members of the committee … at least to those willing to travel to a basement room of an adjoining building to read it. The leadership has prohibited copies.

It is as if college basketball’s March Madness has morphed into a bonafide disorder in Washington, D.C.

There’s value in certainty and predictability. In retail, we’re accustomed to “best sold by” dates on products. Even within the inexact science of health care, clinicians do their best to predict when a patient might recover from a particular condition … “we can take that cast off in three weeks.”

Politics is different. Schedules change and various proposals are launched — often by launch of a trial balloon, like the House draft — and then are either abandoned or deemed “dead on arrival.”

The growing caution and equivocation are due in part to the clear lack of consensus in Washington, D.C. Many lawmakers who attended town hall meetings at home during the recent recess got an earful from constituents about repeal and replace. Pre- and post-election rhetoric aside, there’s no way to fundamentally change the health care law quickly without a lot of disruption in the system. And, there isn’t an option that will satisfy all Americans.

Building consensus will be difficult. Republicans continue to argue that the ACA is about as popular with the public as an alarm clock. They point to the rising cost of insurance and the wholesale abandonment of insurers from the new marketplace. Democrats, while acknowledging that the law is far from perfect, point to the success in several important areas — health coverage for more than 20 million, elimination of pre-existing condition discrimination and the ability of parents to keep their kids on their insurance policy until age 26.

It goes without saying that hospitals have a tremendous stake in the outcome of the debate. Without full repeal we’ll continue to experience Medicare and Medicaid cuts to pay for coverage that is disappearing. The payment cuts to hospitals for just the state of Missouri exceed $9 billion throughout the next decade. Moreover, if replacement plans don’t add significantly to the pool of insured, uncompensated care costs will increase swiftly and unsustainably. Repeal and replace must occur together.

Now, more than ever, members of Missouri’s hospital community need to weigh in with the Missouri congressional delegation. We’ve created a page on MHA’s website where you can make your voice heard.

Our members of Congress must understand that cuts aren’t sustainable without coverage, and “access” and health insurance are not the same thing. In addition, the movement toward value must continue. Cuts don’t improve care, but improved care can lead to savings.

In January, the MHA Board of Trustees approved a set of principles for ACA repeal and replace. And, in early February, the Missouri Chamber of Commerce and Industry joined MHA in a letter to Missouri’s members of Congress underscoring the need for sustaining coverage and an organized transition.

Repeal and replace is likely to get a lot messier before there is a workable, consensus-driven plan. MHA, in partnership with the American Hospital Association, will be advocating for our principles at every step. And, your voice is essential as well.

Please contact your member of Congress. That’s the only way to protect hospitals and the patients hospitals serve.

I’m always interested in your thoughts.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
MedPAC Posts Presentations From March Public Meeting
NHHA Receives Favorable Decision On Disproportionate Share Lawsuit
CMS Expands Scope Of RACs

state and federal health policy developments

MedPAC Posts Presentations From March Public Meeting

Staff Contact: Andrew Wheeler

The following MedPAC presentations from the first day of the March public meeting are available.

The most notable takeaway from the presentations is the Medicare Part B drug payment policy issues that include recommendations that would recalculate the current formula used to set rates for Part B pharmaceuticals, while creating a new, voluntary drug value program aimed to keep program costs down. MHA has made available a detailed summary about the draft recommendation.

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Regulatory News
the latest actions of agencies monitoring health care

NHHA Receives Favorable Decision On Disproportionate Share Lawsuit

Staff Contacts: Jane Drummond, Daniel Landon or Brian Kinkade

Yesterday, the U.S. District Court for the District of New Hampshire issued a decision in favor of the New Hampshire Hospital Association in its lawsuit against the Centers for Medicare & Medicaid Services concerning the standards that should apply to disproportionate share audits. The state of Missouri has sued CMS on the same issue; that lawsuit is under consideration by the U.S. District Court for the District of Columbia.

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CMS Expands Scope Of RACs

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services is expanding the scope of Recovery Audit Contractors to include Medicare Advantage. Although the contracting process with RACs is ongoing, CMS anticipates the contract will be awarded this year.

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Did You Miss An Issue Of MHA Today?

March 2, 2017
House Committee Unveils ACA Reform Legislation
U.S. House Passes Regulatory Reform Bill
State Senate Approves PDMP Legislation
MLN Connects Provider eNews Available

March 1, 2017
CDC Considers Making A Third MMR Dose Available
CMS Announces OQR Education Session
CMS Requests Updates To Hospital Contact Information

February 28, 2017
Governors Assess Federal ACA Replacement Proposals
MHA Releases Comparison Of ACA Replacement Plans
CDC Releases Health Care Access And Use By Adults Report
MHA Offers Orientation For New Infection Prevention Professionals
Iron County Medical Center Names New CEO

February 27, 2017
Trump Administration Hints At Federal Budget Proposal
President Trump Signs Executive Order To Reduce Red Tape
Republican Governors Consider Medicaid Reform Recommendations
MHA Releases Issue Brief: House ACA Replacement Draft
Attestation Deadline For Women’s Health Services Funding Changes Again
HIDI Hosts Monthly Focus Session On Community Health Reports
WPS Releases New Policy For Hospitals Performing Sleep Studies

Consider This ...

March is Women’s History Month. Women are integral in today’s workforce — almost 47 percent of U.S. workers are women.

Source: U.S. Department of Labor