MHA Today | April 14, 2017

April 14, 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.


Herb Kuhn, MHA President & CEO

It’s been said that, “If it weren’t for the last minute, nothing would get done.” The Missouri General Assembly is a deadline-driven organization — it adjourns on Tuesday, May 30, with no consideration of bills after 6 p.m. Friday, May 12. Enactment of the budget is due by Friday, May 5.

With the clock ticking, every moment counts. This week, the Missouri Senate spent a significant amount of committee time reviewing the budget passed by the House of Representatives. Next week, the budget will move to the Senate floor for debate. Where the House and Senate versions disagree, conference committees will hash out a final product before the deadline. It appears that the Senate likely will disagree with the House on several budget issues affecting hospitals, most notably, whether to fund the expansion of statewide Medicaid managed care in the next fiscal year.

Beyond passing a budget, the General Assembly’s other primary function is to create laws. On that front, there’s been significant progress on a number of hospital issues. Regarding medical liability, the “expert witness” legislation — one element of a series of bills related to courts and medical liability reform — already has been approved by Gov. Greitens. MHA’s priority liability reform legislation is a bill to reverse the Jefferson v. Missouri Baptist court ruling. The House and Senate have exchanged bills on this topic, and one of them is in place for final debate and ratification.

MHA-developed legislation for hospital licensure relief has been approved by committees in both the House and Senate, unanimously. The bills would allow compliance with the federal Medicare Conditions of Participation to satisfy or supplant duplicative or contradictory state hospital licensure standards. This would significantly streamline hospital licensure compliance activities.

The effort to adopt a prescription drug monitoring program was given a significant boost last week when a key opponent of the legislation signaled that he would not continue to oppose its progress if its use was mandated. Although yesterday’s Senate debate of the bill shows that other legislators continue to try to block and restrict the legislation, the effort’s viability has increased in the last two weeks. Public opinion, new research and efforts by counties to set up their own database, have helped the issue remain relevant throughout the session, aiding stakeholders’ and Rep. Holly Rehder’s efforts to pass a PDMP, which MHA strongly supports.

Earlier this week, a Senate committee approved a bill to make various changes to standards governing the regulation of stroke, STEMI and trauma centers. Although the bill may not cross the finish line on its own, MHA is working to identify opportunities to amend the provision to other legislation. This is how much legislation is enacted, and MHA is prepared for the flurry of revisions and amendments.

As time grows short, bills that are furthest along in the legislative process have a bit of an advantage in the race to enactment — absent acrimony or shenanigans. However, front-runners can, and do, falter, so vigilance and adaptability are in order. MHA is prepared to press the hospital advocacy agenda to full advantage in the coming month.

It’s impossible to know what will have crossed the finish line by the deadline. However, there are strong signals that the General Assembly will deliver on hospital priority bills. In this regard, continue to watch for news updates, or even a call, from MHA to engage with legislators on issues affecting hospitals and health care in general. Last minute “deals” often need a boost from constituents from home districts. We will keep you apprised if a last minute push is necessary.

There’s a hard deadline of May 12. We’re making good progress.

Send me a note to let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Senate Revises, Approves Prescription Drug Monitoring Legislation
CMS Issues Final Rule On ACA, Market Stabilization
MO HealthNet Issues Outpatient Facility Charge Guidance
MO HealthNet Updates Behavioral Health Submission Requirements

state and federal health policy developments

Senate Revises, Approves Prescription Drug Monitoring Legislation

Staff Contacts: Daniel Landon or Leslie Porth

Yesterday, the state Senate approved House Bill 90 after extended debate and a number of amendments. The bill would create a state prescription drug monitoring program. As previously reported, a prominent Senate opponent of the PDMP legislation recently agreed to drop his opposition if it was amended to require PDMP use. The Senate’s version of the legislation does so. However, other Senate opponents of the measure amended the bill to narrow its scope to two classes of controlled substances, require removal of records older than 180 days and require training of those accessing the system. Another amendment deleted language making failure to check the PDMP grounds for licensure discipline against a practitioner. The bill returns to the House of Representatives for consideration of the Senate’s changes. If the House rejects them, a conference committee likely will be convened to negotiate a new version that will require ratification by each chamber.

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Regulatory News
the latest actions of agencies monitoring health care

CMS Issues Final Rule On ACA, Market Stabilization

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services has issued a final rule that is intended to help stabilize the individual and small group insurance markets, and affirm the traditional role of state regulators. MHA has published an issue brief with additional details.

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MO HealthNet Issues Outpatient Facility Charge Guidance

Staff Contact: Brian Kinkade

MO HealthNet issued a “hot tip” on hospital outpatient facility charges. The tip provides guidance for billers on how to properly code claims for Missouri Medicaid outpatient reimbursement, and addresses common errors that could delay timely payment.

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MO HealthNet Updates Behavioral Health Submission Requirements

Staff Contact: Brian Kinkade

MO HealthNet has issued a bulletin alerting providers who seek precertification for behavioral health services that requests must be submitted on the proper form dated October 2015. Requests submitted after April 12 on previous forms will not be accepted.

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Did You Miss An Issue Of MHA Today?

April 13, 2017
Senate Committee Considers State Budget
Committee Reviews Physical Therapy Referral Restrictions
Legislators Consider Opioid Bills
Committee Approves Advanced Directive Registry
Bill Allows Concealed Weapons In Hospitals
House Combines Consent To Treatment, Medical Records Bills
Senate Committee Approves Perinatal Care Bill
Legislators Revise Assistant Physician Standards
CMS Releases Data About Gender And Minority Quality Of Care In MA
MLN Connects Provider eNews Available

April 12, 2017
Committee Considers, Approves Medical Liability Bills
Task Force To Assess State Boards And Commissions
Bill Addresses Medical Records, Consent To Treatment
Committee Proposes Changes To Stroke, STEMI, Trauma Standards
House Advances Bill On Physician Loan Forgiveness
HIDI HealthStats — Opioid Mortality Research

April 11, 2017
State Legislation Revises Consent To Treatment Standards
State House Approves Helmet Repeal
Opioid Control Bills Advance
JAMA Pediatrics Analyzes Ambulatory Care-Sensitive Conditions

April 10, 2017
Missouri Senate Approves FY 2017 Supplemental Appropriations
Missouri House Adopts FY 2018 Budget
House Committee Reviews Concealed Weapon Bill
MedPAC Releases April Meeting Summary
CMS Releases Region 7 Updates
MHA Releases Interactive Opioid Toolkit
CMS Announces OQR Education Session
CMS Updates 2017 QRDA Category I PSVA Tool

Consider This ...

About 1 out of 10 people may have a seizure in his or her lifetime.

Source: Centers for Disease Control and Prevention