MHA Today | April 28, 2017

April 28, 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.

Insights

Herb Kuhn, MHA President & CEO

Missouri cities and counties seem to be channeling St. Louis native Yogi Berra in their efforts to tackle the opioid crisis. As Berra quipped, “When you come to a fork in the road, take it.”

In the final days of the 2017 Missouri General Assembly, statewide prescription drug monitoring legislation continues to languish. However, the first cohort of cities and counties, led by St. Louis, have launched their own prescription drug monitoring program. The database went live on Tuesday.

It has been estimated that half of the state’s providers and pharmacists are included in the county-level launch and nearly half of the state’s citizens are within the coverage area. Additional municipalities are scheduled to launch later this year. Although a statewide system is optimal, this is great news for Missouri.

MHA is partnering with other provider-community associations to alert physicians and pharmacists about how to register. It’s important to note that physician enrollment is not limited by jurisdiction. Physicians can enroll at any time. For counties and municipalities that have not yet passed a local ordinance to join the PDMP, information is available online, including a list of participating municipalities.

Having the technical infrastructure to help identify patients at risk of opioid misuse in several of Missouri’s largest cities and counties is a major step forward. But, identifying patients at risk is only the first step. Now, providers must be astute in assessing, diagnosing and accessing treatment for patients at risk of dependency or misuse. To achieve this, attention must pivot to outreach, education, assessment and treatment. MHA recently released an opioid crisis interactive toolkit to help providers’ access current research, and practice and policy guidance.

The opioid crisis is multifaceted. Mitigating the crisis will require a variety of strategies to avoid the causes of addiction, as well as address the problems of prescription and illicit drug abuse. Last week, during the congressional recess, Sens. Blunt and McCaskill traveled the state announcing $10 million in funding through the 21st Century Cures Act to assist in treatment for Missourians with opioid addictions. This is more good news.

Although it is late in session and prospects for action on a statewide PDMP are growing dim, significant strides have been made this year. Our legislative champions deserve credit for their work in keeping the bills moving and the issue at the top of the agenda.

A PDMP will further support efforts to reduce prescription drug abuse. However, it will only be as strong as the level of participation. It is essential that hospitals work with employed and affiliated physicians, and hospital pharmacists, to help build participation and use. Signing up isn’t complicated.

The most effective argument for a future statewide PDMP will be the success of Missouri’s county-level effort. The good news is that there’s growing interest among the state’s political subdivisions.

We’re making progress in building awareness of the crisis and implementing the tools to help reduce its cost. However, we still have a lot of work to do. As Yogi would say, “It ain’t over till it’s over.”

Send me an email with your thoughts.

Herb Kuhn, MHA President & CEO



Herb B. Kuhn
MHA President and CEO

In This Issue
MHA Celebrates National Healthcare Volunteer Week
MO HealthNet Releases Aetna Medicaid Managed Care Guidance
CMS Issues Proposed Payment, Policy Updates For IRF PPS
CMS Issues Proposed Hospice Payment Rate Update For 2018
CMS Issues Proposed Payment, Policy Updates For SNFs
MU Center For Health Policy Offers Health Equity Workshops
Appeals Court Upholds Denial Of Anthem/Cigna Merger


Spotlight


MHA Celebrates National Healthcare Volunteer Week

Ste Genevieve County Memorial Hospital In honor of National Healthcare Volunteer Week, MHA is featuring the 2016 hospital auxiliaries and auxilian of the year award winners. Today, we recognize Mercy Springfield Auxiliary. The auxiliary was recognized at MHA’s annual convention for its volunteer activities as an auxiliary representing a hospital with more than 300 licensed beds. Mercy Springfield’s 730 auxilians performed 110,000 hours of service, with 99,000 in the hospital, and an additional 11,000 hours in the community. In addition to the gift of their time and talents, the Mercy Springfield auxilians donated more than $280,000 to support the hospital, including $155,000 for hospital equipment, $11,650 for scholarships and $100,000 for other hospital priorities — including the purchase of a pediatric ambulance. In addition, the auxiliary provides patient advocacy services to support improved patient experiences and better patient care. Highlight your hospital’s auxiliary or an auxilian during National Volunteer Week by submitting an Auxiliary of the Year or Auxilian of the Year award nomination form by Friday, June 30.

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Advocate
state and federal health policy developments


MO HealthNet Releases Aetna Medicaid Managed Care Guidance

Staff Contact: Brian Kinkade

Consistent with the Medicaid managed care health plan contract, all participants enrolled with Aetna Better Health of Missouri will be transitioned to a new managed care health plan effective Monday, May 1. However, for Aetna participants in an inpatient hospital setting that will extend beyond Sunday, April 30, coverage will continue under Aetna until discharged. MO HealthNet is directing hospitals with Aetna Better Health inpatients to call the MO HealthNet Provider Communications Unit at 573/751-2896 with the date of admission and the date of discharge so the patient’s enrollment with Aetna can be extended through the date of discharge.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Issues Proposed Payment, Policy Updates For IRF PPS

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the fiscal year 2018 proposed payment and policy updates for the inpatient rehabilitation facility PPS. Along with payment rate updates, CMS is proposing to remove the 25 percent payment penalty for IRF-Patient Assessment Instrument late transmissions, remove the voluntary swallowing status item from the IRF-PAI, and revise the ICD-10 diagnosis codes that are used to determine presumptive compliance and more. The proposed rule also solicits comments regarding the criteria used to classify facilities for payment under the IRF PPS. CMS estimates that IRF PPS payments will increase by 1 percent or $80 million for 2018. MHA has published an issue brief with additional information. Comments about the rule are due no later than 4 p.m. Monday, June 26.

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CMS Issues Proposed Hospice Payment Rate Update For 2018

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released proposed payment and policy updates for hospice. The proposed rule updates the hospice payment rates, wage index values, cap amount and quality reporting items. CMS estimates that hospices generally will see a 1 percent or $180 million increase in their payments for 2018. The rule also solicits comments about clarifying a regulations text change that identifies the source of the required clinical information used to certify a life expectancy of six months or less. MHA has published an issue brief with additional information. Comments about the rule are due no later than 4 p.m. Monday, June 26.

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CMS Issues Proposed Payment, Policy Updates For SNFs

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the fiscal year 2018 proposed payment and policy updates for the inpatient rehabilitation facility PPS. CMS also released an advance notice of proposed rulemaking which solicits comment about potential revisions to the skilled nursing facility payment system. The rule proposes changes to the payment rates, proposals for the SNF value-based purchasing program and the SNF quality reporting program. CMS estimates that SNF PPS payments will increase 1 percent or $390 million for 2018. Comments about the rule are due no later than 4 p.m. Monday, June 26. MHA will publish an issue brief once available.

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Quality and Population Health


MU Center For Health Policy Offers Health Equity Workshops

Staff Contacts: Peter Rao or Stephen Njenga

The Missouri Center for Health Policy is offering a workshop on building inclusive clinics, which will be offered in Hannibal on Thursday, May 25, and Kirksville on Wednesday, June 21. The workshop provides awareness-building through short presentations, experiential activities, reflection and dialogue. Email fincherc@health.missouri.edu to register.

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Health Law Insight


Appeals Court Upholds Denial Of Anthem/Cigna Merger

Staff Contact: Jane Drummond

The Court of Appeals for the District of Columbia upheld the decision of the lower court to deny the Anthem/Cigna merger. Anthem argued that operational efficiencies created by the merger outweighed the anticompetitive effects. The court disagreed, finding that Cigna was a key Anthem competitor in an already highly concentrated market. The decision is likely the end of the proposed merger, although a pending lawsuit by Anthem against Cigna remains. Anthem is seeking damages from Cigna for the deal’s failure, claiming that Cigna undermined its presentation to the lower court.

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Did You Miss An Issue Of MHA Today?


April 27, 2017
MHA Celebrates National Healthcare Volunteer Week
Senate Approves Its Version Of State Budget
General Assembly Enacts Supplemental Budget
Committee Reviews Stroke, STEMI, Trauma Regulation Bill
MLN Connects Provider eNews Available
CMS Announces Education Session

April 26, 2017
MHA Celebrates National Healthcare Volunteer Week
Committee Reviews Public Hospital Tax Levy Bill
HIDI HealthStats — Opioid Mortality Research
Task Force Releases Preeclampsia Recommendation Statement
CMS Issues MIPS Participation Status Letter

April 25, 2017
MHA Celebrates National Healthcare Volunteer Week
Committee Approves Lawsuit Notification Legislation
MO HealthNet Alerts Hospitals To Upcoming EHR Incentive Deadline
MO HealthNet Clarifies Provider Eligibility Verification Requirements
DHSS Proposes CCHD Regulations
AHA Surveys Hospitals On Lean Approaches
Signature Psychiatric Hospital And Research Psychiatric Center Fill Positions

April 24, 2017
MHA Celebrates National Healthcare Volunteer Week
St. Louis County PDMP Launches April 25
CMS Hosts EP Requirements Final Rule Training Call
Missouri Foundation For Health Announces Public Health Infrastructure Funding
AHA And AHVRP Release New Triple Aim Resource
Landmark Hospital Of Cape Girardeau Names New CEO



Consider This ...

Kidney diseases are the ninth leading cause of death in the U.S.

Source: Centers for Disease Control and Prevention