MHA Today | May 3, 2017

May 3, 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.

In This Issue
New Amendment Could Trigger U.S. House Vote On ACA Repeal/Replacement
General Assembly Faces Budget Deadline
MO HealthNet Issues Managed Care Enrollment Report
CMS Releases Region 7 Updates
CMS Hosts Opioid Epidemic Webinar
HIDI HealthStats — Opioid Mortality Research
CMS Announces Change In Distribution Of OQR Claims Detail Reports
CMS Accepts Submissions For QRDA Category I Files

Advocate
state and federal health policy developments


New Amendment Could Trigger U.S. House Vote On ACA Repeal/Replacement

Staff Contact: Daniel Landon

The U.S. House of Representatives is considering a new amendment intended to garner votes for the American Health Care Act. The House Republican caucus had appeared to lack the 216 votes needed to pass the bill. However, a meeting today between the White House and congressmen Fred Upton (R-MI) and Billy Long (R-MO) produced an additional amendment to the AHCA. While no text is available, it is described as increasing federal spending by $8 billion throughout five years to help offset beneficiary costs associated with pre-existing conditions. A second AHCA amendment, referred to as the “MacArthur amendment,” would give states the authority to waive some of the restrictions in current law on health insurance underwriting practices and variance in health insurance premiums. Upton and Long previously had announced their opposition to the AHCA. MHA has concerns about the AHCA and the MacArthur amendment.

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General Assembly Faces Budget Deadline

Staff Contact: Daniel Landon

The constitutional deadline for state legislators to enact a state budget is 6 p.m. Friday, May 5. The appropriation bills that create the state budget are the subject of “conference committee” negotiations to resolve differences between the budget proposals of the House and Senate. However, that work has been sidetracked pending Senate debate of a controversial bill to restrict a property tax credit given to elderly renters, the passage of which would increase available state revenues by tens of millions of dollars. As of mid-afternoon today, that debate has not begun.

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MO HealthNet Issues Managed Care Enrollment Report

Staff Contact: Brian Kinkade

MO HealthNet issued the first enrollment report for the expanded Medicaid managed care program. The report was prepared on April 21 and shows the number of participants that were projected to be enrolled in each plan, by region, on the first day of the expanded program.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Releases Region 7 Updates

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services’ Region 7 released a newsletter covering various federal topics, including the following.

  • Affordable Care Act/marketplace updates
  • Medicare Access and Children’s Health Insurance Program Reauthorization Act/quality payment program updates
    • new quality payment program resources
    • join the conversation about fostering innovation in electronic data exchange for eMeasurement and quality improvement
    • 2017 MIPS data validation and auditing
    • merit-based incentive payment system participation status letter
  • Medicare and Medicaid updates
    • Improving Medicare Post-Acute Care Transformation Act of 2014 data elements public comments due Monday, June 26
    • rural community hospital demonstration
  • list of upcoming webinars and events


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CMS Hosts Opioid Epidemic Webinar

Staff Contacts: Sarah Willson or Jim Mikes

The Center for Program Integrity is hosting a monthly learning series webinar to discuss the Centers for Medicare & Medicaid Services’ approach to combating the opioid epidemic. The webinar, scheduled at noon, Thursday, May 11, will cover areas of primary focus for CMS, including the use and distribution of naloxone; expanded screening, diagnosis and treatment of opioid disorders; the use of evidence-based practice measures; and overall strategies to reduce the risk of opioid disorders, overdoses, drug diversion and inappropriate prescribing. Register online.

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HIDI Tech Connect


HIDI HealthStats — Opioid Mortality Research

Staff Contact: Mat Reidhead

The May edition of HIDI HealthStats explores drug-related deaths among middle-aged, white Missourians. During fiscal year 2016, 551 individuals died of an opioid-related overdose in a hospital setting in Missouri. Historically, among all drug-induced overdose deaths in Missouri, only 26.6 percent occur in a hospital setting (Figure 5). This suggests that Missouri could experience more than 2,000 opioid-related overdose deaths in 2016, across all settings. Recent data have placed the number of heroin overdose deaths in St. Louis City alone at 256 during 2016. HIDI HealthStats Opioids

Much of the increase in lethal heroin overdoses, which have more than quadrupled since 2010, has been attributed to the recent practice of cutting the drug with cheaper and more potent synthetic opioids, such as fentanyl. Additionally, 75 percent of new heroin users report that their addiction began by abusing prescription opioids, signaling the importance of a statewide prescription drug monitoring program with open access to providers and pharmacists in Missouri. A recent study by GE’s Healthymagination team on the measurement of population health recommends stratification matrices of the health outcome by subgroups of the overall population.

Of the 551 decedents, 25.8 percent had a hospitalization for analgesic opioid misuse during the four-year period leading up to their opioid-related overdose death; an additional 4.6 percent were hospitalized at some point for illicit opioid overuse. The history of opioid abuse was most pronounced for patients who died of an overdose of heroin or synthetic opiates — 43 percent of these patients had a history of analgesic opioid abuse, signaling the relationship between prescription narcotic abuse and eventual substitution with less expensive heroin. Read more.

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Quality and Population Health


CMS Announces Change In Distribution Of OQR Claims Detail Reports

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has announced that Outpatient Quality Reporting Program claims detail reports no longer will be distributed to facilities through secure file transfer. Instead, hospitals with appropriate designated user roles will be able to generate CDRs through the Hospital Reporting – Annual Payment Update Report category on the QualityNet Secure Portal. Facilities can register for a QualityNet account by visiting the registration section on QualityNet. The “Data As Of” date on the CDR displays the date of the last time claims data were uploaded for the provider. The beneficiary claim number column will be updated monthly until approximately 15 days before the submission deadline for that quarter. The CDR includes only Medicare fee-for-service claims that have been finalized in the CMS claims warehouse. Claims related to the OQR ED-Throughput population are excluded from the report.

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CMS Accepts Submissions For QRDA Category I Files

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services’ data receiving system in the QualityNet Secure Portal is accepting submissions of calendar year 2017 Quality Reporting Document Architecture Category I test and production files for the hospital inpatient quality reporting and Medicare electronic health record incentive programs electronic reporting requirements.

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Consider This ...

May is Healthy Vision Month. People with vision problems are more likely to have diabetes, poor hearing, heart problems, high blood pressure, lower back pain and strokes.

Source: Centers for Disease Control and Prevention