MHA Today | May 12, 2017

May 12, 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

At 6 p.m. today, the General Assembly will adjourn. For the first time in eight years, Republican super-majorities in the General Assembly are aligned with a Republican governor. This produced quick action on some long-standing conservative priorities.

However, the session also has had some rocky patches. Since the legislative spring break, there have been outbreaks of hostility among legislators, legislative factions, the House versus Senate, and even the legislature and the governor. Senate filibusters sporadically ground the legislative process to a halt. However, civility occasionally sprouted up like spring flowers. One senator recently brought in donuts and joined another in singing “Kumbaya” on the Senate floor.

Despite the contentious environment, several hospital priorities were enacted. The budget for Medicaid hospital spending is stable. And, while pending state legislation would allow many state accounts to be raided of “excess” balances to pay for legislative priorities, the Federal Reimbursement Allowance is protected.

In addition, lawmakers have adopted bills to streamline hospital licensure and resolve problems in the regulation of stroke, STEMI and trauma centers. Several tort reform measures are enacted, including favorable new court standards for expert witnesses and the valuation of medical services.

After a roller coaster ride through the legislative process, legislation to create a prescription drug monitoring system appears to have stalled at the end of the session. The Senate previously added several restrictive amendments that foundered the bill’s progress. A compromise is still pending, but time is running out. However, the emerging county-based system has great promise and continues to expand.

Another end-of-session roller coaster ride ended well. Legislation to reverse the adverse Jefferson v. Missouri Baptist medical liability court decision has been enacted in the waning hours of the session. The legislation was being blocked by a senator, but rounds of negotiations ultimately yielded a compromise.

Disagreements are a necessary and healthy component of a republic and the core of a legislature. At times, the political climate in Jefferson City veered between comity and comedy. Still, Missouri hospitals are better off, both from what has been enacted and the bad ideas that have been blocked.

Only hours remain until the final buzzer at 6 p.m. We won’t know the full score until then. Next week, we’ll provide a full recap of the legislation that was adopted and avoided.

And, we are not doing this alone. All of us at MHA appreciate our members’ work to help us identify, refine and promote legislative proposals that advance their missions.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Medical Liability Legislation Enacted
Legislators Propose Prescription Drug Monitoring Accord
New State Enactment Addresses Regulatory Reform And Other Topics
WPS Creates Allowance For TJC Accredited Hospitals Performing Sleep Studies
Cyberattacks Target Health Care Facilities
ASPR TRACIE And NETEC Host Infectious Disease Webinar
Anthem/Cigna Merger Officially Off

state and federal health policy developments

Medical Liability Legislation Enacted

Staff Contacts: Daniel Landon, Rob Monsees or Ted Wedel

The Missouri General Assembly has enacted a new version of House Bill 452. The legislation revises medical liability law to reverse the Jefferson v. Missouri Baptist court ruling. The effect will be to narrow hospital liability for those who are not hospital employees. The legislation was being blocked by a senator, but rounds of negotiations ultimately yielded a compromise. Negotiated changes address liability for providers from staffing agencies and in subsidiaries controlled by hospitals.

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Legislators Propose Prescription Drug Monitoring Accord

Staff Contacts: Daniel Landon or Leslie Porth

A conference committee of state legislators has developed a proposed compromise version of legislation to authorize a prescription drug monitoring program. Among other changes, the proposal extends the length of time data may be retained in the PDMP system from 18 months to two years. It also expands the program’s scope to encompass a broader range of controlled substances, as well as allows the continuation of currently operating county PDMPs until the state system is available to “prescribers and dispensers throughout the state.” The compromise proposal needs to be ratified by the House of Representatives and Senate by 6 p.m. today. At press time, it appears unlikely that the legislation will be enacted.

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New State Enactment Addresses Regulatory Reform And Other Topics

Staff Contacts: Daniel Landon or Rob Monsees

The General Assembly has enacted a final version of Senate Bill 50. The underlying bill authorizes the state to contract with a vendor to create an electronic registry of advance directives. The bill was amended to incorporate a variety of other health-related topics, including hospital licensure reform to curtail duplicative or contradictory state and federal standards, state regulatory changes for stroke, STEMI and trauma centers, authorization for state standards for designation of perinatal care providers, additional disease screening tests for newborn blood samples, and expanding the pool of potential applicants for assistant physician licenses.

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WPS Creates Allowance For TJC Accredited Hospitals Performing Sleep Studies

Staff Contact: Jim Mikes

Wisconsin Physicians Services has issued updated guidance on credentialing requirements for performing polysomnography and other sleep studies. Recognizing some confusion created by the release of local coverage determination L36839, WPS will implement the following process.

  • All sleep labs that had The Joint Commission general accreditation before Feb. 16, 2017, must request and apply to TJC for the ambulatory care sleep specific credentials. This must be done within 90 days of the publication of the guidance.
  • The application and letter must be available upon request by WPS.
  • The final credentialing must be in place within 12 months of the notice’s publication.
More information is available on WPS’ website.

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HIDI Tech Connect

Cyberattacks Target Health Care Facilities

Staff Contact: Bryant McNally

A major cyberattack hit the British National Health Service earlier today. The attack appears to involve ransomware that was circulated by email. Security experts involved with the investigation believe the ransomware is exploiting a vulnerability that Microsoft provided a patch for last March.

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Quality and Population Health

ASPR TRACIE And NETEC Host Infectious Disease Webinar

Staff Contact: Stacie Hollis

ASPR’s Technical Resources, Assistance Center, and Information Exchange, and the National Ebola Training and Education Center, are hosting a highly pathogenic infectious disease exercise planning webinar at 1 p.m. Wednesday, May 24, that is tailored for participants from front-line facilities. The webinar features NETEC’s suite of free, fully customizable, Homeland Security Exercise and Evaluation Program-compliant exercise materials. Register online; space is limited.

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Health Law Insight

Anthem/Cigna Merger Officially Off

Staff Contact: Jane Drummond

Anthem announced that it has abandoned its efforts to acquire Cigna, one day after a Delaware court refused to enjoin Cigna from terminating the merger. However, the litigation between the parties is not over. Anthem is seeking what it terms “massive damages” from Cigna for allegedly sabotaging the deal by undermining the evidence Anthem presented to fight the Justice Department’s successful challenge to the merger. At the same time, Cigna is seeking $1.85 billion from Anthem in breakup fees.

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Did You Miss An Issue Of MHA Today?

May 11, 2017
MHA Releases Q&A On Missouri’s Former High-Risk Pool
MLN Connects Provider eNews Available
CMS Selects Targeted Hospitals For IQR Program Validation

May 10, 2017
State Board Of Nursing Recognizes Air Force Program As P.N. Program
MHA Solicits Trustee Of The Year Nominations

May 9, 2017
MHA Distributes Final Wage Index, Occupational Mix Data For Review
Rural Health Information Hub Hosts Substance Abuse Webinar
HIDI Posts February MUR On HIDI Analytic Advantage®

May 8, 2017
MHA Celebrates National Hospital Week
MHA Develops Emergency Preparedness CoPs Interactive Toolkit
CMS Updates eCQM Specifications For CY 2018
Bates County Memorial Hospital Names Interim CEO

Consider This ...

In fiscal year 2015, the Health Resources & Services Administration invested $111 million in nursing workforce development programs.

Source: Health Resources & Services Administration