MHA Today | May 16, 2017

May 16, 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
MHA Publishes 2017 State Legislative Session Summary
Emergency Physicians Say Anthem ED Pay Policy Violates “Prudent Layperson” Standard
Hospital Associations And TJC Host Sleep Accreditation Webinar
DHSS Posts Home Health CoP Guide
CMS Clarifies Transfer And Discharge Requirements For LTC
CMS Issues State Innovation Waiver Checklist
MHA Releases 2017 Annual Workforce Report


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Aug. 15-17
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Advocate
state and federal health policy developments


MHA Publishes 2017 State Legislative Session Summary

Staff Contacts: Daniel Landon or Rob Monsees

MHA has published an issue brief with the outcomes of the 2017 Missouri legislative session. The session ended May 12. MHA deeply appreciates all of the support its membership provided to advance our advocacy efforts.

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Emergency Physicians Say Anthem ED Pay Policy Violates “Prudent Layperson” Standard

Staff Contact: Dave Dillon

The American College of Emergency Physicians and its Missouri chapter have challenged Anthem’s list of nearly 2,000 diagnoses that Anthem has announced it will consider “non-urgent.” Anthem recently circulated a letter to hospitals and other providers signaling it will refuse reimbursement for treatment that could be provided at a lower level of care than the emergency department. However, ACEP and Missouri emergency physicians argue that the policy violates provisions of the Affordable Care Act and state law in 30 states that set a “prudent layperson” standard for ED decisions. Jonathan Heidt, M.D., FACEP, President of Missouri's ACEP Chapter said, “This policy threatens the citizens of Missouri. If this practice of denying emergency care can happen in our state, it can happen in any state and we must work both locally and nationally to fight for our patients’ rights to have access to emergency care as protected by the 'prudent layperson' standard.” In April, MHA released a copy of the letter to the St. Louis Post-Dispatch.

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Hospital Associations And TJC Host Sleep Accreditation Webinar

Staff Contact: Jim Mikes

MHA is hosting a webinar with the Kansas, Nebraska, Iowa, Indiana and Michigan hospital associations and The Joint Commission at 2:30 p.m. Monday, May 22, regarding the recent Wisconsin Physicians Services sleep study changes. The webinar will provide insight into WPS’ notification which allows accredited hospitals to immediately begin billing for sleep studies. Mark Crafton and Kristen Witalka from TJC will explain the process and the advantages of obtaining sleep accreditation through TJC. Advanced registration is required.

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Regulatory News
the latest actions of agencies monitoring health care


DHSS Posts Home Health CoP Guide

Staff Contacts: Sarah Willson or Jim Mikes

The final Conditions of Participation for home health agencies were published in the Federal Register in January. The Missouri Department of Health and Senior Services has posted a regulatory guide that outlines the new regulations. The Centers for Medicare & Medicaid Services is finalizing the interpretive guidance for surveyors. The new conditions were set to be surveyed Thursday, July 13, but CMS extended the date to Jan. 13, 2018. Additional information can be found on CMS’ website.

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CMS Clarifies Transfer And Discharge Requirements For LTC

Staff Contacts: Sarah Willson or Jim Mikes

The Centers for Medicare & Medicaid Services has issued new guidance outlining the changes in policy that impact the actions a long-term care facility is supposed to take in situations of transfer or discharge of residents. The policy is effective immediately. The state’s ombudsman program is referenced in the guidance and is a powerful advocate for resident rights.

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CMS Issues State Innovation Waiver Checklist

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released a new checklist intended to help states complete Section 1332 waivers, which would allow states to opt-out of certain provisions under the Affordable Care Act. The tool is specifically designed to help states complete waivers that would allow them to establish high-risk pools and state-operated reinsurance programs. CMS Administrator Seema Verma stated, “Today’s guidance addresses the ACA’s impact in driving up insurance costs and reducing choices. State initiated waivers that implement high-risk pool/state-opted reinsurance programs will help lower premiums, stabilize the health insurance exchange, and meet the unique needs of each state.”

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Workforce News


MHA Releases 2017 Annual Workforce Report

Staff Contact: Meredith Kenyon Herb Kuhn, MHA President & CEO

MHA has released the 2017 workforce report along with 10 region-specific reports. The reports find that hospital vacancies reached an all-time high, with 86 percent of positions surveyed increasing in vacancy from the previous year. The statewide vacancy rate for staff nurses increased to 15.9 percent, an all-time high in the 16-year history of the report. Turnover for staff nurses remains high at 14.3 percent. The report includes data from 142 hospitals and identifies trends among 36 hospital-based positions, and five clinic and physician practice positions. This year’s report highlights the need for innovation and partnership at all levels — local, state and federal — with a focus on adapting workforce planning processes to incorporate collaboration, advocacy and commitment in new and innovative ways.

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Consider This ...

According to this year’s workforce report, the highest turnover rate of 30.9 percent was reported for unlicensed assistive personnel.

Source: 2017 MHA Annual Workforce Report