MHA Today | June 20, 2017

June 20, 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
State House Of Representatives Debates Abortion Legislation
Anthem Offers 2018 Marketplace Plans In Missouri
CMS Releases New Medicare Card Details
CMS Issues New Guidance In Several Key Areas
TJC Releases New Pain Management Standards


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Thursday, July 20
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Advocate
state and federal health policy developments


State House Of Representatives Debates Abortion Legislation

Staff Contacts: Daniel Landon or Rob Monsees

The Missouri House of Representatives is debating and amending its own version of state legislation to regulate abortion. Gov. Eric Greitens called the Missouri General Assembly into special session to consider legislation on this topic, and last week the Missouri Senate approved its version of Senate Bill 5. The House revisions ― which are ongoing at press time ― assure that the legislation will return to the Senate for further debate and approval. The Senate is scheduled to return to Jefferson City on Thursday, June 22.

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Anthem Offers 2018 Marketplace Plans In Missouri

Staff Contact: Andrew Wheeler

Anthem announced that they will continue offering coverage on the health insurance exchange in Missouri for 2018; however, they stated that they could adjust the decision as the year goes on. Anthem also signaled that premiums likely will increase. Anthem currently offers marketplace plans in 85 Missouri counties.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Releases New Medicare Card Details

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services recently announced details about their efforts to remove social security information from beneficiary identification. The current SSN-based Health Insurance Claim Number will be replaced by the Medicare Beneficiary Identifier. The transition is planned to occur between April 1, 2018, and Dec. 31, 2019. CMS has released five steps that a provider can take to prepare for the transition.

  1. Visit our provider website and sign up for the weekly MLN Connects newsletter.
  2. Attend informational quarterly calls, which are announced in MLN Connects.
  3. Verify all of your Medicare patients’ addresses. If the addresses you have on file are different than the Medicare address you receive on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.
  4. Work with us to help your Medicare patients adjust to their new Medicare card. When available later this fall, you can display helpful information about the new Medicare cards. Hang posters about the change in your offices to help us spread the word.
  5. Test your system changes and work with billing staff to be sure your office is ready to use the new MBI format.


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CMS Issues New Guidance In Several Key Areas

Staff Contacts: Sarah Willson or Jim Mikes

The Centers for Medicare & Medicaid Services has issued new survey guidance in several key areas. First, CMS is clarifying end stage renal disease conditions for coverage criteria for the Hepatitis C screening exception. The ESRD guidance states that surveyors should not cite ESRD facilities that do not conduct routine or periodic screening for Hepatitis C.

Second, CMS issued new guidance for the formatting of plans of correction and allegations of compliance for providers/suppliers and clinical laboratory improvement amendments laboratories. The most notable change is the ability to submit PoCs/AOC as a separate attachment and not document them on the CMS Form 2567.

The most recently released guidance is related to voluntary termination. Currently, Medicare providers terminated by CMS under 42 CFR §489.53 may reapply using a CMS-approved accreditation program once the provider has been able to operate without recurrence of deficiency for a period of time. According to the guidance, a provider that is allowed to voluntarily terminate before a termination action is made effective also can reapply using a CMS-approved accreditation program.

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TJC Releases New Pain Management Standards

Staff Contacts: Sarah Willson or Jim Mikes

The Joint Commission has released new pain management guidelines to update its current standards with best practices and nationally accepted guidelines. The pre-publication standards, effective Jan. 1, 2018, focus on hospital leadership, education for providers and staff, defined criteria to screen, assess and reassess pain, and monitoring the use of opioids.

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Consider This ...

In the U.S., a gun is the cause of death in more than 1 in 10 deaths of people younger than 18.

Source: Los Angeles Times