MHA Today | June 21, 2017

June 21, 2017

MHA Today: News for Healthcare Leaders

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MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.

In This Issue
Trajectories — Opioid Use Disorder
MHA Distributes Wage Index Data For Review
MO HealthNet Notifies Medicare-Only MO Rx Participants About Coverage Termination
CMS Proposes Changes To MACRA In Second Year Of Quality Payment Program

Quality and Population Health


Trajectories — Opioid Use Disorder

Staff Contact: Leslie Porth AHCA Per Capita Fed Net Medicaid Expenditures by Expansion Status

The July 2017 edition of Trajectories highlights the issue of opioid use and abuse. One of the most effective tools for providers to protect patients and communities from opioid misuse and abuse is a prescription drug monitoring program. The Missouri General Assembly failed to adopt a statewide system this year. However, the St. Louis County Department of Public Health launched a PDMP that is being used in the St. Louis area and is available to any Missouri jurisdiction that passes an ordinance to participate in their program. The St. Louis County Department of Public Health's effort establishes the architecture needed for county-level implementation. Registration is growing and additional counties are discussing and adopting PDMP systems. A video is available to help providers understand the importance of the system. Providers can enroll online.

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Advocate
state and federal health policy developments


MHA Distributes Wage Index Data For Review

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released public use files that are the foundation of the federal fiscal year 2019 Medicare wage index. Hospitals can review their hospital-specific data and request revisions until Friday, Sept. 1. This is the only opportunity hospitals have to request data revisions. Subsequent opportunities for correction can only address Medicare administrative contractor mishandling of the data. Requests and supporting documentation for revisions should be directed to the MAC. MHA has posted the files to HIDI Analytic Advantage® for review.

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MO HealthNet Notifies Medicare-Only MO Rx Participants About Coverage Termination

Staff Contact: Brian Kinkade

MO HealthNet has given notice to MO Rx Participants who are enrolled only in the Medicare program that their MO Rx eligibility will end on Friday, June 30. MO Rx participants who are dually enrolled in Medicare and Medicaid will continue to be covered. Funding for MO Rx benefits for Medicare-only participants was cut from the state fiscal year 2018 budget which takes effect July 1. The budget action will end benefits for about 64,000 seniors making $22,000 or less per year. Currently, MO Rx pays 50 percent of participants’ costs for Medicare Part D coverage, including costs resulting from the gap in Part D coverage commonly referred to as the “donut hole.”

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Regulatory News
the latest actions of agencies monitoring health care


CMS Proposes Changes To MACRA In Second Year Of Quality Payment Program

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services has issued a proposed rule which would make changes to the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015. These changes are being made to help simplify the program for small, independent and rural practices. One of the major changes includes an increase the number of clinicians who are exempt. CMS would accomplish this by raising the low-volume threshold from less than or equal to $30,000 in part B allowed charges or less than or equal to 100 part B beneficiaries to less than or equal to $90,000 or less than or equal to 200 beneficiaries. Due to this change, an additional 834,000 clinicians will be excluded from participation in the program, bringing the total percentage of clinicians participating down to 37 percent of total. CMS Administrator Seema Verma stated, “We’ve heard the concerns that too many quality programs, technology requirements, and measures get between the doctor and the patient. That’s why we’re taking a hard look at reducing burdens.” Comments on the proposed rule must be received by 4 p.m. on Monday, August 21. MHA has released an Issue Brief on the proposed rule.

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Consider This ...

Nearly 1 in 10 men say they feel some depression or anxiety every day, while one-third of men experience a period of major depression at some point in their lives.

Source: Centers for Disease Control and Prevention