MHA Today | July 6, 2017

July 6, 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 MHA Research Finds Health Care Equity Gap Widens In Senate’s BCRA
Budget Documents Detail Gubernatorial Spending Restrictions
CMS Releases Updated Hospital Discharge Appeal Notices
MLN Connects Provider eNews Available
Federal Court Orders Illinois To Pay Medicaid Providers
CMS Issues Guidance Regarding IPFQR PY 2018 Reporting

state and federal health policy developments

New MHA Research Finds Health Care Equity Gap Widens In Senate’s BCRA

Staff Contact: Mat Reidhead

MHA and the Texas Hospital Association jointly released a policy brief on the U.S. Senate’s Better Care Reconciliation Act of 2017. Researchers found that the 19 states that did not expand Medicaid under the Affordable Care Act will forego $737 billion in net federal Medicaid outlays throughout a decade compared to states that have opted to expand the program. In addition, the researchers investigated the BCRA’s Medicaid program per capita cap proposal. Under the proposal, per capita federal spending for expansion states is projected to slow between 2016 and 2019, and experience a greater reduction between 2020 and 2021. However, by 2026, the nonexpansion states are projected to receive $1,192 per capita, while expansion states would receive $1,987 per capita under the BCRA — a difference of 67 percent.

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Budget Documents Detail Gubernatorial Spending Restrictions

Staff Contacts: Daniel Landon or Brian Kinkade

As reported previously, Gov. Eric Greitens ordered $251 million in state spending restrictions for the fiscal year that began July 1. The governor asserts that the restrictions are needed to maintain a balanced budget in light of “lower than expected tax receipts from 2016 and rising health care costs.” Budget documents provide an overview of the restrictions and more detail about restrictions involving new or lapsed funding. The Medicaid disproportionate share hospital item reflects a revised projection of the DSH allotment reduction for state mental hospitals and will not affect hospital payments. The 1.5 percent Medicaid rate cut applies to General Revenue funds and also does not alter hospital payments. State officials are considering ways to achieve Greitens’ call for $30 million in “efficiencies” in the Department of Social Services. The restrictions block new funding of Area Health Education Centers, cord blood courier services and a community paramedic demonstration, as well as continue spending restrictions on two telemonitoring initiatives.

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Regulatory News
the latest actions of agencies monitoring health care

CMS Releases Updated Hospital Discharge Appeal Notices

Staff Contact: Jim Mikes

The Centers for Medicare & Medicaid Services has released the following hospital discharge forms that hospitals must start using no later than Monday, Aug. 28.

  • Important Message from Medicare (Form CMS-R-193)
  • Detailed Notice of Discharge (Form CMS-10066)

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MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issues updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • End-stage renal disease proposed 2018 policy and payment rate changes
  • Open payments program posts 2016 financial data
  • MLN Matters article: Modernized national plan and provider enumeration system
  • Medicare vision services fact sheet
  • Quality payment program new clinician resources

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Health Law Insight

Federal Court Orders Illinois To Pay Medicaid Providers

Staff Contact: Meghan Henderson

On June 30, the U.S. District Court for the Northern District of Illinois ordered the state of Illinois to pay $586 million per month to Medicaid providers. The order impacts vouchers first submitted after June 30 on behalf of Medicaid providers, including managed care organizations. Beginning July 1, Illinois also must pay $2 billion toward reducing the backlog of approximately $4.14 billion of unpaid vouchers that previously were submitted for Medicaid services. The court ordered Illinois to appropriately prioritize payments to safety-net hospitals and other providers that are most crucial to affording access to federally mandated health care services. 

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Quality and Population Health

CMS Issues Guidance Regarding IPFQR PY 2018 Reporting

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services previously postponed the collection of data for the following three measures in the Inpatient Psychiatric Facility Quality Reporting Program from July 1, 2016, to Jan. 1, 2017.

  • Transition Record with Specified Elements Received by Discharged Patients
  • Timely Transmission of Transition Record Measures
  • Screening for Metabolic Disorders

CMS has clarified that although the fields to enter the data for these measures are available in the payment year 2018 IPFQR web-based data collection tool in the QualityNet Secure Portal, it is permissible to leave the data entry fields for these three measures “Incomplete” or to enter zeros. CMS advises the following.

  • Providers concerned about signing a Data Accuracy and Correctness Acknowledgement when their measure summary screen still displays the words “Incomplete” for these three measures may choose to enter zeros in the denominator and numerator data entry fields.
  • CMS will not be evaluating data entry for the transition record and screening for metabolic disorders measures as part of the PY 2018 annual payment update determination, nor will these three measures be published on Hospital Compare in the December 2017 release.
  • The remaining data entry fields within the web-based data collection tool must be completed and all other IPFQR program requirements met for an IPF to receive full APU for PY 2018.
  • The PY 2018 data submission deadline is Tuesday, Aug. 15.

The June 20 IPFQR educational webinar provided guidance on how to successfully meet the fiscal year 2018 IPFQR program requirements. The webinar was recorded and archived on the Quality Reporting Center website. 

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Consider This ...

July is Ultraviolet Safety Month. Studies show that long-term exposure to bright sunlight may increase the risk of cataracts and growths on the eye, including cancer. UV rays reflected off sand and water can cause eyes to sunburn, potentially resulting in temporary blindness in just a few hours.

Source: American Academy of Ophthalmology