MHA Today | August 16, 2017

August 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
Telemedicine Report Examines Policies And Status In Missouri
New Report Assesses Medicare Financing And Solvency
Subcommittee Proposes CON Policy Change
MO HealthNet Updates Retail Pharmacy Reimbursement Limits
CBO Estimates Cutting ACA Payments Would Increase Marketplace Premiums
CMS Releases Proposed Rule To Change CJR, Cancel EPMs And CR
CMS Announces IQR Education Session

Advocate
state and federal health policy developments


Telemedicine Report Examines Policies And Status In Missouri

Staff Contact: Jim Mikes

MHA has released a new report investigating the challenges and opportunities for telemedicine in Missouri. Continued growth in rural broadband, investments in the health care workforce, and reimbursement policies that support adoption and utilization of telemedicine, could increase the ability of telemedicine to address some of the state’s rural health challenges. Although Missouri’s policies position the state well for expansion of telemedicine, challenges remain. The research identifies several areas where policy changes could influence uptake.

Back To Top


New Report Assesses Medicare Financing And Solvency

Staff Contacts: Daniel Landon or Andrew Wheeler

An updated report from the Congressional Research Service assesses the future solvency of the Medicare program. It also addresses Medicare’s funding sources and categories of expenditures. 

Back To Top


Subcommittee Proposes CON Policy Change

Staff Contact: Daniel Landon

A subcommittee of the Missouri Health Facilities Review Committee ― a state board which reviews and acts on applications for certificates of need for health care capital development projects ― is recommending two proposed changes in the standards for CON review. One of them would require an occupancy rate of at least 75 percent for the licensed hospital beds within a 15-mile radius during the year prior to the CON application. Another would use more detailed age cohorts in assessing the area population’s need for nursing home beds. Under current Missouri law, CON review of hospital capital development projects is limited to the development of a new hospital at a location where one previously did not exist and the acquisition of a single piece of medical equipment costing more than $1 million. A hospital can add beds without CON review. MHA is assessing the implications of the proposal. 

Back To Top


MO HealthNet Updates Retail Pharmacy Reimbursement Limits

Staff Contact: Brian Kinkade

MO HealthNet has reduced the wholesale acquisition cost limit in the reimbursement hierarchy for retail pharmacies from WAC minus .25 percent to WAC minus 3.1 percent, plus the standard dispensing fee. The change is retroactive for claims paid on or after April 1. A mass adjustment will be made to the Friday, Sept. 8, MO HealthNet payroll. Also, effective Aug. 15, reimbursement for 340B contract pharmacies will be reduced from the lower of WAC minus 31 percent to WAC minus 49 percent, plus the professional dispensing fee, or the usual and customary charge. These changes will not affect hospital outpatient pharmacy claims, which will continue to be reimbursed at a percentage of billed charges.

Back To Top


Regulatory News
the latest actions of agencies monitoring health care


CBO Estimates Cutting ACA Payments Would Increase Marketplace Premiums

Staff Contact: Andrew Wheeler

The Congressional Budget Office and Joint Committee on Taxation has estimated the effects of the federal budget, health insurance coverage, market stability and premiums if payments for cost-sharing reductions are eliminated. MHA has published an issue brief with additional details.

Back To Top


CMS Releases Proposed Rule To Change CJR, Cancel EPMs And CR

Staff Contact: Andrew Wheeler

Yesterday, the Centers for Medicare & Medicaid Services released a proposed rule that would cancel episode payment models and the cardiac rehabilitation incentive payment model. The proposed rule also makes changes to the comprehensive care for joint replacement model. CMS estimates that the proposed changes to the CJR model would save the Medicare program $204 million instead of $294 million from 2018 to 2020. Under the proposed rule, all previously mandated metropolitan statistical area participants in Missouri would be considered voluntary participants. MHA has published an issue brief with additional details.

Back To Top


Quality and Population Health


CMS Announces IQR Education Session

Staff Contact: Sherry Buschjost

An outreach and education session for hospitals participating in the Inpatient Quality Reporting Program has been scheduled at 1 p.m., Tuesday, Aug. 29. The webinar is titled “FY 2018 IPPS Final Rule: Acute Care Hospital Quality Reporting Programs Overview.”  Registration is required.

Back To Top



Consider This ...

In the U.S., the majority of drug overdose deaths for teens ages 15-19 are unintentional.

Source: Centers for Disease Control and Prevention