MHA Today | October 30, 2017

October 30, 2017

 

MHA Today: News for Healthcare Leaders

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October 30, 2017

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

In This Issue
AUR And Stage 3 Delayed One Year
CMS Proposes Rule To Allow States To Define EHB
CMS Releases Final ESRD PPS Update For CY 2018
The Joint Commission Releases Suicide Prevention Recommendations
Missouri Updates Ground Ambulance Standards
Multiple Amendments Proposed Impacting Social Workers
CMS Announces New Medicare Card Project Forum
CMS Revises Technical Release Notes For eCQM
MHA Activates Missouri Hospital Query To Monitor Impact Of National IV Fluid Shortage


What You Need To Know This Week

  • Open enrollment on the healthcare marketplace begins Wednesday, Nov. 1. MHA has enrollment resources available on its website.
  • A number of final rules will be released this week, in addition to the ESRD rule released last week. Watch for rules on OPPS, home health, physician update and physician quality.
  • MHA's 95th Annual Convention is Nov. 1 - 3 at Tan-Tar-A Resort. Online registration ends at noon Tuesday, Oct. 31.

 

Regulatory News
the latest actions of agencies monitoring health care


AUR And Stage 3 Delayed One Year

Staff Contact: Sarah Willson

A state requirement that Missouri hospitals must report antibiotic use and antibiotic resistance through the National Healthcare Safety Network Antimicrobial Use and Resistance Module will be delayed a year. The basis for the delay is Centers for Medicare & Medicaid Services’ decision to postpone the scheduled full implementation of Stage 3 Meaningful Use standards for use of electronic health records. Implementation was slated for January 2018. In its 2,456-page final rule for the fiscal year 2018 Medicare Hospital Inpatient Prospective Payment System, CMS opted to delay full implementation until January 2019. A memo was sent to MHA membership on October 27.

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CMS Proposes Rule To Allow States To Define EHB

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released a proposed rule that would give states more flexibility in interpreting the Affordable Care Act essential health benefits. The aim of the proposed rule is to provide flexibility to stabilize the individual and small-group insurance marketplace while improving health care affordability. Comments about the proposed rule are due by 4 p.m. Monday, Nov. 27.

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CMS Releases Final ESRD PPS Update For CY 2018

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the calendar year 2018 final payment and policy updates for the Medicare End-Stage Renal Disease prospective payment system. CMS is projecting the payment update to increase ESRD payments by $60 million from CY 2017 to CY 2018. The rule also contains changes to the ESRD quality incentive program, updates to the extraordinary circumstances exception policy, performance score certificate and national health care safety network dialysis event data validation methodology. MHA has published an issue brief with additional details.

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The Joint Commission Releases Suicide Prevention Recommendations

Staff Contacts: Sarah Willson, Alison Williams or Jackie Gatz

The Joint Commission released a special report outlining recommendations for assessing and addressing a safe environment of care in health care facilities to aide in suicide prevention. According to the report, suicide is now the tenth leading cause of death in the U.S. TJC worked with several key stakeholders, including Centers for Medicare and Medicaid Services, to develop the set of recommendations. TJC plans to continue collaboration with the stakeholders to address safety issues that could be used to aide a completed suicide in other areas of care. Tools and additional resources for hospitals related to safety and suicide prevention can be found on the MHA S.A.F.E.R website.

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Missouri Updates Ground Ambulance Standards

Staff Contacts: Sarah Willson or Jackie Gatz

Missouri has updated 19 CSR 30-40.309 Application and Licensure Requirements Standards for the Licensure and Relicensure of Ground Ambulance Services. The proposed amendments filed in March 2017 will be effective Thursday, Nov. 30. The most notable changes include the acceptance of the Commission on Accreditation of Ambulance Services Ground Vehicle Standard for Ambulances version 1.0, as well as the NFPA 2016 edition of Standard for Automotive Ambulances.

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Multiple Amendments Proposed Impacting Social Workers

Staff Contact: Sarah Willson

Multiple proposed amendments have been filed with the Secretary of State’s office and are printed in the Missouri Register. The amendments impact licensure requirements, including reexamination, reciprocity and continuing education among several others. Most of the proposed amendments contain a 30-day comment period. Anyone may file a statement in support of or in opposition to this proposed amendment with the State Committee for Social Workers, Tom Reichard, Executive Director, Page 1592 Proposed Rules November 1, 2017 Vol. 42, No. 21, PO Box 1335, Jefferson City, MO 65102, by fax at 573-526-3489 or by email at lcsw@pr.mo.gov. To be considered, comments must be received within 30 days after publication of this notice in the Missouri Register. No public hearings are scheduled.

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Quality and Population Health


CMS Announces New Medicare Card Project Forum

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services is hosting a New Medicare Card Project Special Open Door Forum at 1 p.m. Thursday, Nov. 9. The call will educate stakeholders about the change from Social Security number-based health insurance claim numbers to new Medicare beneficiary identifiers. Topics include:

  • background and implementation
  • MBI format
  • timeline and milestones, including transition period
  • beneficiary outreach and education
A question and answer session will follow the presentation. Registration is not required. To participate, dial 1-800-837-1935, conference ID #49255212.

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CMS Revises Technical Release Notes For eCQM

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services revised the technical release notes for the addendum to the electronic clinical quality measure annual update specifications for fourth quarter 2017 and 2018 reporting periods. Revisions include:

  • fourth quarter 2017 reporting
    • Eligible Hospital and Critical Access Hospital measures: CMS71v6, CMS72v5, CMS104v5 and CMS108v5
  • 2018 reporting
    • Eligible Hospital and CAH measure: CMS108v6
    • Eligible Clinician and Eligible Professional measures: CMS90v7, CMS117v6, CMS136v7, CMS137v6, CMS146v6, CMS147v7, CMS156v6, CMS164v6 and CMS166v7

The revised TRN files were updated to reflect:

  • the inclusion of additional TRNs to accurately document all applicable coding changes for each measure
  • the removal of TRNs that were irrelevant to a specific measure
  • the numbers of codes indicated in the TRNs

Only the TRNs have been updated. The value set content recently published in September as part of the addenda has not changed. Revised TRN files are available for download on the EP/Eligible Clinician eCQMs and Eligible Hospital/CAH eCQMs webpages of the eCQI Resource Center.

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MHA Activates Missouri Hospital Query To Monitor Impact Of National IV Fluid Shortage

Staff Contact: Jackie Gatz

MHA staff activated a query of Missouri hospitals in EMResource to assess the current IV fluid shortage impact. Respondents were asked to provide their current supply status, indicating whether conservation practices had been put in place. In addition to providing immediate statewide situational awareness, the query will remain open for the immediate future for hospitals to update their statuses as the situation unfolds.

As reported last week, the IV fluid shortage is in part due to pharmaceutical market consolidation, production interruptions from quality issues in 2016 and, more recently, the hurricane damage incurred to the production facilities in Puerto Rico. With the onset of flu season, demand for small-volume parenteral solutions could increase.

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Consider This ...

Thirty million people, or 15 percent of U.S. adults, are estimated to have chronic kidney disease.

Source: Centers for Disease Control and Prevention