MHA Today | November 3, 2017

November 3, 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
MHA Supports House CHIP Reauthorization Proposal
U.S. House Approves IPAB Repeal
Task Force Recommends State Boards And Commissions Changes
CMS Releases Finalized Payment And Policy Updates For OPPS, ASC, Home Health PPS, PFS and QPP
CMS Announces New Medicaid Opioid Treatment Options
CMS Schedules Open Door Forum To Discuss Final OPPS Rule And S-10 Changes
MLN Connects Provider eNews Available
MHA Announces Six-Sigma Project For HIIN Hospitals
President’s Commission Releases Final Draft Report On Opioid Crisis
CMS Releases Overall Hospital Quality Star Rating HSRs
CMS Corrects FUH-30 And FUH-7 Data Displayed In Preview Report
CMS Updates OQR Known Issues Document
HIDI Releases 2016 Average Hospital Charges For Medicare Patients Report


Advocate
state and federal health policy developments


MHA Supports House CHIP Reauthorization Proposal

Staff Contact: Daniel Landon or Brian Kinkade

The U.S. House of Representatives passed H.R. 3922 that would provide a 5-year extension of funding for the Children’s Health Insurance Program as well as delay federal reductions of Medicaid Disproportionate Share Hospital payments for two years, until October 2019. In addition, the measure reauthorizes National Health Service Corps laws and funding. After MHA sent a letter of support for the legislation in advance of the House vote, it was amended to increase Medicare premiums for wealthy beneficiaries, a change which curtailed bipartisan support for the bill.

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U.S. House Approves IPAB Repeal

Staff Contact: Daniel Landon

By a vote of 307-111, the U.S. House of Representatives has approved legislation to repeal the Independent Payment Advisory Board. The IPAB is authorized by the Affordable Care Act but has not been appointed or implemented. Under current law, it is empowered to reduce federal payments if spending under the ACA exceeds specified targets. There is bipartisan support for retracting this authority from an unelected group of appointees.

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Task Force Recommends State Boards And Commissions Changes

Staff Contact: Daniel Landon or Ted Wedel

A task force to examine consolidation of Missouri state boards and commissions has issued its final report. The task force was created by an executive order of Gov. Greitens. Its recommendations include consolidation and elimination of various state boards and commissions. If implemented as proposed, the recommendations would reduce the number of gubernatorial appointments by 450. Many of the recommendations require state legislative enactments.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Releases Finalized Payment And Policy Updates For OPPS, ASC, Home Health PPS, PFS and QPP

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services has issued calendar year 2018 payment and policy updates for the outpatient PPS, the ambulatory surgical center payment system, the home health PPS, the physician fee schedule and the quality payment program.

Medicare outpatient PPS payments are expected to increase by 1.4 percent while ASC payments are expected to increase by 3 percent for 2018. Major changes finalized in the rule include reducing payments for drugs and biologicals purchased through the 340B program, supervision of hospital outpatient therapeutic services, outpatient PPS and ASC quality reporting program and revisions to the inpatient only list. MHA has published an issue brief with additional details.

The home health agency payment update will decrease CY 2018 payments by 0.4 percent or $80 million. CMS also finalized their proposal to sunset the rural add-on provision. MHA will publish an issue brief on the home health rule early next week.

The physician fee schedule also has been finalized for CY 2018, which includes an overall payment increase of 0.41 percent, bringing the PFS conversion factor to $35.99. CMS included other changes in the final rule, including payment rate reductions for nonexcepted off-campus provider-based hospital departments, changes to telehealth services and improvement of payment rates for office-based behavioral health services.

CMS also issued the final rule for the second year of the quality payment program, as required by the Medicare Access and CHIP Reauthorization Act of 2015. CMS states that they “finalized policies for Year 2 of the Quality Payment Program to further reduce your burden and give you more ways to participate successfully.” Major changes for the second year of the QPP include raising the Merit-based Incentive Payment System performance threshold to 15 points, weighting of MIPS domains, awarding up to five bonus points for treatment of complex patients and small practices, adding virtual groups as a participation option and offering additional detail on how eligible clinicians participating in selected Advanced Alternative Payment Models will be assessed under the APM scoring standard.

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CMS Announces New Medicaid Opioid Treatment Options

Staff Contact: Brian Kinkade or Leslie Porth

Through a letter to state Medicaid directors, the Centers for Medicare & Medicaid Services has announced a new policy allowing more opioid abuse treatment options for Medicaid enrollees. The options would be implemented through a current Medicaid demonstration project model, but with enhanced flexibility and outcome tracking.

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CMS Schedules Open Door Forum To Discuss Final OPPS Rule And S-10 Changes

Staff Contact: Jim Mikes

The Centers for Medicare and Medicaid Services will hold an Open Door Forum conference call on November 7 at 1:00 p.m. The agenda will include the following.

  • CY 2018 Outpatient Prospective Payment System Final Rule with comment
  • Extension to Jan. 2, 2018 of the deadline for resubmission of the 2014 and 2015 Worksheet S-10 Data
  • Clarifications and changes to Worksheet S-10
To participate in the call, dial 800/837-1935 and use conference ID: 61321615.

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MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issued 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.

  • Outpatient claims: Correcting deductible and coinsurance for code G0473
  • SNF value-based purchasing program FY 2018 final rule call – Nov. 16
  • Administrative simplification enforcement and testing tool
  • CMS offers Medicare enrollment relief for Americans affected by recent disasters
  • Physician compare preview period extended to Dec. 1
  • ESRD PPS: updates to policies and payment rates

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Quality and Population Health


MHA Announces Six-Sigma Project For HIIN Hospitals

Staff Contact: Amanda Keilholz

MHA will offer a new Lean Six Sigma Green Belt Project exclusively to Hospital Improvement Innovation Network-participating hospitals. Lean Six Sigma is a performance improvement platform with roots originating in the production and manufacturing industry. Its methodology builds upon a 5-step process, Define-Measure-Analyze-Improve-Control, with an intense focus on the removal of errors, defects or “waste” —described as any step, motion or resource that does not add value to the process.

Two cohorts are offered; one in the St. Louis metro area and one in the Kansas City metro area. Completing the eight-month intensive project, including in-person trainings covering the steps of Lean Six Sigma DMAIC methodology, will result in a Green Belt certification. Each training will be followed by an implementation phase to apply the knowledge and skills learned toward a required hospital-based improvement project.

The application process will be open Nov. 1, through Jan. 12, 2018. An informational webinar will be offered at 1:30 p.m., Tuesday, Nov. 21, to outline the project, define the timeline, set expectations and answer questions about the project and application process. Questions relating to the Lean Six Sigma Green Belt Projects should be directed to Amanda Keilholz.

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President’s Commission Releases Final Draft Report On Opioid Crisis

Staff Contact: Leslie Porth

The President’s Commission on Combating Drug Addiction and the Opioid Crisis final draft report was released this week by the White House. The commission’s report makes multiple recommendations to help fight the opioid crisis, including ongoing requests for non-burdensome funding mechanisms to provide localized resources and support.

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CMS Releases Overall Hospital Quality Star Rating HSRs

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has announced the release of December 2017 Hospital Compare overall hospital quality star rating hospital-specific reports. The reports will include the overall hospital quality star rating results, confidence intervals for group and summary scores, group performance category assignment and standardized individual measure scores. Facilities will receive notification from QualityNet about how to access the reports from the secure portal. Supplementary materials, such as the quarterly updates and specifications report, will be available after release of the HSRs to assist hospitals interpret their results. Additional information regarding the overall hospital quality star rating is available on QualityNet.

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CMS Corrects FUH-30 And FUH-7 Data Displayed In Preview Report

Staff Contact: Sherry Buschjost

A data calculation error was discovered related to the Follow-Up After Hospitalization for Mental Illness measures, FUH-30 and FUH-7, after the December 2017 Hospital Compare preview reports release. To allow facilities to preview the corrected FUH-30 and FUH-7 measure data, the Centers for Medicare & Medicaid Services has sent a special preview report that only includes those two measures to each facility’s designated security administrator. The document was sent via the QualityNet secure file transfer and contains the recalculated FUH measure data that will be displayed on Hospital Compare in December.

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CMS Updates OQR Known Issues Document

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has updated the known issues document associated with the Outpatient Quality Reporting Program. The document, which includes newly identified issues and issue resolutions, is available on QualityNet.

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HIDI Tech Connect


HIDI Releases 2016 Average Hospital Charges For Medicare Patients Report

Staff Contact: Shane VanOverschelde

HIDI’s Average Hospital Charges for Medicare Patients Report, based on the 2016 Medicare Provider Analysis and Review file, is now available. The MedPAR file includes 100 percent of Medicare beneficiaries using short-stay hospital inpatient services. The report features fiscal year 2016 hospital-specific detail on Medicare DRG cost components, utilization and ranks. It also includes a comprehensive set of reports and associated data files. This report is available as an a la carte offering and also was available as part of the 2017 Premier Reporting Package. For current Premier Reporting Package subscribers, the report can be found on HIDI Analytic Advantage® in the following location, with the following file name.

  • File Location: Finance and Policy/Premier Reports
  • File Name: MO0000_MEDPAR_2016.zip

Hospitals interested in subscribing to the 2018 HIDI Premier Reporting Package should review the package information. Hospitals interested in the a la carte offering of this report should contact HIDI.

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Did You Miss An Issue Of MHA Today?


October 31, 2017
U.S. House To Debate CHIP Reauthorization Bill
The Joint Commission Issues Pre-Publication Emergency Preparedness Standards
FEMA Refreshes National Incident Management System
Supplemental Document For Inpatient Specifications Manual Version 5.2b Available

October 30, 2017
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



Consider This ...

November is National Diabetes Month.More than 30 million Americans have diabetes; only one-quarter are disgnosed.

Source: Centers for Disease Control and Prevention