As Congress races toward the new year with tax policy and a host of health care items on its agenda, a quiet second half of December seems unlikely. Reauthorization of the Children’s Health Insurance Program, funding for Medicare extenders and even a fix for the health insurance marketplace subsidies discontinued by the administration earlier this year, could occur before Jan. 1.
Although Congress is winding down its legislative year, Missouri lawmakers are gearing up for theirs. The Missouri legislative session begins in less than three weeks, and hundreds of bills already have been pre-filed in the Missouri House and Senate.
Earlier this week, MHA released its 2018 Missouri Legislative Guide. The guide provides a blueprint for our advocacy efforts and informs hospital advocacy programs in support of the hospital and health care agenda.
Among the issues included in the guide is reauthorization of the Federal Reimbursement Allowance program, which will lapse on Sept. 30, 2018. The FRA and other provider tax programs help the state allocate limited general revenue resources to support other state priorities, including education, infrastructure and veterans services. Since the program was created in 1992, the FRA has been reauthorized 12 times — each time with strong, bipartisan support.
The FRA has an enormous positive impact on the state’s budget. In fiscal year 1990, 39.5 percent of the state’s Medicaid spending was from general revenue. In FY 2017, only 17.1 percent came from general revenue. As a testament to the strength of the FRA program, 70 percent of the state’s share of Medicaid spending for hospitals comes directly from this program. In 2017, the program produced $1.1 billion, which was used to secure $2 billion in federal match for Missouri’s Medicaid program. The FRA is the third highest source of revenue for the state of Missouri behind the state’s income tax and sales and use tax. It is more than two and a half times greater than the state’s corporate income tax.
Medicaid relies on the FRA and other provider taxes. However, changes to the program — including the expansion of Medicaid managed care — have made it more complicated. In addition to reauthorization, this year we will seek to upgrade the safeguards included in the law to ensure greater accountability in tracking funds and payments.
The FRA is a longstanding partnership between the state and hospital community. However, efforts to address state budget challenges by diverting FRA-generated funds could jeopardize that partnership. We’ll be sending a strong message to lawmakers that FRA diversion would violate this longstanding trust and could lead to increased costs for businesses, insurers and patients.
The legislative guide includes numerous issues beyond the FRA, including regulatory and legal reforms, Medicaid and managed care improvement opportunities, medical liability improvements, and workforce and operational policy goals. I encourage you to keep the guide handy.
Have a look, and let me know what you think.
P.S. — Today is the final day for enrollment in the health insurance marketplace. Enrollment has been strong so far, but the truncated enrollment period, significantly reduced advertising budget and limited on-the-ground assistance for the 2018 enrollment year may influence awareness and enrollment. The marketplace closes tonight at midnight Pacific Time. There’s still time to build awareness in the final hours. Consider sharing information about the deadlines with your communities one last time.
Herb B. Kuhn
MHA President and CEO
Billing 340B Modifiers Under OPPS FAQs Available
Staff Contact: Andrew Wheeler
A proposal to decrease payments for certain drugs purchased under the 340B program was recently finalized by the Centers for Medicare & Medicaid Services. CMS has now addressed frequently asked questions regarding the new 340B billing and payment methodology, including instruction on how to use modifiers “JG” and “TB.” Additional instructions for rural sole community and critical access hospitals also are provided. These changes will take place on Monday, Jan. 1, 2018.
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December 11, 2017
Congress Passes And Trump Signs Continuing Resolution
CMS Releases Medicare Deductible, Coinsurance And Premium Rates For 2018
Free Opioid Training Available
MHA Joins Hospital Association Amicus Contesting 340B Reductions
December 12, 2017
2018 State Legislative Guide Available
Analysis Of S-10 Data And Medicare DSH Implications Available From MHA
December 13, 2017
CMS Releases Week Six Marketplace Enrollment Results
Trajectories: ED Utilization – Right Care. Right Place. Right Time.
Second Quarter CY 2017 Update To Discharge Data-Based Quality Indicators Available
Bates County Memorial Hospital Names CEO
December 14, 2017
MHA Urges Prosecutors To Use New Law To Curb Workplace Violence
MLN Connects Provider eNews Available
Missouri’s Health Ranking Falls In National Survey
CMS Selects Random Sample Of Hospitals For Chart Abstracted And HAI Measures Validation
OQR Times Newsletter Available