MHA Today | January 10, 2018

MHA Today: News for Healthcare Leaders

twitter linkedin
January 10, 2018

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

In This Issue
FFY 2018 Medicare Pay-For-Performance Measure Trends Available
CMS Announces New Voluntary Bundled Payment Models
House Republicans Seek 340B Reforms
CMS Updates Schematron For CY 2018 QRDA I Implementation Guide
Plaintiffs To Appeal Dismissal Of 340B Challenge

Advocate
state and federal health policy developments


FFY 2018 Medicare Pay-For-Performance Measure Trends Available

Staff Contact: Andrew Wheeler

The Missouri Hospital Association provided an analysis of the third quarter 2017 data found in the Centers for Medicare & Medicaid Services’ Hospital Compare database. This information is used to set payment adjustments under Medicare’s pay-for-performance programs. Although critical access hospitals are exempt from these models, a trend analysis is available to track performance. Policy and analytic studies are available for download to authorized users of HIDI Analytic Advantage®.

Back To Top

 

Regulatory News
the latest actions of agencies monitoring health care


CMS Announces New Voluntary Bundled Payment Models

Staff Contact: Andrew Wheeler

New voluntary bundled payment models within the inpatient and outpatient setting were announced by the Centers for Medicare & Medicaid Services. The Bundled Payments for Care Improvement-Advanced Model encompasses 32 clinical-based episodes, including 29 inpatient and three outpatient models. The new models begin Oct. 1, and will run through Dec. 31, 2023. The model also will be considered an advanced alternative payment model under the Medicare Access and CHIP Reauthorization Act. CMS is hosting a BPCI Advanced open door forum at 11 a.m. Tuesday, Jan. 30, and registration is open. MHA published an issue brief with additional information.

Back To Top


House Republicans Seek 340B Reforms

Staff Contacts: Jane Drummond or Jim Mikes

House Republicans on the Energy and Commerce Committee released a report detailing suggested reforms to the 340B program. While noting broad bipartisan support for the program, the report is critical of certain aspects, including an ambiguous mission and a lack of regulatory authority given to the Health Resources and Services Administration for sufficient oversight and enforcement of program requirements. The report also contains recommendations for program improvements. Suggestions include greater enforcement in existing areas under HRSA authority, further oversight authority to HRSA and disclosures by covered entities regarding annual program savings/revenues.

Back To Top

 

Quality and Population Health


CMS Updates Schematron For CY 2018 QRDA I Implementation Guide

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services published an updated Schematron for the 2018 CMS Quality Reporting Document Architecture Category I Implementation Guide for Hospital Quality Reporting. This guidance is for electronic clinical quality measure submissions for calendar year 2018 and QRDA Category I files only for the Hospital Inpatient Quality Reporting Program and Medicare and Medicaid Electronic Health Record Incentive Program for Eligible Hospitals and Critical Access Hospitals.

The updated Schematron addresses an issue in the implementation of the QRDA I conformance statement CONF: CMS_0009, which states that a patient identifier, other than the Medicare Health Insurance Claim Number or Medicare Beneficiary Identifier, must be present in the recordTarget element. Before the Schematron update, a file submitted without an additional patient identifier would not be flagged in error. The update ensures the presence of the additional patient identifier beyond HICN and MBI.

Back To Top

 

Health Law Insight


Plaintiffs To Appeal Dismissal Of 340B Challenge

Staff Contact: Jane Drummond

The plaintiffs who challenged the Centers for Medicare & Medicaid Services’ proposed cuts to the 340B program filed a notice of their intent to appeal the court’s dismissal of the case. The federal district court for the District of Columbia recently dismissed the case brought by the American Hospital Association, America’s Essential Hospitals, the Association of American Medical Colleges and several hospital plaintiffs on the grounds that it lacked jurisdiction.

Back To Top

 


Consider This ...

There are 89,000 prescriptions for narcotics per 100,000 Missourians. Missouri is one of 22 states to register a drug overdose rate above the national average.

Source: Columbia Missourian