MHA Today | February 12, 2018

February 12, 2018
MHA Today: News for Healthcare Leaders

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February 12, 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
MHA Obtains Favorable Ruling In Medicaid DSH Lawsuit
President Trump Releases FY 2019 Budget
Issue Brief: Bipartisan Budget Act Of 2018
MHA Distributes Financial Indicators Analysis
HIDI Releases FFY 2017 Inpatient And Outpatient Physician Loyalty Report
Hospital Quality Reporting Center Winter 2018 Newsletter Available

What You Need To Know This Week

  • In the bipartisan budget bill passed last week to avert a government shutdown, disproportionate share hospital reductions were delayed by two years through 2018 and 2019. Watch for information later this week on how this will affect your hospital.
  • The president released his budget proposal, which now goes to Congress for their consideration for a longer term budget solution. Watch for additional details regarding the budget.

Health Law Insight


MHA Obtains Favorable Ruling In Medicaid DSH Lawsuit

Staff Contact: Jane Drummond

The Missouri Hospital Association prevailed in its litigation against the Centers for Medicare & Medicaid Services over the audit methodology used to conduct the Medicaid disproportionate share hospital audits beginning in 2011. MHA challenged both the FAQ guidance that first appeared in 2010, requiring an offset for payments from Medicare and third-party insurers in calculating hospital-specific DSH reimbursement limits, as well as the final rule promulgated by CMS in 2017 containing the same methodology.

The court found that the FAQ guidance was a substantive change in the cost calculation that should have been promulgated through formal rulemaking procedures. Further, the methodology was contrary to the plain text of the Medicaid statute, which sets out the calculation in unambiguous terms. The court invalidated the final rule on the same grounds and enjoined CMS from imposing the methodology from 2011 forward.

If CMS appeals, any activity with respect to the DSH audits will remain stayed during the appeal. If CMS does not appeal, the existing audits will have to be reconducted to remove Medicare and third-party payments from the cost calculation.

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Advocate
state and federal health policy developments


President Trump Releases FY 2019 Budget

Staff Contact: Andrew Wheeler

President Trump has released the fiscal year 2019 budget, which “builds upon…incredible successes throughout the past year.” The Department of Health and Human Services’ budget amounts to $1,216 billion, of which 52 percent is expected to be spent on Medicare and 34 percent is expected to be spent on Medicaid. Some of the mandatory cuts include the following.

  • eliminate Social Services block grant — $16.7 billion throughout 10 years
  • Medicaid waste, fraud and abuse – all savings from DSH cuts in 2026 — $19.5 billion
  • Medicaid drug negotiations — $404 million
  • allow Medicaid modified adjusted gross income asset test — $5.6 billion
  • reduce Exchange premium payment grace period — $1.3 billion
  • Medicare Part D drug reforms — $5.3 billion
  • reduce opioid prescriptions in Part D, and use medication-assisted treatment in Medicaid — $965 million

HHS Secretary Azar stated, “The President’s budget makes investments and reforms that are vital to making our health and human services programs work for Americans and to sustaining them for future generations.”

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Issue Brief: Bipartisan Budget Act Of 2018

Staff Contact: Andrew Wheeler

Last week, Congress passed and the president signed into law the Bipartisan Budget Act of 2018. MHA published an issue brief outlining the Congressional Budget Office scoring of the bill.

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MHA Distributes Financial Indicators Analysis

Staff Contact: Andrew Wheeler

The Missouri Hospital Association released a financial indicator analysis that provides comparative financial metrics for individual hospitals compared to national benchmarks. The analysis uses standard accepted formulas as defined and published by various rating agencies. The source for the financial information is the third quarter 2017 Healthcare Cost Report Information System database, which includes the Medicare cost report data. MHA posted these files to HIDI Analytic Advantage® for review.

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HIDI Tech Connect


HIDI Releases FFY 2017 Inpatient And Outpatient Physician Loyalty Report

Staff Contact: Shane VanOverschelde

The full federal fiscal year 2017 inpatient and outpatient Physician Loyalty report is available for download to subscribers of the Premier Reporting Package on HIDI Analytic Advantage®.

This report displays a list of physicians, by name, and the frequency in which they were attending physicians across combinations of inpatient/outpatient, hospital, patient zip code, DRG and payer. This data is delivered in a ready-to-query Microsoft Access database file. The file is located in “Strategic Planning/Premier Strategic Reports,” and the file name is as follows.

  • MO0000_PHY_LOY_HIDI_RGNS_2017.zip

Hospitals interested in subscribing to the HIDI Premier Data Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.

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Quality and Population Health


Hospital Quality Reporting Center Winter 2018 Newsletter Available

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services released the Hospital Quality Reporting Center Winter 2018 newsletter. The issue contains information for acute care hospitals, critical access hospitals, inpatient psychiatric facilities and PPS-exempt cancer hospitals. Topics include the following.

  • tools and resources for the Feb. 28 eCQM reporting deadline
  • attest to 2017 EHR Incentive Program requirements by Feb. 28
  • important National Healthcare Safety Network deadlines
  • tips for reporting HCP influenza vaccination data
  • new tools for quality reporting
  • important dates

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Consider This ...

In the U.S., approximately 600,000 hysterectomies are performed each year, and it is the second most frequently performed major surgical procedure among reproductive-aged women.

Source: Centers for Disease Control and Prevention