February 16, 2018
MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.
Last week ended on a high note.
On Friday, the federal district court for the western district of Missouri granted MHA’s motion for summary judgment in our lawsuit on the Medicaid disproportionate share hospital audits. The court enjoined the Centers for Medicare & Medicaid Services from enforcing its FAQ-based guidance and the subsequent final rule adopted in 2017.
CMS has 60 days to appeal the decision. It probably will, but we will be doing all we can to convince them otherwise. As a result, a final determination of the status of the 2011 to 2014 audits — that were conducted using the FAQ methodology — may be quite a way down the road. If the Missouri decision prevails, these audits must be redone.
I was thinking about the decision in the context of the slogan, “Think globally, act locally.” Obviously, the Missouri court’s decision was a local victory. However, our local effort to achieve clarity on this issue would have implications for hospitals nationwide.
Hospitals in Missouri have a lot at stake. Combined, the 2011 and 2012 audits would require hospitals return nearly $100 million in excess payments to the federal treasury. However, there’s a more fundamental issue — one that I’ve talked about many times before. Fairness.
The FAQ guidance was an end-run on the rulemaking process. Hospitals are one of the nation’s most regulated organizations. And, the lack of opportunity to clearly and specifically comment on the impacts of a change of this magnitude is clearly unfair.
The 2017 regulation adopting the FAQ methodology was an attempt to get ahead of the issue. However, it failed to address a more basic problem — the Medicaid statute includes a formula for calculating a hospital’s maximum DSH reimbursement. CMS adopted that formula in 2008.
The MHA Board of Trustees authorized pursuing a legal remedy in 2016. Our intent was local — we wanted CMS to ensure a fair process governed by the statutory language. The result may be clarity for all. And, a strong rebuke to fundamental changes by bureaucratic fiat.
What all parties need — and deserve — is fair dealing. The Missouri court put down an important marker on that last week.
Let me know what you think.
Herb B. Kuhn
MHA President and CEO
the latest actions of agencies monitoring health care
Staff Contact: Jane Drummond
On Friday, Feb. 2, MO HealthNet announced that it will be rescinding its regulations governing telehealth and advising providers to follow the Missouri Revised Statutes in administering and billing for telehealth services. Chapter 208 of the Missouri Revised Statutes includes some restrictions on the use of telemedicine to treat MO HealthNet participants. MHA prepared an Issue Brief to guide providers in applying the relevant statutes.
Back To Top
Did You Miss An Issue Of MHA Today?
February 12, 2018
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
February 13, 2018
Issue Brief Reviews President Trump’s FY 2019 Budget
HSGAC Releases Report On Opioid Manufacturers And Third-Party Advocacy Groups
MHA Releases Analysis Of Revised Wage Index And Occupational Mix Data For Development Of FFY 2018 Wage Index
Management And Productivity Report Available
February 14, 2018
TJC Releases Addendum To Specifications Manual Version 2017B2
CMS Announces IQR Education Session
February 15, 2018
State Senate Approves FRA Legislation
2017 To 2026 Projections Of National Health Expenditures Available
MLN Connects Provider eNews Available
RHG-C Acquires Cooper County Memorial Hospital
Eighty percent of people with Alzheimer's disease and related dementias are receiving care in their homes. Each year, 15 million Americans provide more than 17 billion hours of unpaid care for family and friends with Alzheimer's disease and related dementias.
Source: Centers for Disease Control and Prevention