MHA Today | April 9, 2018


 

MHA Today: News for Healthcare Leaders

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April 9, 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
MO HealthNet Expands Coverage To Certain Radiology, Psychology Codes
Kaléo Announces Initiatives To Increase Access To Nalaxone
CMS Emergency Preparedness Rule Includes Provision For Integrated Health Care Systems
CMS Seeks Public Comments On Draft 2019 QRDA Category I Schematron
CMS Announces OQR Education Session

What You Need To Know This Week

  • Tomorrow is the deadline for CMS to appeal the Missouri U.S. District Court’s invalidation of the final rule allowing the agency to claw back money from Missouri hospitals' disproportionate-share hospital allotments.
  • A legislative alert was sent last week asking you to contact members of the Missouri Senate about the Medicaid budget for hospitals. It is critical that you contact your Senator to express the effects these cuts will have on your hospital.
  • A survey regarding the effects of cuts to the 340B program was distributed to selected hospitals last week. Responses are due back to MHA by Friday, April 13.

Regulatory News
the latest actions of agencies monitoring health care


MO HealthNet Expands Coverage To Certain Radiology, Psychology Codes

Staff Contact: Brian Kinkade

MO HealthNet added radiology codes to reimburse heart image PET scans and low-dose CT lung screens, as well as psychology codes to reimburse 60-minute psychotherapy sessions. The new radiology codes may be billed for services delivered on and after Jan. 1, and the psychology codes may be billed for services delivered on and after March 1. Prior authorization and provider certification requirements apply.

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Quality and Population Health


Kaléo Announces Initiatives To Increase Access To Naloxone

Staff Contacts: Leslie Porth or Shawn Billings

Pharmaceutical company, kaléo, announced two new programs to increase access to naloxone in support of the Surgeon General’s advisory on naloxone and opioid overdose.

  1. Virtual Standing Order program: Those with commercial insurance, without a prescription, can receive EVZIO at no cost by calling 877/883-8946 to talk to a pharmacist and arrange delivery of naloxone directly to their home. As part of the initial pilot program, the Virtual Standing Order program now is available in six states, including Arizona, California, Colorado, Missouri, Nevada and Ohio. Kaléo plans to expand the program to additional states.
  2. Direct Purchase Price program: A direct purchase price of $180 per auto-injector of EVZIO ($360 per pack of two auto injectors and a trainer) is available to all federal and state government agencies and tribes who purchase the product directly from kaléo, including those agencies that receive federal grant funding to address the opioid overdose epidemic. To obtain more information, visit evzio.com.

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CMS Emergency Preparedness Rule Includes Provision For Integrated Health Care Systems

Staff Contact: Stacie Hollis

The Centers for Medicare & Medicaid Services’ Emergency Preparedness Rule includes a provision for integrated health care systems, which consist of multiple, separately certified health care facilities under one parent organization. If a regulated facility is part of an integrated health care system that elects to have a unified and integrated emergency preparedness program (rather than have each facility separately conduct their own emergency preparedness program), then each facility and the parent organization must adhere to the integrated health care system requirements outlined in the final rule. Additional information is available to health care system emergency planners about the integrated health care system requirements in the final rule.

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CMS Seeks Public Comments On Draft 2019 QRDA Category I Schematron

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services is accepting public comments on the draft 2019 CMS Quality Reporting Document Architecture Category I Schematron for Hospital Quality Reporting. The schematron is a companion to the 2019 CMS QRDA I Implementation Guide for HQR and allows for computerized validation of QRDA documents against the IG requirements. The schematron helps eligible hospital and critical access hospital submitters check QRDA I files for electronic clinical quality measures beginning with the calendar year 2019 reporting period. The final schematron is incorporated into the CMS pre-submission validation application tool and the QualityNet system to ensure QRDA I files comply with the IG. Comments must be submitted via JIRA ticket number QRDA-681 by Friday, April 20. The final 2019 CMS QRDA I Schematron and sample file will be published on Friday, May 4, on the eCQI Resource Center QRDA page.

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CMS Announces OQR Education Session

Staff Contact: Sherry Buschjost

An outreach and education session for hospitals participating in the Outpatient Quality Reporting Program has been scheduled on Wednesday, April 18. The webinar, “Website Walk-through: Tools and Resources for the Hospital Outpatient Quality Reporting Program,” is offered at 9 a.m. and 1 p.m., and registration is required.

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Consider This ...

Nearly 7 percent of American adults have taken prescription antidepressants for at least five years. White women over age 45 account for about one-fifth of the adult population but account for 41 percent of antidepressant users.

Source: The New York Times