MHA Today | April 25, 2018

April 25, 2018
MHA Today: News for Healthcare Leaders

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April 25, 2018

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

Congressional Column


MHA invited each member of Missouri’s Congressional Delegation to share a column outlining their health care priorities. The first column submitted is from Sen. Claire McCaskill.

Claire McCaskill Twelve percent. That’s the average annual price increase for the top 20 most prescribed brand name drugs for seniors, based on a report I released through my Homeland Security and Governmental Affairs Committee. That twelve percent price increase is more than 10 times the average annual price of inflation. This is unstainable, and it’s unfair — and I’m working to stop it.

While drug prices continue to rise, Missouri taxpayers are subsidizing more and more of pharmaceutical companies’ advertising costs. That’s right — Americans are subsidizing more than $6 billion in fully tax-deductible prescription drug advertising costs. Taxpayers are the ones on the hook, paying for the ads we see every time we turn on the TV. With drug companies continuing to raise the prices of life-saving drugs, I think the least we can do is stop making Americans pay for them to advertise those drugs. That’s why I’ve introduced legislation to eliminate this tax deduction.

But that’s just one step I’m taking to help lower the cost of prescription drugs.

During my time as the top Democrat on the Senate Aging Committee, I joined Republican Committee Chairman Susan Collins to launch an in-depth investigation into prescription drug price increases. That report led to bipartisan legislation — signed by President Trump and now law — to increase competition for generics and help lower costs and improve the accessibility of decades-old prescription drugs.

Senator Collins and I teamed up again to introduce legislation to ban “pharmacy gag clauses” that prevent pharmacists from telling consumers if their prescription would cost less if they paid for it out of pocket rather than using their insurance. I think it’s common sense that a pharmacist should be able to tell patients about more affordable ways to get the drugs they need.

I’ve conducted oversight of naloxone manufactures and asked them what they are doing to increase affordability and access to this life-saving anti-opioid drug. I’m working with Republican Senators Lisa Murkowski and Dan Sullivan to expand access to opioid treatment in rural communities by asking the Drug Enforcement Administration to issue a new rule allowing doctors, nurses or other practitioners to obtain a “special registration” to prescribe controlled substances used as part of opioid addiction treatment via telemedicine.

I’ve also launched a comprehensive Congressional investigation into the opioid crisis, requesting documents from opioid manufacturers and distributors — looking at their role in fueling the epidemic. And, I successfully fought to make sure that Missouri’s network of local prescription drug monitoring programs were eligible for federal funding that historically was restricted to states, even as legislators in Jefferson City continue to make our state the only one in the country without a statewide program.

These issues touch folks young and old, in our cities and rural areas — all across the state. I’ve heard from far too many Missourians who are struggling to afford their prescriptions or who have been touched by the opioid epidemic. Their feedback has fueled my fights in Washington on their behalf. And I won’t give up.

U.S. Senator Claire McCaskill is the senior senator from Missouri.



In This Issue
House Approves Opioid Legislation
Committee Approves Emergency Care Coverage Bill
Committee Endorses Medicaid Chiropractor Benefit
CMS Releases Inpatient PPS And LTCH FFY 2019 Proposed Rule
MHA Distributes FFY 2019 Medicare SNF VBP Projection
St. Luke’s Rehabilitation Hospital Names New CEO

Advocate
state and federal health policy developments


House Approves Opioid Legislation

Staff Contacts: Daniel Landon or Rob Monsees

The state House of Representatives gave first-round approval to House Committee Bill 15, which includes a variety of components relating to opioid abuse. In House debate, a number of amendments were added, including a state form for patients to decline opioids, expanded authority of the state legislature to redirect accumulated fund balances of professional licensure boards and expanded authority to use hemp oil in medical treatment

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Committee Approves Emergency Care Coverage Bill

Staff Contacts: Daniel Landon or Rob Monsees

A state House committee approved House Bill 2463. Developed and promoted by MHA, the bill clarifies how the state’s “prudent layperson” law applies to insurers’ coverage restrictions on hospital emergency department services. It is one of several such proposals pending in the General Assembly.

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Committee Endorses Medicaid Chiropractor Benefit

Staff Contacts: Daniel Landon or Rob Monsees

A House committee approved a new version of Senate Bill 597. It authorizes Medicaid coverage of chiropractic services with a cap of 20 visits per year. The committee amended the bill to address several insurance regulatory topics.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Releases Inpatient PPS And LTCH FFY 2019 Proposed Rule

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the federal fiscal year 2019 proposed payment and policy updates for acute inpatient prospective payment system and long-term care hospitals. CMS also released a notification about how it will extend the payment adjustment for low-volume hospitals and the Medicare-dependent hospital programs for discharges between October 2017 and September 2018. CMS is projecting IPPS hospitals to receive a 1.75 percent payment rate increase, while long-term care hospitals are projected to receive a decrease by 0.1 percent. Other major changes include the following.

IPPS:

  • Continue the transition away from Medicare SSI data and Medicaid days to worksheet S-10 in determining Medicare disproportionate share uncompensated care payments.
  • Request for information on positive solutions to achieve better interoperability or the sharing of health care data between providers.
  • Call for greater price transparency by requiring certain hospitals to publish their list of standard charges online.
  • Request for information about barriers preventing providers from informing patients of their out-of-pocket costs, and notifying patients about out-of-network bills from physicians.
  • Meaningful measures reduce 19 measures from the quality programs, eliminate the duplication of another 21 measures and adopt one claims-based readmissions measure.
  • Eliminate the Value-Based Purchasing Program safety of care domain and measures.
  • Begin to measure hospital-acquired conditions pay-for-performance program against peers with similar proportions of dual-eligible patients.

LTCH:

  • Eliminate the 25 percent threshold policy in a budget neutral manner by decreasing the standard federal payment rate by 0.9 percent.

Comments about the proposed payment and policy updates are due no later than 4 p.m. Monday, June 25.

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MHA Distributes FFY 2019 Medicare SNF VBP Projection

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services finalized a new Medicare Value-Based Purchasing Program for skilled nursing facilities. MHA released an analysis illustrating the projected effects of the program. The projections are based on historical data from Nursing Home Compare. Policy and analytic studies are available for download to authorized users of HIDI Analytic Advantage®.

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CEO Announcements


St. Luke’s Rehabilitation Hospital Names New CEO

Staff Contact: Carol Boessen

Chris Baechle, chief executive officer of St. Luke’s Rehabilitation Hospital in Chesterfield, announced his resignation, effective Thursday, April 26. He has served as CEO since March 9, 2015, and has accepted the CEO position with Cardinal Ritter Senior Services in St. Louis. Don Foster has been named his successor. Foster previously served as director of quality and therapy services at the hospital and has extensive experience in rehabilitation services. A list of CEO changes is available online.

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Consider This ...

Today is National DNA Day, which celebrates the 15th anniversary of the completion of the Human Genome Project. At the base-pair level, your genome is 99.9 percent the same as all of the humans around you — but in that 0.1 percent difference are many of the things that make you unique. Human genomic variation is particularly important because a very small set of these variants are linked to differences in various physical traits: height, weight, skin or eye color, type of earwax, and even specific genetic diseases.

Source: National Human Genome Research Institute