MHA Today | May 4, 2018

MHA Today: News for Healthcare Leaders

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May 4, 2018

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


Herb Kuhn, MHA President & CEO Next week, MHA will lead a delegation of Missouri hospital leaders to visit with the state’s Congressional delegation in Washington, D.C. All will be attending the American Hospital Association’s annual membership meeting. Although enactment of major health care legislation is unlikely before November’s mid-term election, there is no shortage of issues before Congress. For Missouri, there are several more focused issues important to hospitals and health care providers that deserve congressional attention.

Both the U.S. House of Representatives and U.S. Senate are working on legislation to address the national opioid crisis. Hospitals experience the toll of the opioid crisis every day — from overdose cases in the emergency department, to babies born with neonatal abstinence syndrome who receive treatment in neonatal intensive care units. To date, federal funds delivered through the State Targeted Response to the Opioid Crisis Grants have enabled Missouri hospitals to lead in development of medication-assisted treatment programs. Missouri’s “medication first” model is returning positive results. Legislation to build on developing best practices and a significant budgetary commitment from Congress will be necessary to stem the tide of the crisis.

Another crisis we will discuss is the epidemic of violence in hospitals. Hospital and health care workers are four times more likely to be victims of workplace violence than workers in other settings. Among surveyed hospitals in Missouri, 54 percent cited workplace violence or violent behavior among their top three organizational threats. Unfortunately, federal guidance from the Centers for Medicare & Medicaid Services and the Occupational Health and Safety Administration do not align. CMS regulations focus on patients, while OSHA focuses on employees. Hospitals need clarity and consistency.

Anthem’s ED and other claim-rejection policies have attracted attention in Congress, as well. Since Anthem’s ED coverage restrictions took effect last year, MHA and physician organizations have pushed back hard on basing coverage determinations for emergency services on post-encounter diagnoses rather than the symptoms that brought the patient to the ED. It’s unfair, and it violates the “prudent layperson” standard in both federal and state law. Moreover, our research suggests that Anthem’s policy would fall heavier on ailments common among women and minorities. We’re working with state and federal lawmakers to clarify the standard and to protect patients.

Finally, we’ll be urging members of the delegation to protect the 340B Drug Discount Program. The program has allowed hospitals to strengthen the safety net. However, those programs could be jeopardized by 340B-related proposals before Congress. We’ll be urging our delegation to preserve the scope of the program and consult with hospitals as they work to clarify its regulatory oversight and refine the program to increase accountability and transparency. MHA has issue papers on each of these issues.
Hand Hygiene Day
Next week is National Hospital Week. MHA shared resources with hospital public relations staff on Monday. We’ll be celebrating your work and sharing your stories throughout the week. You also have access to AHA's Hospital Week resources to help promote your National Hospital Week events and efforts.

P.S. — The Missouri House and Senate conferees have yet to finalize the Medicaid budget proposal for state fiscal year 2019. Only a week remains to meet their constitutional deadline. We continue to advocate for fairness and equity in Medicaid payments for hospitals. There will be a budget adopted next week. Time is short. Call or send an email to your legislator about a fair and equitable Medicaid budget.

I’m always interested in what you’re thinking. Have a great weekend, happy Hospital Week in advance and May the 4th be with you.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Legislators To Negotiate Differences In Provider Tax Legislation
New Congressional Proposal Revamps VA Choice Program
World Hand Hygiene Day Is May 5
CMS Announces Preview Period For FY 2019 IQR Claims-Based Measures
CMS Announces IPFQR Education Session
MHA Releases Issue Briefs For 2019 CMS Proposed Payment Systems

state and federal health policy developments

Legislators To Negotiate Differences In Provider Tax Legislation

Staff Contacts: Daniel Landon or Rob Monsees

The state Senate and House have formed a conference committee to negotiate a resolution to their differences on Senate Bill 775, which addresses provider taxes. Those differences include the following.

  • The duration of the reauthorization of the hospital Federal Reimbursement Allowance and the other state provider taxes – the House has one year; the Senate, two years.
  • The threshold of a new hospital payment safeguard in the hospital FRA law. The House version allows for a state “cushion” comparable to that of current law. The Senate has a narrower cushion. Other language upgrading the 17-year-old safeguard in current law for hospital payments funded by the FRA is common to both versions and excluded from negotiation. The new safeguard emphasizes greater transparency and accountability.
  • The level of access to proprietary Medicaid-managed care data used in implementing the hospital FRA payment safeguard.
  • Authorization of a new provider tax on managed care plans.

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New Congressional Proposal Revamps VA Choice Program

Staff Contact: Daniel Landon

A new congressional proposal to revamp the U.S. Department of Veterans Affairs’ Veterans Choice Program appears to be on a fast track. The President tweeted that he wants the new legislation to be enacted by Memorial Day, a timetable reinforced by the Acting Secretary of Veterans Affairs. The legislation has bipartisan support, and a key House committee will consider the bill on Tuesday, May 8. The current VA Choice program is expected to exhaust its funding in June. The new bill provides $5.2 billion to maintain the current program until a replacement is operational.

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Quality and Population Health

World Hand Hygiene Day Is May 5

Staff Contact: Jessica Stultz
Hand Hygiene Day
In celebration of World Hand Hygiene Day, the Centers for Disease Control and Prevention reminds everyone that keeping hands clean is one of the most important ways to prevent infections – and when we prevent infections, we help prevent the development of sepsis.

Practicing good hand hygiene, such as handwashing and using an alcohol-based hand sanitizer, is a simple yet effective way to help prevent serious infections that can lead to sepsis.

Each year, the World Health Organization’s SAVE LIVES: Clean Your Hands campaign aims to progress the goal of maintaining a global profile on the importance of hand hygiene in health care and to “bring people together” in support of hand hygiene improvement globally.

An infographic on sepsis prevention is available. Learn more about becoming part of the WHO movement to improve hand hygiene. View CDC’s Clean Hands Count and Get Ahead of Sepsis educational efforts for additional information and materials.

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CMS Announces Preview Period For FY 2019 IQR Claims-Based Measures

Staff Contact: Sherry Buschjost

Hospital-specific reports for the fiscal year 2019 Hospital Inpatient Quality Reporting Program claims-based measures are available on the QualityNet Secure Portal. The preview period ends Saturday, June 2. Additional details are available.

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CMS Announces IPFQR Education Session

Staff Contact: Sherry Buschjost

An outreach and education session for hospitals participating in the Inpatient Psychiatric Facility Quality Reporting Program is scheduled for 1 p.m. Thursday, May 17. The presentation will summarize the proposed updates to the IPFQR program as outlined in the fiscal year 2019 inpatient psychiatric facility prospective payment system proposed rule. Registration is required.

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MHA Releases Issue Briefs For 2019 CMS Proposed Payment Systems

Issue_brief_logoThe Centers for Medicare & Medicaid Services released proposed rules for 2019 payment systems. Learn more about each in payment system-specific MHA Issue Briefs.

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Did You Miss An Issue Of MHA Today?

April 30, 2018
CMS Outlines FY 2018 Medicare Low-Volume Notification Process
CMS Releases FY 2019 IPPS And LTCH Proposed Payment, Policy Updates
CMS Releases FY 2019 Inpatient Psychiatric Facility Proposed Rule
CMS Releases FY 2019 Inpatient Rehabilitation Facility Proposed Rule
CMS Releases FY 2019 Hospice Proposed Rule
CMS Announces eCQM Education Session
2018 Trustee Of The Year Award Nomination Period Open
Fulton Medical Center Names Interim CEO

May 1, 2018
Senate Committee Considers Organ Donation Legislation
Legislative Committee Reviews Collaborative Practice Bill
CMS Releases FY 2019 Skilled Nursing Facility Proposed Rule
Meaningful Measures Initiative And The FY 2019 Medicare Proposed Rules
MO HealthNet To Implement Morphine MME Limitations May 1
HIDI Releases Hospital Profile Report
CMS Releases Hospital Quality Reporting Center Spring Newsletter
MHA Releases Issue Briefs For 2019 CMS Proposed Payment Systems

May 2, 2018
House Committee Reviews Bill On Emergency And Out-Of-Network Coverage
House Advances Bill On EMS, DUI Testing
Mammography Coverage Bill Approved
Behavioral Health Legislation Gets House Endorsement
Committee Advances Newborn Eye Drops Proposal
NIH Hosting All Of Us Event At Kansas City’s Union Station This Sunday
Intermedix Announces Organizational Changes
CMS Announces IQR Education Session
MHA Releases Issue Briefs For 2019 CMS Proposed Payment Systems
St. Luke’s Hospital Acquires Des Peres Hospital
Twin Rivers Regional Medical Center Announces Closure
Nominate A Rural Health Champion
Ranken Jordan Pediatric Bridge Hospital Names Interim CEO

May 3, 2018
Congressional Column
Committees Advance Hospital Regulatory Reform Bills
Committee Reworks Managed Care Accreditation Bill
Committee Reviews Nursing Licensure Change
NFPA Releases Standard For Active Shooter/Hostile Event Response Program That May Affect Hospitals
CMS Announces Webinar For Quality Payment Program Participation Criteria
MLN Connects Provider eNews Available
CMS Announces IQR Education Session
MHA Releases Issue Briefs For 2019 CMS Proposed Payment Systems

Consider This ...

May is Asthma and Allergy Awareness Month. An estimated 24 million people in the U.S. are living with asthma. Of those people with asthma, 60 percent of adults and 80 percent of children have asthma triggered by allergies.

Source: Asthma and Allergy Foundation of America