What You Need To Know This Week
Look for an MHA email with information about projected Medicaid payments for state fiscal year 2019, with a link to your hospital’s Schedule A and other detailed worksheets.
MHA will release its comments on the annual proposed changes to federal rules for the Medicare Inpatient, Long-Term Care Hospital, and Rehabilitation and Psychiatric Facilities prospective payment systems. The deadline for submitting comments is Monday, June 25, for the IPPS/LTAC rules and Tuesday, June 26, for the Psychiatric and Rehabilitation rules.
On Tuesday, the MO HealthNet Division will hold a hearing on a proposed Medicaid managed care contract amendment. It would cap Medicaid payment at 90 percent of the fee-for-service rate if a hospital does not contract with Medicaid managed care plans.
Parson Appoints Kehoe As Lt. Governor
Staff Contacts: Daniel Landon or Rob Monsees
Governor Mike Parson appointed Missouri Senate Majority Leader Mike Kehoe (R-Jefferson City) to be Lieutenant Governor, filling the post Parson left to become governor on June 1. Missouri constitutional and statutory law is unclear about the governor’s authority to make such an appointment, so the matter may result in litigation.
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MACPAC Releases June 2018 Report On Medicaid And CHIP To Congress
Staff Contact: Brian Kinkade
The Medicaid and CHIP Payment and Access Commission released its 2018 report to Congress, which includes the following information.
- recommendations to close pharmacy rebate program loopholes
- a review of states’ approaches to substance use disorder treatment and the common gaps in states’ program designs
- recommendations for improving clinicians’ access to patients’ substance use disorder health information
- a review of state managed care programs providing long-term services and support for persons with multiple, complex health care needs
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MedPAC Releases Report To Congress
Staff Contact: Andrew Wheeler
The Medicare Payment Advisory Commission released the June 2018 report to Congress, which includes analysis and information about potential refinements to the Medicare payment system. This year’s report includes the following information.
- effect of the hospital readmission reduction program
- rebalancing Medicare’s physician fee schedule
- post-acute care unified prospective payment system
- potential policies to encourage plan development of managed care dual-eligible plans
- formalize quality principles and apply them to two population-based outcome measures
- identification of important issues related to two-sided risk within the accountable care organization program
- using payment to ensure appropriate access to and use of emergency department services
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CMS Notifies Hospitals Of Hospital-Specific Reports Regarding Pneumonia Readmission Measure
Staff Contact: Sherry Buschjost
The Centers for Medicare & Medicaid Services is notifying hospitals that a confidential hospital-specific report will be provided for hospitals to review two disparity methods that assess hospital performance for patients with social risk factors in the Hospital 30-day, All-Cause, Risk-Standardized Readmission Rate Following Pneumonia Hospitalization measure. Results from these two methods will reveal differences in outcomes for patient groups based on social risk factors to provide hospitals with information that could illuminate any disparities in care and outcome that can be targeted through quality improvement efforts. The confidential HSR will be available for hospitals to preview from Friday, Aug. 24, through Monday, Sept. 24. Details are available.
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Federal And State Opportunities Address Opioids At Local Level
Staff Contacts: Leslie Porth or Shawn Billings
The Health Resources & Services Administration’s Federal Office of Rural Health Policy will award as many as 75 grants to rural communities as part of a new Rural Communities Opioid Response initiative. The grants will support treatment for, and prevention of, substance use disorder with a focus on the 220 counties identified by the Centers for Disease Control and Prevention as being at risk, as well as other high-risk rural communities. Successful awardees will receive $200,000 for one year to partner with at least three other entities and develop plans to implement opioid use disorder prevention, treatment and recovery interventions designed to reduce opioid overdoses among rural populations. Please note that the process for registering for federal grants can take up to 30 days to complete.
The State Office of Rural Health initiated a partnership with state-level organizations to support local efforts. These partners currently include the Missouri Hospital Association, Missouri Department of Mental Health, Missouri Primary Care Association and the Missouri Rural Health Association.
To facilitate strong planning efforts and to reduce duplication of effort, these statewide partners will support applications from any partnerships interested in collaborating to address the opioid issue in their communities through the provision of the following.
- content to strengthen and align efforts
- grant-writing support
- gap analysis
- connecting partners not already engaged at the local level
- commitment to provide ongoing technical assistance during the funding period and into implementation
Please notify Melissa VanDyne, director of the State Office of Rural Health, via email if you are interested in applying. In the email, please include a list of partners you anticipate will be part of your application, as well as a brief overview of the community, county or region the project will cover.
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