MHA Today | June 22, 2018

June 22, 2018
MHA Today: News for Healthcare Leaders

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June 22, 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 & CEOLast week, I wrote about Missouri’s new governor, Mike Parson. Since he was sworn in on June 1, he’s been visiting with leaders throughout the state, listening to their concerns and offering comments about priorities for his administration.

At his request, Gov. Parson met with MHA staff and members of the hospital community in St. Louis on Wednesday. We had a good discussion, and the governor was engaged. He asked good questions and took notes.

Although the meeting was styled as a briefing, there was an “ask.” The attendees urged Parson to suspend action on a pending amendment to the state’s contracts with Medicaid managed care organizations. Without action, beginning Sunday, July 1, Medicaid MCOs may reduce provider payments to 90 percent of fee-for-service rates for non-contracted hospitals or providers. This is bad policy for a variety of reasons.

First, the amendment distorts the payer and provider contract process — for all hospitals. By tipping the leverage toward the state’s MCOs, the change gives the plans unilateral rate-setting power. If a hospital doesn’t agree to accept whatever payment rate the Medicaid managed care plan offers, the plan can simply refuse to sign a contract, locking in the fee-for-service level cut. This is a clear example of the MO HealthNet Division putting a “thumb on the scale” to influence the negotiation.
Medicaid Issue Briefing
Second, the state just awarded a contract to conduct a top-to-bottom assessment of the Missouri Medicaid program. It doesn’t make sense to prejudge the outcome of this consultant engagement. Put another way, why is the state of Missouri spending $2.7 million on a consultant when they have already tipped their hand on certain operational changes? In addition, MHD and hospital and MHA executives have been meeting throughout the state to discuss MCO policies and practices. This process should be allowed to play out. A half-baked solution could only compound the problems providers are experiencing currently.

Finally, MCOs win, while the state gets nothing — or loses. It appears that the MHD is not reducing its capitated payments to the Medicaid managed care plans in response to this contract amendment. Without an offsetting reduction in the capitated payment to the plans, the policy change does not generate state Medicaid savings. This allows the state’s three MCOs to reduce their expenses while maintaining their revenues. At the same time, health care providers and their communities throughout Missouri lose — through reduced bottom lines and less impact on local economies.

In one of the oddest twists to the entire affair, the June 19 hearing — required by legislative directive — was botched. The webinar technology didn’t work and the hearing — scheduled for 90 minutes — was adjourned after 13 minutes. Many individuals dialed in to either listen or comment on the amendment. In a final bizarre development, comments will be accepted through Monday, July 9 — more than a week after the amendment takes effect.

But, earlier today, the state filed notice of a second hearing. The email announcement says the hearing is on June 19; fortunately, the public notice has the correct date of Tuesday, June 26. Despite this new round of confusion over this hearing, we have two working days to prepare for another chance to build the public record. Hospitals are urged to register and participate in this hearing.

The Medicaid MCOs have yet to demonstrate that they produce value for the state or Medicaid enrollees. It takes an incredible amount of chutzpah to now demand a rigged system.

As a new governor, Parson has an opportunity to set a new course based on his themes of collaboration and a “roll-up-your-sleeves” approach to governing. Suspending the amendment would send a strong signal in that regard. To that end, the MHA Board of Trustees has written Gov. Parson. A similar letter from other Missouri hospitals affected by the contracting change will quickly follow.

The amendment is bad policy. It is bad for hospitals and other health care providers, bad for state government and bad for communities throughout the state. It should go no further.

Send me a note to let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
MO HealthNet Schedules Second Hearing On Impending Managed Care Contract Amendment
Congressional Committee Leaders Investigate Hospital Sexual Assault Response Capacity
House Passes Opioid Legislation
Federal Resource Available Providing Health Care Providers With Lessons From Mass Shootings

state and federal health policy developments

MO HealthNet Schedules Second Hearing On Impending Managed Care Contract Amendment

Staff Contact: Brian Kinkade

The MO HealthNet Division will conduct a second hearing on Tuesday, June 26, on the Medicaid managed care contract amendment that would limit reimbursement to nonparticipating providers to 90 percent of prevailing Medicaid fee-for-service rates. MHA opposes the amendment and urges its members to submit comments or testimony. Technical problems kept interested parties from participating in the first hearing held earlier this week. The second hearing will be held at the MHD Office at the following address.

MO HealthNet Division
615 Howerton Court
Second Floor Conference Room 202
Jefferson City, MO

Once again, an option to participate via WebEx will be provided; persons planning to participate by WebEx must register in advance. The hearing will be open for participants to make statements for and against the proposed amendment. The hearing notice also provides instructions for submitting comments in writing.

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House Passes Opioid Legislation

Staff Contact: Andrew Wheeler

The U.S. House of Representatives passed a bipartisan opioid bill titled the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. The SUPPORT Act passed by a vote of 396 to 14.

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Congressional Committee Leaders Investigate Hospital Sexual Assault Response Capacity

Staff Contacts: Daniel Landon or Sarah Willson

The Republican chairs of the U.S. House Energy and Commerce Committee and its Oversight and Investigations Subcommittee sent letters to 10 state hospital associations, excluding Missouri, about hospitals’ capacity to gather forensic evidence for use in prosecuting allegations of sexual assault. The query asks for information about the availability of Sexual Assault Nurse Examiners and the kits used to collect the evidence in hospital emergency departments. The Illinois legislature recently enacted a law requiring hospitals to secure 650 nurses with SANE training by 2022, a process involving 40 hours of training and clinical experience. It was opposed by Illinois hospitals.

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Quality and Population Health

Federal Resource Available Providing Health Care Providers With Lessons From Mass Shootings

Staff Contact: Jackie Gatz

In the recent Assistant Secretary for Preparedness and Response newsletter, The Exchange, lessons learned are shared related to pre-hospital care, trauma and emergency response from mass shootings at a large outdoor concert, nightclub and place of worship. MHA staff continue to promote resources for safe environments of care through our S.A.F.E.R. Initiative, to include training staff in the Run, Hide, Fight approach when encountering an active shooter situation.

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Did You Miss An Issue Of MHA Today?

June 18, 2018
Parson Appoints Kehoe As Lt. Governor
MACPAC Releases June 2018 Report On Medicaid And CHIP To Congress
MedPAC Releases Report To Congress
CMS Notifies Hospitals Of Hospital-Specific Reports Regarding Pneumonia Readmission Measure
Federal And State Opportunities Address Opioids At Local Level

June 19, 2018
MO HealthNet Holds Managed Care Contract Hearing; Phone Problems Prevent Hospital Participation
MHA Submits Comment Letter On Proposed Medicare IPPS/LTCH Regulation Changes
Comments Offered On Proposed Medicare Rules For Psychiatric Facilities
Medicare Rehabilitation Facility Regulatory Comments Submitted
Association Health Plan Final Rule Available
NIH Research Finds Methadone And Buprenorphine Reduce Risk Of Death After Opioid Overdose
Talent For Tomorrow Initiative Hosts Regional Meetings
Trustee of the Year Award Call For Applications

June 20, 2018
U.S. Senate Committee Considers 340B Administration
FDA Provides Update On Unresolved Drug Shortages
MHA Distributes Analysis For Proposed Updates To 2019 SNF PPS
MHA Distributes Analysis For FFY 2019 Proposed LTCH PPS
Opioid Epidemic: Taking Lives And Displacing Children
MRHA To Host 2018 Missouri Rural Health Conference

June 21, 2018
MHA, Hospitals And Health Systems Meet With Governor Parson
U.S. House Of Representatives Passes More Opioid Bills
Congressional Committee Reviews Opioid Programs In Military Health Care
MO HealthNet Posts Recording Of Flawed Managed Care Contract Hearing
CMS Issues RFI About Reducing Burdens Of Stark Law
CMS Issues Guidance On Extension Of EPSDT Services To Children In IMD Placements
Joint Commission Issues Safety Bulletin On Human Trafficking
CMS Launches Data Element Library
MLN Connects Provider eNews Available
KPMG Study Finds Traveling Nurses Cost Less Than Staff Nurses

Consider This ...

More than twice as many U.S. college and university campuses were smoke free or tobacco free in 2017 as in 2012.

Source: Centers for Disease Control and Prevention