MHA Today | June 27, 2018

June 27, 2018
MHA Today: News for Healthcare Leaders

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June 27, 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
CMS Announces Medicaid Program Integrity Initiatives
MHA Comments On Proposed Medicaid Outpatient Hospital Reimbursement Rule
CDC Extends NHSN Consent Deadline
CMS Releases CART Resources
Selle Announces Resignation From Pike County Memorial Hospital

Advocate
state and federal health policy developments


CMS Announces Medicaid Program Integrity Initiatives

Staff Contacts: Daniel Landon or Brian Kinkade

The Centers for Medicare & Medicaid Services issued a press release and fact sheet describing new or enhanced program integrity measures in the Medicaid program. They include targeted audits of managed care organization financial reporting and compliance with medical loss ratio standards, eligibility verification in selected states, enhanced data-sharing capabilities, and an expanded federal role in screening providers.

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Regulatory News
the latest actions of agencies monitoring health care


MHA Comments On Proposed Medicaid Outpatient Hospital Reimbursement Rule

Staff Contacts: Daniel Landon, Kim Duggan or Brian Kinkade

MHA submitted a comment letter responding to the MO HealthNet Division’s proposed rule that purports to change the prospective outpatient hospital reimbursement methodology for outpatient surgical procedure codes, outpatient drugs, the technical component of outpatient radiology procedures and the telehealth originating site fee from a percentage of billed charges to fee schedules. The proposed rule also provides for adjustments to the calculation of the outpatient payment percentage rates to remove services reimbursed on a fee schedule. The proposed rule is flawed in several ways, including making capricious changes in reimbursement levels without complying with the protections provided by the rulemaking procedures of Chapter 536 RSMo and the due process protections of the Missouri constitution. For these reasons, MHA strongly opposes MHD’s proposed rule and expects to challenge it before the Joint Committee on Administrative Rules, the legislative body that oversees executive branch rulemaking, should the rule be promulgated as written. Comments on the rule must be filed by Sunday, July 1, and may be submitted by mail to Department of Social Services, Legal Services Division-Rulemaking, P.O. Box 1527, Jefferson City, MO 65102-1527, or by email to rules.comment@dss.mo.gov.

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Quality and Population Health


CDC Extends NHSN Consent Deadline

Staff Contact: Sherry Buschjost

The Centers for Disease Control and Prevention extended the deadline for completing the online National Healthcare Safety Network agreement to participate and consent form to Monday, July 9. Additional details are available.

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CMS Releases CART Resources

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services released topic-specific documents pertaining to universal (alphabetical) abstraction and the CMS Abstraction and Reporting Tool. These documents, available on QualityNet, are effective for July 1 through Dec. 31, 2018, discharges. Separate documents are provided for the following.

  • Universal abstraction paper tools — data elements are arranged in alphabetical order rather than tool-specific order
  • CART abstraction paper tools — data elements are arranged in CART order
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CEO Announcements


Selle Announces Resignation From Pike County Memorial Hospital

Staff Contact: Carol Boessen

Justin Selle, chief executive officer of Pike County Memorial Hospital in Louisiana, Mo., announced his resignation, effective Friday, Aug. 3. He served as CEO since March 2015. Selle has accepted the President/CEO position at HSHS St. Nicholas Hospital in Sheboygan, Wis., effective Monday, Aug. 20. A search is being conducted for Selle’s replacement at Pike County Memorial Hospital. A list of CEO changes is available online.

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Consider This ...

About 41,000 nonsmoking adults die from heart disease and lung cancer every year because of secondhand smoke.

Source: Centers for Disease Control and Prevention