MHA Today | July 18, 2018

July 18, 2018
MHA Today: News for Healthcare Leaders

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July 18, 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
UnitedHealthcare Cuts Payments For Drugs Purchased Under 340B
MO HealthNet Accepting Applications For Additional Primary Care Health Homes
Opportunity Available To Participate In A Non-Expansion State Medicare DSH Appeal

Advocate
state and federal health policy developments


UnitedHealthcare Cuts Payments For Drugs Purchased Under 340B

Staff Contact: Andrew Wheeler

UnitedHealthcare released a bulletin (page 43) containing changes to Medicare Advantage payment rates for drugs purchased under the 340B program. Hospitals who are not contracted or who are contracted and receive payments “in accordance with CMS payment methodology” will receive the average sales price less 22.5 percent for certain drugs paid under the 340B program. MHA is assessing implications and collaborating with other stakeholders.

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MO HealthNet Accepting Applications For Additional Primary Care Health Homes

Staff Contact: Brian Kinkade

The MO HealthNet Division is soliciting additional practice sites for its Primary Care Health Home program. Primary care practices with patient panels that are at least 25 percent Medicaid or uninsured may submit an application by Friday, Aug. 31, to be considered for participation. MHD pays a monthly case management fee to approved health homes for the services provided to assigned patients that are not otherwise reimbursable under the Medicaid program. Participating patients must be enrolled in MO HealthNet and must exhibit two or more of the following conditions or characteristics: asthma, behavioral health conditions (anxiety, depression or substance use disorder), diabetes, cardiovascular disease (including hypertension and hyperlipidemia), overweight, developmental disability, or tobacco use. An informational webinar is scheduled for 10:30 a.m. Monday, Aug. 13.

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Regulatory News
the latest actions of agencies monitoring health care


Opportunity Available To Participate In A Non-Expansion State Medicare DSH Appeal

Staff Contact: Andrew Wheeler

The Missouri Hospital Association and APS extends an invitation to attend a webinar by Besler and Cozen O’Connor about an appeal opportunity for hospitals in non-expansion states. If successful, participants will receive a payment settlement that would reverse the impact of Medicare disproportionate care payments in non-Medicaid expansion states. If your organization is interested in participating in the appeal, please contact Dennis George or Andrew Wheeler. Besler and Cozen O’Connor are offering two opportunities to learn more about the appeal.

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Consider This ...

Xanax and Valium were involved in more than 30 percent of opioid overdose deaths between 2010 and 2014, far more than cocaine and methamphetamines.

Source: Stateline