MHA Today | August 23, 2018

August 23, 2018
MHA Today: News for Healthcare Leaders

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August 23, 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
MO HealthNet Increases Reimbursement For Physician Services
MO HealthNet Implements Payment Edit For Daily Maximum Drug Limits
MLN Connects Provider eNews Available
Registration Open For Webinar On Expanding Access To Addiction Medicine
CMS Releases Fall OQR Newsletter
340B Recertification Deadline Approaching

Regulatory News
the latest actions of agencies monitoring health care


MO HealthNet Increases Reimbursement For Physician Services

Staff Contact: Brian Kinkade

The MO HealthNet Division increased reimbursement for physician services by 1.5 percent for dates of service on and after July 1, in accordance with the state budget adopted for fiscal year 2019. (Note: The bulletin is very large and may download very slowly.) Providers will be paid the lesser of their usual and customary charge, or the MHD rate. MHD will automatically adjust claims paid after July 1, but before the rate tables were updated to include the rate increase.

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MO HealthNet Implements Payment Edit For Daily Maximum Drug Limits

Staff Contact: Brian Kinkade

The MO HealthNet Division implemented an edit on Aug. 19, to deny pharmacy claims that exceed maximum daily quantity limits set by MHD or First Databank’s Medknowledge. The correct day's supply must be submitted on drug claims based on the quantity dispensed and the prescriber’s directions. Prescribers should contact MO HealthNet Pharmacy and Clinical Services at 573/751-6963 with questions about billing or denied claims.

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MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

Updates to MLN Connects Provider eNews were issued by the Centers for Medicare & Medicaid Services. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • New Medicare card: 0 not O
  • 2016 Physician Quality Reporting System and 2018 value modifier experience report
  • Patients Over Paperwork: Medicare Physician Fee Schedule proposed rule presentation
  • 2016 inpatient hospital utilization and payment data
  • Hospices: Second quarter Hospice Quality Reporting Program update

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Quality and Population Health


Registration Open For Webinar On Expanding Access To Addiction Medicine

Staff Contact: Shawn Billings

Opioid use disorder and related morbidity and mortality continues to increase in much of the U.S. As a result, related emergency department visits and hospitalizations significantly have increased. The webinar, “Expanding Access to Medication Assisted Treatment for Opioid Use Disorder to Patients in the Hospital,” will provide an overview of the opioid epidemic, and the laws and regulations that dictate how medication assisted treatment (primarily buprenorphine and methadone) can be used in the treatment of OUD. Discussions will include hospital-based initiatives being used across the U.S., as well as the exceptions that exist to regulations that allow for providers to use medication to treat OUD in patients seen in the ED or who are admitted to the hospital. The webinar is scheduled for 11 a.m. Central time Tuesday, Aug. 28.

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CMS Releases Fall OQR Newsletter

Staff Contact: Sherry Buschjost

The fall OQR Times Newsletter has been released by the Centers for Medicare & Medicaid Services. The issue includes the following topics for the Hospital Outpatient Quality Reporting Program.

  • CY 2019 Proposed Rule comments
  • downloading your preview report
  • Nov. 1 clinical data submission
  • education events
  • what’s the difference: CDR versus CDR

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Noteworthy


340B Recertification Deadline Approaching

Staff Contact: Jim Mikes

Hospitals are required to recertify for 340B participation on an annual basis, and the deadline for recertification is Wednesday, Sept. 12. Hospitals should have received an email recertification notice from noreply@hrsa.gov that provides instructions. The email was sent to the primary contact and authorizing official listed in the hospital account. The recertification period began Aug. 15; however, before beginning the recertification process, the primary contact and authorizing official must set up a user account in the new 340B Office of Pharmacy Affairs Information System. The 340B OPAIS username and password will allow access to the account information needed to perform the recertification. The authorizing official will be required to log in to the 340B database, update information as needed and attest to the organization’s compliance with 340B Program requirements.

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Consider This ...

A 2016 study found that children in foster care were twice as likely as others to have learning disabilities and developmental delays, five times as likely to have anxiety, six times as likely to have behavioral problems and seven times as likely to have depression.

Source: NPR