MHA Today | September 12, 2018

September 12, 2018
MHA Today: News for Healthcare Leaders

twitter linkedin
September 12, 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
General Assembly Considers Veto Of Time Critical Diagnosis Funding
State Legislative Committee Reviews Medicaid Managed Care
Navigator Programs Receive $10 Million To Support Marketplace Enrollment
MHA Distributes Analysis Of Final Updates To 2019 Medicare SNF PPS
CMS Modifies Individual Mandate Hardship Exception Process
Trajectories — Integrating Evidence-Based OUD Treatment: A Medication First Model
CMS Identifies Error In FY 2019 Readmissions Reduction Program HSR User Guide
IPFQR Education Session Registration Open
OQR Specifications Manual Available
Lee’s Summit Medical Center Names New CEO

Advocate
state and federal health policy developments


General Assembly Considers Veto Of Time Critical Diagnosis Funding

Staff Contact: Daniel Landon or Rob Monsees

The General Assembly convened its annual session to consider gubernatorial vetoes of legislation enacted during the regular session. By a vote of 134-13, the state House of Representatives voted to override Governor Parson’s veto of $153,546 in funding for three staff in the Missouri Department of Health and Senior Services to administer the Time Critical Diagnosis program. The program addresses the designation of stroke, STEMI and trauma centers, and the transport of patients with those conditions. The Senate ended its veto session without taking action, so the veto will stand. The Parson administration has indicated that it will continue to fund the TCD staffers using its budget flexibility. Many in the House of Representatives argue that the executive branch does not have such flexibility.

Back To Top


State Legislative Committee Reviews Medicaid Managed Care

Staff Contact: Daniel Landon or Rob Monsees

The state House of Representatives’ Health and Mental Health Policy Committee held a hearing yesterday on Medicaid managed care contracting, reimbursement and provider relations. MHA’s testimony addressed various topics, including MO HealthNet’s recent changes to contracting standards, allegations of “excessive" Medicaid payment rates for hospitals and the challenges posed by Medicaid managed care plans’ utilization review standards. Physicians and executives from MHA-member hospitals also testified, highlighting the effects on patients and hospitals of Medicaid managed care plans’ decisions to terminate provider contracts, the tenuous financial positions of many rural hospitals, the importance of the 340B drug discount program, the role of the hospital federal reimbursement allowance in financing the state’s Medicaid system and the challenges of bearing an aggregate FRA tax burden of $1 billion annually. The committee also heard presentations by the Missouri Health Plan Association and the Department of Social Services, who defended efforts to reduce Medicaid hospital spending.

Back To Top


Navigator Programs Receive $10 Million To Support Marketplace Enrollment

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services awarded $10 million to 39 organizations that will serve as navigators in the federally-facilitated exchanges in 2019. These funds support organizations that assist consumers in navigating the exchange, shopping for health insurance products and enrolling in health insurance coverage. The Missouri Alliance of Area Agencies on Aging will receive $300,000 to support navigator assistance in Missouri.

Back To Top


MHA Distributes Analysis Of Final Updates To 2019 Medicare SNF PPS

Staff Contact: Andrew Wheeler

MHA has prepared an analysis illustrating the financial effect of the federal fiscal year 2019 final updates to the Medicare skilled nursing facility PPS. In aggregate, Missouri SNFs will receive an estimated increase of 1.9 percent in Medicare payments. The analysis does not include effects caused by high-cost outliers or payment for managed care patients. Although footnoted, the 2 percent Medicare sequestration also is excluded from the study. Facility-specific results will vary based on resource utilization group. This analysis is posted online for authorized users of HIDI Analytic Advantage®. Current subscribers with questions about downloading files should contact HIDI.

Back To Top


Regulatory News
the latest actions of agencies monitoring health care


CMS Modifies Individual Mandate Hardship Exception Process

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services announced a more streamlined way for consumers to claim hardship exemption from the individual mandate. The new method includes filing a federal income tax return without presenting the documentary evidence or written explanation that generally is required. However, CMS states that “consumers should keep with their other tax records any documentation that demonstrates qualification for the hardship exemption.”

Back To Top


Quality and Population Health


Trajectories — Integrating Evidence-Based OUD Treatment: A Medication First Model

Staff Contact: Shawn Billings
Trajectories
Several Missouri initiatives expand access to integrated prevention, treatment and recovery support services for individuals with opioid use disorder. These initiatives include multidisciplinary provider and layperson training on opioid overdose education and naloxone distribution; increased patient access to pharmacotherapies, including buprenorphine, through clinician education; and patient programs designed to promote the safe and timely transfer of patients between levels and settings of care. Find out more in the September issue of Trajectories.



Back To Top


CMS Identifies Error In FY 2019 Readmissions Reduction Program HSR User Guide

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services identified a documentation error in the Fiscal Year 2019 Hospital Readmissions Reduction Program Hospital-Specific Reports User Guide. The guide lists incorrect Inclusion/Exclusion Indicators in Column G for the Discharge-Level Worksheets. The corrected FY 2019 HSR User Guide is available on QualityNet. The data for FY 2019, which includes claims for readmission measures during the performance period of July 1, 2014 through June 30, 2017, is not affected. The review and corrections period ends Friday, Sept. 14.

Back To Top


IPFQR Education Session Registration Open

Staff Contact: Sherry Buschjost

The next webinar for hospitals participating in the Inpatient Psychiatric Facility Quality Reporting Program is at 1 p.m. Monday, Sept. 17. Registration is required for the webinar titled, “A Community Approach to Follow-Up Care.”

Back To Top


OQR Specifications Manual Available

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has released Hospital Outpatient Quality Reporting Specifications Manual version 11.0b, effective with encounters dated Oct. 1 through Dec. 31, 2018. Updates included in this version are the removal and addition of new ICD-10 codes in Appendix A. The manual and associated release notes are available on QualityNet.

Back To Top

 

CEO Announcements


Lee’s Summit Medical Center Names New CEO

Staff Contact: Carol Boessen

HCA Midwest Health in Overland Park, Kan., has named John McDonald as CEO of Lee’s Summit Medical Center, effective Sept. 4. He succeeds Matt Sogard, who was named CEO of Overland Park Regional Medical Center in April 2018. McDonald has served as chief operating officer at HCA’s Corpus Christi Medical Center in Texas since 2015 and before that, served in several roles at Universal Health Services in Amarillo, Texas. He began his health care career at Houston Methodist Hospital System in 2006. A list of CEO changes is available online.

Back To Top



Consider This ...

Anorexia nervosa has the highest mortality rate of any mental disorder.

Source: National Institute of Mental Health