MHA Today | October 4, 2018

October 4, 2018
MHA Today: News for Healthcare Leaders

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October 4, 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
Congress Enacts Opioid Legislation
MHA Distributes Analysis Of Final Medicare Inpatient PPS For FFY 2019
CMS Changes Medicare Integrity Manual For Local Coverage Determinations
MLN Connects Provider eNews Available
CMS Provides Claims Detail Reports For OP-35 and OP-36
2019 Reporting Period eCQM Flows Available
Trustee Orientation Manual Template Available

Advocate
state and federal health policy developments


Congress Enacts Opioid Legislation

Staff Contact: Daniel Landon or Leslie Porth

With the U.S. Senate’s 98-1 vote to ratify House Rule 6, Congress completed its enactment of legislation to address treatment and prevention of opioid abuse. A two-page summary by Health Policy Source provides an overview; a congressional staff summary offers more details.

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Regulatory News
the latest actions of agencies monitoring health care


MHA Distributes Analysis Of Final Medicare Inpatient PPS For FFY 2019

Staff Contact: Andrew Wheeler

MHA released a summary and analysis of the federal fiscal year 2019 inpatient prospective payment system proposed payment and policy updates. The analysis includes the financial effects of marketbasket updates, the budget neutrality adjustment, reductions mandated by the Affordable Care Act and coding adjustments. Results are illustrated in national, Missouri, health system and individual hospital groupings. Inpatient PPS hospitals in Missouri are projected to receive an estimated 3.6 percent increase in Medicare payments. Although footnoted, the effects of the Medicare sequestration are not included.

Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are available for download to authorized users of HIDI Analytic Advantage®.

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CMS Changes Medicare Integrity Manual For Local Coverage Determinations

Staff Contact: Andrew Wheeler

As part of the 21st Century Cures Act, the Centers for Medicare & Medicaid Services revised chapter 13 of the Medicare Program Integrity Manual relating to the local coverage determination process. The revisions include a step-by-step description of the LCD process, a request process for informal meetings with the Medicare Administrative Contractors, restructured Contractor Advisory Committee meetings, expanded Contractor Advisory Committee participation to other health care professionals, better communications, and much more.

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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.

  • Merit-based Incentive Payment System
    • Targeted review request: Deadline Monday, Oct. 15
    • Virtual groups: Election period open through Dec. 31
    • List of quality measures impacted by ICD-10 updates
  • New Medicare card
  • Long-term Care Hospital Compare refresh
  • Inpatient Rehabilitation Facility Compare refresh

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Quality and Population Health


CMS Provides Claims Detail Reports For OP-35 and OP-36

Staff Contact: Sherry Buschjost

For calendar year 2020 payment determination, the Centers for Medicare & Medicaid Services is providing facilities with Claims Detail Reports for the following two measures.

  • OP-35: Admissions and Emergency Department Visits for Patients Receiving Outpatient Chemotherapy measure
  • OP-36: Hospital Visits After Hospital Outpatient Surgery measure

The CDRs are available for download through the QualityNet secure portal. Additional details are available.

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2019 Reporting Period eCQM Flows Available

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services published the 2019 reporting period electronic clinical quality measure flows for eligible hospitals and critical access hospitals to the eCQI Resource Center. This additional resource was developed in response to stakeholder feedback and is designed to assist with interpretation of the eCQM logic and calculation methodology for reporting rates; the flows should not be used in place of the eCQM specification or for reporting purposes. The eCQM flows provide an overview of each of the population criteria components and associated data elements that lead to the inclusion or exclusion into the eCQM’s quality action (numerator). The flows supplement eCQM specifications for eligible hospitals and CAHs for the following programs.

  • Medicare and Medicaid Promoting Interoperability (PI)
  • Hospital Inpatient Quality Reporting (IQR)

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Noteworthy


Trustee Orientation Manual Template Available

Staff Contact: Dana Dahl

MHA released a Board of Trustees Orientation Manual, which is a template for hospitals to develop and customize their own orientation manual. The document is a Microsoft Word template that enables hospitals to quickly and easily add and delete content to modify the manual to your organization’s unique needs. An Instruction Guide is available to assist with editing the document.

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Consider This ...

October is Domestic Violence Awareness Month. Nearly one in five adult women and about one in seven adult men report having experienced severe physical violence from an intimate partner in their lifetime.

Source: Centers for Disease Control and Prevention