MHA Today | February 20, 2019

February 20, 2019
MHA Today: News for Healthcare Leaders

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February 20, 2019

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.


In This Issue
House Budget Subcommittee Advances Recommendations
Legislative Committee Approves Medicaid Work Requirement
State House Approves Medical Futility Legislation
MHA Supports Liability And Utilization Review Legislation
OIG Report — CMS Improperly Paid SNFs $84 Million
Crittenton Children’s Center Names New President

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state and federal health policy developments


House Budget Subcommittee Advances Recommendations

Staff Contact: Rob Monsees or Bill Anderson

A state House subcommittee that does the initial review of proposed budgets for the Departments of Health and Senior Services, Mental Health, and Social Services made its recommendations to the House Budget Committee. The subcommittee resolved a concern raised by MHA about the use of additional hospital provider tax to fund the state’s Poison Control Center. It also added specific authorization to spend $166,000 to staff the Department of Health and Senior Services’ Time Critical Diagnosis program. TCD staff funding was controversial in 2018; the latest action demonstrates the legislature’s commitment to the program. The subcommittee did not add budget authorization for enhanced federal Medicaid funding of an initiative to expand the use of ADT technology to improve coordination of care. That issue, and others, will be revisited by the full House Budget Committee as the budget process unfolds in the next few weeks.

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Legislative Committee Approves Medicaid Work Requirement

Staff Contact: Rob Monsees or Bill Anderson

By a vote of 4-2, a state Senate committee approved a new version of Senate Bill 76. The bill would require Medicaid enrollees to engage in at least 80 hours a month of work, training, job search or other community engagement activities. The Department of Social Services would seek federal authorization to implement the requirements. Exempted populations include children, the elderly, the medically frail, primary caregivers of a young child or dependent adult, and various other groups.

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State House Approves Medical Futility Legislation

Staff Contact: Daniel Landon or Rob Monsees

The state House of Representatives gave first-round approval to House Bill 138. Dubbed “Simon’s Law,” the legislation addresses standards for withdrawing medically futile care for pediatric patients. The legislation has been controversial in past sessions, but the 2019 bill represents a compromise accord and is not being contested.

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MHA Supports Liability And Utilization Review Legislation

Staff Contact: Daniel Landon or Rob Monsees

MHA staff expressed support for several bills in state legislative committee hearings.

  • Senate Bill 276 would, among other changes, preclude a liability lawsuit based on the Missouri Merchandising Practices Act in conjunction with a medical malpractice or wrongful death liability lawsuit.
  • Senate Bill 298 would impose more stringent requirements on insurers regarding their prior authorization and other utilization review standards and practices.
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OIG Report — CMS Improperly Paid SNFs $84 Million

Staff Contact: Andrew Wheeler

The U.S. Department of Health and Human Services’ Office of Inspector General released the results of a skilled nursing facility 3-day qualifying policy audit. According to the OIG, from 2013 through 2015, SNFs were improperly paid approximately $84 million in claims because the 3-day rule was not met. The OIG blames the absence of a coordinated notification mechanism among hospitals and SNFs. The OIG recommends that the Centers for Medicare & Medicaid Services’ qualifying hospital stay edit for SNF claims be enabled and require hospitals to provide beneficiaries written notification of the number of inpatient days of care provided during a hospital stay.

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CEO Announcements


Crittenton Children’s Center Names New President

Staff Contact: Carol Boessen

Dr. Jerrie Jacobs-Kenner was named president of Saint Luke’s Hospital of Kansas City Crittenton Children’s Center, effective Jan. 6. Dr. Jacobs-Kenner joined Saint Luke’s in 2015 as senior director of community-based programs. She has 33 years of clinical and leadership experience in social and behavioral health fields. She replaced Janine Hron, who left in April 2018. A list of CEO changes is available online.

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Consider This ...

Because measles is so contagious, between 93 and 95 percent of people in a community need to be vaccinated to achieve herd immunity, which diminishes the risk for people who can’t be vaccinated for medical reasons: infants, pregnant women and people who are immune compromised.

Source: The New York Times