MHA Today | February 21, 2019

 

MHA Today: News for Healthcare Leaders

linkedin twitter facebook
February 21, 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
Senate Committee Reviews FRA Reauthorization Legislation
MHA Opposes Maternal Mortality Review Legislation
AHA Releases Surprise Billing Principles
MHA Releases CAH And PPS Rate Comparison
CMS Releases National Health Expenditure Projections
MHD To Require NDC Reporting For Outpatient 340B Drug Reimbursement

Advocate
state and federal health policy developments


Senate Committee Reviews FRA Reauthorization Legislation

Staff Contact: Rob Monsees

A state Senate committee reviewed Senate Bill 29, which would reauthorize the Federal Reimbursement Allowance and other state provider taxes for two years. Under current law, the state laws establishing these provider taxes will lapse as of Sept. 30. The provider taxes are used to generate federal funding for the state's Medicaid program.

Back To Top


MHA Opposes Maternal Mortality Review Legislation

Staff Contact: Daniel Landon or Sarah Willson

MHA staff expressed opposition for House Bill 664 in a state legislative committee hearing on Tuesday. HB 664, as originally written, largely is a statutory overlay of already existing actions to collect and analyze data to reduce the state’s maternal mortality rate. The prescriptive language of the bill likely would thwart progress by diverting attention to meet the law instead of proactively using existing authority to address public health issues.

Back To Top


AHA Releases Surprise Billing Principles

Staff Contact: Andrew Wheeler

Addressing the surprise billing issue has been a bipartisan concern in Congress throughout the past few years. Both Congress and the administration continue to grapple with ways to fix the problem. Due to this, the American Hospital Association adopted a set of principles that will be used to shape legislative and regulatory guidance. The principles include emphasis on patient protection, continued access to emergency care, preserved private negotiation activities, patient education about the differences in regular out-of-pocket expenses and surprise bills, ensuring adequate provider networks, greater health plan transparency, and supporting state laws that work. MHA is focused on preserving the benefits of a favorable Missouri state law on this topic.

Back To Top

 

Regulatory News
the latest actions of agencies monitoring health care


MHA Releases CAH And PPS Rate Comparison

Staff Contact: Andrew Wheeler

MHA released an analysis comparing how existing Medicare inpatient, outpatient and swing bed payments would be affected if critical access hospitals currently reimbursed based on cost were to instead be paid prospectively. The information is intended to be used for advocacy purposes. Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are available for download to authorized users of HIDI Analytic Advantage®.

Back To Top


CMS Releases National Health Expenditure Projections

Staff Contact: Andrew Wheeler

According to a report by the Centers for Medicare & Medicaid Services, nation health expenditure is expected to grow 5.5 percent annually, reaching $6 trillion by 2027. The health share of Gross Domestic Product is expected to rise from 17.9 percent in 2017 to 19.4 percent by 2027, largely due to faster growth in national health spending than in GDP. Throughout the next decade, health spending and enrollment is expected to be driven by growth in income and employment, baby-boomers aging into Medicare, and increasing prices for medical goods and services.

Back To Top


MHD To Require NDC Reporting For Outpatient 340B Drug Reimbursement

Staff Contact: Brian Kinkade

Effective Tuesday, April 30, the MO HealthNet Division will require 340B hospitals that carve in to the 340B program for Missouri Medicaid services to include the National Drug Code when submitting claims for pharmaceuticals administered in an outpatient setting. Claims must be submitted with the exact NDC that appears on the product administered and will be subjected to MHD’s usual preferred drug list and clinical review edits. Reimbursement will be the lesser of Wholesale Acquisition Cost minus 25 percent, or the provider’s usual and customary charge.

Back To Top

 


Consider This ...

Twenty-one percent of the nation's rural hospitals are at high risk of closing. That equates to 430 hospitals across 43 states that employ about 150,000 people and generate about $21.2 billion in total patient revenue a year.

Source: Modern Healthcare