March 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
GAO Reviews Out-of-Network Air Ambulance Billings
MHD Adds Alternative Therapies For Chronic Pain Treatment
MLN Connects Provider eNews Available
Report Shows Fentanyl Deaths On The Rise
SSM Health Saint Louis University Hospital Names New President
state and federal health policy developments
Staff Contact: Daniel Landon
The U.S. Government Accountability Office released a report and summary regarding balance billing of privately insured patients for out-of-network air ambulance transport. The GAO’s 2017 data show a median price of $36,400 for helicopter transport and $40,600 for fixed-wing transport. Sixty-nine percent of the 20,700 transports examined were out-of-network. Reviewing 60 consumer complaints from two states, the GAO found only one involving a balance billing of less than $10,000.
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Staff Contact: Brian Kinkade
The MO HealthNet Division will reimburse acupuncture, chiropractic therapy and physical therapy for patients with chronic pain beginning Monday, April 1. A bulletin summarizing reimbursement rates and limits for these new services should be issued before the end of the month. One-hour webinar training sessions on the limitations and billing requirements for the new services will be held at the following dates and times; advance registration is required using the respective links.
With the additional services available to treat chronic pain, MHD also will lower its morphine milligram equivalent accumulation limit from 300 MME to 200 MME. The 200 MME accumulated limit takes effect on Thursday, April 4. This limit applies to prescriptions combined; the 90 MME daily limit per script limit is unchanged. Exceptions to the 200 MME limit are allowed for patients diagnosed with cancer or sickle cell disease, and patients in palliative or hospice care.
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the latest actions of agencies monitoring health care
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.
Quality and Population Health
Staff Contact: Shawn Billings or Tiffany Bowman
A spike in fentanyl use and a subsequent steep rise in related deaths marks the third wave of the opioid crisis in the U.S., according to a recent report by the Centers for Disease Control and Prevention. Increases are affecting specific populations more heavily than others. Fentanyl also is appearing when mixed with other illicit drugs, and the user may not be aware, according to news sources. This underscores the need for more widespread naloxone distribution, which ultimately will reduce deaths due to opioid overdose.
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Staff Contact: Carol Boessen
SSM Health Saint Louis University Hospital named Steven Scott as president, effective March 20. He most recently served as interim chief operating officer at the University of Texas Medical Branch in Galveston, Texas. Scott has more than 35 years of health care leadership experience and has served as interim president since January 15. He succeeds Kathleen “Kate” Becker who accepted the chief executive officer position at the University of New Mexico Hospitals in Albuquerque in July 2018. A list of CEO changes is available online.
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March is Brain Injury Awareness Month. Researchers found that activities that contributed to the highest number of sports- and recreation-related traumatic brain injury ED visits were football, bicycling, basketball, playground activities and soccer.
Source: Centers for Disease Control and Prevention