MHA Today | March 22, 2019

March 22, 2019
MHA Today: News for Healthcare Leaders

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March 22, 2019

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


Herb Kuhn, MHA President & CEO There isn’t an official mid-point to Missouri’s regular session of the General Assembly, but lawmakers’ return from legislative spring break usually is considered the second half of the January to May session. This week, most lawmakers have been back home. During the break, we encouraged hospital leaders to reach out to their local lawmakers on a couple of issues. As we enter the unofficial home-stretch, I’d like to provide an update on several legislative priorities — including progress in the state’s budget and improving the regulatory climate, as well as tort reform, managed care accountability, workforce development and patient safety.

Budget work for the 2019–2020 state fiscal year is well underway. Because of federal and state tax code changes, state income tax revenues are unpredictable. So the state’s budget and new investments likely will be small. However, funding for hospitals has remained stable ― no payment cuts. In addition, funding for expansion of Admit Discharge Transfer technology through Medicaid is included in the pending budget. Using $1 million in Federal Reimbursement Allowance funds, the state can receive $9 million in federal matching funds to support the initiative. FRA reauthorization legislation is on track as well.

Several bills are designed to improve the regulatory climate, including legislation to require notification for emergency rule filing and to address potential hospital inspector conflicts of interest. Legislation has been filed to address concerns about care for patients in the custody of law enforcement. And, lawmakers are considering legislation to streamline reporting for infections and antibiotic stewardship practices.

Several medical liability reform bills are working their way through the chambers. Significant reforms have been adopted in the past several sessions, and legislation to curtail liability for punitive damages under the state’s merchandising practices law are being discussed.

Two bills related to Medicaid managed care accountability have been filed, and a hearing on one is expected soon. In addition, bills to improve prior authorization and utilization review standards, and promote prompt credentialing and payment for practitioners, are moving through the legislative process.

Gov. Parson has made workforce development a centerpiece of his agenda. The recent announcement that the State Board of Nursing will be growing the capacity of the state’s schools of nursing was welcome news for hospitals. Lawmakers are working on several pieces of legislation related to the health care workforce as well, including legislation that would improve oversight of, and provide more flexibly to, health care workers. In addition, legislation to allow psychiatrists to receive loan repayment is on the fast track — a profession in high demand throughout Missouri.

Prescription drug monitoring program legislation has been approved in the Missouri House and has advanced in the Missouri Senate. However, this isn’t the only initiative designed to protect patients with substance use disorder. Legislation in support of medication-assisted treatment and revisions to allowable pharmacy for patients at discharge are being discussed.

Lawmakers’ ability to file new bills for the 2019 session ended several weeks ago. Bills that have been reviewed by committees likely are to start moving faster to discussion by the full bodies of both chambers. These bills are more likely to appear as amendments to other bills as the speed of the legislative process increases.

We’re watching a significant number of bills. Playing “whack-a-mole” with legislation that would harm hospitals and the health care system is an effort that continues until the closing bell. Nonetheless, there are some very good policies being discussed this year that could improve hospital operations and patient care.

The second half of the session is where the process gets more interesting. We’ll continue to provide updates on the status of individual bills and our agenda regularly.

I always want to know what you think. Send me an email if you have thoughts or concerns.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
HHS 2018 Annual Report Available
National Academies Report Pushes More Medicaid For Opioid Treatment

Regulatory News
the latest actions of agencies monitoring health care

HHS 2018 Annual Report Available

Staff Contact: Andrew Wheeler

The Department of Health and Human Services released its 2018 Annual Report, highlighting several ideas, policy changes and research projects. The report includes five goals that correspond to HHS’ 2018-2022 strategic plan.

  • reform, strengthen and modernize the nation’s health care system
  • protect the health and well-being of Americans where they live, learn work and play
  • strengthen the economic and social well-being of Americans across the lifespan
  • foster sound, sustained advances in the sciences
  • promote effective and efficient management and stewardship
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Quality and Population Health

National Academies Report Pushes More Medicaid For Opioid Treatment

Staff Contact: Shawn Billings or Tiffany Bowman

The National Academies of Sciences, Engineering and Medicine offered several potentially controversial recommendations to boost the use of medication-assisted treatment for opioid use disorder in a new report. For instance, the report says that MAT shouldn't be withheld from patients if behavioral interventions, such as counseling, aren't available.

The report says that MAT is effective in a broader range of settings than currently is the norm, and that all classes of FDA-approved drugs for the treatment of OUD should be available in any care or criminal justice system. It raises concerns with laws and regulations that pose barriers to methadone and buprenorphine, in particular, as methadone only can be given in state and federally certified opioid treatment programs, and some states exclude both MAT options entirely from Medicaid coverage.

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Did You Miss An Issue Of MHA Today?

March 18, 2019
MedPAC Releases March Report To Congress
MHA Releases Analysis Of Medicare ED Evaluation
CMS Announces IQR Education Session

March 19, 2019
Navigant Releases Preliminary Analysis Of Medicare Expansion Effects On Hospitals
CHR&R Announces Release Of The Tenth Edition Of Their Rankings
Provident Young Professionals To Host Panel On The Opioid Crisis
CMS Invites Comments On Draft 2020 QRDA I Implementation Guide

March 20, 2019
HIDI Releases New Market Forecaster To Missouri Participating Hospitals
Six Missouri Colleges And Universities Receive Nursing Education Grants
Black River Medical Center Discusses Merger With Saint Francis Healthcare System
HRSA And Delta Regional Authority Schedule Telehealth Webinar

March 21, 2019
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

Consider This ...

Today is World Water Day. Around the world, 2.1 billion people live without safe drinking water at home. Lack of safe drinking water and safe sanitation services increase the chance of outbreaks of waterborne diseases.

Source: Centers for Disease Control and Prevention