MHA Today | April 4, 2019

April 4, 2019
MHA Today: News for Healthcare Leaders

linkedin twitter facebook
April 4, 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 Advances PDMP Legislation
Prompt Credentialing Legislation Advances
CMS Issues Bad Debt Accounting Classification For Medicare-Medicaid Crossover
Analysis Of S-10 Data And Medicare DSH Implications Available
CMS Provides Outpatient Claims Detail Reports
TJC Announces Direct Data Submission Webinar
BNDD Promotes National Drug Takeback Day

Advocate
state and federal health policy developments


Senate Committee Advances PDMP Legislation

Staff Contact: Rob Monsees or Daniel Landon

By a 4-2 vote, a state Senate committee approved legislation that would authorize a statewide prescription drug monitoring program. House Bill 188 previously was approved by the House of Representatives. The fate of the bill will be decided in debate by the full Senate, where opposition by a few senators, coupled with the tradition of unlimited debate, may result in the bill being blocked or significantly diluted. Eighty-four percent of Missouri’s population and 94 percent of its health care providers are in cities or counties that have adopted the voluntary PDMP model initiated by Saint Louis County.

Back To Top


Prompt Credentialing Legislation Advances

Staff Contact: Daniel Landon or Rob Monsees

A state House committee unanimously approved legislation to revise state law on insurers’ credentialing of practitioners for their networks. House Bill 654 will be placed in the queue for debate by the House of Representatives. Upon credentialing a practitioner, the insurer will pay for the practitioner’s treatment of its enrollees while the credentialing application was pending. MHA supports the measure.

Back To Top

 

Regulatory News
the latest actions of agencies monitoring health care


CMS Issues Bad Debt Accounting Classification For Medicare-Medicaid Crossover

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issued instructions about correctly classifying unpaid deductible and coinsurance amounts for Medicare-Medicaid crossover claims. These instructions are effective for cost reporting periods beginning on or after Oct. 1, 2019. They state, “Providers claiming Medicare bad debt must meet 42 CFR 413.89 and all requirements from Chapter 3 of the Provider Reimbursement Manual. Correctly classify unpaid deductible and coinsurance amounts for Medicare-Medicaid crossover claims in your accounting records. For bad debt amounts:

  • Do not write off to a contractual allowance account.
  • Charge to an expense account for uncollectible accounts (bad debt).

Effective for cost reporting periods beginning on or after Oct. 1, providers must comply with these longstanding Medicare bad debt requirements.”

Back To Top


Analysis Of S-10 Data And Medicare DSH Implications Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services finalized a second year of a three-year transition to distribute Medicare disproportionate share uncompensated care pool payments based on S-10 data. MHA prepared an analysis of the effect of this change. Along with the fiscal impact study, a separate analysis is included, which provides comparative data to determine if changes to the S-10 data are needed. All inpatient prospective payment hospitals will receive a report regardless of DSH eligibility. Medicare DSH hospitals in Missouri are expected to receive an estimated $24 million in additional DSH payments as a result of the transition and an estimated $31 million as a result of the increase to the national DSH pool in FFY 2019. Policy and analytic studies are available for download to authorized users of HIDI Analytic Advantage®.

Back To Top

 

Quality and Population Health


CMS Provides Outpatient Claims Detail Reports

Staff Contact: Sherry Buschjost

For hospitals participating in the Outpatient Quality Reporting Program, the Centers for Medicare & Medicaid Services are providing a zip file that includes claims detail reports for the following three measures.

  • OP-32: Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy measure (Colonoscopy measure)
  • OP-35: Admissions and Emergency Department Visits for Patients Receiving Outpatient Chemotherapy measure (Chemotherapy measure)
  • OP-36: Hospital Visits after Hospital Outpatient Surgery measure (HOPD surgery measure)

Additional details are available.

Back To Top


TJC Announces Direct Data Submission Webinar

Staff Contact: Sherry Buschjost

Registration is open for The Joint Commission webinar, “2019 eCQM Direct Data Submission for All Hospitals: Transitioning to the Direct Data Submission Platform.” The webinar will prepare hospitals for the transition to direct data submission and discuss how the DDSP empowers hospitals with tools to improve data validation. The webinar is offered at 1 p.m. Tuesday, April 23. Registration is required and will close when maximum capacity is met.

Back To Top

 

Noteworthy


BNDD Promotes National Drug Takeback Day

Staff Contact: Sarah Willson or Leslie Porth

The Bureau of Narcotic and Dangerous Drugs reminds pharmacists and other health care providers of the upcoming National Drug Take Back Day on Saturday, April 27. Law enforcement agencies are authorized to collect unwanted medications for disposal. BNDD has a helpful guide for providers who wish to establish drug take-back and disposal processes. The hospital must contact the DEA and follow their processes to ensure compliance and safety.

Back To Top

 


Consider This ...

April is Sexual Assault Awareness Month. Sexual violence affects health in many ways, and can lead to short and long-term physical and mental health problems. Promoting healthy and respectful relationships can help reduce sexual violence.

Source: Centers for Disease Controland Prevention