MHA Today | April 19, 2019

April 19, 2019
MHA Today: News for Healthcare Leaders

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April 19, 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 Former Speaker of the U.S. House of Representatives, Tip O’Neill, was an adherent to the principle that “all politics is local.” Throughout the week, MHA has been delivering hospital board-adopted resolutions supporting investments in rural Missouri that have implications for rural hospitals and rural health. With approximately one month left in this year’s legislative session, they are a reminder to lawmakers that the work they do in Jefferson City can have big implications for the citizens they represent.

More than 40 hospitals and health systems submitted resolutions in support of the Reimagine Rural Health agenda. The resolutions support investments and policy innovations, and commend Gov. Parson for leadership in promoting workforce development, rural infrastructure improvements and expanded broadband — among other initiatives. These policies would improve access to health care for rural Missourians and currently are moving through the Missouri General Assembly.

The benefit of better roads and bridges, a stronger rural workforce, and expanded broadband aren’t exclusive to hospitals. Nonetheless, with existing and future health care workforce shortages, and growing telehealth use, these investments will create new opportunity.

The need for better roads and bridges in rural Missouri is obvious to anyone who travels them. However, in an emergency, the stakes are much higher. It’s important that access to health care — emergency or otherwise — isn’t determined by whether you live in a rural, urban or suburban community.

Earlier this year, we invited the governor and lawmakers to reimagine our state’s rural health system. We introduced a broad array of investments and policy changes — some require state funds, others imagination and flexibility — that could lead to sustainable rural health policy. The extensive agenda has been well received and likely will take several legislative sessions to achieve. That’s why this year’s session, which provides the first installment, is so important.

Reimagine Rural Health Having hospital boards engaged underscores the “local” aspect of the conversation. Elected and appointed boards are comprised of community leaders who care enough about their hospital and local health care to provide their time and expertise. Moreover, they understand that having a strong health care system improves individual, community and economic health.

Improving health care in all parts of the state requires engagement with policymakers. The resolutions are a reminder that just like politics, health care is local. Having hospital board members share the message that better care and better value are possible if local leaders and state policymakers work together is powerful.

Thank you to the hospitals and health systems — both rural and nonrural — that supported this effort.

Send me a note to let me know what you are thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
MHA Releases Issue Brief On CMS’ Proposed Updates To FY 2020 IPF
CMS Issues Marketplace 2020 Payment Notice
CMS Extends Deadline For Interoperability Rule Comments
MHD Modifies Precertification Requirements For Individual, Family And Group Therapy
MHD Behavioral Health Provider Training Sessions Available
MLN Connects Provider eNews Available

Regulatory News
the latest actions of agencies monitoring health care

MHA Releases Issue Brief On CMS’ Proposed Updates To FY 2020 IPF

Staff Contact: Andrew Wheeler

Yesterday, the Centers for Medicare & Medicaid Services released proposed updates to the fiscal year 2020 Medicare inpatient psychiatric facility prospective payment system. The rule includes proposals to rebase and revise the market basket to reflect a 2016 base year from a 2012 base year. CMS estimates that the effect of the payment and policy updates will increase IPF payments by 1.7 percent, or $75 million. CMS also proposes to adopt a new claims-based measure to the IPF Quality Reporting Program for FY 2021; the medication continuation following inpatient psychiatric discharge. This measure “assesses whether patients admitted to IPFs with diagnoses of major depressive disorder, schizophrenia, or bipolar disorder filled at least one evidence-based medication within two days prior to discharge or during the 30-day post-discharge period.” Comments are due Monday, June 17. MHA published an issue brief with additional information.

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CMS Issues Marketplace 2020 Payment Notice

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the final annual notice of benefit and payment parameters for the 2020 benefit year. The 2020 payment notice reduces user fees for marketplace plans and encourages the use of lower-cost generic drugs. CMS is reducing the user fees by 0.5 percent in an effort to reduce costs that is intended to be passed on to the consumer.

The rule also finalizes changes to the navigator program and changes the methodology used to calculate subsidies. CMS Administrator Seema Verma stated, “The rule issued today will give consumers immediate premium relief by reducing the exchange user fees in the Federally-facilitated Exchanges and State-based Exchanges using the federal platform for 2020 thanks to successful efforts to improve the efficiency of the exchange. At CMS, we have improved the operations of the exchange to deliver a better consumer experience at a lower cost.”

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CMS Extends Deadline For Interoperability Rule Comments

Staff Contact: Daniel Landon

The Centers for Medicare & Medicaid Services is extending its deadline for public comments regarding its proposed regulation on “interoperability.” Comments now will be due Monday, June 3. The initial deadline was Friday, May 3. The proposed rule addresses various topics concerning the transfer and use of health data. They include a mandate for hospitals with electronic health record systems to transmit Admission Discharge Transfer information, and a request for information regarding opening for public disclosure the negotiated payment rates of contracts between health care providers and insurers.

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MHD Modifies Precertification Requirements For Individual, Family And Group Therapy

Staff Contact: Brian Kinkade

The MO HealthNet Division is increasing the number of hours of individual, family and group therapy that may be provided without precertification from four to 14 hours. Precertification is required for services beyond the initial 14 hours. The precertification period is being increased from six months to 12 months, and the maximum allowable service levels per 12-month period will increase accordingly. The changes take effect Wednesday, May 1, and apply to services for MHD participants covered under the fee-for-service program only.

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MHD Behavioral Health Provider Training Sessions Available

Staff Contact: Brian Kinkade

The MO HealthNet Division will offer training for behavioral health providers from 10:30 a.m. to 4:30 p.m. on Thursday, April 25, and Thursday, June 27. Preregistration is required, and space is limited. Program guidelines, program benefits and limitations, precertification processes, and documentation requirements and claims billing requirements will be discussed. Representatives from the three MHD managed care plans will make presentations on their respective programs’ requirements and a representative from Conduent will demonstrate the behavioral health functionality of the MHD CyberAccess system.

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MLN Connects Provider eNews Available

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.

  • Air ambulance transports: Comparative billing report in April
  • Physician Compare: Supplemental preview period open until Saturday, April 27
  • Medicare Diabetes Prevention Program: Become a Medicare-enrolled supplier
  • CMS proposes expanding coverage of ambulatory blood pressure monitoring
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Did You Miss An Issue Of MHA Today?

April 15, 2019
Legislative Committee Approves Medication First Coverage Enhancements
Legislators Review Air Ambulance Surprise Billing Measure
HIDI HealthStats — Assessing Community Health Needs With exploreMOhealth
MHA Offers Workplace Violence Prevention Workshops

April 16, 2019
General Assembly Completes Enactment Of Supplemental Spending Bill
House Of Representatives Endorses Hospital Inspection Bill
House Advances Hospital Infection Control Legislation
State House Approves Nursing Legislation
Today Is National Healthcare Decisions Day
CMS Announces IQR Education Session

April 17, 2019
Senate Committee Approves Hospital Inspections Bill
Senate Committee Hears Hospital Infection Control Legislation
KFF Releases Medicaid Expansion State Fact Sheets
CMS Releases Proposed Payment And Policy Updates To FY 2020 IRF
Washington University Announces Free Or Reduced Cost Medical School

April 18, 2019
Hospital Boards Affirm Commitment To Rural Health Investments
State Legislative Chambers Exchange Health Care Bills
Corsi Resigns From Department Of Social Services Post
MHA Releases Issue Brief On Proposed Payment And Policy Updates To FY 2020 IRF
CMS Releases Proposed Payment And Policy Updates To FY 2020 IPF
ASAM Offers Addiction Medicine Training Opportunity

Consider This ...

April is National Donate Life Month. With 114,000 men, women and children awaiting lifesaving organ transplants, even the largest football stadium in the U.S. could not fit the number of patients on the national transplant waiting list.

Source: Donate Life America