MHA Today | May 2, 2019

May 2, 2019
MHA Today: News for Healthcare Leaders

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May 2, 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
State Legislators Approve Tort Reform Bills
Legislative Committee Advances Health Proposal
CMS Administrator Posts Blog About Recovery Audit Contractor Burden
MLN Connects Provider eNews Available
New Resources Available To Address The Opioid Crisis
CMS Releases QDM Version 5.5

Advocate
state and federal health policy developments


State Legislators Approve Tort Reform Bills

Staff Contact: Daniel Landon or Rob Monsees

The General Assembly enacted tort reform legislation that revises the venue where civil lawsuits will be tried and standards for consolidating issues or parties into a single lawsuit. Senate Bill 7 goes to Gov. Parson, who will approve it, describing it as a “huge win.” Also, the House of Representatives gave its final approval to House Bill 489. It sets higher thresholds for liability for punitive damages, with specific changes addressing health care providers. The bill moves to the Senate.

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Legislative Committee Advances Health Proposal

Staff Contact: Rob Monsees or Bill Anderson

A state House committee reviewed Senate Bill 70. As passed by the Senate, the legislation includes various health-related proposals. Among other changes, it would streamline hospital infection control data reporting, create conflict of interest standards for hospital licensure inspectors, allow hospitals to be training sites for certified nursing assistants, permit Medicaid eligibility to be suspended during incarceration, and clarify the scope of a 2018 state law on billing and payment standards for out-of-network practitioners in in-network hospitals. Opposition to the bill arises from its other components, including insurance coverage mandates for pregnancy care and off-label drugs.

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CMS Administrator Posts Blog About Recovery Audit Contractor Burden

Staff Contact: Andrew Wheeler

Centers for Medicare & Medicaid Services Administrator Seema Verma posted a blog that points to reasons for Recovery Audit Contractor burden decreases. She states that while RAC burdens have significantly declined, “the Medicare FFS Recovery Audit Program still continues to significantly reduce improper payments.” Actions that CMS has taken include the following.

  • holding RACs accountable to maintain a 95 percent accuracy rate
  • require RACs to maintain an overturn rate of less than 10 percent
  • RACs contingency fee is held until after the second level of appeal is exhausted

MHA appreciates these actions, which respond to past MHA advocacy on this topic.

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Regulatory News
the latest actions of agencies monitoring health care


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.

  • New Medicare card: Transition period ends in eight months
  • Inpatient Rehabilitation Facility, Long-Term Care Hospital and Skilled Nursing Facility Quality Reporting Programs: Submission deadline Wednesday, May 15
  • Nursing Home Compare refresh
  • Addressing social determinants of health will help achieve health equity
  • Durable Medical Equipment, Prosthetic, Orthotics and Supplies competitive bidding webcast series: Get ready for round 2021
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Quality and Population Health


New Resources Available To Address The Opioid Crisis

Staff Contact: Shawn Billings or Tiffany Bowman

The Centers for Medicare & Medicaid Services issued new resources and guidance to address the opioid crisis. Included are guidance on covered medications and prescribing practices for Part D, discontinuation of opioid tapering and improved safety alerts. The website includes multiple resources that can be utilized to address opioid use in medical practice.

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CMS Releases QDM Version 5.5

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services published Quality Data Model version 5.5. Electronic clinical quality measures produced using the QDM versions 5.5 publication are anticipated for the 2021 reporting/performance period. Changes from QDM version 5.4 and additional information are available.

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Consider This ...

May is Skin Cancer Awareness Month. Skin cancer is the most common cancer in the U.S. with approximately 9,500 people diagnosed with it each day.

Source: American Academy of Dermatology