MHA Today | May 16, 2019

May 16, 2019
MHA Today: News for Healthcare Leaders

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May 16, 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 Enact Health Insurance Task Force
MHD Issues Guidance On Outpatient Surgical Billing
MLN Connects Provider eNews Available
Trajectories — Neonatal Abstinence Syndrome: A Conversation That Could Save Two Lives
Missouri Receives Grants For Opioid Response In Rural Communities
Court Enjoins Implementation Of Liver Transplant Policy

Advocate
state and federal health policy developments


State Legislators Enact Health Insurance Task Force

Staff Contact: Daniel Landon

State legislators completed enactment of Senate Bill 414. It creates a Missouri Health Insurance Innovation Task Force to assess the implications and opportunities of Missouri state government applying for a federal Section 1332 waiver. Such waivers permit alternative regulatory standards for commercial insurers, so long as they are comparable in effect to what is required under the federal Affordable Care Act.

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Regulatory News
the latest actions of agencies monitoring health care


MHD Issues Guidance On Outpatient Surgical Billing

Staff Contact: Brian Kinkade

The MO HealthNet Division is alerting hospitals submitting fee-for-service claims with certain outpatient surgical revenue codes that claims must be accompanied by an appropriate surgery CPT code. Similar requirements will be enforced for outpatient dental surgeries; an appropriate oral surgery CDT code must be included in claims when outpatient dental surgeries are billed. Outpatient claims billed with surgical revenue codes that do not include surgical procedure codes may be subject to recoupment.

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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.

  • Putting our rural health strategy into action
  • Promoting Interoperability Program: Hardship exception application
  • Medicare Diabetes Prevention Program: Become a Medicare-enrolled supplier
  • eCQM: Specifications and materials for 2020 reporting
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Quality and Population Health


Trajectories — Neonatal Abstinence Syndrome: A Conversation That Could Save Two Lives

Staff Contact: Shawn Billings
Medication-assisted treatment of OUD
Medication-assisted treatment is an evidence-based treatment approach for individuals with opioid use disorder. It is the standard of care for pregnant women with OUD and leads to improved birth outcomes, including higher birthweight, reduced incidence of neonatal abstinence syndrome and shorter hospital stays for the infant. It is reported that 50 percent of pregnant women with OUD in publicly-funded treatment programs receive MAT.

The May 2019 issue of Trajectories provides MAT guidance on FDA-approved drugs for the treatment of OUD.

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Missouri Receives Grants For Opioid Response In Rural Communities

Staff Contact: Shawn Billings or Tiffany Bowman

The Health Resources and Services Administration awarded $24 million dollars nationally to rural communities in the form of planning grants. The grants are for one year and provide funding for planning a coordinated opioid response in rural communities. Missouri received six planning grants totaling more than $1 million for 2019. The list of all states and territories receiving grants is available.

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Health Law Insight


Court Enjoins Implementation Of Liver Transplant Policy

Staff Contact: Jane Drummond or Daniel Landon

Just days after denying a request by hospitals and prospective transplant patients to halt a controversial liver transplant policy, a federal judge reversed course and granted an injunction to stop the policy from going into effect. The plaintiffs promptly appealed the order denying their request for a temporary restraining order and asked for an injunction to stay implementation of the policy during appeal. Under the slightly different procedural posture and standard of review, the court reassessed the parties’ arguments and concluded that substantial harm to transplant recipients could result if the policy were allowed to proceed without further judicial review.

The policy would alter the geographic distribution of donated organs, which numerous hospitals, including Saint Luke’s Hospital of Kanas City, Washington University and Barnes-Jewish Hospital, argue would result in unused organs and patient deaths.

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Consider This ...

Missouri's rural hospitals employ approximately 29,000 workers who, through their economic activity, support another nearly 29,000 jobs elsewhere in the economy.

Source: Missouri Hospital Association