MHA Today | May 17, 2019

May 17, 2019
MHA Today: News for Healthcare Leaders

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May 17, 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 In most years, the final week of the state legislative session is akin to a final sprint to the tape. This year has been different. A 27-hour Senate filibuster by the Senate Conservative Caucus started Monday afternoon and lasted until Tuesday evening. First thing Wednesday morning, the Senate Democrats began a filibuster to block passage of an abortion bill. Normal business resumed Thursday at noon. With long periods of inaction, the pressure to winnow and enact legislative priorities by the constitutional deadline of Friday at 6 p.m. is intense. Since you are receiving this edition of MHA Today in advance of the deadline, the story is unfinished. One thing is sure — we continue to advocate until the closing bell.

Last week, I gave a brief update on the newly-enacted state budget for the next fiscal year. Medicaid funding — the biggest priority for hospitals in the state’s budget — is solid, addressing the expected increase in payments to hospitals for Medicaid services. Funding for the Time Critical Diagnosis system, which created a controversy last year, was included in this year’s budget as well. In addition, $5 million for broadband, and nearly $10 million for Missouri One Start — a worker-training program that was part of Gov. Parson’s agenda — were included.

Two other items in the budget are worth mentioning. Funding to implement an expanded Admit Discharge Transfer technology system via the Hospital Industry Data Institute was included in the state fiscal year 2020 budget. The program will use funds from the Federal Reimbursement Allowance to allow the state to draw a 90-10 match from the federal government. In addition, the SFY 2020 budget includes $34 million to transform and modernize Medicaid.

The Parson administration is earnest in its desire to reduce costs while creating value in the state’s Medicaid program. The McKinsey study, released earlier this year, provided options for Medicaid transformation. MO HealthNet Director Todd Richardson indicated that the report, while not a roadmap, will inform development of policy options. The $34 million will provide resources to move forward. However, stakeholder engagement will be essential to building a better program.

Health care happens at the patient and provider level, not in Jefferson City. We have been — and will continue to be — a solution-oriented partner in the effort. Our goal is to bring policies to the table that are sustainable and that serve the best interests of patients, providers and the taxpayers.

Among the nonbudgetary items enacted earlier this session, lawmakers passed several tort reform measures designed to be fairer to hospitals when they are defending lawsuits. Workforce initiatives — a key priority of Gov. Parson in his first session as governor — were enacted. After years of contention, all parties developed a legislative compromise on consent to stop medically futile treatment of children. The measure passed unanimously in the House and Senate.

What did not get done is as important as what did. MHA, hospitals and health care stakeholders beat back numerous bills that would have been detrimental to hospitals and the state’s health care system. Proposals to allow concealed weapons in hospitals and to expand limited-benefit insurance coverage are but two examples.

There is a very good chance that next year’s agenda will include significant Medicaid-related policy changes. The Medicaid transformation funding, and the ongoing work by Director Richardson, are setting the stage for next year. We’re already engaged in discussions with the state, and have board-appointed hospital leaders reviewing policies to prepare for and shape those discussions. It’s never too early to start thinking about next year.

The bills adopted this year will move through formal review and to the governor for his signature or veto. As spring moves into summer, there will be bill signings and effective dates of the legislation. Next week, MHA will produce an Issue Brief outlining what happened and didn’t happen this session.

As always, I’m interested in hearing what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
General Assembly Extends FRA And Other Provider Taxes
State Legislators Enact Omnibus Health Bill
U.S. Senate Group Proposes Surprise Billing Legislation
Report Reviews Marijuana Use And Driver Impairment
TJC Offers Webinar On Comprehensive Cardiac Center Certification
Health Care Leadership Convenes At MHA’s Leadership Forum

state and federal health policy developments

General Assembly Extends FRA And Other Provider Taxes

Staff Contact: Daniel Landon or Rob Monsees

The Missouri General Assembly enacted Senate Bill 29, which reauthorizes the hospital Federal Reimbursement Allowance and the other state provider taxes for an additional year, to Sept. 30, 2020.

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State Legislators Enact Omnibus Health Bill

Staff Contact: Daniel Landon or Rob Monsees

The General Assembly completed its enactment of Senate Bill 514. It was amended to include many health-related components, including a number of MHA legislative priorities, such as streamlining hospital infection data reporting, establishing conflict of interest standards for hospital inspectors, allowing hospitals to be training sites for certified nurse assistants and creating new restrictions on insurer prior authorization practices. More details will be provided in MHA’s Issue Brief summarizing the outcomes of the 2019 legislative session.

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U.S. Senate Group Proposes Surprise Billing Legislation

Staff Contact: Daniel Landon or Andrew Wheeler

A bipartisan group of U.S. Senators released its proposed legislation on “surprise billing” by out-of-network practitioners. It is similar to a proposal issued earlier this week by a bipartisan group in the House of Representatives, but adds aspects of arbitration to resolve payment disputes. The Senate group also provided a summary of its proposal.

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Quality and Population Health

Report Reviews Marijuana Use And Driver Impairment

Staff Contact: Daniel Landon

A Congressional Research Service report summarizes research regarding marijuana use and driver impairment. It notes that self-reported marijuana use has grown “slowly but steadily” since 2008, but the growth appears not to correlate with state actions to loosen restrictions on marijuana use.

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TJC Offers Webinar On Comprehensive Cardiac Center Certification

Staff Contact: Sherry Buschjost

The Joint Commission is offering a complimentary webinar at noon on Thursday, May 23, during which the requirements and application process for comprehensive cardiac center certification will be reviewed. Registration is required.

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Health Care Leadership Convenes At MHA’s Leadership Forum

Staff Contact: Mary Becker

MHA Leadership Forum This week, hospital and health system leaders from across the state attended MHA's Annual Leadership Forum to gain insight into the trends that are transforming health care.

Attendees heard from the nation’s top authorities in health care policy, population health, leadership development and governance, who offered strategies to help organizations better serve patients and communities.

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Did You Miss An Issue Of MHA Today?

May 13, 2019
MHA Report Demonstrates Hospitals’ Significant Economic Value
CBO Scores President’s 2020 Budget
CMS Seeks Comment On Hospital Co-Location Guidance
TJC Announces Pioneers In Quality eCQM Webinar
Celebrate National Hospital Week With MHA

May 14, 2019
Legislators Enact Medical Futility Legislation
Interoperability Hardship Exception Available
Two Opportunities For Buprenorphine Waiver Training Available

May 15, 2019
House Shows Strong Support For Medicaid DSH Cut Delay
House Energy & Commerce Committee Releases Discussion Draft About Surprise Billing
Tidball Named Acting Director Of Social Services
CMS Announces IQR Education Session
St. Mary’s Medical Center Names New CEO

May 16, 2019
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

Consider This ...

Since 1990, health care-related employment in Missouri has doubled. According to the Bureau of Economic Analysis, of the 559,000 jobs created in Missouri since 1990, 212,000 — or more than one-third — have been in the health care sector.

Source: Missouri Hospital Association