MHA Today | June 4, 2019

June 4, 2019


MHA Today: News for Healthcare Leaders

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June 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
Congressional Subcommittee Reviews DSH Cut And Behavioral Health Bills
MHD Updates Ambulance Reimbursement Policy
MHA Distributes Analysis Of The Proposed FFY 2020 IPF PPS
HIDI Releases Second Quarter FFY 2019 Inpatient, Outpatient, Missouri Databases
MHA Resource Available To Implement CHNAs

Health Care Leadership Series 2019-2020

Series Dates
All sessions are held on Fridays.

  • Session 1 — Sept. 6, 2019
  • Session 2 — Oct. 4, 2019
  • Session 3 — Nov. 15, 2019
  • Session 4 — Jan. 10, 2020
  • Session 5 — Feb. 7, 2020
  • Session 6 — March 6, 2020
  • Session 7 — April 3, 2020
  • Session 8 — May 1, 2020

Drury Plaza Hotel Columbia East
Columbia, Mo.

Register for the series by Friday, July 12.


state and federal health policy developments

Congressional Subcommittee Reviews DSH Cuts And Behavioral Health Bills

Staff Contact: Daniel Landon

The Health Subcommittee of the U.S. House of Representatives Energy and Commerce Committee held a hearing on H.R. 3022. The legislation would repeal the cuts in state Medicaid Disproportionate Share Hospital allotments slated to take effect Oct. 1. The reductions originally were mandated by the Affordable Care Act and have been delayed but expanded four times since 2014. Witnesses provided testimony.

The subcommittee also considered H.R. 1767. It would extend the June 30 expiration of the Certified Community Behavioral Health Clinic demonstration project in Missouri and seven other states. U.S. Senator Roy Blunt of Missouri sponsored the original legislation and is promoting its continuation and expansion. Congressman Billy Long of Missouri is a member of the subcommittee and the full committee.

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Regulatory News
the latest actions of agencies monitoring health care

MHD Updates Ambulance Reimbursement Policy

Staff Contact: Brian Kinkade

Included in the MO HealthNet Division ambulance policy manual update posted on May 30 are two substantive changes. First, the update adds a definition of “emergency services” in Section 13.3.A as follows.

“‘Emergency services’ are medical/behavioral services that are furnished by a provider that is qualified to furnish these services and are needed to evaluate or stabilize an emergency medical condition.”

Second, the updated policy adds documentation requirements for ground advance life support services reimbursement in Section 13.3.D as follows.

“The provider must maintain documentation on file that the ALS Assessment and/or an ALS service was performed in order to receive reimbursement. An ALS intervention must be medically necessary to qualify as an intervention for payment for an ALS level of service. The provider must maintain documentation on file regarding this medical necessity.

In the case of an appropriately dispatched ALS emergency service, if the ALS crew completes an ALS assessment, the services provided by the ambulance provider shall be covered at the ALS emergency level, regardless of whether the patient required ALS intervention services during the transport, provided that ambulance transportation itself was medically reasonable and necessary.”

These provisions apply to ALS-1 and ALS-2 levels of care.

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MHA Distributes Analysis Of The Proposed FFY 2020 IPF PPS

Staff Contact: Andrew Wheeler

MHA released a summary and comprehensive analysis of the proposed federal fiscal year 2020 Medicare Inpatient Psychiatric Facility Prospective Payment System updates. The analysis compares FFYs 2019 and 2020, which includes updates to the federal per diem base rate, wage index and labor-related share percentage. In aggregate, the state will see an increase of 2.6 percent for services paid under the IPF PPS. The analysis does not include effects caused by high-cost outliers, payments for managed care patients, or any modification in fee-for-service payments as a result of hospital participation in new payment models being tested under Medicare demonstration or pilot programs. Although effects of the Medicare sequestration have been estimated, the rate increase excludes the sequestration payment reduction. The analysis, which is available online for authorized users of HIDI Analytic Advantage,® includes a summary for the nation, Missouri, health systems and individual hospitals. Comments about the proposed rule must be submitted by Monday, June 17.

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HIDI Tech Connect

HIDI Releases Second Quarter FFY 2019 Inpatient, Outpatient, Missouri Databases

Staff Contact: Shane VanOverschelde

The second quarter federal fiscal year 2019 inpatient and outpatient databases, including HIDI-reporting hospitals in Missouri and Illinois (but excluding hospitals in Kansas City, Kan. for the current quarter), now are available for download to subscribers of the Premier Data Package on HIDI Analytic Advantage.® These databases will be updated to include the Kansas City, Kan. hospital data for the current quarter in the coming weeks. The databases consist of a patient-level limited dataset, including all HIDI-reported discharges and visits to hospitals. Files are delivered as both text files and ready-to-query Microsoft Access database files. The files are located in “Strategic Planning/Premier Data” and are organized in the following categories.

  • Q2 FFY2019, Inpatient
  • Q2 FFY2019, Outpatient Classified
  • Q2 FFY2019, Outpatient Unclassified

Hospitals interested in subscribing to the 2019 HIDI Premier Data Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.

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Quality and Population Health

MHA Resource Available To Implement CHNAs

Staff Contact: Stephen Njenga
Community Health Improvement Week
During Community Health Improvement Week, MHA is highlighting a variety of Community Health Needs Assessment resources available to member hospitals. Following yesterday’s feature on a CHNA guidance document that assists hospitals in completing a CHNA, MHA also has developed a CHNA implementation guide that provides the guidance necessary to implement their CHNAs. The guide incorporates the most current regulatory requirements from the Internal Revenue Service and provides the tools necessary to complete the implementation plan.

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Consider This ...

Tourette Syndrome is a condition that affects the brain and nerves, causing people to make repeated movements and sounds, also known as motor and vocal tics, that they cannot control. It is estimated that approximately one of every 162 children have TS.

Source: Centers for Disease Control and Prevention