MHA Today | July 19, 2019

July 19, 2019
MHA Today: News for Healthcare Leaders

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July 19, 2019

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.


Insights


Herb Kuhn, MHA President & CEO When you think of the “culture wars,” motorcycle helmet requirements are unlikely to make a top 10 list of emotionally charged issues. However, for nearly four decades, some motorcycle enthusiasts and advocates have attempted to reduce or eliminate the state’s helmet mandate. The issue pits motorcyclists’ goal of “individual liberty” against health and public health leaders’ argument that helmetless riding is dangerous and potentially costly.

Late last week, Gov. Mike Parson vetoed legislation that included reduced helmet requirements. MHA was part of a coalition urging the veto. The bill — which included several other licensing, motor vehicle and traffic-related topics — was vetoed because of provisions not related to the helmet portion. This isn’t the first time changes to the law have been approved by the General Assembly and vetoed. That happened in 1993 and 2009. However, it is the first time the issue has landed on Parson’s desk. As a state representative and state senator, Parson has supported helmet law repeal legislation.

Helmet laws decrease the likelihood of death and brain injuries from motorcycle crashes. According to the National Highway and Traffic Safety Administration, helmets reduce the risk of death from motorcycle-related accidents by 37 to 42 percent. In addition, NHTSA research finds that unhelmeted motorcyclists are three-times more likely than helmeted riders to suffer traumatic brain injuries. The Insurance Institute for Highway Safety reports that 5,172 motorcyclists were killed in crashes in 2017 — more than double the number in 1997. In 2008, motorcyclist deaths reached an all-time high of 5,307, accounting for 14 percent of total highway crash deaths.

Looking at our surrounding states, we can see the difference helmet laws make. According to a St. Louis Post-Dispatch editorial about the veto, “the fatality rate for motorcycle accidents in Missouri is 13 percent, while the rates for Illinois and Iowa, which both allow helmetless riding, are 74 percent and 94 percent respectively. The cause-and-effect isn’t terribly hard to figure out.”

Hospitals have consistently and vocally opposed changes to the state’s helmet requirement because a significant body of research supports that helmets save lives and reduce harm. There also are economic reasons to oppose the change.

The NHTSA estimates that the nationwide economic cost savings from helmet use is nearly $3.4 billion. For the purposes of the research, NHTSA defines economic costs as lost productivity, medical costs, legal and court costs, emergency service costs, insurance administration costs, congestion costs, property damage, and workplace losses. Missouri’s savings is $110,740,486. This doesn’t take into consideration the life-value multiplier, which significantly increases the societal value proposition.

Although a change in the law would not lead to every motorcycle rider abandoning their helmet, some would. These riders wouldn’t simply be exercising their freedom to feel the wind in their hair, they also would be shifting significant economic risk to other Missourians.

The safety statistics on helmet-wearing ought to drive sensible policy. If not, then the economic risks all Missourians will assume should.

Since the General Assembly adopted legislation this year and Parson was silent on the issue in his veto message, the no-helmet advocates will almost certainly push for passage again next year. However, the circumstances which allowed the helmet repeal legislation to evade a Senate filibuster this year were unusual. Even so, we will continue to oppose changes to the helmet law. The costs are just too high.

Let me know what you think.

Herb Kuhn, MHA President & CEO



Herb B. Kuhn
MHA President and CEO

In This Issue
Governor Forms Health Insurance Innovation Task Force
Medicaid Caseload Slide Continues
MHD Increases Rates For Physician Services, Therapies, Private Duty Nursing And DME
CMS Updates Medicaid Scorecards
District Court Upholds Rule Expanding Non-ACA Health Plans
MLN Connects Provider eNews Available
Drug-Related Deaths Rise In Missouri
CMS Announces Preview Period For October 2019 Hospital Compare Data


MHA Seeks Member Feedback by July 31


MHA Today now is only published on Mondays, Wednesdays and Fridays. As we work to redesign the publication, MHA seeks feedback to better meet the needs of our membership. Please complete the short survey by Wednesday, July 31.



Advocate
state and federal health policy developments


Governor Forms Health Insurance Innovation Task Force

Staff Contact: Daniel Landon or Rob Monsees

Gov. Parson signed an executive order creating a Missouri Health Insurance Innovation Task Force. The group is to “identify and develop concepts that will result in significant innovation in the Missouri health insurance market.” Its work may be used to apply for a federal section 1332 waiver, which would permit alternative regulatory standards for commercial insurers, so long as they are comparable in effect to what is required by federal law. Last week, Parson vetoed enacted legislation on this topic based on objections that the bill’s compressed timeline would preclude thorough review. The executive order gives the governor more flexibility in appointing the group’s members and using its work.

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Medicaid Caseload Slide Continues

Staff Contact: Brian Kinkade

Missouri’s Medicaid caseload fell by 11,500 in June, marking the 10th month in a row that the number of persons covered by the program has fallen. Once again, essentially all of the reduction was among children (- 9,039) and parents (- 2,324). Throughout the past 12 months, the number of children covered by Missouri’s Medicaid program fell by more than 73,000, or 12.2 percent, and the number of parents covered fell by more than 19,000, or 20.5 percent.

The Department of Social Services attributes the declining caseload to the improving economy, although it has been noted that the reduction generally coincides with the introduction of automated system processes to review participants’ eligibility. A recent study by Georgetown University’s Health Policy Institute questions whether the large reductions seen in 2018 in some states like Missouri can be explained by economic conditions alone. Among the five states with a reduction of 5 percent or more in child Medicaid enrollment in 2018, Missouri’s reduction was second greatest at 9.1 percent.

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MHD Increases Rates For Physician Services, Therapies, Private Duty Nursing And DME

Staff Contact: Brian Kinkade

The MO HealthNet Division increased reimbursement for a number of noninstitutional services, including physician services; school-based physical, occupational and speech therapies; school-based private duty nursing and person care services; and durable medical equipment, by 1.5 percent for dates of service on and after July 1 in accordance with the 2020 state budget. These rate increases are applicable to services delivered under the fee-for-service program. MHD automatically will adjust claims paid after July 1 but before the claims system’s rate tables are updated. Similar rate increases for other noninstitutional services will be announced in the coming weeks.

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CMS Updates Medicaid Scorecards

Staff Contact: Brian Kinkade

The Centers for Medicare & Medicaid Services refreshed the scorecards on state Medicaid program performance that first were issued last summer. The scorecards include data voluntarily reported by states on some or all of 19 program measures of program effectiveness in six broad program areas.

This latest update includes 53 new data points reported by states in 12 different measures. CMS says in its release on the update that additional scorecard improvements will be released later this year.

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Health Law Insight


District Court Upholds Rule Expanding Non-ACA Health Plans

Staff Contact: Jane Drummond

A federal judge upheld a Trump administration rule expanding the duration of short-term limited duration health plans. The policies, which are exempt from the coverage mandates of the Affordable Care Act, were limited to a maximum period of three months by the Obama administration. The Trump administration lengthened the initial term to 12 months and authorized renewals for as much as three years. A number of insurers challenged the rule as contrary to the intent of the ACA and HIPAA.

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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.

  • CMS proposes to cover acupuncture for chronic low back pain for Medicare beneficiaries enrolled in approved studies
  • Program for Evaluating Payment Patterns Electronic Reports for Home Health Agencies and Partial Hospitalization Programs
  • Qualified Medicare beneficiary billing requirements
  • Durable Medical Equipment, Prosthetics, Orthotics, and Supplies competitive bidding: round 2021 bid window is open
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Quality and Population Health


Drug-Related Deaths Rise In Missouri

Staff Contact: Leslie Porth

Earlier this month, the Centers for Disease Control and Prevention, National Center for Health Statistics released new drug-related death data. Nationally, the predicted count of drug overdose deaths decreased by 5.1 percent in the 12-month period ending December 2018 compared to the preceding 12-month period ending December 2017. However, Missouri deaths increased by 16.3 percent and totaled 1,635 deaths for the period ending December 2018. Missouri and Delaware were the two states with the highest percent increase in deaths.

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CMS Announces Preview Period For October 2019 Hospital Compare Data

Staff Contact: Sherry Buschjost

October 2019 Hospital Compare preview data is available on QualityNet. The preview period ends Wednesday, Aug. 14, and is applicable for hospitals and facilities participating in the following programs.

  • Hospital Inpatient Quality Reporting
  • Hospital Outpatient Quality Reporting
  • Prospective Payment System Exempt Cancer Hospitals Quality Reporting
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Did You Miss An Issue Of MHA Today?


July 15, 2019
Governor Vetoes Legislation From 2019 Session
CRS Releases Report On Medicare Financial Status And Insolvency Projections
MHD Increases Reimbursement For Behavioral Health, Ambulance, Home Health Services
May MUR Available On HIDI Analytic Advantage®
CMS Announces HAC And HRRP Education Session

July 17, 2019
U.S House Committee Approves New Version Of Surprise Billing, Medicaid DSH Legislation
Congressional Committee Creates Rural And Underserved Communities Health Task Force
Legionella Now Reportable Within One Day
MHA Releases Issue Brief On Proposed CY 2020 Home Health Updates
Long-Term Care Facility Rules Put Patients Over Paperwork And Update Arbitration Requirement
MHA Releases Analysis Of FFY 2019 Post-Acute Care Transfer Policy
MHA PFAC Releases Part Two In Vlog Series



Consider This ...

Total drug overdose deaths in America declined by around 5 percent last year, the first drop since 1990. However, Missouri deaths increased by 16.3 percent and totaled 1,635 deaths.

Source: The New York Times/CDC