MHA Today | July 31, 2019

July 31, 2019

 

MHA Today: News for Healthcare Leaders

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July 31, 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
GAO Examines States' Supplemental Medicaid Payments To Hospitals
Governor Appoints State Health Insurance Innovation Task Force
MHA Distributes Financial Indicators Analysis
MHA Releases Issue Briefs On Medicare Payment And Policy Updates
DHSS Publishes Legionella News Release
CMS Issues PHI Memo


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Advocate
state and federal health policy developments


GAO Examines States' Supplemental Medicaid Payments To Hospitals

Staff Contact: Daniel Landon or Brian Kinkade

The U.S. Governmental Accountability Office issued a report and summary on states’ Medicaid supplemental payments to hospitals. Among other topics, it reviews state payments for uncompensated care costs. The report notes that Missouri was one of a few states in which Medicaid Disproportionate Share Hospital payments exceeded uncompensated care costs. MHA disagrees. Among other objections, the GAO assertion is based on the results of the original 2014 Medicaid DSH audits. Successful litigation by MHA and other plaintiffs compelled CMS to allow states to redo those audits using a standard that significantly will lower Missouri hospitals’ Medicaid DSH audit liabilities.

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Governor Appoints State Health Insurance Innovation Task Force

Staff Contact: Daniel Landon or Andrew Wheeler

Gov. Parson appointed seven members of the Health Insurance Innovation Task Force created by a previous gubernatorial executive order. The group is slated to hold its first meeting on Thursday, Aug. 8, in Jefferson City.

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MHA Distributes Financial Indicators Analysis

Staff Contact: Andrew Wheeler

MHA released a financial indicator analysis providing comparative financial metrics for individual hospitals compared to state and national benchmarks. The analysis uses standard accepted formulas as defined and published by various rating agencies. The source for the financial information is the first quarter 2019 Healthcare Cost Report Information System database, which includes the Medicare cost report data. MHA posted these files to HIDI Analytic Advantage® for review.

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Regulatory News
the latest actions of agencies monitoring health care


MHA Releases Issue Briefs On Medicare Payment And Policy Updates

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services recently released finalized and proposed payment and policy updates.

Fiscal year 2020 inpatient psychiatric facility payment and policy updates were finalized, and CMS estimates that the updates will increase IPF payments by 1.5 percent, or $65 million. Major provisions of the rule include rebasing the market basket, removing the one-year lag of the wage index data and changing the IPF Quality Reporting Program.

CMS also finalized the FY 2020 inpatient skilled nursing facility payment and policy updates, and estimates that the updates will increase SNF payments by 2.4 percent, or $851 million. Major provisions of the proposed rule include transitioning to the Patient Driven Payment Model, changing the SNF Value-Based Purchasing Program and updating the SNF Quality Reporting Program.

Proposed updates to the calendar year 2020 Medicare End-Stage Renal Disease and Durable Medical Equipment Prospective Payment System were released. CMS projects that Medicare payments to ESRD facilities will be $11.1 billion, amounting to a 1.7 percent increase. Major provisions of the proposed rule include basing the wage index values on the latest available data, updating the outlier policy, changing the transitional drug add-on payment adjustment and proposing discontinuation of the erythropoiesis-stimulating agent monitoring policy.

Calendar year 2020 proposed updates also were released for the Medicare Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System. Major provisions of the proposed rule consist of utilizing the inpatient wage index including proposed changes for low-wage index hospitals, increasing price transparency requirements, changing the hospital outpatient and ASC quality reporting programs, and removing total hip arthroplasty from the inpatient only list.

Comments on the proposed rules must be received 4 p.m. Friday, Sept. 27. MHA published issue briefs with additional details.

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DHSS Publishes Legionella News Release

Staff Contact: Sarah Willson or Jackie Gatz

The Missouri Department of Health and Senior Services published a news release regarding new Legionella reporting standards. The release follows an emergency rule, which was effective July 8, moving Legionellosis from the list of diseases or findings that must be reported within three days to the list of diseases or findings that must be reported within one day. The department published a proposed rule in the Aug. 1 Missouri Register, which currently is open for comment until Friday, Aug. 30. MHA encourages hospitals to submit comments of support or opposition to Adam Crumbliss, Director, Department of Health and Senior Services, Division of Community and Public Health, P.O. Box 570, Jefferson City, MO 65102. MHA also requests hospitals share their positions with MHA by contacting Sarah Willson at swillson@mhanet.com or 573/893-3700, ext. 1304.

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CMS Issues PHI Memo

Staff Contact: Sarah Willson or Jane Drummond

The Centers for Medicaid & Medicare Services QIES Technical Support Office recently issued a memo to state and regional offices on actions to take in the event of a personal health information security breach. The memo addressed to home health, hospice, long-term care hospitals and swing bed providers is applicable to all hospital providers and is a reminder to ensure PHI is securely sent regardless of request or by whom.

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Consider This ...

Federal Drug Enforcement Administration data says about 1.6 billion prescription pain pills were supplied to Missouri pharmacies from 2006 to 2012.

Source: Missourinet.com