MHA Today | August 14, 2019

August 14, 2019

 



MHA Today: News for Healthcare Leaders

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August 14, 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
D.C. Court Rules Against Hospitals In DSH Litigation
CMS Reports On Enrollment In Individual Insurance Market
CMS Releases CART-Inpatient Version 4.23.1
Hospital-Specific Reports Available For CMS Hospital Readmission Reduction Program
CMS Selects Hospitals For eCQM Validation


UPCOMING SEMINARS
Excellence in Clinical Care Series — Quality Improvement, Infection Prevention

Wednesday, Sept. 25, to Friday, Sept. 27
Camden on the Lake
Lake Ozark, Mo.

Register on or before Wednesday, Sept. 11.


Health Law Insight


D.C. Court Rules Against Hospitals In DSH Litigation

Staff Contact: Jane Drummond

The U.S. Court of Appeals for the District of Columbia Circuit ruled against hospitals challenging the Disproportionate Share Hospital cost calculation established by the Centers for Medicare & Medicaid Services’ 2017 rule. The lawsuit raises the same issues as MHA’s suit currently pending before the 8th Circuit Court of Appeals.

The court rejected the hospitals’ argument that the rule violates the plain text of the Medicaid statute. While the Medicaid statute sets out certain payments that the secretary must consider in determining costs (Medicaid and uninsured payments), nothing in its text prohibited the secretary from considering other payments. While acknowledging that the rule represents a policy change from the 2008 DSH audit rule, the court declined to deem it arbitrary and capricious, as CMS had provided a reasonable rationale for the change — ensuring hospitals did not receive payment for costs compensated by another source.

The ruling reverses the nationwide injunction against the 2017 rule. The rule remains enjoined in Missouri because of the ruling entered by the Missouri district court. Staff now anticipates a ruling from the 8th Circuit within a matter of weeks.

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Advocate
state and federal health policy developments


CMS Reports On Enrollment In Individual Insurance Market

Staff Contact: Daniel Landon

The Centers for Medicare & Medicaid Services issued two reports on enrollment in the individual insurance market, including federally subsidized coverage. The “Early 2019 Effectuated Enrollment Snapshot” reviews enrollment by state in the federal health insurance exchange in in February 2019 and for the 2018 plan year. The “Trends in Subsidized and Unsubsidized Enrollment Report” assesses the entire individual insurance market in 2018.

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Quality and Population Health


CMS Releases CART-Inpatient Version 4.23.1

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services announced that Inpatient Version 4.23.1 of the CMS Abstraction and Reporting Tool now is available on QualityNet. The release corrects a saving abstractions defect to support version 5.6 of the Specifications Manual for National Hospital Inpatient Quality Measures covering discharges from July 1 through Dec. 31, 2019.

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Hospital-Specific Reports Available For CMS Hospital Readmission Reduction Program

Staff Contact: Sherry Buschjost

Hospital-specific reports for the fiscal year 2020 Hospital Readmissions Reduction Program now are available on the QualityNet Secure Portal. The HSRs reflect information about payment reductions effective Tuesday, Oct. 1. The review and corrections period is open and ends Monday, Sept. 9. Additional information is available on QualityNet.

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CMS Selects Hospitals For eCQM Validation

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services’ Hospital Inpatient Quality Reporting Program has selected the hospitals for validation of electronic clinical quality measures for calendar year 2018, to establish fiscal year 2021 payment determination. The CY 2018 quarters eligible for validation for FY 2021 payment determination are first through fourth quarter 2018. A list of selected hospitals is available on QualityNet. eCQM validation resources also are available.

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Consider This ...

The Centers for Disease Control and Prevention has identified 220 U.S. counties at risk of outbreaks of H.I.V. and Hepatitis C because of the opioid crisis – 13 are in Missouri.

Source: Missourinet.com