MHA Today | November 4, 2019

November 4, 2019
MHA Today: News for Healthcare Leaders

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November 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
CMS Finalizes CY 2020 Home Health Payment And Policy Update
CMS Deadline Approaches For CAH Hardship Exception Application
MO HealthNet To Reject Claims For Dual Eligibles Without MBI Number January 1
Appellate Court Reverses Injunction Against DSH Rule
Council Of Economic Advisors Updates Economic Cost Of Opioid Use Disorder
SAMHSA Launches New Website To Help Individuals Locate SUD Treatment
CMS Releases January 2020 Hospital Compare Hospital Data For Preview

What You Need To Know This Week

  • The MHA convention begins Wednesday, Nov. 6, at Margaritaville Lake Resort (formerly Tan-Tar-A) and features a great speaker line up. Online registration closes tomorrow, Nov. 5, at noon.
  • Recently, a memo on medical marijuana was sent to members advising some revisions to guidance for hospitals on MHAnet.
  • Watch for issue briefs detailing CMS final rules coming out this week.


2019 MHA Convention & Trade Show

Regulatory News
the latest actions of agencies monitoring health care


CMS Finalizes CY 2020 Home Health Payment And Policy Update

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services published the final calendar year 2020 payment and policy updates for the Home Health PPS. CMS projects that Medicare payments to home health agencies will increase 1.3% or $250 million. MHA published an issue brief with additional details.

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CMS Deadline Approaches For CAH Hardship Exception Application

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services requires that all critical access hospitals use the 2014 or 2015 edition certified electronic health record technology to meet reporting requirements of the Medicare promoting interoperability program. CAHs that do not meet this requirement will receive a downward payment adjustment. If a CAH experiences significant hardship and cannot meet the requirements, a hardship exception application may be submitted to avoid the payment reduction. These applications are due Monday, Dec. 2, at 10:59 p.m., and may be submitted either electronically or verbally by calling 866-288-8912.

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MO HealthNet To Reject Claims For Dual Eligibles Without MBI Number January 1

Staff Contact: Brian Kinkade

All Medicare claims submitted after Jan. 1, 2020, are required to use the new Medicare Beneficiary Identification number. Correspondingly, MO HealthNet Division claims for dual eligibles — patients who are covered by Medicare and Medicaid — must be filed with the patient’s MBI number after Jan. 1, 2020. Claims filed with patients’ Health Insurance Claim Numbers after this date will be rejected.

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Health Law Insight


Appellate Court Reverses Injunction Against DSH Rule

Staff Contact: Jane Drummond

The Eighth Circuit Court of Appeals reversed a lower court’s ruling in favor of MHA’s challenge to the Centers for Medicare & Medicaid Services’ 2017 rule for calculating hospital-specific disproportionate share limits. The rule codified a methodology introduced by CMS via an informal guidance document, which was successfully challenged by MHA and several other hospitals and hospital associations across the country. As a result of the litigation, CMS abandoned the informal guidance and instead promulgated a rule that would have required hospitals to include third-party and Medicare payments when calculating costs. The rule was slated to take effect in 2017, but has been enjoined due to MHA’s lawsuit and a similar case brought by the Children’s Hospital Association of Texas, and others in Washington, D.C.

In August, the Court of Appeals for the District of Columbia Circuit ruled in favor of CMS and reversed a nationwide injunction of the rule. However, the injunction remained in effect in Missouri because of MHA’s suit. The Eighth Circuit’s ruling now paves the way for CMS to fully implement the 2017 rule.

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Quality and Population Health


Council Of Economic Advisors Updates Economic Cost Of Opioid Use Disorder

Staff Contact: Leslie Porth or Mat Reidhead

In 2017, the Whitehouse CEA published a study quantifying the full economic cost of the opioid crisis in the U.S. in 2015. At $504 billion, or 2.8% of Gross Domestic Product, the study far surpassed previous estimates by fully accounting for the value of lives lost in addition to direct costs related to opioid use disorder. While the number of OUD-related overdose deaths has leveled off since 2017, the CEA estimates the cost of the crisis at $696 billion in 2018, or 3.4% of GDP.

This estimate is very similar to the costs published by MHA earlier this year that found a 2017 economic burden of OUD in the U.S. to be $685 billion, or 3.5% of GDP.

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SAMHSA Launches New Website To Help Individuals Locate SUD Treatment

Staff Contact: Shawn Billings

Last week, the Department of Health and Human Services' Substance Abuse and Mental Health Services Administration launched FindTreatment.gov, a website that will help connect Americans looking for substance abuse treatment with approximately 13,000 locations throughout the U.S. More than 19.3 million American adults had substance use disorder in 2018. "Better access to treatment, prevention, and recovery services is one of the five pillars of HHS's strategy to end the opioid crisis," said HHS Secretary Alex Azar.

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CMS Releases January 2020 Hospital Compare Hospital Data For Preview

Staff Contact: Sherry Buschjost

January 2020 Hospital Compare preview data is now available on QualityNet. The preview period ends Tuesday, Dec. 3, and is applicable for hospitals and facilities participating in the following programs.

  • Hospital Inpatient Quality Reporting
  • Hospital Outpatient Quality Reporting
  • Inpatient Psychiatric Facility Quality Reporting
  • Prospective Payment System Exempt Cancer Hospitals Quality Reporting

Additional information and resources are available.

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Consider This ...

In Missouri, 1 in 6 children go hungry every day, a USDA report finds.

Source: St. Louis Public Radio