MHA Today | December 20, 2019

December 20, 2019
MHA Today: News for Healthcare Leaders

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


Herb Kuhn, MHA President & CEOHistory’s most republished newspaper editorial was a response to a letter from a young girl who lived at 115 West 95th Street in New York City. Her name was Virginia.

Virginia was having a pre-holiday season crisis of faith. Her friends told her that Santa wasn’t real. The response from Francis Pharcellus Church was much more than a rejection of her friends’ assertion. It was a timeless paean to the collective goodness of humanity.

As members of the hospital community, we experience truly good and meaningful work daily. However, these acts — some large, but many small — can pass without recognition. Church says this.

“The most real things in the world are those that neither children nor men can see.”

A great deal happened in health care this year. But for this moment, let me shine a light on some health-related issues that happened just recently — things that will make a real difference for hospitals and the patients hospitals serve, but likely didn’t capture many headlines.

Last week, we announced that through engagement with the Centers for Medicare & Medicaid Services and X12 — a group that enforces HIPAA standards — we were able to make progress toward resolving problems with the processing of Medicare-Medicaid crossover claims. Although implementation is pending, CMS has endorsed our alternative process to alleviate the unnecessary cost and administrative burden of the method the state Medicaid program instituted earlier this year.

Our ongoing engagement with MHA members and CMS continues to bear fruit through the wage-index system, as well as through the reporting conversion to the S-10 worksheet for uncompensated care. These changes and other factors will result in a significant Medicare payment boost in Missouri in 2020.

This week, CMS announced Missouri will be among states to receive funding to combat maternal opioid abuse. This program will add value to the existing maternal morbidity and mortality efforts and medication-assisted opioid treatment programs in Missouri.
2020 Legislative Guide
Also this week, MHA released the 2020 legislative guide for state-level advocacy. The agenda, “Leading Missouri Forward: 2020,” will help hospitals engage state lawmakers on issues that affect the hospital community and the state’s health care system.

All of these efforts support — directly and indirectly — hospitals’ ability to effectively serve their communities.

Advocacy matters — particularly when we have partners, like the American Hospital Association. Advocacy helps deliver the policies and payments that allow the caregiver to focus on connecting with the patient and healing.

Church was an advocate for Santa. To him, Santa was the embodiment of the invisible bonds that exist between us, connecting us — our shared culture, traditions and values. Church wrote, “Yes, VIRGINIA, there is a Santa Claus. He exists as certainly as love and generosity and devotion exist, and you know that they abound and give to your life its highest beauty and joy.”

Few places are these intangibles more present than in health care. And, few times are they more genuinely expressed than when hospital employees sacrifice their holidays to serve those in great need.

Have a wonderful holiday season. Send me a note to let me know what you are thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
CMS Reports 2020 Marketplace Enrollment Remains Stable
CMS Issues Guidance For Excluded Hospitals
MLN Connects Provider eNews Available
MHA Activates Pediatric Bed Query In EMResource
HRSA Announces Rural Care Coordination Funding Program
New Guidance Addresses Opioid Prescribing For Acute Pain
CMS Releases IQR Program Manual Version 5.8

state and federal health policy developments

CMS Reports 2020 Marketplace Enrollment Remains Stable

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services announced that preliminary data indicates the 2020 Open Enrollment Period ended with more than 8.3 million people enrolled compared to approximately 8.5 million people enrolled last year. “We are reporting that for the third year in a row enrollment in the federal exchange remained stable,” said CMS Administrator Seema Verma. These numbers exclude consumers who left their contact information at the call center due to high volume, among others. CMS plans to release an updated snapshot during the second week of January with the final enrollment data.

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Regulatory News
the latest actions of agencies monitoring health care

CMS Issues Guidance For Excluded Hospitals

Staff Contact: Sarah Willson

The Centers for Medicare & Medicaid Services has issued a memo outlining updates to the certification and CMS certification number assignment process for excluded hospitals with excluded units. The fiscal year 2019 Inpatient PPS and Long-Term Care Hospital PPS final rule allowed an IPPS-excluded hospital to have an excluded psychiatric and/or rehabilitation unit beginning with cost reporting periods on or after Oct. 1, 2019. The guidance outlines changes to the certification process.

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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.

  • Provider minute video: The importance of proper documentation
  • Payment for outpatient clinic visit services at excepted off-campus provider-based departments: updated
  • Long-Term Care Hospital and Inpatient Rehabilitation Facility compare refresh
  • Medicare Diabetes Prevention Program: Become a Medicare-enrolled supplier

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Quality and Population Health

MHA Activates Pediatric Bed Query In EMResource®

Staff Contact: Jackie Gatz or Carissa Van Hunnik

By member request, this week MHA activated a pediatric bed availability query in response to increases in pediatric inpatients in the metropolitan areas. While the query notice is visible to all EMResource users, only hospitals with licensed capacity for pediatric, obstetrics, and pediatric and neonatal intensive care units have access to input data. Participating facilities are requested to update their information on a routine basis, with a daily reminder sent electronically at 8 a.m. The query will remain active for the immediate future and its duration will be determined based on surge levels and member feedback as to the value of this information.

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HRSA Announces Rural Care Coordination Funding Program

Staff Contact: Stephen Njenga or Dana Dahl

The Health Resources and Services Administration announced a new opportunity to apply for federal funding that improves access and quality of care through rural health consortiums. The program will invest approximately $7.5 million throughout three years to support as many as 10 applicant organizations. Each consortium will include at least three health care entities that will coordinate strategies for collaboration, leadership and workforce, improved outcomes, and sustainability in rural communities.

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New Guidance Addresses Opioid Prescribing For Acute Pain

Staff Contact: Shawn Billings or Tiffany Bowman

The National Academies of Science, Engineering and Medicine released a report addressing opioid prescribing practices and evidence-based treatment for acute pain and injury. The Food and Drug Administration requested the National Academies develop a framework to evaluate clinical practice guidelines, recommend indications for which new evidence-based guidelines should be developed, and recommend a future research agenda to inform and enable the development and dissemination of evidence-based CPGs. The result was a guidance document for prescribing practices and evidence-based strategies designed to address this serious public health challenge.

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CMS Releases IQR Program Manual Version 5.8

Staff Contact: Sherry Buschjost

Now available on QualityNet is version 5.8 of the Specifications Manual for National Hospital Inpatient Quality Measures for the Hospital Inpatient Quality Reporting Program. The manual is for implementation with acute inpatient discharges from July 1, 2020, through Dec. 31, 2020. Updates were made to the following.

  • data dictionary data elements
  • sepsis measure information form
  • appendix F
  • links to QualityNet

A complete list of changes is available in the release notes.

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Did You Miss An Issue Of MHA Today?

December 16, 2019
Marketplace Open Enrollment Extended Through Dec. 18
CMS Releases Marketplace Effectuated Enrollment For The First Half Of 2019
MLN Connects Provider eNews Available
MHA Addresses Delays In Care In December Trajectories
CMS Releases OQR Specifications Manual Version 13.0a
CMS Updates QRDA Conformance Statement Resource
HRSA Accepts Applications For Nursing Workforce Program
FCC Announces Shortened Suicide Prevention Hotline Number

December 18, 2019
U.S. House Advances Compromise Spending Accord
Medicare And MHD To Deny All Claims With HICNs Beginning Jan. 1
MACPAC Releases MACStats 2019 Edition
Proposed Rule Allows For Importation Of Certain Prescription Drugs
CMS And HRSA Issue Proposals To Increase Organ Supply Accountability And Availability
CDC COCA Provides Update On Ebola Diagnostics In The U.S.
CMS To Streamline QualityNet Account Management
Mercy Hospital Lebanon Names Interim Administrator

Consider This ...

In 2018, 5.3% of Missouri children under age 6 were uninsured, up from 3.6% two years earlier. Nationwide, uninsured rates in that age group rose to more than 4%.

Source: St. Louis Public Radio