MHA Today | January 22, 2020

January 22, 2020

 

MHA Today: News for Healthcare Leaders

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January 22, 2020

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

In This Issue
State Legislators Consider Opioid-Related Bills
Committee Approves Medicaid Global Waiver Bill
Missouri Medicaid Provider Reverification Effort Creates Confusion
MHA Distributes Medicare Home Health PPS Analysis
CDC Reports First U.S. Case Of Coronavirus From China
PFAC Releases Final In Vlog Series
Supreme Court Declines To Expedite Affordable Care Act Appeal


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Advocate
state and federal health policy developments


State Legislators Consider Opioid-Related Bills

Staff Contact: Rob Monsees or Daniel Landon

A state Senate committee reviewed legislation on litigation between the Attorney General and drug manufacturers and distributors based on damages caused by the promotion and use of opioids. The bill directs proceeds from a settlement agreement to be used exclusively for opioid addiction treatments and services, and health care and law enforcement costs related to opioid addiction treatment. Also, a House committee reviewed legislation authorizing state government to operate a prescription drug monitoring program.

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Committee Approves Medicaid Global Waiver Bill

Staff Contact: Rob Monsees or Bill Anderson

A Senate committee approved legislation that would direct the Missouri Department of Social Services to apply for a federal waiver of Medicaid requirements to permit a global budget for the Medicaid program. Senate Bill 524 is sponsored by the committee’s chair, David Sater.

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Regulatory News
the latest actions of agencies monitoring health care


Missouri Medicaid Provider Reverification Effort Creates Confusion

Staff Contact: Brian Kinkade

Recently, the Missouri Medicaid Audit and Compliance Unit notified certain physicians who last had their Medicaid provider status revalidated in January and February of 2016 and 2017 that their Medicaid enrollment is due for revalidation. Correspondence regarding the required revalidation indicated that the action is past due, but this is not accurate. Physicians who received the notice are, in fact, presently enrolled as MO HealthNet providers, but they must complete the revalidation process by Saturday, Feb. 29, to remain enrolled.

MMAC’s purpose in revalidating some providers sooner than the federally mandated five-year standard is to more evenly distribute the number of providers due for reverification over time. This would help decrease the likelihood of future processing delays by reducing the spikes in the number of providers due for reverification at the same time.

As the year progresses, MMAC will notify additional physicians who were last revalidated between 2016 and 2019 that their revalidation due date has been moved up. Future email notices will go out to providers 90 days before the revalidation due date, and every 30 days until revalidation is complete, or the due date has passed.

Providers revalidated this year will not be due again until 2025, and every five years after that. For questions about the revalidation process, contact the MMAC Revalidation Unit at 573-751-5238 or MMAC.Revalidation@dss.mo.gov.

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MHA Distributes Medicare Home Health PPS Analysis

Staff Contact: Andrew Wheeler

MHA published a comprehensive analysis of the calendar year 2020 final payment and policy updates for the Medicare Home Health Prospective Payment System. The analysis includes a summary of the final rule, a description of the methods underlying the analysis and assessments of the financial implications. The financial implications include effects of the CY 2020 updates to the marketbasket, the productivity reduction mandated by the Affordable Care Act, the patient-driven grouping model, the budget-neutrality increase and changes to the wage index. The estimated effect of the final home health rule will increase payments in Missouri by 3.2%, or $1,288,900.

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Quality and Population Health


CDC Reports First U.S. Case Of Coronavirus From China

Staff Contact: Jackie Gatz or Keri Barclay

Yesterday, the Centers for Disease Control and Prevention confirmed the first case of 2019 Novel Coronavirus (2019-nCoV) in the U.S., specifically in the state of Washington. The patient returned on Jan. 15 from Wuhan, China, where an outbreak of pneumonia caused by this novel coronavirus has been ongoing since December 2019. The patient sought care and was treated at a medical facility in Washington.

The CDC is closely monitoring the outbreak in China. Additional information and guidance for health care professionals is available on its website, as well as criteria to guide the evaluation of patients under investigation for 2019-nCoV.

Health care providers should immediately notify infection control personnel at their health care facility, as well as their local or state health department in the event of a PUI for 2019-nCoV.

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PFAC Releases Final In Vlog Series

Staff Contact: Toi Wilde or Allison Williams

The MHA Patient Family Advisory Council released its final two-part vlog in its five-part series. In the vlogs, Denise L. Williams, BSN, R.N., CPPS, CPHQ, Director of Patient Safety at Mercy Health, discusses her experience as a patient and a health care professional.

PFAC Vlog In part one, “The Patient’s Perspective: Why It Matters & How It Can Improve Patient Safety,” Williams shares the importance of hearing the patient perspective and gaining feedback, as it plays a pivotal role in enhancing patient safety efforts in a way that caregivers alone would not be able to accomplish. In part two, “Why Hospital PFACs Matter: A Patient & Caregiver’s View,” she shares the importance of having a PFAC, or engaging a patient and/or family member on a hospital committee to gain their unique perspective in delivering safe, effective and compassionate care.

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Health Law Insight


Supreme Court Declines To Expedite Affordable Care Act Appeal

Staff Contact: Jane Drummond

The Supreme Court rejected efforts by the U.S. House of Representatives and several states to fast track the appeal of the ruling by the 5th Circuit Court of Appeals invalidating the individual mandate under the Affordable Care Act. The decision makes it unlikely the court will address the issue until after the presidential election.

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Consider This ...

Nearly one-third of U.S. adults in the most rural areas have arthritis, which includes more than 100 conditions that affect the joints, tissues around the joint and other connective tissues.

Source: Centers for Disease Control and Prevention