MHA Today | January 27, 2021

Staff Contact: Sarah Willson or Alison Williams

The Institute for Safe Medication Practices is aware of an extremely hazardous packaging error involving certain cisatracurium products from Meitheal Pharmaceuticals. While the outer carton identifies the vials inside as cisatracurium, the vials contained in the carton are labeled phenylephrine injection. The vials actually contain cisatracurium and have caps appropriate for a paralyzing agent. However, this cap warning may not be noticed since the vial is labeled phenylephrine.

Due to the nature of this situation and the potential for death if these vials are used as phenylephrine injection in patients who are not intubated and ventilated, we urge facilities to immediately examine all cartons of cisatracurium from Meitheal Pharmaceuticals for this serious packaging error. The possibility that any of these vials were actually distributed also should be considered. ISMP has confirmed that both the U.S. Food and Drug Administration and the manufacturer are aware of this situation and that a recall is imminent.

Staff Contact: Daniel Landon or Rob Monsees

Gov. Mike Parson delivered the 2021 State of the State address to the Missouri General Assembly today. The annual speech provides governors the opportunity to describe their state legislative priorities. The governor also released summary documents concerning his administration’s recommended state budget for the fiscal year beginning the following July. The governor’s budget proposal traditionally serves as the starting point for legislative budget discussions. In his remarks, Parson commented on his inclusion of funding to implement Medicaid expansion as authorized by the state’s voters last August. MHA will be engaging with its membership on the details and implications of the governor’s speech and budget proposals.

Staff Contact: Rob Monsees or Bill Anderson

The state Senate Appropriations committee approved legislation to reauthorize the hospital Federal Reimbursement Allowance and the other state provider taxes used to generate additional federal matching funds for the Medicaid program. The bill extends the expiration of the provider taxes for an additional two years, through Sept. 30, 2023. The legislation was approved by a vote of 11-1 and now advances to the full Senate for review.

Staff Contact: Rob Monsees or Bill Anderson

A state House committee reviewed six bills, summarized here, regarding standards for public health ordinances and orders. MHA submitted comments urging caution in limiting public health authority to respond to infectious disease outbreaks. The committee is expected to consolidate the proposals into a new version.

Staff Contact: Daniel Landon or Rob Monsees

The chairman of the Senate Health and Pensions committee held a hearing on his legislative proposal to designate the month of May as Ehlers-Danlos Syndrome Month. In presenting the bill to the committee, he proposed expanding it to also repeal Certificate of Need review of new hospitals and medical equipment purchases of more than $1 million, as well as bar hospitals and insurers from requiring medical specialty board certification as a condition of employment or network participation. MHA offered initial comments to the committee and will express its concerns in writing after assessing the details of the new proposal.

Staff Contact: Andrew Wheeler

The Biden administration withdrew three proposed rules by the Centers for Medicare & Medicaid Services. The withdrawn rules include the following.

• conditions for coverage for end-stage renal disease facilities – third-party payments
• strengthening oversight of accrediting organizations and preventing AO conflict of interest, and related provisions
• revisions to Medicare Part A enrollments