MHA Today | July 21, 2021

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the calendar year 2022 outpatient prospective payment system and ambulatory surgical center payment system proposed rule. Comments about the proposed rule will be due 60 days after publication within the Federal Register. MHA published an issue brief with additional information. The major proposals include the following.

• • increased penalties for hospitals not in compliance with the hospital price transparency regulations
  • request for information on guidelines surrounding the Rural Emergency Hospital program
  • request for comments about making certain temporary COVID-19 public health emergency policies permanent
  • continuation of the reduced 340B payment policy of ASP minus 22.5%
  • continuation of using a physician fee schedule equivalent payment rate for certain hospital outpatient department visit services
  • proposals related to the Radiation Oncology Model

Staff Contact: Brian Kinkade

MO HealthNet will provide 340B hospitals that carve-in for Missouri Medicaid a report of non-340B pharmacy claims submitted during the previous pay cycle. The report will help hospitals verify the accuracy of the claims submitted under the new billing requirements that took effect July 1. Claims submitted by carved-in 340B providers that do not have the requisite modifiers (SCC 20 for retail and specialty claims; JG or TB for medical and outpatient claims) will be interpreted as non-340B by MO HealthNet. MO HealthNet will pursue manufacturer rebates for these claims, and so these claims will be subject to significant scrutiny in 340B compliance audits. Claims that are found to be incorrectly reported can be corrected by the end of the calendar quarter.

To request a report, hospitals must send the following information to the MO HealthNet Pharmacy Help Desk at MHD.PharmacyAdmin@dss.mo.gov.

• name of the 340B covered entity
• the entity’s Medicaid ID and national provider identifier
• name(s) and email address(es) of those to whom the report should be sent

Staff Contact: Jackie Gatz or Kara Amann-Kale

This afternoon, Gov. Parson announced the launch of a statewide COVID-19 vaccination incentive program, “MO VIP.” The goal of this program is to encourage Missourians ages 12 years and older to receive the COVID-19 vaccine. Throughout the next three months, Missourians who have or choose to become vaccinated will have the opportunity to enter a drawing to win a cash or an education savings account prize in the amount of $10,000 by visiting MOStopsCovid.com/win. The first drawing will be held on Aug. 13 and drawings will occur every two weeks through Oct. 8. Additional details about the program can be found at MOStopsCovid.com/win.

In addition, it was announced that local public health agencies that administer the COVID-19 vaccine are eligible to provide an incentive of up to $25 for individuals receiving the COVID-19 vaccine. LPHAs are able to partner with enrolled COVID-19 vaccinators within the State of Missouri to be part of this program. To apply or learn more about this program MOStopsCovid.com/vaccinators by Aug. 15.

Staff Contact: Sherry Buschjost

The confidential reporting period of the 30-Day Stroke Mortality Measure with National Institutes of Health Stroke Scale is Aug. 2-31. Measure results provided during this period will be calculated based on discharges from Oct. 1, 2017, through Dec. 1, 2019. Results will not be used for public reporting or payment determination. Additional information is available.

Staff Contact: Shawn Billings

Leaders from the National Institutes of Health published a perspective addressing the impact that language has on individuals with mental health issues and/or SUD. The perspective points to evidence that stigma-related bias among clinicians can contribute to a treatment-averse mindset and to flawed clinical care, including failure to implement proven methods of treatment. There are 35% of people with serious mental illness in the U.S. and nearly 90% of people with substance use disorders that do not receive treatment ― research reveals stigma as a contributing factor. While stigma is difficult to eliminate, authors contend that changing the language used to describe these conditions can make a significant and immediate difference for the people experiencing them.

Staff Contact: Daniel Landon

Gov. Parson announced his appointment of Donald Kauerauf as the next director of the Missouri Department of Health and Senior Services. Kauerauf has more than 30 years of experience in emergency management and public health administration for the State of Illinois, including service as the Assistant Director of the Illinois Department of Public Health. Robert Knodell, the governor’s Deputy Chief of Staff, served as the department’s interim director since the April 20 resignation of former director Randall Williams, M.D.