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05.12.21
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Past issues are available in the Media Library.
General Assembly Enacts Prescription Drug Monitoring Program
MHA Sends Letter About UnitedHealthcare’s Designated Diagnostic Provider Program
United Healthcare Optum Pay Available To Unlimited Users
MHA Distributes Analysis For Proposed Updates To 2022 SNF PPS
CMS Issues Interim Final Rule Requiring LTC To Report COVID-19 Vaccination Rates
Patients Report Outcomes On Extended-Release Buprenorphine
Resilient Leadership Series — Six-Part Virtual Series
The series begins Tuesday, June 1.
Register on or before Thursday, May 27.
Staff Contact: Rob Monsees or Bill Anderson
The General Assembly enacted Senate Bill 63, which authorizes the creation of a statewide prescription drug monitoring program. The state program will be operated through a vendor. When it is available to dispensers throughout the state, it will supplant the current county-based vendor arrangement.
Staff Contact: Andrew Wheeler
MHA previously announced that UnitedHealthcare has created a Designated Diagnostic Provider benefit design that only will cover outpatient lab services delivered by freestanding or hospital lab providers who have applied for and received such designation. MHA now has sent a letter to the Missouri Department of Commerce and Insurance voicing concerns and urging the department to review the policy for its consequences on patient costs, network adequacy, timely access to care and good faith contracting.
Staff Contact: Andrew Wheeler
MHA previously announced that hospitals would be subject to a 0.5% fee to receive UnitedHealthcare’s Optum Pay premium portal access. User account access for the free basic portal access was limited. Hospitals would need to pay the 0.5% fee to become a premium portal access subscriber to receive unlimited user account access. Due to the efforts of the Multistate Managed Care Coalition, the American Hospital Association, MHA and other state associations, UnitedHealthcare now is granting unlimited user accounts within the Optum Pay system. Beginning Saturday, May 22, the free basic portal access will be available to unlimited users.
Staff Contact: Andrew Wheeler
MHA released a summary and comprehensive analysis of the proposed updates to the Medicare Skilled Nursing Facility Prospective Payment System for federal fiscal year 2022. The analysis compares estimates for FFYs 2021 and 2022, which include updates to the market basket, productivity reductions mandated by the Affordable Care Act, wage index and SNF Value-Based Purchasing program. Projected payment rates for FFY 2022 are based on the new Patient-Driven Payment Model rates. The analysis does not include effects caused by high-cost outliers, payments for managed care patients, or any modification in fee‑for‑service payments as a result of hospital participation in new payment models being tested under Medicare demonstration or pilot programs. The analysis also does not include the effects of the 2% Medicare sequestration. Comments about the proposed rule must be submitted by Monday, June 7. The analysis is posted online for authorized users of HIDI Analytic Advantage. Current subscribers with questions about downloading files should contact HIDI.
Staff Contact: Andrew Wheeler
The Centers for Medicare & Medicaid Services announced an interim final rule with comment period that would require long-term care facilities to report vaccination status and therapeutic treatments for residents and staff. The IFC also would require the LTC facilities and intermediate care facilities for individuals with intellectual disorders to provide education about COVID-19 vaccines, as well as offer the vaccine to all residents and staff. Although reporting vaccination rates will not be required, CMS encourages the facilities to do so on a voluntary basis.
Staff Contact: Andrew Wheeler
MHA published an analysis of the hospital wage index and occupational mix data that the Centers for Medicare & Medicaid Services will use to develop the federal fiscal year 2022 Medicare hospital wage index. Hospitals can review their hospital-specific data and submit correction requests until Friday, May 28. Requests and supporting documentation for corrections should be directed to CMS and the Medicare Administrative Contractor. Requests for corrections are limited to mishandling of the data. MHA posted the files to HIDI Analytic Advantage for review.
Staff Contact: Shawn Billings or Kaylen Payne
It is well established that medications used to treat opioid use disorder are highly effective in preventing relapse into drug-taking, facilitating recovery and preventing overdoses. However, retention rates for these drugs are quite low, and 40% to 50% of patients treated with methadone or buprenorphine relapse within six months of starting treatment.
A randomized trial recently was conducted in Australia to compare patient-reported outcomes for daily sublingual buprenorphine treatment (tablets given under the tongue) versus a weekly or monthly injection of extended-release buprenorphine for OUD. The researchers found that the extended-release injection of buprenorphine was well-tolerated, acceptable to patients and produced generally more positive patient-reported outcomes, including overall patient satisfaction, effectiveness and convenience, compared to daily oral buprenorphine.