MHA Today | May 8, 2023

The Missouri General Assembly approved the state budget with just hours to spare before the 6 p.m. constitutional deadline on May 5. The record $51 billion spending plan includes hospital priorities of $20 million for FRA tax relief, $25 million for inpatient psychiatric rate adjustments, $5 million for higher education grants for nurse training and $2 million for payments for boarded developmental disability patients. Medicaid is fully funded, including the adult expansion, without rate reductions or concerning policy directives. Concerning language limiting expenditure of state funds for DEI activities was not included in the final budget. The governor must approve the budget or veto specific line items by Friday, June 30. The new state fiscal year begins Saturday, July 1.

Staff Contact: Jane Drummond or Brian Kinkade

On Friday, the General Assembly gave its final approval to several legislative measures of interest to MHA and its members. Legislation was passed to extend Medicaid postpartum coverage from 60 days to one year for women who are covered by Medicaid at the time they give birth. The bill authorizing the expansion includes an emergency clause, which makes the law effective upon the governor’s signature. A standard Medicaid state plan amendment must be submitted by DSS and approved by CMS for the extended coverage to begin.

The legislature also revised the hospital licensure statute to allow for a hospital to be licensed as a Rural Emergency Hospital under the designation established by CMS. MHA’s attempt to clarify the notary requirements for involuntary commitment forms passed, as did provisions relaxing certain practice requirements for APRNs. The General Assembly concludes its session Friday, May 12.

Staff Contact: Andrew Wheeler

MHA released a summary and comprehensive analysis of the proposed FFY 2024 Medicare IPF PPS payment and policy updates. The analysis compares FFYs 2023 and 2024, which includes updates to the federal per diem base rate, wage index and labor-related share percentage. In aggregate, the state will see an estimated increase of 1.93% for services paid under the IPF PPS. 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. Although effects of the Medicare sequestration have been estimated, the rate increase excludes the sequestration payment reduction.

The analysis, which is available online for authorized users of HIDI Advantage^®, includes a summary for the nation, Missouri, health systems and individual hospitals. Comments about the proposed rule must be submitted by Monday, June 5.

Staff Contact: Andrew Wheeler

MHA published an analysis of the Hospital-Acquired Condition reduction program, the Value-Based Purchasing program, a Medicare quality program overview and quality trending reports. Although CAHs are exempt from the Medicare IPPS pay-for-performance program, the quality trends reports are available for CAHs that submit quality data to CMS. Policy and analytic studies, prepared for distribution by HIDI, are available for download to authorized users of HIDI Advantage^®.

Staff Contact: Jackie Gatz or Christy Carel

MHA is offering three prestigious awards to recognize the sustained improvements of its member hospitals — the Aim for Excellence Award, the Visionary Leadership Award and the Trustee of the Year Award. Information about the selection criteria and submission process, as well as the online forms, for each award is available at the respective links. All awards will be presented during MHA’s Annual Convention in November. The deadline to apply and/or nominate is 5 p.m. Friday, May 12.