Staff Contact: Andrew Wheeler

MHA released a summary and analysis of the federal fiscal year 2021 Inpatient Prospective Payment System final payment and policy updates. The analysis includes the financial effects of market basket updates, the budget neutrality adjustment, reductions mandated by the Affordable Care Act, Medicare disproportionate share changes, quality-based payment adjustments and coding adjustments. Results are illustrated in national, Missouri, health system and individual hospital groupings. IPPS hospitals in Missouri are projected to receive an estimated 1.7% increase in Medicare payments. Although footnoted, the effects of the Medicare sequestration are not included.

Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are available for download to authorized users of HIDI Analytic Advantage^®.

Staff Contact: Kim Duggan

The MO HealthNet Division published three Orders of Rulemaking, beginning on page 1621, in the Oct. 15 Missouri Register.

• 13 CSR 70-15.010 Inpatient Hospital Services Reimbursement Plan; Outpatient Hospital Services Reimbursement Methodology
• 13 CSR 70-15.015 Direct Medicaid Payments
• 13 CSR 70-15.110 Federal Reimbursement Allowance

These rules authorize the use of a quadratic regression for the projected days’ calculation, and established the Federal Reimbursement Allowance assessment rate and trend factors for state fiscal year 2021. MHD accepted MHA’s comments and amended the final rules to reflect the changes. The rules become effective 30 days after publication in the Code of State Regulations.

Staff Contact: Brian Kinkade

The Missouri Medicaid caseload grew by nearly 16,000 in September to 991,000. Enrollment in all eligibility categories increased: elders, disabled, parents, kids and pregnant women. This marks the eighth straight month of caseload growth after more than two years of steady declines. Since Jan. 31, Missouri’s Medicaid caseload has grown by 145,000, or 17%. The number of children covered has increased by nearly 90,000 during this span.

The growth in the caseload is expected. To qualify for a 6.2% increase in federal matching funds available to the state under the Families First Coronavirus Relief Act, those currently eligible for Medicaid coverage will remain covered unless they move to another state, die or request that their coverage end. Also, because Medicaid is an income-tested program, the deteriorating economy and massive unemployment caused by COVID-19 shutdown orders is increasing the number of citizens qualifying for coverage.

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issued updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

• CMS takes action to protect integrity of COVID-19 testing
• new waived tests
• provider compliance tips for glucose monitors and diabetic accessories/supplies — revised

Staff Contact: Shawn Billings

MHA is honored to provide the EPICC Statewide Status Report on behalf of all the local and state partners that work to connect patients from hospitals to evidence-based substance use treatment and grassroot recovery supports. Collectively, there are 118 unique Missouri agencies (80 active and 38 planning) that are participating in EPICC programming and/or infrastructure development. This broad base of EPICC stakeholders are supported actively by a technical assistance team comprised of an additional 10 agencies — with representation from local and state institutions.

Developing strong links between health care, first responder programs, education, transportation infrastructure, community services, mobile treatment centers, telemedicine support, the justice system and others is critical to providing a rich network of access points to local, regional and state opioid use disorder treatment and recovery support services (e.g. medication-assisted treatment telemedicine).

It is unclear what additional challenges COVID-19 will have on our ability to thoughtfully serve our communities that struggle with OUD. Although, the power of coming together and beginning to discuss how we can improve our systems of care is a necessary first step.

MHA would like to give a special thanks to all the certified peer specialists who share the gift of recovery and fellowship, and make EPICC possible.

Staff Contact: Jane Drummond

The Court of Appeals for the District of Columbia Circuit heard oral arguments Oct. 15 in the American Hospital Association’s challenge to the Centers for Medicare & Medicaid Services’ 2019 rule requiring hospitals to publicly display their charges, including negotiated rates with commercial insurers. A federal district court upheld the rule, which ruling AHA appealed. Should the court decline to overturn the rule, it will go into effect Jan. 1, 2021.