Minnesota Hospital Association


January 06, 2014

MHA Newsline

In this issue

MHA and March of Dimes recognize 35 hospitals for reducing early elective deliveries

MHA and the March of Dimes have recognized 35 Minnesota hospitals for reducing the number of elective inductions and Cesarean deliveries performed before 39 completed weeks of pregnancy. Babies delivered before full term are at increased risk of serious health problems and death in their first year of life. Each hospital will receive a banner to display that spreads the message that “Healthy Babies are Worth the Wait.”  

Banner recipients were determined by reviewing the MHA Perinatal Safety Roadmap and early elective delivery outcome data submitted to the Patient Safety Registry. All recipients had less than a 5 percent early elective delivery rate for four quarters, a hard stop policy with clearly defined medical indications for deliveries less than 39 weeks, and a process to monitor the scheduling of Cesarean sections and inductions of labor prior to 39 weeks gestational age.  

See a complete list of banner recipients here. For questions, contact Kattie Bear-Pfaffendorf, patient safety and quality specialist, 651-659-1404. return to top

Minnesota ranked best overall health care quality in the nation

The Agency for Healthcare Quality and Research (AHRQ) has ranked Minnesota with the best overall health care quality in the nation for the second year in a row. Minnesota has the eighth highest quality score for hospital care and is first for ambulatory care (tied with Wisconsin). AHRQ has been releasing its “State Snapshots” report annually since 2004. Since 2006, Minnesota has ranked in the top three states. This report is highly regarded for measuring the health care quality performance of states. return to top  

New laws started Jan. 1

The new year brought the beginning of new state laws. Most relevant for MHA members are the implementation of Medicaid expansion to 138 percent of the federal poverty level and changes to what is allowed to be asked on job applications.  

The expansion of Medicaid, Medical Assistance in Minnesota, is expected to extend health insurance to nearly 40,000 low-income Minnesotans, with thousands more moving from MinnesotaCare to Medical Assistance. The Affordable Care Act (ACA) provided states the opportunity to extend Medicaid to more people, with the federal government paying 100 percent of the cost through 2016 and 90 percent thereafter for newly-eligible individuals. MHA strongly supported this legislation in the 2013 legislative session.  

The second law, so-called “ban the box” legislation, prohibits public and private employers from inquiring whether a job applicant has a criminal record or criminal history at the time a person applies for a job. The law removes the question that asks job applicants to check a box about whether they have ever been convicted of a felony or gross misdemeanor. Employers now also must wait until an applicant is selected for an interview to ask the question. For jobs that don’t include an interview, employers cannot ask about criminal issues until there is a conditional offer of employment.  

Another law that affects MHA members is the implementation of the Comprehensive Home Care Provider License. The Minnesota Department of Health (MDH) is accepting applications for temporary licenses under the new program. More information can be found online. return to top 

Providers asked to verify health insurance enrollment through DHS provider call center

The Department of Human Services (DHS) is recommending providers contact the DHS provider call center to verify whether patients who have chosen health insurance products through MNsure but have not yet received notice or an insurance card are enrolled in those health plans. Because of delays in getting information from MNsure to health carriers, some patients may not have received their health insurance cards by early January, despite having enrolled in a health plan. Providers should use their usual sources of Eligibility Verification System (EVS) and MN–ITS for verifying eligibility and if no information is available in these systems, call the provider call center.  

Members should be aware this system is not for presumptive eligibility for Medicaid. That process is still under consideration by DHS.  

For more information, visit the DHS website. return to top  

IRS issues ACA guidance for tax-exempt hospitals

As one of its last rulemaking actions of 2013, the Internal Revenue Service (IRS) issued direction to nonprofit, charitable hospitals with respect to new requirements under the Affordable Care Act (ACA).  

The first document clarifies that tax-exempt hospitals subject to the ACA’s requirement to complete a community health needs assessment (CHNA) may rely on the previously proposed rulemaking issued in June 2012 and April 2013 until further guidance or a final rule are promulgated. This does not change any of the existing statutory or regulatory requirements that hospitals have been using as they complete their CHNAs.  

The second document, seeks comments from stakeholders regarding the IRS’s intention to allow charitable hospitals to correct and self-report violations of the ACA’s financial assistance, debt collection or CHNA requirements. Through reporting and correcting inadvertent, technical or unintentional noncompliance, charitable hospitals would avoid loss of their tax-exempt status, although the proposal would leave hospitals subject to financial penalties.  

Comments to the IRS are due by March 14. MHA intends to submit comments and encourages members to send suggestions or concerns to Matt Anderson, MHA vice president of regulatory and strategic affairs, 651-659-1421 or Ben Peltier, MHA legal counsel, 651-603-3513. return to top  

MHA submits friend-of-court brief in guardianship case

MHA submitted an amicus brief to the Minnesota Supreme Court in a case reviewing the ability of Minnesota hospitals to rely on the decision-making authority of court appointed guardians for patients facing decisions about end-of-life care. The Minnesota Court of Appeals issued a decision in July overturning a lower court decision that may have required hospitals to seek court authority before undertaking a variety of actions in response to a request of a court-appointed guardian. The Appeals Court decision was consistent with a joint request from MHA and the Minnesota Medical Association (MMA).  

The underlying case involved the care of a moderately-impaired patient. The patient had no responsible family so a Minnesota court appointed a guardian to manage the patient’s medical care and other affairs. While residing in a group home, the patient suffered respiratory and cardiac arrest. Although he survived, the patient suffered severe and irreversible brain injury and became deeply comatose. The hospital ethics committee determined that no benefit could be achieved with further intensive treatment and notified the guardian of the determination.  

The guardian argued that the general guardian appointment provided the necessary authority to authorize the end of treatment but a Hennepin County judge determined that under Minnesota law only a court could make such an authorization for an incapacitated person in this situation.  

Minnesota providers — including doctors and hospitals — explained in the amicus brief that health care providers are the most appropriate sources to evaluate a patient’s health and to provide advice to guardians about end-of-life care. Based on that advice and information, guardians —  rather than judges —  are in the best position to make decisions about how to proceed with treatment.   

For additional information about the case, or guardianship issues in general, contact Ben Peltier, MHA legal counsel, 651-603-3513. return to top  

Minnesota Credentialing Collaborative announces upgrades and changes

The Minnesota Credentialing Collaborative (MCC) — a joint venture of Minnesota’s hospitals, physicians, and health plans providing a community-wide solution to the repetitive process of applying for hospital and health plan credentials — announced changes for 2014.  

First, MCC is rolling out a simplified process for purchasing annual subscriptions. Effective Jan. 6, users will be able to purchase new provider subscriptions, often referred to as PRAC codes, from the same website users access to update and manage provider’s records.  

In addition, beginning Jan. 6 CredentialSmart, the vendor behind the MCC system, will begin enforcing a provision of its User Agreement requiring providers to maintain (keep current) their annual subscription.  Beginning Jan. 6, accounts that are not renewed within 60 days of their expiration date will be deleted.  This change will allow MCC to reduce administrative costs and ensure that confidential information is current and secure.   

Additional information about MCC and these changes is available here. return to top  

HIT funding initiative workshop to take place Jan. 28

Key Health Alliance, an extension assistance center for health information technology (HIT), is holding a workshop with U.S. Department of Agriculture (USDA) and the Office of the National Coordinator for HIT (ONC) to discuss issues related to meeting Meaningful Use in rural communities. Leaders of rural hospitals, federally qualified health centers, nursing homes, emergency medical services, mental health centers and rural health clinics are encouraged to attend this workshop to:

  • Learn about technology needs with health reform;
  • Understand available USDA programs and funding options;
  • Obtain project support with HIT ideas and funding opportunities; and
  • Discover how to develop a successful proposal.

The workshop will take place Tuesday, Jan. 28 from 9 a.m. to 3 p.m. at the College of St. Scholastica in Sartell. Register online by Friday, Jan. 17. Registrants are asked to complete this brief survey prior to the workshop. For more information, contact Angie LaFlamme, 218-727-9390, ext. 222. return to top