Minnesota Hospital Association


March 18, 2013

MHA Newsline

In this issue:

House HHS Policy Committee significantly amends MNA staffing bill

On Friday, the MNA staffing quota bill was heard in the House Health and Human Services Policy Committee. At the direction of House Speaker Paul Thissen (DFL-Minneapolis), an “agreement in principle” was reached to delete H.F. 588 as presented and replace the bill with a requirement that hospitals’ chief nursing officer or designee develop a core-staffing plan for each patient care unit and report that plan to MHA’s Quality Report website. The bill also requires the Minnesota Department of Health (MDH) to convene a work group to study the correlation between nurse staffing levels and patient outcomes and report to the Legislature by Jan. 15, 2015.

The bill has been characterized as a “work in progress,” and we are far from finished with this discussion. It moves next to the House Health and Human Services Finance Committee, where the discussion will continue as well as a fiscal note for the MDH study.

S.F. 471 (the original version of the bill) will get its first hearing today (Monday) in the Senate Health, Human Services and Housing Committee chaired by Sen. Kathy Sheran (DFL-Mankato) where it is possible it will be amended. MHA will keep you updated as this legislation continues to move through the process. Thank you all for your outreach to legislators. Members have been unbelievable in their ability to come to St. Paul and testify on short notice, and we will continue to call on you. ^top of page

Health insurance exchange one step closer to law

Last Wednesday, a Minnesota House-Senate Conference Committee completed the final bill for a Minnesota health insurance exchange, called the Minnesota Insurance Marketplace (MIM). The bill passed the House of Representatives early Friday morning on a party-line vote and is slated for a vote in the Senate today. If it passes the DFL-controlled Senate, the bill will be signed into law by Gov. Dayton.

The final version of H.F. 5 funds the MIM from a premium withhold of 1.5 percent in 2014 and 3.5 percent starting 2015. The other funding option, which was in the House legislation, was the health impact fee, a tobacco tax. Using the provider tax to fund the marketplace was not in the legislation. The exchange is estimated to cost $52 million in its first year of operation and $64 million in 2015. Federal funds that have been used for developing the infrastructure will also be used for the first year of operation.

H.F. 5 also includes the so-called “active selector” or “active purchaser” model for the exchange marketplace. This means the MIM board will have the authority to choose which carriers can sell their products in the marketplace, starting in 2015. For 2014, all health insurance plans that meet the criteria to be Qualified Health Plans (QHP) per the Affordable Care Act will be able to be sold.

The governance board of the exchange remains small, with six people appointed by the governor, with the advice and consent of the Legislature, and the commissioner of human services or designee. There remains a strict conflict of interest provision which prohibits any health care provider, health insurance representative, or navigator or insurance broker from serving on the board within one year of employment or other association with those entities.

The exchange, or MIM, is one of the major pieces of the federal health care reform law, the Affordable Care Act. States wishing to operate their own exchanges must have them operational in time for enrollment to begin in October of this year. Minnesota’s exchange must be signed into law by the end of March or risk the federal government setting up a federally-run exchange instead. More than 1 million Minnesotans are anticipated to use the exchange to purchase health care insurance, as well as apply for subsidies for that insurance and for public programs. ^top of page

Governor signs bill exempting hospitals from new advanced diagnostic imaging requirements

Hospitals are exempt from new state-imposed accreditation requirements on advanced diagnostic imaging. Legislation clarifying a 2012 law requiring Minnesota hospitals to undergo duplicative accrediting requirements for MRI, CT, and nuclear medicine equipment passed unanimously by the Senate and was signed by Gov. Dayton last week.

Thanks especially to our rural members who contacted their legislators to let them know that the new requirements were duplicative of current safety surveys performed on the equipment used by hospitals. ^top of page

Governor releases supplemental budget

Gov. Dayton has released his latest budget proposal, updated to reflect the February economic forecast. As a result of the decrease of the deficit from $1.1 billion to $627 million, the governor has withdrawn some of his more controversial tax proposals and also increased spending in many areas. The business to business sales tax as well as the lowering and expansion of the sales tax have both been removed from his plan. Dayton continues to push for increases in income, corporate and tobacco taxes.

The governor includes $2 million in additional health and human services spending. After adjusting spending proposals due to the forecast, he includes new spending for MinnesotaCare to comply with certain requirements of the Affordable Care Act; a youth homeless prevention program; and buying back a 1.67 percent rate reduction for long-term care providers. Unfortunately, Dayton did not withdraw his proposal to eliminate the Minnesota Subsidy Grant, a grant for hospitals with inpatient mental health units in Greater Minnesota for accepting certain patients with mental illnesses. ^top of page

ICSI to host 16th annual colloquium on health care transformation

The Institute for Clinical Systems’ (ICSI) 16th annual colloquium, “Changing Health Care, Connecting the Dots” will focus on how to link the fragmented parts of the health care system, and provide successful strategies for medical groups and hospitals to engage patients and communities in their health and wellness.

Laura Adams, president and CEO, Rhode Island Quality Institute, and John Santa, director, Consumer Reports Health Ratings Center, will keynote this year’s event.

Workshops plus 25 presentations will address: quality/safety; leadership/accountability; behavioral health/primary care; and patient engagement/consumer experience.

The colloquium will take place May 6-8 at the St. Paul RiverCentre. To get the complete brochure and early bird registration savings, go to: http://bit.ly/11TQX6n. ^top of page

Webinar: Reducing sugary beverages in health care facilities — starting the conversation

The Public Health Law Center, in partnership with the Minnesota Cancer Alliance, has developed the “Minnesota Healthy Beverages in Healthcare Toolkit.” The toolkit is a set of resources geared to support efforts to develop and build healthy beverages programs in Minnesota health care facilities. The toolkit will be presented during a webinar on April 3 from noon – 1:15 p.m.

Participants will learn why growing numbers of hospitals are taking steps to reduce sugary drink consumption within their facilities. You will also learn about strategies and tools being used by these institutions, drawing on examples from hospitals around the country as well as highlighting work in Minnesota. Finally, you will learn about an opportunity to receive free, individualized technical assistance to help you start a conversation about developing a program for your own institution.

Registration is free, but you must register online to attend. For questions or more information, contact Julie Ralston Aoki, staff attorney, Public Health Law Center, 651-290-7532. ^top of page

Sen. Franken joins Sen. Klobuchar in pushing for Hospital Payment Fairness Act

Minnesota Sen. Al Franken has signed onto S. 183, the Hospital Payment Fairness Act of 2013, joining Minnesota Sen. Amy Klobuchar. This legislation would repeal a provision in the federal health care reform law that allowed two hospitals in Massachusetts to convert to critical access hospital status and thus significantly inflated wage indexes across the state at the expense of other states. In calendar year 2013 Minnesota hospitals will experience a $12.1 million loss as a result of this manipulation of the wage index while hospitals in Massachusetts will receive almost $257 million in additional funding. Forty-one states in total have experienced reduced funding. MHA members are encouraged to thank Sens. Klobuchar and Franken for their support of S. 183. ^top of page