In
this issue
Happy
new year from MHA
The start of a new year is a time to
set new goals, embrace new opportunities and meet new challenges. It is also a
time for Minnesota’s hospitals and health systems to renew our commitment to
our nonprofit mission of providing nation-leading, high-quality health care for
people and communities across the state. View MHA’s new year’s greeting. return to top
Minnesota
among eight states selected to pilot Certified Community Behavioral Health
Clinics
The U.S. Department of Health and Human Services on Dec. 21 announced Minnesota’s selection as one of
eight states to pilot a new model of mental and chemical health care, called
Certified Community Behavioral Health Clinics (CCBHCs). CCBHCs are an
innovative model designed to bring together behavioral, chemical and physical
health care for people with mental and substance use disorders, serving as a
“one-stop-shop” for comprehensive mental health and addiction services.
Minnesota was eligible for selection for this nationwide pilot as a result of
the passage of the Excellence in Mental Health Act in the final supplemental
budget bill during the 2015 state legislative session. Partnering with the
Minnesota Association of Community Mental Health Programs, MHA helped shepherd
the introduction of the Excellence Act and prioritize its passage.
Six Minnesota clinics have been certified by the Minnesota Department of Human
Services (DHS) as pilot sites:
- Northern Pines Mental Health
Center in the north-central part of the state
- Northwestern Mental Health
Center serving seven northwest counties
- Wilder Children and Family
Services in the Twin Cities metro area
- People Incorporated in the Twin
Cities metro area
- Ramsey County Mental Health
Center in the Twin Cities metro area
- Zumbro Valley Mental Health
Center in Olmsted and Fillmore counties in the southeast
This is great news in helping to create more community-based
mental health services around the state. MHA members will be asked to partner
with these sites. Learn more about Minnesota’s selection on the DHS website. return to top
2017
Minnesota legislative session launches with emphasis on health insurance
The 2017 Legislature opened with the introduction of Senate File
1 (Benson – GOP-Ham Lake)/House File 1 (Hoppe – GOP-Chaska) legislation to address the affordability of
premiums for health plans sold on the individual insurance market.
Hearings on the bill are scheduled in both bodies this week.
Highlights from the legislation:
- General fund dollars would be
used to provide tiered premium subsidies for individuals below 800 percent
of the Federal Poverty Guidelines (FPG) for plans purchased in the
individual market (see chart below). Funding would be available for
continuation of care for individuals with certain health conditions in the
middle of treatment.
- For-profit health plan
organizations would be allowed to sell products in Minnesota.
The legislation includes new
language regarding surprise billing. Hospitals may be obligated to inform
patients and get written consent acknowledging that the use of a
nonparticipating provider may result in costs not covered by the health
plan.
- The legislation also states that an enrollee must have the same
cost-sharing requirements for nonparticipating providers as those
applicable to services received by the enrollee from a participating
provider. In addition, a participating provider is prohibited from
billing an enrollee for the difference.
The breakdown of premium relief is as follows:
MHA has indicated general support for proposals that provide relief to
Minnesotans experiencing these large increases and for using general fund
revenues rather than the Health Care Access Fund.
With questions, contact Mary Krinkie, vice president of government
relations, MHA, 651-659-1465, or Kristin Loncorich, director of state government relations, MHA,
651-603-3526.
Session bill tracker
For a complete list of 2017 legislative bills MHA is tracking, visit the MHA Member Center. For assistance accessing the
Member Center, contact Emily Lowther, communications manager, MHA,
651-603-3545. return to top
ACA
repeal efforts begin on first day of 115th Congress
On Jan. 3, Senate Republicans began their efforts to repeal the
Affordable Care Act (ACA) by introducing the fiscal year (FY) 2017 budget
resolution, which included reconciliation instructions aimed at repealing certain
ACA provisions.
The Senate budget resolution, which is expected to pass the Senate and House
next week, instructs the committees with jurisdiction over the ACA to make
recommendations on what provisions can be repealed under the reconciliation process.
The reconciliation process allows the Senate to approve legislation with 50
votes, not the usual 60. The committees with jurisdiction are expected to begin
debating repeal proposals as early as Jan. 23 and a reconciliation bill could
be on President Trump’s desk in February.
The reconciliation bill repealing the ACA is expected to be similar to the bill
vetoed by Obama in January 2016. The vetoed reconciliation bill would have:
- Repealed health care exchanges
and eliminated subsidies
- Terminated the individual
mandate and employer mandate
- Repealed Medicaid expansion
(phased in over two years)
- Eliminated risk adjustment
programs for insurance companies that lose money under the ACA
- Repealed taxes, including the
over-the-counter medicine tax, “Cadillac tax,” medical device tax,
prescription drug tax, annual fee on health insurers and tax on indoor
tanning services
The reconciliation bill does not address ACA replacement
proposals and the timing of consideration of a replacement plan is unknown.
Some GOP members are pushing for a replacement bill to be introduced in a few
months, while other Republicans have expressed support for delaying the ACA
repeal for two or more years to allow Congress enough time to develop and
approve replacement provisions. Some in the health industry, including the
American Hospital Association, are urging Congress to repeal and replace the
ACA simultaneously, in part to ensure the continuation of health insurance
coverage for those who became covered under the law.
MHA has shared the following messages with policymakers:
- The ACA has been good for
consumers and for Minnesota hospitals and health systems. In Minnesota,
the ACA has led to a drop in the uninsured rate, from 9 percent to 4
percent. Nearly 300,000 low-income Minnesotans have gained health care
coverage since 2011.
- The amount of charity care
provided by hospitals to those who were uninsured has also declined, from
$226.7 million in 2010 to an estimated $137 million in 2015. If the
individual mandate is dropped, uncompensated care (which includes bad debt
and charity care) will increase again.
- Minnesota’s hospitals and
health systems want to ensure that health care coverage remains for low
income Minnesotans who gained coverage as a result of the Medicaid
expansion.
- Even before the Affordable Care
Act, Minnesota has innovated – and done so with bipartisan support.
Whatever changes are made, we want to be able to innovate at the state
level.
With questions, contact Briana Nord Parish, policy analyst, MHA, 651-603-3498, or Ben Peltier,
vice president of legal and federal affairs, MHA, 651-603-3513. return to top
HRSA
issues final rule on 340B drug ceiling prices and manufacturer penalties
The Health Resources and Services Administration (HSRA) has
released its final rule, “340B Drug Pricing Program Ceiling
and Manufacturer Monetary Penalties,” as required by the Affordable Care Act
(ACA).
The final rule amends Section 340B of the Public Health Service Act to impose
monetary sanctions (not to exceed $5,000 per instance) on drug manufacturers
that “knowingly and intentionally” charge a 340B hospital or covered entity
more than the ceiling price established under the procedures of the 340B
program. It also codifies current policy on “penny pricing” for ceiling price
calculations resulting in a zero value and establishes new drug pricing policy
when sufficient information to establish a 340B ceiling price for a new drug is
not yet available.
The final rule will require manufactures to refund 340B covered entities within
120 days if the manufacturer determines an overcharge occurred. The final rule
also requires greater transparency in calculating the 340B ceiling drug prices
to ensure that drug manufacturers are not overcharging 340B covered entities.
HRSA said it will begin enforcing the final rule’s requirements on April 1,
requiring manufacturers that offer 340B ceiling prices as of April to comply
with the rule. HRSA plans to issue further guidance on the 340B ceiling price
reporting system and how 340B covered entities can access ceiling price
information to establish instances of manufacturer overcharges.
With questions, contact Joe Schindler, vice president of finance, MHA,
651-659-1415, or Briana Nord Parish, policy analyst, MHA,
651-603-3498. return to top
Safe
Place for Newborns law offers options for parents in crisis
After a baby was left inside a door at the St. Paul Cathedral
last week, the Department of Human Services and MHA remind members of
Minnesota’s Safe Place for Newborns law, which allows mothers to safely and
anonymously give up newborns to safe places such as hospitals and urgent care
facilities, or by calling 911. The law allows mothers, or others acting with
mothers’ permission, to safely and anonymously surrender unharmed infants born
within the past seven days to a designated safe place. A safe place includes a
hospital, an urgent care facility during its hours of operation or an ambulance
that is dispatched in response to a 911 call.
Under the law, ambulance, urgent care and hospital staff have the
responsibility to calmly accept newborns, avoid asking the identity of mothers
and inform the responsible county social service agencies to place the newborns
in foster care or follow the provisions of the Indian Child Welfare Act, if it
applies.
Twenty-two newborns were saved from 2013 through late December 2016 under the
Safe Place for Newborns law, which was amended in 2012 after tragedies
involving abandoned infants. That includes three infants in 2013, six in 2014,
10 in 2015 and three from the beginning of 2016 through Dec. 20.
More information is available on Safe Place for Newborns website. return to top
Updates
to Communicable Disease Reporting Rules are effective Jan. 8
On Jan. 8, changes to the Minnesota’s Communicable Disease
Reporting Rules took effect. The changes help ensure a strong public health
system by addressing new and emerging infectious diseases along with changes in
clinical practice. Hospitals and health systems should familiarize themselves
with the updated rules. For more detail on all the changes to the rules, view
the MDH fact sheet and infectious disease reporting website. return to top
Register
for Jan. 19 patient and family engagement webinar
MHA convenes a statewide virtual Patient and Family Advisory
Committee (PFAC) webinar on the third Thursday of each month. The next
Community of Patient Partners webinar will take place on Jan. 19 from 11 a.m.
to noon on the topic of health records.
During the webinar, MHA will lead a discussion about who has access to health
records and present information about the CARE Act, Minnesota’s new law allowing
patients to designate a caregiver in the health record. In addition, a patient
in a health system that uses Open Notes will share how his health care
experience changed as a result.
Online registration is required to join the
webinar.
MHA’s virtual PFAC is an inclusive online community for anyone who is involved
in a local PFAC in Minnesota. It is open to patient partners, patient and
family engagement leaders and anyone passionate about including patients as
partners in their care.
To learn more or submit proposed content for the webinar discussion, contact Joy Benn,
quality and patient safety specialist, MHA, 651-659-1441. return to top
Webinar
on SQRMS 2017 hospital measures changes to be held Jan. 10
The Minnesota Department of Health, Minnesota Community
Measurement and Stratis Health will present an informational webinar on Jan. 10
from 8-9 a.m. to review Statewide Quality Reporting Measurement System (SQRMS)
2017 hospital measures changes.
Webinar objectives include:
- Review quality measurement
statutory requirements and development of the Statewide Quality Reporting
and Measurement System.
- Describe 2017 hospital measures
and deadlines for quality data reporting.
- Understand the hospital quality
measures recommendation process.
Register online to attend the webinar. return to top
DEA
changes notification process for renewal applications
Starting January 2017, DEA will no longer send its second
renewal notification by mail. Instead, an electronic reminder to renew
will be sent to the email address associated with the DEA registration.
At this time, DEA will otherwise retain its current policy and procedures with
respect to renewal and reinstatement of registration. This policy is as
follows:
- If a renewal application is
submitted in a timely manner prior to expiration, the registrant may
continue operations, authorized by the registration, beyond the expiration
date until final action is taken on the application.
- DEA allows the reinstatement of
an expired registration for one calendar month after the expiration date.
If the registration is not renewed within that calendar month, an
application for a new DEA registration will be required.
- Regardless of whether a
registration is reinstated within the calendar month after expiration,
federal law prohibits the handling of controlled substances or List 1
chemicals for any period of time under an expired registration.
To learn more, visit the DEA website. return to top