Health Innovation Grant Program RFP forthcoming from MDH
The Minnesota Department of Health (MDH) will publish a
competitive Request for Proposal (RFP) process for the state’s new Mental
Health Innovation Grant Program before the end of 2017. To receive updates on
the RFP, subscribe to the Mental Health News mailing list.
The development of this grant program was one of MHA’s top priorities during
the 2017 legislative session. The program is designed to improve access to and
the quality of community-based, outpatient mental health services and reduce
the number of people admitted to regional treatment centers (RTCs) and Community
Behavioral Health Hospitals (CBHHs). Funds of $2.171 million will be made
available for fiscal years 2018-19. Grantees will be challenged to begin
Eligible applicants include counties, tribes, mental health service providers,
hospitals or community partnerships. Half of all grants will be awarded to
eligible applicants in the metropolitan area and half to eligible applicants
outside the metropolitan area.
Awards will be based upon a demonstrable commitment to equity, underserved
communities, multidisciplinary collaborations and visionary ways of helping all
adults with mental illnesses reduce psychiatric emergencies and entrance into
RTCs and CBHHs. Awardees will develop and/or enhance mental health services,
which promote access, inclusion, improve quality and the overall experience of
service-users and their families.
Sample grant projects may include:
- Intensive Residential Treatment
Services (IRTS) providing time-limited mental health services in a
- Short-term and critical access
centers and/or supportive living environments
- Collaborative efforts between
crisis teams and hospitals
- Community support programs and
services that integrate multidisciplinary practitioners
To learn more, view the MDH update bulletin or contact Amanda Calmbacher, Mental Health Division, DHS, 651-503-4050. return to top
MACRA payment rule includes MHA-requested changes
CMS released the final rule for the second payment year of its
Quality Payment Program (QPP), which was created by the Medicare Access and
CHIP Reauthorization Act (MACRA). The final rule contains a wide range of
changes to the QPP for 2018 and beyond. Some of those changes reflect policies
that the Minnesota Hospital Association (MHA) encouraged the agency to adopt.
The proposed rule issued by CMS earlier this year would have delayed giving any
weight to clinicians’ scores on cost-of-care measures in the QPP formula used
to adjust providers’ Medicare reimbursement rates. For years, MHA has advocated
for payment methodologies that take providers’ costs and efficiency of care
into account. MHA’s comment letter regarding the proposed rule urged CMS to
abandon its proposed delay and, instead, move forward with its original plan to
phase in the use of efficiency scores in the QPP formula. Ultimately, CMS
reverted to its original plan as requested by MHA and will weigh providers’
efficiency scores as 10 percent of their total QPP score in 2018, and then as
30 percent in 2019 and subsequent years.
In its comment letter, MHA also advocated for including providers’ risk-bearing
agreements with Medicare Advantage plans in the criteria CMS uses to determine
whether clinicians will receive financial incentives for participating in a
qualified Advanced Alternative Payment Model (APM). Because Minnesota has a
disproportionately large number of people enrolled in Medicare Advantage plans
compared to other states, it is statistically harder for our providers to meet
the Advanced APM thresholds when the criteria are based solely on Medicare
fee-for-service beneficiaries. MHA is pleased that the final rule will allow
providers to include enrollees in Medicare Advantage plans with whom the provider
has a risk-bearing agreement for purposes of qualifying as an Advanced APM
beginning in 2019.
For more information about the final rule, see the CMS QPP Final Rule Fact Sheet. return to top
committee approves tax bill; Senate releases its tax reform proposal
On Nov. 9, the House Ways and Means Committee
approved the Tax Cuts and Jobs Act (HR 1) and Senate Republicans released their
initial tax reform proposal. Both include provisions impacting hospitals.
The House bill would limit hospitals’ ability to access low-cost capital
financing through private activity bonds (PABs) by eliminating the tax
exemption for PABs. Access to tax-exempt PABs is estimated to save nonprofit
hospitals 2 percentage points on their borrowing compared to taxable bonds or
bank financing. Some experts project that interest rates for borrowers would
increase by 1.5 percent to 2.5 percent under the House provision, which
translates to an increase of 25 percent to 35 percent in the cost of borrowing
over the term of the financing. The ability to obtain tax-exempt financing is a
key benefit of hospital tax-exemption that supports providing access to vital
hospital services. The Senate Republicans’ proposal does not include this
Both the House bill and Senate proposal would eliminate advance refunding of
MHA has expressed strong concerns with these provisions to House Ways and Means
Committee member Rep. Erik Paulsen and the rest of the Minnesota House
delegation, as well as to Sens. Amy Klobuchar and Al Franken.
The House bill would repeal the itemized deduction of medical expenses beginning
next year and eliminate the deduction for contributions to Archer medical
savings accounts. These provisions are not included in the Senate proposal.
Currently, neither the House bill nor Senate proposal would make changes to
federal tax exemption for not-for-profit hospitals or modify an individual’s
ability to itemize deductions for charitable giving.
Neither bill includes repeal of the Affordable Care Act’s individual mandate;
however, repeal of the individual mandate could be added as a way to offset the
cost of the bill or to garner support needed to pass legislation.
Tax reform legislation is expected to move quickly through Congress and be on
President Trump’s desk by the end of the year.
MHA will continue to work closely with the Minnesota delegation and Sens.
Klobuchar and Franken to oppose the provisions negatively impacting hospitals
and patients. return to top