Minnesota Hospital Association


April 29, 2019

MHA Newsline: April 29, 2019

In this issue 

Legislature works on budget proposals; employment-related bills move in House

Legislature continues to work on budget proposals
The House and Senate returned from their legislative break on April 23 and spent the week moving their omnibus budget bills through the legislative process. On April 25, the House spent over seven hours debating the health and human services (HHS) omnibus bill on the floor. HF 2414, authored by Rep. Tina Liebling (DFL-Rochester), includes MHA legislative priorities of funding for mental health programs and repealing the provider tax sunset. The bill also includes Gov. Walz’s ONECare insurance proposal. MHA has shared questions and concerns about how the proposal would be implemented.   

Over 100 amendments were offered, but few were added to the bill. It ultimately passed 74-55, with all of the DFL members present voting for the bill and all of the Republican members present voting against the bill. The next stop for this bill will be a conference committee, charged with working out the significant differences with the Senate companion legislation.   

Also on April 25, the Senate Finance Committee took up its HHS omnibus bill. While SF 2452, authored by Sen. Michelle Benson (R-Ham Lake), includes some funding for mental health services, it also has two very concerning budget provisions. The first provision would change the benefit set for adults in Medical Assistance and MinnesotaCare to the 2016 federal benchmark plan benefit set, eliminating coverage for adult dental and vision care, well baby visits, transplants and chemotherapy. The second provision limits PMAP (Prepaid Medical Assistance Program) growth to 1%. These provisions were likely included as cost savings because the Senate budget proposal does not continue the provider tax. The bill will be taken up on the Senate floor the week of April 28.   

Paid family leave, other employment-related bills continue to move in House
The House DFL majority caucus has identified access to paid family leave, paid sick leave and wage theft as some of its top priorities. All three bills are now included in the omnibus jobs bill, HF 2208, authored by Rep. Tim Mahoney (DFL-St. Paul). They are also on the House general register as stand-alone bills.   

HF 5, authored by Rep. Laurie Halverson (DFL-Eagan), would create a paid family and medical benefit modeled after the state’s unemployment insurance program. HF 11, authored by Rep. John Lesch (DFL-St. Paul) would create a paid sick leave law modeled after the earned sick and safe time ordinance that was implemented in St. Paul, Minneapolis and Duluth. HF 6, also authored by Mahoney, defines wage theft provisions and creates penalties for employers who commit wage theft.   

These bills are not moving in the Senate, nor are any of them included in the Senate’s jobs and economic development bill.   

With questions, contact Mary Krinkie, vice president of government relations, MHA, 651-659-1465, or Kristen McHenry, director of state government relations, MHA, 651-603-3526.   

Session bill tracker
For a complete list of 2019 legislative bills MHA is tracking, visit the MHA Member Center. For assistance accessing the Member Center, contact Ashley Beno, member services and communications specialist, MHA, 651-603-3545. return to top   

Clinic facility fee disclosure bill signed into law

Gov. Walz on April 11 signed into law SF 131, authored by Sen. Rich Draheim (R-Madison Lake), which requires that any clinic that charges a facility fee notify the patient and “must post prominently in locations easily accessible to and visible by patients, including its website, a statement that the provider-based clinic is part of a hospital and the patient may receive a separate charge or billing for the facility, which may result in a higher out-of-pocket expense.”   

The law, which goes into effect Aug. 1, applies to any provider-based clinic, including hospital-owned or health system-owned clinics. It does not apply to laboratory services, imaging services or other ancillary health services that are provided by staff who are not employed by the health care facility.   

The posting could say, “This hospital-based clinic charges a facility fee. For more information, please contact [name and title/office name, contact information].”   

With questions about posting requirements, contact Joe Schindler, vice president of finance, MHA, 651-659-1415. return to top   

Annual statewide workforce summary now available

Since 2008, Minnesota hospitals and health systems have submitted demographic data to MHA. The workforce planning project collects demographic and vacancy data on 40 direct-patient care job types across 11 attributes. With this data, MHA produces an annual statewide summary of Minnesota’s current health care workforce. The annual statewide summary is available to all members on the MHA Member Center. In 2019, 116 hospitals submitted workforce data.   

MHA developed a custom Workforce Planning Tool for members. The online tool allows participating members to view their individual data through different analyses and to compare it to their specific region and/or to the statewide results. Nonparticipants can only access the statewide data.   

For questions about the MHA Workforce Planning Tool project, contact Nathalie Squire, workforce project manager, MHA, 651-603-3540. return to top   

CMS releases proposed Medicare inpatient rule for FY 2020

The Centers for Medicare and Medicaid Services (CMS) on April 23 released its inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2020. MHA will analyze the proposed rule and submit a comment letter. MHA invites member hospitals to share concerns with the proposed rule over the next two months. Comments are due to CMS by June 24. The final rule will be published around Aug. 1, with the policies and payment rates effective Oct. 1.    

Under the proposed rule, the net increase to hospital payments in fiscal year (FY) 2020 is expected to be 3.2% for hospitals that were meaningful users of electronic health records (EHR) and that submit data on quality measures. This reflects the projected hospital market basket update of 3.2% reduced by a 0.5 percentage point productivity adjustment and a proposed +0.5 percentage point adjustment required by legislation. CMS estimates total Medicare spending on inpatient hospital services to increase by about $4.7 billion in FY 2020.   

CMS proposed increasing the marginal rate of the new technology add-on payment, including for CAR-T therapies, from 50 to 65%.   

DSH payment changes 
CMS proposed distributing $8.49 billion in Medicare disproportionate share hospital (DSH) payments in 2020, an increase of $216 million. CMS proposed to use a single year of uncompensated care data to determine the distribution of DSH uncompensated care payments for FY 2020.   

Wage index changes
The agency proposed changes to the area wage index, including an increase to the wage index for hospitals with a wage index value below the 25th percentile and a decrease to the wage index for hospitals with values above the 75th percentile to make the provision budget-neutral. Decreases in a hospital’s wage index would be capped at 5% in FY 2020. The proposed wage index changes would be in place for four years. CMS also proposed removing the urban-to-rural hospital reclassifications for calculating the rural floor wage index value starting in FY 2020.   

Hospital quality incentive program changes
CMS proposed a number of updates to its hospital quality incentive programs, adding three new electronic clinical quality measures to the inpatient quality reporting program, including two opioid-related measures and a hybrid hospitalwide all-cause readmission measure. More information on CMS’ proposed changes to quality programs can be found on the CMS fact sheet.   

With questions or comments, contact Joe Schindler, vice president of finance, MHA, 651-659-1415. return to top