In this issue
miss the chance to earn recognition for your hospital
nominations due Friday, Feb. 14
Is your hospital a best Minnesota workplace? Do you have an
innovative patient safety program or exemplary caregiver who deserves
recognition? If so, consider submitting a nomination for MHA’s annual awards
program. For the past 30 years, the MHA Awards have celebrated outstanding work
by Minnesota hospitals and health systems and we want to honor you.
MHA award categories recognize excellence involving community health, workforce
issues, patient care and career promotion, for example. Honors for individuals
recognize trustees, volunteers, hospital executives, caregivers and public
officials. Additional information on the categories and judging criteria can be
found on MHA’s website.
Entries are due by Friday,
Feb. 14; find the entry form here: MHA Awards: Nomination Form
MHA will notify all entrants whether they have won in mid-March. A reception
and dinner will take place Friday,
April 25 at the Metropolitan Ballroom in suburban Minneapolis. All MHA members and associate members
are invited and encouraged to attend the awards ceremony. Mark
your calendars and plan to join us for this celebration of excellence in
Minnesota health care.
For more information, contact Sarah Bohnet, MHA visual communications
specialist, 651-603-3494. return to top
moves closer to Sustainable Growth Rate replacement
Federal legislation to permanently replace the
Sustainable Growth Rate (SGR) cuts to physicians’ Medicare payment rates law
took another important step forward last week. On a bipartisan basis,
congressional leaders from the Senate Finance Committee and the House Ways and
Means and Energy and Commerce Committees agreed on terms to repeal the SGR cuts
and, instead, provide small rate increases over five years while Medicare
transitions to new value-based payment models.
The Medicare Physician Payment Innovation Act, HR 574, has significant hurdles remaining.
Most notably, the agreement among the three committees does not include the
difficult cuts to other federal spending that is needed to pay for the costs
associated with repealing the SGR. Unless repealed or delayed, the SGR law
would impose a 28 percent cut to physicians’ Medicare payments beginning April
Hospitals and health systems around the country are concerned that Congress will
look to cut other providers to finance the change to physician payment rates.
MHA will continue to advocate that hospital payments not be used as an offset.
In previous comment letters and discussions with Minnesota’s members of
Congress, MHA encouraged Congress to use the SGR repeal as an opportunity to
implement more aggressive reforms that base payment rates on the quality and
efficiency of physician services. Accordingly, MHA regards the compromise
reached by the three committees as a positive step toward the association’s
long-standing priority of reforming Medicare’s payment methodologies.
At the same time, MHA is disappointed that a provision to reverse Medicare’s
direct supervision of outpatient therapeutic services policy, which had been
part of the Senate Finance Committee’s version of the legislation, does not
appear in the compromise language.
Lawrence Massa, president and CEO of MHA, said “the SGR bill offers a great
vehicle for Congress to correct the deeply flawed direct supervision policy.”
He said that if the SGR bill does not include language to reverse that policy,
MHA and the American Hospital Association will continue to build support for
separate legislation to address hospitals’ concerns on that issue.
For more information, contact Matt Anderson, MHA vice president of
regulatory and strategic affairs, 651-659-1421. return to top
rule remains in flux
The Centers for Medicare and Medicaid Services (CMS) announced a
six month extension of its partial enforcement delay of the new two-midnight policy for inpatient admissions.
According to the recent CMS decision, Recovery Audit Contractors (RACs) will
not review patient status of paid inpatient hospital claims for admissions
between Oct.1, 2013 through Sept. 30, 2014. RACs and other Medicare contractors
will conduct pre-payment “probe and educate” audits on select claims for
patients admitted during this timeframe.
Previously, CMS intended to begin two-midnight rule enforcement in April.
CMS will discuss the two-midnight rule further during a Medicare Learning Network
call on Thursday, Feb. 27 at 1:30 p.m. Details on the Feb. 27 call are
available on the CMS website.
For more information, contact Joe Schindler, MHA vice president of finance,
651-659-1415. return to top
website causes another Meaningful Use extension
Unable to log on or complete a registration, inordinately long
delays despite a looming deadline. Health care providers have raised these
concerns regarding the website that providers must use to attest to meaningful
use of electronic health records in order to receive Medicare's 2013 incentive
payments for eligible professionals.
Because of multiple problems with its website, the Centers for Medicare and
Medicaid Services (CMS) extended the deadline for attestations from Feb. 28 to March 31.
MHA members voiced similar complaints about the website and remain concerned
whether the extension will be sufficient. Many MHA members described the
website as almost completely inoperable during normal business hours either
because providers are unable to log on to the website or because it kicks them
out. Those who have been able to access the site describe the process as so
slow and tedious that it takes hours to complete the attestation for a mere
handful of eligible providers.
Frustrated and concerned about the looming deadline, many MHA members have been
resorting to having staff work on the attestation process in the middle of the
night and over weekends, when less traffic to the website allows for slightly
Despite the extension, MHA members continue to hold concerns about whether they
will be able to complete the required attestations for thousands of eligible
providers by March 31 if CMS does not repair the website.
For more information, contact Mark Sonneborn, MHA vice president of
information services, 651-659-1423. return to top
reverses its position on Medicaid sequestration cuts
In a welcomed response, MHA was informed last week that the Minnesota
Department of Human Services (DHS) has decided to reverse its earlier position
of implementing payment cuts to the Medicaid program due to sequestration (see Jan. 20 Newsline).
Some of the services impacted by the 2 percent sequestration cuts were
outpatient facility fees, ambulance, radiology, laboratory, orthotics and
prosthetics. A Feb. 5 posting on its website indicates DHS will be
refunding the take-backs they’ve collected from providers over the last month.
In December 2013, DHS began making cuts to Medicaid services that use a
Medicare fee schedule as the basis for payment. Their rationale was that
Medicare had cut its fee schedules 2 percent due to federal sequestration,
therefore the state of Minnesota would follow suit.
For questions, contact Joe Schindler, MHA vice president of finance,
651-659-1415. return to top
legislation introduced to remove the 96-hour physician certification
requirement for CAHs
Late last week, U.S. Reps. Adrian Smith (R-NE), Greg Walden
(R-OR), Lynn Jenkins (R-KS), and Dave Loesback (D-IA) introduced the Critical
Access Hospital (CAH) Relief Act of 2014, H.R. 3991, to remove the 96-hour
physician certification requirement as a condition of payment for CAHs.
MHA staff submitted a request to all of our House Congressional offices
encouraging them to co-sponsor the bill. MHA members are encouraged to follow
up with their representatives to voice support of this request.
Under the current requirement physicians at CAHs must certify at the time of
admission that a Medicare beneficiary is expected to be discharged or
transferred to another hospital within 96 hours of admission as a condition of
payment. If something unforeseen occurs and the beneficiary needs to stay
longer than 96 hours, the physician must certify and document the changed
circumstances in order to still meet the condition of payment.
There is a separate and distinct condition of participation which requires CAHs
to provide acute inpatient care for a period that does not exceed, on an annual
average basis, 96 hours per patient. H.R. 3991 does not impact the condition of
CMS has historically not enforced the condition of payment, but recently published
guidance implying that the agency will enforce this condition of payment going
forward. This means in many cases CAHs will no longer receive payment from
Medicare for medical services requiring a beneficiary stay of longer than 96
CAHs typically maintain an annual average of 96 hours per patient, but some of
the medical services they offer have lengths of stay greater than 96 hours per
patient. For example, a Medicare beneficiary with pneumonia may wish to receive
care from the local CAH and remain close to family and home rather than
traveling further to an urban or regional prospective payment system hospital.
If this condition of payment is enforced, access to care will be compromised
for these beneficiaries. MHA strongly supports H.R. 3991 as a solution to this
For more information contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
Accountable Health model announces e-health grant program
The Minnesota Accountable Health Model, Minnesota’s State
Innovation Model (SIM) grant program, will soon release a request for proposals
(RFP) for its e-Health Grant Program. E-Health is a major component of the
Accountable Health Model, which will promote community oriented efforts to
improve population health and health care quality.
The future grants will provide funding to community collaboratives to
develop a plan for meeting e-health requirements or to implement and expand
e-health capabilities for participation in the model. MHA encourages members to
consider this opportunity when the RFP is released and will provide additional
information when it becomes available.
For more information, click here. return to top
Swan to present opening session at Healthcare Leadership Institute
Maureen Swan, president of Eden Prairie-based MedTrend, Inc.,
will present the opening session at the Healthcare Leadership Institute this
March. During her presentation, Health Care 2015 and Beyond: The Shifting
Landscape of the Who, Where and What of Health Care, she’ll discuss the core
drivers of change transforming the U.S. health care industry and the role
mobile devices, data mining analyzers, health insurance exchanges and national
health care marketplaces will play in those changes. She’ll examine the
implications of these issues for delivery systems in both rural and urban
settings and what this means for the health care industry in Minnesota.
The conference, “Daring to Lead in Times of Change,” will take place March 5-7
at the Crowne Plaza Minneapolis West in Plymouth. For more information and to
register, download the conference brochure or visit MHA’s website. return to top
provides recommended practices for hospitals to optimize the safety and safe
use of EHRs
Electronic health records (EHRs) have the
potential to improve the quality and safety of health care. However, EHR users
have experienced safety concerns from EHR design and usability features that
are not optimally adapted for the complex workflow of real-world practice
settings. The Office of the National Coordinator for Health Information
Technology (ONC) has released a new suite of guides to help hospitals and
health care organizations to optimize the safety and safe use of EHRs. These
tools, referred to as the Safety Assurance Factors for EHR Resilience (SAFER)
guides, can be used by hospitals to self-assess the safety and effectiveness of
their EHR implementations, identify specific areas of vulnerability and change
their cultures and practices to mitigate risks. The guides are available for
free online. return to top