In this issue
CMS
seeks further comments on supervision levels of certain outpatient therapeutic
services
The Advisory Panel on Hospital Outpatient Payment (HOP Panel),
which advises the Centers for Medicare and Medicaid Services (CMS) regarding
the appropriate level of supervision for individual hospital outpatient
therapeutic services, recently recommended the agency reduce the supervision
level for 18 services to general supervision. However, CMS did not accept all
of the panel’s recommendations, instead only
accepting the recommendation to reduce the level of supervision for six
services.
CMS’s decision is preliminary and open for public comment until 5 p.m. Eastern
Time on April 30, 2014.
Most of the services that were not moved forward for general supervision were
related to chemotherapy and wound debridement. CMS is seeking specific clinical
input on each of these services and may re-assess. The specific feedback CMS is
looking for along with instructions on how to submit comments are included in
the link above.
MHA will submit comments on behalf of our members, but members are urged to
consult with their clinical staff and draft comments with examples related to
your individual organization as well.
For additional information, or to share feedback from your clinical staff that
MHA can incorporate into our comments, contact Matt Anderson, MHA vice president of regulatory and strategic affairs,
651-659-1421. return to top
Minnesota
Rep. Tim Walz supports legislation to remove the 96-hour physician
certification requirement
Last week, Rep. Walz (D) signed on as a cosponsor to H.R. 3991,
the Critical Access Hospital (CAH) Relief Act of 2014, to remove the 96-hour
physician certification requirement as a condition of payment for critical
access hospitals (CAHs).
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 participation.
CMS has historically not enforced the condition of payment, but recently
published guidance implying that the agency will enforce it going forward.
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.
As previously reported in Newsline, Minnesota Sens. Klobuchar (D) and
Franken (D) are original cosponsors of the Senate companion bill.
MHA and the American Hospital Association support this legislation. MHA staff
submitted a request to all of Minnesota’s House offices requesting they
cosponsor the bill. MHA members are encouraged to follow up with their
representatives to voice support of this request and to thank Rep. Walz and the
senators for their leadership.
For more information contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
President
signs Excellence in Mental Health Act
On Tuesday, President Barack Obama signed into law a bill to
enact the Excellence in Mental Health Act demonstration program. The program
provides the biggest federal investment in community mental health in decades.
The legislation establishes a $900 million, two-year demonstration program in
eight unspecified states to offer a broad range of mental health and substance
use treatment services, including 24-hour crisis psychiatric services, while
setting new standards for provider organizations. The law:
- Creates criteria for “Certified
Community Behavioral Health Clinics” as entities designed to serve
individuals with serious mental illnesses and substance use disorders that
provide intensive, person-centered, multidisciplinary, evidence-based
screening, assessment, diagnostics, treatment, prevention, and wellness
services. The Secretary of the Department of Health and Human Services is
directed to establish a process for selecting states to participate in a
two-year pilot program.
- Provides $25 million that will
be available to states as planning grants to develop applications to
participate in the two-year pilot. Only states that have received a
planning grant will be eligible to apply to participate in the pilot.
- Stipulates that eight states
will be selected to participate in the two-year pilot program.
Participating states will receive 90 percent Federal Medical Assistance
Percentages (FMAP) for all of the required services provided by the
Certified Community Behavioral Health Clinics.
- Requires participating states
to develop a prospective payment system for reimbursing Certified
Behavioral Health Clinics for required services provided by these
entities.
For more information visit the National Council for Behavioral Health website.
return to top
Lt.
Governor seeking input on Olmstead Plan
Input from individuals with disabilities, their families,
advocacy organizations, service providers and others is being sought on
modifications to a plan that will help Minnesota develop the next generation of
opportunities for people with disabilities. A subcabinet of state agency
leaders led by Lt. Gov. Yvonne Prettner Solon is holding listening sessions
throughout the state over the next several months. Hospitals and health systems
are encouraged to attend these meetings to provide their feedback to the plan,
particularly for services delivered to people with mental illnesses and other
disabilities.
The “Olmstead Plan” is a result of the settlement of a 2011 federal court case
involving the treatment of clients at a Department of Human Services facility,
which required the state to develop a strategy for serving people in the least
restrictive and most community-integrated setting possible. The plan is not
only intended to carry out the actions agreed to in the settlement but also to
chart a course that will help ensure Minnesotans with disabilities have the
opportunity to learn, work and enjoy life in the most integrated setting. The
term “Olmstead” refers to a U.S. Supreme Court decision.
The next session will be held Monday, April 21, from 3 to 5 p.m. at the Elmer
L. Andersen Human Services Building in Room 2380, 540 Cedar Street, St. Paul.
For more information, including other dates and locations, visit Minnesota’s Olmstead Plan online. return to top
Cambridge
Medical Center hosts mental health community forum
Cambridge Medical Center, a member of Allina Health, hosted a
mental health community forum last Monday in response to the closure of
Riverwood Centers, the region’s main community mental health agency. Hospital
President Gary Shaw and Allina Vice President for Mental Health Paul Goering
were joined by Department of Human Services (DHS) Commissioner Lucinda Jesson,
Assistant Commissioner for Chemical and Mental Health David Hartford,
Children’s Mental Health Division Director, Adult Mental Health Services Acting
Director Glenace Edwall, and other DHS staff to discuss community concerns in
light of the closure. Over 100 advocates, consumers, county workers and others
attended the forum and provided input on what can be done in the short term to
address clients’ needs, possible longer-term solutions and service gaps to
address.
One community mental health services provider reported referring clients
needing prescriptions and affected by the closure to Cambridge’s emergency
department, because of the provider’s lack of prescribers. Hospitals and health
systems seeing clients affected by the Riverwood closure are encouraged to
refer those with county case management to the appropriate county: Chisago, Isanti,
Kanabec, Mille Lacs or Pine. Providers are also working to find services for
patients without county case management services. The mental health crisis
services line for this region is 800-523-3333. Patients with questions about
continuity of care can contact Chuck Hurd, regional governing board chair of
the 7E Mental Health Initiative at 320-679-6357. Medical record requests can be
made at 320-396-3333.
For more information, contact Jen McNertney, MHA policy analyst,
651-659-1405. return to top
St.
Cloud Hospital offering Mental Health Conference this Thursday
On Thursday, April 10, St. Cloud Hospital is hosting Mental
Health 2014, a one-day conference for health care professionals who assist
individuals with mental health care and substance abuse. Following the program,
participants will be able to:
- Discuss current Autism Spectrum
Disorder developments and resources;
- Discuss the differential
diagnosis for fetal alcohol spectrum disorders and identify effective
strategies for coping with its challenges;
- Identify common medications
used to treat alcohol withdrawal;
- Identify indications for using
Phenobarbital vs. short-acting benzodiazepines for alcohol withdrawal;
- Discuss current forensic and
mental health concerns in central Minnesota;
- Describe opportunities and
advantages for collaboration among mental health consumers, healthcare
workers and law enforcement personnel;
- Explain the progress of
implementation of the Patient Protection & Affordable Care Act and how
implementation is related to the various cost, safety and quality
initiatives being put in place for Medicare and health care; and
- Assist participants to
recognize the complexity of the political, economic and demographic issues
that drive the health care system and be able to anticipate future changes
in reimbursement and regulation driven by those factors.
The conference takes place from 8 a.m. to 4 p.m. in the
Windfeldt Room of the CentraCare Health Plaza in St. Cloud. Click here for a brochure. Registration is still
available. return to top
Integrating
Prescription Monitoring Program data with health IT
The Minnesota Board of Pharmacy is hosting a meeting about
efforts underway to integrate access to controlled substance prescription data
contained in prescription monitoring program databases into electronic health
records and options available in Minnesota.
In 2010, the MN Prescription Monitoring Program (MN PMP) began collecting
controlled substance prescription information for prescriptions dispensed
within and into Minnesota by Minnesota-licensed dispensers
(pharmacies). Prescribers and pharmacists access this valuable data via a
secure web portal using a valid user ID and password. Although an
efficient manner of access at the time the system was launched, it has now become
even more important to look at ways to integrate with electronic health
records.
The meeting will take place Tuesday, May 13 from 9 a.m. to 3 p.m. at the
Radisson Hotel-Roseville. Meeting and registration information can be found here. Space is limited so early registration
is encouraged. return to top
RWJF
examines progress of IOM recommendations on transforming the work environment
for nurses
A decade after the Institute of Medicine (IOM) published “Keeping Patients Safe: Transforming
the Work Environment of Nurses,” the Robert Wood Johnson Foundation
recently examined the progress of recommendations in a brief published in Charting the Nursing’s Future. The
brief reviews the IOM’s recommendations for transforming the work environment
to avert patient harm and highlights both progress and areas for improvement. return to top
Rural
health information technology grant available
The Lac Qui Parle Health Network, Medi-sota Health Consortium
and Normandale Community College are launching a three-year rural health
information technology (IT) training program called MENTOR (Modeling Effective
Network Training Opportunities for Rural) Health IT. The health IT training is
grant funded through Health Resources and Service Administration (HRSA) and
begins mid-April 2014. The goal of the grant is to develop a knowledgeable and
skilled workforce that can support health care facilities in the rural areas of
Minnesota with the health IT activity and needs. The training is not strictly
for information technology professionals, but is very fitting for nurses, CNAs,
HIM, allied health, office managers, clinic managers, pharmacy or individuals
who have an interest in health IT and would like to work within a rural
Minnesota health care facility.
More information is available online. return to top
Mayo Clinic celebrating 150th anniversary
Congratulations to the Mayo Clinic, which is celebrating its 150th
anniversary. The Mayo Clinic dates back to 1864 when William Worrall Mayo, M.D.
settled his family in Rochester and opened a small medical practice. According
to the Mayo Clinic website, Dr. Mayo was dedicated to serving people and
advancing medical science. He and his wife, Louise, passed their pioneering
spirit on to their sons, William J. Mayo, M.D., and Charles H. Mayo, M.D., who
transformed the family practice into Mayo Clinic. The Mayo Clinic’s
contributions to medicine are many, including:
- developing the first
integrated, multi-specialty practice of medicine;
- creating the first
anit-blackout suits for military pilots during World War II;
- winning the Nobel Prize in 1950
for discovering cortisone;
- developing a DNA test that
detects anthrax in less than one hour; and
- continuing a tradition of
helping individuals in the most need of help.
MHA is proud to have esteemed organizations like
the Mayo Clinic and the 142 other hospitals in Minnesota as our members. Thank
you for helping make Minnesota #1 in health care quality! return to top