Minnesota Hospital Association


April 07, 2014

MHA Newsline: April 7, 2014

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