In this issue
for Ebola discussed as budget hearings continue
Last week the Senate completed overview hearings on the
governor’s budget recommendations. The House and Senate Health and Human
Services committees passed several bills relating to ambulance services. The
Senate Finance committee passed legislation including $2 million for Ebola
related costs for EMS providers and the four Ebola treatment hospitals (S.F.
174 – Sen. Cohen – St. Paul). This legislation was passed to the Senate floor.
The House Health and Human Services Reform committee passed legislation to
expand the rural loan forgiveness program (H.F. 211 – Rep. Kiel –
Upcoming hearings of
On Monday, Feb. 9 at 10:15 a.m., the House Ways and Means Committee will hold a
hearing on legislation to provide funding to EMS providers and the four Ebola
treatment hospitals (H.F. 264 – Rep. Knoblach – St. Cloud). At noon, the Senate
Health, Human Services and Housing Committee will hold a hearing on the
Interstate Physician Licensure Compact (S.F. 253 – Sen. Sheran – Mankato), and
legislation to create a task force to review health care regulation with a
report due in 2016. As introduced, MHA would appoint one of the 22 members to
the task force.
On Tuesday, Feb. 10 and Wednesday, Feb. 11 at 12:45 p.m., the House Health and
Human Services Finance Committee will hold a meeting to hear public testimony
on the governor’s budget. MHA will testify at one of these hearings.
On Tuesday, Feb. 10 at 2:45 p.m., the House Health and Human Services Reform
Policy Committee will hold a hearing on legislation to fund a portion of the
poison information center (H.F. 346 – Rep. Hoppe – Chaska). The committee will
also consider legislation to require EMS providers to develop stroke transport
protocols (H.F. 513 – Rep. Zerwas – Elk River).
On Wednesday, Feb. 11 at 8:15 a.m., the House Aging and Long Term Care Policy
Committee will consider legislation to expand the loan forgiveness program
(H.F. 627 – Rep. Franson – Alexandria) and legislation to develop a grant
program to further long term care careers (H.F. 614 – Rep. Baker – Willmar).
Legislation of interest
New bills introduced last week included:
A bill to permit medical assistance coverage for certain mental health services
provided by physician assistants in outpatient settings (S.F. 453 – Sen.
Clausen – Apple Valley).
For a complete list of 2015 legislative bills MHA is tracking, visit the Member Center. For
assistance accessing the Member Center, contact Ashley Gauster, MHA member services and communications specialist,
651-603-3545. return to top
shares Medicaid rates for PPS hospitals
In a Feb. 6 webinar, Department of Human Services (DHS) staff
provided hospital-specific impact numbers showing the transition to a reformed
Medicaid inpatient fee-for-service payment system using APR-DRGs. DHS’
contractor, Navigant, was on hand to go through the details of the various
policy adjusters that were used to help mitigate potentially detrimental payment
swings related to key service areas such as mental health, pediatrics, and
obstetrics in rural Minnesota.
DHS is also pursuing development, with input from hospitals, to create a more
sensible disproportionate share hospital (DSH) add-on payment system. This
effort is intended to reinforce critical services and access for Medical
The critical access hospital (CAH) payment methodology is still under
development for implementation later this year. They intend to create a
cost-based methodology similar to Medicare’s to ensure rural access. CAH
payment rates will continue using the current payment methodology, at least
through September 2015.
For more information, contact Joe Schindler, MHA vice president of finance,
651-659-1415. return to top
miss the chance to earn recognition for your hospital
nominations due Friday, Feb. 20
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. 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
Entries are due by Friday,
Feb. 20; find the entry form here: MHA Awards: Nomination Form
A reception and dinner will take place Friday,
April 24 at the Metropolitan Ballroom in suburban Minneapolis. All MHA members and associate members
are invited and encouraged to attend the awards ceremony.
Additional information on the categories and judging criteria can be found on MHA’s website, and for more information,
contact Sarah Bohnet, MHA visual communications specialist, 651-603-3494. return to top
reintroduced to remove 96-hour certification requirement for CAH; protect
access to outpatient therapeutic services
U.S. Senate and House legislation was recently reintroduced that
would remove the 96-hour physician certification requirement as a condition of
payment for critical access hospitals (CAHs).
Sens. Amy Klobuchar and Al Franken, and Reps. Collin Peterson and Tim Walz are
co-sponsors of S. 258/H.R. 169, the CAH Relief Act. MHA has requested the
remainder of the delegation to sign onto the bills. The legislation is also
supported by the American Hospital Association.
Medicare currently requires physicians to certify that patients admitted to a
CAH will be discharged or transferred to another hospital within 96 hours in
order for the CAH to receive payment under Medicare Part A. The Centers for
Medicare and Medicaid Services has not historically enforced the requirement,
but in recent guidance related to its two-midnight admissions policy implied
that it will, a situation that could threaten patients’ access to longer care
The legislation would not remove the requirement that CAHs maintain an average
annual length of stay of 96 hours, nor affect other certification requirements
In addition, legislation was reintroduced in the U.S. Senate that would allow
general supervision by a physician or non-physician practitioner for many
outpatient therapeutic services. Sens. Klobuchar and Franken are co-sponsors of
S. 257, the Protecting Access to Rural Therapy Services (PARTS) Act, would
require CMS to adopt a default setting of general supervision (rather than
direct supervision) for outpatient therapeutic services, and create an advisory
panel to establish an exceptions process for risky and complex outpatient
services that may require a higher, direct level of supervision. The
legislation would also hold critical access hospitals harmless from civil or
criminal action regarding CMS’s retroactive reinterpretation of “direct
supervision” requirements for the period 2001 through 2015.
For more information contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
rescinds letters requesting eligibility information from CAHs
MHA recommends CAHs
take immediate steps to locate original documentation of eligibility
Last week, the American Hospital Association (AHA) alerted
critical access hospitals (CAHs) that the Centers for Medicare and Medicaid
Services (CMS) was sending letters asking for information related to each
hospital’s eligibility for the CAH program.
In conversations with AHA, CMS clarified that these letters were only sent to
CAHs in North Carolina and Tennessee and CMS has now rescinded all letters.
CMS has the authority to request this documentation, and may do so through the
standard CAH survey process in the future, but has not regularly asked for this
information in the past. MHA recommends that all CAHs take the necessary steps
to retrieve the original paperwork confirming CAH status whether it is through
necessary provider status or the federal mileage requirements.
If CAH members are having difficulty locating their documentation they can
contact Judy Bergh, Minnesota rural hospital flexibility and critical access
hospitals, Office of Rural Health and Primary Care, Minnesota Department of
AHA continues to meet with CMS to encourage the agency to provide guidance and
specifics on the documentation they may be looking for in the future. Locally,
MHA is in close communication with the Office of Rural Health and Primary Care
along with AHA on this issue and will provide additional information as it
For more information, contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
advocates for rural PPS legislation
This week MHA submitted a request to the Minnesota congressional
delegation to co-sponsor legislation that will make permanent both the
Medicare-dependent hospital (MDH) and the enhanced low-volume Medicare payment
adjustment (LVA) for small, rural prospective payment system (PPS) hospitals.
The current short-term extension of these programs is scheduled to expire on
Minnesota has 25 LVA and three MDH hospitals. These designations are particularly
important for hospitals that are too large to qualify for critical access
hospital status, but would be/are challenged to thrive under PPS without the
This legislation also has the support of the American Hospital Association.
For more information, contact Ann Gibson, MHA vice
president of federal relations and workforce at 651-603-3527. return to top
collaborating on Minnesota’s response and preparation for Ebola
MHA recognizes the commitment of Minnesota hospitals to ensure
the state stands ready should a Minnesota Ebola case develop. For months, you
have been training and drilling caregivers and staff on how to deliver optimal
care safely; communicating and coordinating efforts with the Minnesota
Department of Health (MDH), MHA and other health care providers; evaluating
facilities for appropriate isolation space; and ensuring that the necessary
personal protective equipment (PPE) and supplies are available.
Working closely with MDH, MHA has proactively engaged its members to develop a
statewide plan for management of suspected and confirmed cases of Ebola Virus
Disease (EVD) in Minnesota. Last Tuesday, senior MHA leaders met with MDH and
the four designated Ebola assessment and treatment facilities through the
Minnesota Collaborative for Healthcare Response to Ebola.
During this meeting, MHA and members provided feedback to help shape MDH’s
Concept of Operations (CONOPS) for Management of Suspected and Confirmed Cases
of Ebola Virus Disease (EVD), including a situation overview, collaborative
charter, purpose and scope, key organizations with respective assignment of
responsibilities, detailed guidance on specimen collection, packing and
shipping for Ebola virus testing, in addition to personal protective equipment
(PPE) guidelines to be used and on the processes for donning and doffing (i.e.,
putting on and removing) PPE for all healthcare workers entering the room of a
patient hospitalized with confirmed EVD.
MHA’s role in the collaborative is to support the collaborative by leveraging
resources that will increase overall infrastructure alignment and promote
sustainability among the four Ebola Treatment Centers; facilitate on-going
communication and situational awareness with all MHA members; serve as a
trusted partner for information and guidance; as well as serve as an advocate
for the collaborative hospitals. “The state of readiness in Minnesota is high
thanks to the continued engagement and hard work being done by our hospitals,” said Tania Daniels, MHA vice president for patient safety.
The next all-hospital call on Minnesota’s Ebola preparations takes place
Thursday, Feb. 12 at 3 p.m. To join the call, contact Karen Olson,
MHA patient safety/quality coordinator, 651-603-3521. return to top
Leadership Institute participants to explore role of telemedicine; framework
for patient safety
The American College of Healthcare Executives (ACHE) Minnesota
Health Care Group has developed two panel discussions at MHA’s Healthcare
Leadership Institute in March.
The first panel discussion, “Health Care Safety — Protecting Patients and Front
Line Staff,” will present a framework for a patient safety program that
protects patients and health care providers from preventable injury. You will
hear from health care professionals who have implemented programs and will
provide you with lessons learned and what organizational infrastructure is
required to successfully implement an effective safety program.
- Laura Keithahn, senior
operations leader for acute care hospitals, HealthEast Care System, St.
- John Strange, president and
CEO, St. Luke’s Hospital, Duluth;
- Steve Underdahl, CEO,
Northfield Hospital; and
- Beth L. Heinz, vice president,
operations and chief quality officer, Regions Hospital, St. Paul
During the second panel discussion, “Telemedicine in the Health
Care Delivery System,” panelists will explore the current and future role of
telemedicine in the delivery of health care and will delve into how well this
technology has been utilized and received by clinicians and patients.
Technical, operational, regulatory and financial aspects of the development of
telemedicine programs will be investigated.
- Maureen Ideker, R.N., BNS, MBA,
director of Telehealth, Essentia Health-Graceville;
- Kelly Rhone, M.D., Avera
McKennan Hospital, Sioux Falls, S.D.; and
- Steven Mulder, M.D., president
and CEO, Hutchinson Health (moderator).
Both sessions have been approved by ACHE for 1.5 ACHE
Face-to-Face credits. Participants do not need to be ACHE members to attend
these sessions as they are geared toward all senior leadership. The conference
will also feature sessions on professional resiliency and physician leadership.
The March 4-6 program will take place at the Crowne Plaza Minneapolis West in
For more information, download the brochure. return to top
memoriam: Ken Bank
Ken Bank, who served as president and CEO of
Northfield Hospital and Clinics from 1988-2010, passed away unexpectedly at his
home in Tucson, Arizona recently.
Ken was a thoughtful, progressive leader who was instrumental in positioning
Northfield Hospital and Clinics to grow and thrive in a challenging health care
environment. During his tenure, he presided over the development of the Center
for Sports Medicine and Rehabilitation, the expansion of surgical services and
diagnostic imaging, the development and construction of a new hospital and the
development of a primary clinic network. He was also active in many community
projects. Ken was very involved with MHA and a great supporter of the
organization. MHA extends our condolences to Ken’s family and friends. return to top