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HHS issues guidance, grants for states implementing insurance exchanges 05/16/2012
The Department of Health and Human Services today issued guidance for states implementing health insurance exchanges under the Patient Protection and Affordable Care Act. The guidance includes a draft blueprint for approval of state-based and partnership exchanges, and general guidance on federally facilitated exchanges. According to the blueprint, states seeking to operate a state-based exchange or electing to participate in a partnership exchange for plan year 2014 must submit a complete "exchange blueprint" by Nov. 16, 2012. In related news, HHS awarded six states $181 million in grants to help establish exchanges: Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington. To date, 34 states and the District of Columbia have received the Exchange Establishment grants, which states can apply for through 2014. Under the ACA, individuals and small businesses will use the exchanges to purchase health insurance beginning in 2014. HHS has scheduled several regional forums for states and stakeholders implementing the exchanges.
| MO hospitals share readiness lessons from disastrous tornado, storms 05/16/2012
A new report from the Missouri Hospital Association shares lessons learned by hospitals responding to an exceptional series of natural disasters in the state last year, including a catastrophic tornado that struck the city of Joplin May 22. "During storms that brought unprecedented snow, ice, floods and tornadoes to Missouri in 2011, hospitals throughout the state once again demonstrated their ability to serve their communities," said MHA President and CEO Herb Kuhn. "In times of emergency, communities depend on hospitals for immediate, lifesaving medical assistance. This report demonstrates that Missouri's hospitals fulfilled that role and more, especially following the Joplin tornado. Sharing the experiences of 2011 will help every hospital prepare for the unexpected." The report focuses on nine key areas of hospital and health system preparedness: planning, communications, resources and assets, safety and security, staffing, volunteers, utilities, medical surge and evaluation.
| NLRB suspends changes to process for union representation cases 05/16/2012
In response to a federal court decision invalidating its expedited union election rule, the National Labor Relations Board yesterday announced it will temporarily suspend implementation of changes to its process for union representation cases while it considers how to respond to the court decision. "About 150 election petitions were filed under the new procedures," the Board said. "Many of those petitions resulted in election agreements, while several have gone to hearing. All parties involved in the 150 cases will be contacted and given the opportunity to continue processing the case from its current posture rather than re-initiating the case under the prior procedure." A federal district court ruled Monday that the Board did not have the statutorily required quorum when it adopted the rule, which was challenged by the U.S. Chamber of Commerce and Coalition for a Democratic Workplace. In February, the AHA and its American Society for Healthcare Human Resources Administration and American Organization of Nurse Executives affiliates joined the HR Policy Association and Society for Human Resource Management in filing a friend-of-the-court brief supporting the Chamber and CDW challenge.
| Non-profits share Form 990/Schedule H concerns with House panel 05/16/2012
The House Ways and Means Oversight Subcommittee today held the first in a series of hearings on oversight of tax-exempt organizations by the Internal Revenue Service. Testifying on the concerns of tax-exempt hospitals, Michael Regier, senior vice president of legal and corporate affairs for VHA Inc., said VHA, AHA and the Healthcare Financial Management Association have urged the IRS to streamline and simplify its revised Schedule H for hospitals. Noting that the agency has yet to issue any regulations implementing the new requirements for tax-exempt hospitals under the Patient Protection and Affordable Care Act, Regier urged Congress to ensure "that hospitals are able to direct their limited resources toward meeting their communities' most significant health needs as opposed to complying with excessively burdensome paperwork requirements." In the context of comprehensive tax reform, he urged the committee to avoid taking any action that would jeopardize the income tax exemption for charitable hospitals, tax-exempt financing for hospital facilities, or deductibility of charitable contributions and bequests for hospital donors. Testifying for the National Association of College and University Business Officers, Cornell University Chief Financial Officer Joanne DeStefano called the revised 990 Form "so complicated that our trustees don't know where to begin."
| Reminder: AHA Audit Education Series begins Tuesday 05/16/2012
On May 22, AHA will hold the first of six members-only educational webinars to help hospitals manage the growing number of payment audits from government contractors and reduce vulnerability to payment denials. As part of the AHA Audit Education Series, AHA also will issue educational resources to help members navigate the audit and appeals process, which include a new member advisory on "Reducing Vulnerabilities to Payment Denials." The webinars will feature top officials from the Centers for Medicare & Medicaid Services, congressional staff, compliance and legal experts, and hospital representatives who will share successful practices. Each webinar also will include an update on AHA efforts to advocate for Congress and CMS to streamline auditing programs and eliminate duplicative audits and inappropriate denials. For more information and to register for the first two webinars, click here.
| AHA supports proposed delay in ICD-10 compliance deadline 05/15/2012
The AHA supports the Centers for Medicare & Medicaid Services' proposed one-year delay in the compliance date for the International Classification of Diseases 10th Edition Clinical Modification and Procedure Coding System, and strongly recommends that CMS move forward with both the CM and PCS coding systems at the same time, the association said in comments submitted today. The comment letter includes highlights from an AHA survey in February, which found most hospital leaders prefer limiting the delay to one year and finalizing the deadline soon so they can adjust their implementation plans. The survey also found that while many hospitals are well prepared for the transition, a short delay will allow them to address competing initiatives, such as adoption of electronic health records. AHA plans to submit separate comments on other elements of the proposed rule, including adoption of a standard for a unique health plan identifier and changes to the national provider identifier requirements. "However, we are very concerned about establishing the same compliance date for ICD-10 and the [health plan ID]," AHA said. "We recommend that the date for the HPID be one year later than the revised Oct. 1, 2014 date for ICD-10-CM and ICD-10-PCS" to isolate the cause of any processing problems that occur.
| CA budget proposal would cut nearly $200 million more from hospitals 05/15/2012
California Gov. Jerry Brown yesterday released a revised state budget proposal aimed at closing a $15.7 billion deficit, which would cut $150 million from private hospitals and more than $40 million from public hospitals, in addition to $86 million in cuts to private safety net hospitals proposed in January. California Hospital Association President Duane Dauner said the association "offered viable alternatives that would minimize the negative impact to patients and hospitals," but they were not included in the revised budget. He said CHA "supports the governor's tax increase initiative that will appear on the Nov. 6 general election ballot. Revenues, combined with budget cuts, are a reasonable compromise. The same principle should apply to hospitals. If more Medi-Cal cuts are imposed on hospitals, the state should make needed regulatory changes that reduce hospital costs. Otherwise, Medi-Cal losses in hospitals will get worse and private patients will get stuck with higher bills."
| Court rules NLRB election rule invalid 05/15/2012
A federal district court judge in Washington, D.C. yesterday invalidated the National Labor Relations Board's expedited union election rule, declaring that the Board did not have the statutorily required quorum when it adopted the rule. "Two members of the Board participated in the [Dec. 16] decision to adopt the final rule, and two is simply not enough," the opinion states. "Member Hayes cannot be counted toward the quorum merely because he held office, and his participation in earlier decisions relating to the drafting of the rule does not suffice." The case was brought by the U.S. Chamber of Commerce and Coalition for a Democratic Workplace. AHA and its American Society for Healthcare Human Resources Administration affiliate are members of the Coalition. In February, they and the AHA's American Organization of Nurse Executives subsidiary joined the HR Policy Association and Society for Human Resource Management in filing a friend-of-the-court brief supporting the Chamber and CDW challenge.
| HHS issues national plan to fight Alzheimer's disease 05/15/2012
The Department of Health and Human Services today released a national plan to develop effective prevention and treatment approaches for Alzheimer's disease by 2025, as required by the National Alzheimer's Project Act of 2011. The plan details federal and other activities and recommendations to prevent and treat the disease, a progressive and irreversible brain disease that affects up to 5.1 million Americans, most after age 60. "Given the great demographic shifts that will occur over the next 30 years, including the doubling of the population of older adults, the success of this effort is of great importance to people with [Alzheimer's disease] and their family members, public policy makers, and health and social service providers," the plan states. HHS also announced $24 million for clinical trials to prevent and treat the disease; $2 million for geriatric education centers to teach health care providers about the disease; and a new web resource (www.alzheimers.gov) for families and friends caring for Alzheimer's patients.
| ONC seeks comments on governance of national health information network 05/15/2012
The Department of Health and Human Services will accept comments through June 14 on draft proposals for a governance mechanism for the nationwide health information network, according to a notice published today in the Federal Register. HHS' Office of the National Coordinator for Health Information Technology seeks comments as it develops a proposed rule for the governance mechanism. ONC defines the nationwide health information network as a "continually expanding ecosystem of electronic exchange activities for which stakeholders would be able to select the appropriate set of standards, services, and policies to meet their electronic exchange needs," not as a specific infrastructure to actually exchange data. The request for information seeks broad input on a range of topics, including an initial set of "conditions for trusted exchange" of electronic health information and a process to revise, adopt and retire such conditions; a voluntary program to validate conformance with the conditions; and a process to classify nationwide readiness to adopt and use technical standards and specifications to support health information exchange.
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