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AHA opposes efforts to weaken moratorium on physician-owned hospitals   12/19/2014
In comments submitted yesterday on the health care-related discussion draft released last month by House Committee on Ways and Means Subcommittee on Health Chair Kevin Brady (R-TX), AHA voiced strong opposition to a proposal to weaken significantly the moratorium on physician-owned hospitals. A proposal in the draft would expand the Affordable Care Act’s grandfather provision to allow hospitals that were under construction on Dec. 31, 2010 to bill Medicare for services provided to Medicare beneficiaries. In addition, it would eliminate most of the conditions a physician-owned hospital must meet in order to receive approval for expansion, making it much easier for such hospitals to expand. “We urge the committee to maintain current law, which would preserve the ban on physician self-referrals to new physician-owned hospitals and retain restrictions on the growth of existing physician-owned hospitals,” AHA Executive Vice President Rick Pollack wrote.
AHA seeks candidates for Board of Trustees   12/19/2014
The AHA Committee on Nominations is accepting nominations for chair-elect of the Board of Trustees and four trustees at large, all of whom will take office Jan. 1, 2016. Potential candidates must be CEOs, senior executives, trustees or physicians of AHA member hospitals or health systems and have a demonstrated record of participation and leadership in AHA governance and policy development through membership on Regional Policy Boards, committees or section governing councils. Representation from metropolitan, specialty and independent hospitals is especially welcome, as are women and racial/ethnic minorities. Candidates or those recommending them are asked to contact Michael Guerin, committee secretary, at (312) 422-2711 or mguerin@aha.org as soon as practical but no later than Feb. 27. Members recommending candidates also may request an appointment to meet with the committee when it convenes at 1 p.m. ET on May 3, during the AHA Annual Membership Meeting in Washington, D.C.
Court dismisses AHA lawsuit on Medicare appeals   12/19/2014
The District of Columbia federal district court yesterday dismissed a lawsuit brought by the AHA and several hospitals to compel the Department of Health and Human Services to meet statutory deadlines for timely administrative review of Medicare claims denials. While sympathizing with hospitals that wait years for resolution of appeals, the court said that “the waiting game must go on” for the time being because the delay in processing appeals to HHS’s Office of Medicare Hearings and Appeals is not so egregious as to warrant judicial intervention. “No one denies that OMHA’s [administrative law judges] are unable to render decisions in accord with the statutory guidelines laid out by Congress [and] that this is a problem in need of a fix,” Judge Boasberg’s opinion reads. “This Court, however, is not in a position to provide that fix. The Court hopes that the Secretary and Congress will continue working together toward a solution and that OMHA will receive the resources necessary to fulfill its obligations. Hospitals that are owed reimbursement should not be indefinitely deprived of funds.” In a statement, AHA President and CEO Rich Umbdenstock said, “We disagree with the court’s decision not to compel the Department of Health and Human Services to meet statutory deadlines for timely review of Medicare claims denials on the basis of ‘competing priorities.’ We expect to appeal the decision and will call upon the government to identify those priorities that trump providing hospitals with the necessary resources to provide essential care to the nation’s elderly and most vulnerable patients.”
GAO announces six new MACPAC members   12/19/2014
The Government Accountability Office today named six new members to the Medicaid and CHIP Payment and Access Commission, including two with hospital and health plan expertise. They are Chuck Milligan, senior vice president of enterprise government programs at Presbyterian Healthcare Services in Albuquerque, NM, and a former state Medicaid director in New Mexico and Maryland; and Sheldon Retchin, M.D., currently CEO of Virginia Commonwealth University Health System in Richmond and recently named CEO of the Wexner Medical Center at Ohio State University in Columbus. MACPAC was created by the Children’s Health Insurance Program Reauthorization Act of 2009 to review Medicaid and CHIP access and payment policies and advise Congress on issues affecting Medicaid and CHIP.
MedPAC considers post-acute payment recommendations for 2015   12/19/2014
At a two-day meeting concluding today, the Medicare Payment Advisory Commission considered a package of draft recommendations to Congress that would affect post-acute care and other providers. The draft post-acute recommendations for 2015 would freeze Medicare fee-for-service payments for home health agencies, skilled nursing facilities, inpatient rehabilitation facilities and long-term care hospitals at 2014 levels. Also considered were proposals to rebase the SNF payment system, a budget-neutral “rebalancing” of HH payments in a manner that would favor hospital-based agencies, and a HH co-pay for non-hospital transfers. In addition, the commission considered two site-neutral payment proposals for post-acute settings. One proposal, discussed yesterday, would pay LTCHs rates similar to those for general acute-care hospitals for “chronically critically ill” patients, defined as those who do not receive eight or more intensive care unit days during the prior inpatient hospital stay. Savings realized from the change would be redistributed to a new outlier pool for CCI cases treated in inpatient prospective payment system hospitals. (An LTCH-inpatient PPS site-neutral payment policy is already slated to begin in October 2015 under legislation enacted in December 2013.) The other proposal would eliminate payment differences between IRFs and SNFs for selected, similar conditions, with some IRF regulatory relief granted for these cases. During the meeting, MedPAC staff also presented a status update on the Medicare Advantage program. The commission will vote on the draft recommendations at its Jan. 15-16 meeting.
Premium subsidy opponents to file Supreme Court brief Monday   12/19/2014
The petitioners in King v. Burwell are expected to submit their brief to the Supreme Court Monday. The Supreme Court last month agreed to review the case, in which the Fourth Circuit upheld premium subsidies for individuals who purchase health coverage through federally facilitated exchanges. The petitioners seek to limit subsidies under the Affordable Care Act to states that set up their own health insurance exchanges. On Jan. 28, AHA will file a friend-of-the-court brief urging the court to affirm the Fourth Circuit’s judgment that the ACA makes premium subsidies available nationwide. It filed similar briefs in the Fourth Circuit in March and the D.C. Circuit in November, urging that the premium subsidies be upheld.
Study: Expanding Medicaid to uninsured adults would boost NC economy, jobs   12/19/2014
If North Carolina expanded Medicaid eligibility to low-income uninsured adults by 2016, nearly 500,000 uninsured residents could gain coverage by 2017 and the state’s economy could add $21 billion in federal revenue and more than 43,000 jobs by 2020, according a new study by the Center for Health Policy Research at George Washington University. The estimated $1.7 billion in additional state Medicaid costs would be fully offset by gains in state tax revenues and potential savings in other health costs, for a net savings of at least $318 million by 2020, the study found. The authors estimate the state’s economy is $1.7 billion smaller this year because the state declined to expand Medicaid in 2014. The report was funded by the Cone Health Foundation and Kate B. Reynolds Charitable Trust.
Study: Measures can penalize hospitals for reducing readmissions   12/19/2014
The Hospital Readmissions Reduction Program penalizes hospitals that reduce both readmissions and discharges, according to an analysis released this week by Altarum Institute’s Center for Elder Care and Advanced Illness. The authors found that San Diego County is doing better than the national average at reducing readmissions to hospitals, yet nearly all eligible hospitals are being penalized by the readmissions program. They said the problem is that the program measures progress by dividing the number of readmissions by the number of discharges, yet good practices can reduce discharges at nearly the same rate as readmissions. In such cases, hospital readmission rates do not appear to improve when they have. “The challenge is to correct the malfunctioning metric and keep up the head of steam that is improving quality and reducing costs,” said Joanne Lynn, M.D., director of the center.
AHA comments on Ways and Means discussion draft   12/18/2014
AHA today expressed its appreciation for the health care-related discussion draft released last month by House Committee on Ways and Means Subcommittee on Health Chair Kevin Brady (R-TX), saying the proposals are “deserving of serious and thoughtful consideration and discussion.” AHA Executive Vice President Rick Pollack voiced support for some of the proposals but noted others “raise significant concerns or need clarification or modification.” Specifically, he expressed AHA’s strong objection to any proposals that would cut hospital payments. The draft includes items on Medicare’s recovery audit contractor program, “two-midnight” policy and short inpatient stays; the Centers for Medicare & Medicaid Services’ 96-hour physician certification requirement for critical access hospitals; adjustments to the Hospital Readmissions Reduction Program; and physician self-referral to hospitals in which they have an ownership interest, among other topics. AHA expressed appreciation for the committee’s attempt to offer a solution to issues related to patient status determinations, the two-midnight policy and the overwhelming number of claims in the appeals process, but noted the proposal “is complex, confusing and administratively burdensome.” In addition, it said many of the RAC-related proposals “fall far short of what will be necessary to reduce excessive and inappropriate denials by RACs and alleviate the administrative and financial burden the RAC program imposes on hospitals and the administrative appeals process.” AHA urged the committee to consider additional fundamental RAC program reforms.
AHRQ releases health literacy tool for pharmacies   12/18/2014
The Agency for Healthcare Research and Quality has released standardized instructions for pill administration in six languages to help patients understand and adhere to medicine regimens and reduce possible errors. Developed and tested by researchers, the instructions follow the Universal Medication Schedule, which simplifies complex medicine regimens by using standard time periods for administration (morning, noon, evening and bedtime). The instructions are available in English, Chinese, Korean, Russian, Spanish and Vietnamese. “While every effort was made to ensure accuracy and reliability of these translations, each pharmacy and pharmacist should confirm the validity and the medical appropriateness of any given translation for a particular patient before using it for the patient's drug label,” the agency said. For additional health literacy tools for pharmacies, visit AHRQ’s Pharmacy Health Literacy Center.