Hospital groups urge Congress not to cut Medicare   02/10/2014
Nine organizations representing the nation’s hospitals today urged members of the House of Representatives to oppose a proposal that would extend the sequestration for mandatory spending – including Medicare spending – until 2024 as an offset to pay for a one-year extension of the nation’s debt limit. “America’s hospitals strongly oppose a proposal to cut funding for seniors’ Medicare to pay for an extension of the debt limit,” wrote the AHA, America’s Essential Hospitals, Association of American Medical Colleges, Catholic Health Association of the United States, Children’s Hospitals Association, Federation of American Hospitals, National Association of Psychiatric Health Systems, Premier Healthcare Alliance and  VHA Inc. “While we do not oppose the extension of the debt limit, we do oppose using Medicare reductions to pay for non-Medicare related spending. Medicare has been cut time and time again – most recently under the budget agreement signed into law in December. Medicare is meant to assure seniors access to needed medical care, not serve as a piggybank for other programs. It is bad policy to further extend Medicare sequester cuts that could undermine care for seniors.” House leaders are expected to unveil debt limit legislation in the coming days.
House members urge HHS secretary to immediately reform RAC process   02/10/2014
The Centers for Medicare & Medicaid Services should “immediately reform the Recovery Audit Contractor process,” 111 members of the U.S. House of Representatives told Health and Human Services Secretary Kathleen Sebelius today. In addition, the House members said Congress and CMS should consider an alternative payment arrangement with RACs to ensure RACs are not improperly incentivized to deny claims for profit and focus on prevention of errors. RACs currently are paid a commission, ranging between 9% and 12.5%, on the dollar amount of the claims they deny. “We also urge CMS to adopt the commonsense reforms supported by 181 bipartisan members of Congress that are contained in the Medicare Audit Improvement Act of 2013 (H.R. 1250),” the representatives wrote. The letter notes that, based on a November 2012 Office of Inspector General report, “72% of hospital Medicare Part A appeals that have reached the third level of the Medicare appeals process are overturned in favor of the hospital.” The letter also highlights how Medicare beneficiaries suffer when their inpatient stay is inaccurately denied by a RAC, noting, “They pay higher out-of-pocket expenses under Medicare Part B and are sometimes held financially responsible for the post-acute care services they require. This is not the way the Medicare program was intended to operate.”
Associations to NLRB: Confidentiality critical to effective peer review   02/10/2014
AHA today joined the Kansas Hospital Association, Texas Hospital Association and Texas Nurses Association in a friend-of-the-court brief supporting Menorah Medical Center in Overland Park, KS, in a National Labor Relations Board case challenging the confidentiality of peer review activities. In the case, an NLRB administrative law judge found that the hospital violated the National Labor Relations Act by implementing a policy of confidentiality pertaining to peer review activities of the state-mandated Nurse Peer Review Committee. “[T]he need for confidentiality in the peer review process stems from the need for comprehensive, honest, and sometimes critical evaluations of medical providers by their peers in the profession,” the associations argue. “[A] third party’s need for information about the details of peer review proceedings is outweighed by the public interest in improving the quality of health care” that is the primary goal of peer review.
Health system CEO named 2014 TRUST Award recipient   02/10/2014
Nancy Schlichting, CEO of Henry Ford Health System in Detroit, will receive the Health Research & Educational Trust's 2014 TRUST Award at the Health Forum/AHA Leadership Summit July 20 in San Diego. Schlichting joined the health system in 1998 and has served in her current role since 2003. She was honored for her tremendous commitment to clinical excellence, an extraordinary patient experience and a great environment for all health care professionals. The health system is nationally recognized for its patient safety, customer service and diversity initiatives, and received a 2011 Malcolm Baldrige National Quality Award for quality and performance excellence. “Nancy’s work transcends the usual accolades bestowed to honorees,” said Michael Rock, M.D., chief medical officer at Mayo Rochester Hospitals/Mayo Foundation and chair of the HRET Board of Trustees. “Through her leadership, patients are better cared for, communities are bourgeoning and her organization is a model of quality.” HRET is an AHA affiliate.
AHA surveying hospitals about physician relationship models   02/10/2014
AHA is surveying hospitals through March 14 to learn more about how they engage with physicians. The survey was mailed today to all hospital CEOs for their chief medical officer to complete. The results will help AHA develop resources and information to strengthen the bond between physicians and hospitals, and report on the state of physician-hospital relationships that improve health care quality and efficiency. For more on the survey, contact AHA survey support staff at (800) 530-9092 or surveysupport@healthforum.com.