HHS asked to clarify states' options after Supreme Court ruling on ACA   07/10/2012
The National Governors Association and National Association of Medicaid Directors have asked federal officials to clarify how the recent Supreme Court ruling on the Patient Protection and Affordable Care Act will affect states' Medicaid options under the law. On June 28, the U.S. Supreme Court ruled the ACA's individual mandate and Medicaid expansion constitutional, but struck down a provision that allowed Congress to take all Medicaid funds from a state that refuses to participate in the Medicaid expansion. The decision allows states to choose whether to expand their Medicaid program with federal funding. In separate letters last week, NGA and NAMD posed questions about the ruling's impact to Department of Health and Human Services officials. NGA said "formal guidance from HHS will assist governors as they deliberate next steps" at the NGA's Annual Meeting on July 13. Among other questions, NAMD asked the Centers for Medicare & Medicaid Services to clarify whether states are still subject to Medicaid maintenance of effort requirements prior to 2014 and whether Medicaid funding for Disproportionate Share Hospitals will still be reduced according to the schedule stipulated in the ACA.
NLRB: Off-duty employee access policy is unlawful    07/10/2012
A hospital policy limiting access of off-duty employees to the facility violated the National Labor Relations Act, the National Labor Relations Board ruled July 3. At issue in the case (Sodexo America LLC) was a provision of USC University Hospital's no-access policy which states, "Off-duty employees are not allowed to enter or re-enter the interior of the hospital or any other work area outside the hospital except to…conduct hospital-related business." The policy defined "hospital-related business" as "the pursuit of the employee's normal duties or duties as specifically directed by management." The Board states, "as in Saint John's, because this policy allows [the employer] unlimited discretion to decide when and why employees may access the facility, we find [that the] no-access policy violates Section 8(a)(1) [of the Act] because it 'does not uniformly prohibit access to off-duty employees seeking entry to the property for any purpose.'" In the December 2011 Saint John's decision, the Board found that a hospital policy barring off-duty employees' access to the facility except for employer-sponsored events violated the Act. "The potential impact of these cases for hospital employers is significant," said AHA outside labor counsel Curt Kirschner, a partner at Jones Day. "Hospitals should review these decisions, carefully consider their implication for current hospital policies and monitor additional legal developments." AHA members will find more on these Board decisions in an upcoming edition of the association's Health Care Labor Report.
IOM recommends action to increase mental health workforce for elderly   07/10/2012
The Institute of Medicine today called for a national effort to boost the number of mental health and substance abuse providers to meet the needs of the nation's aging baby boomers. The report estimates that between 5.6 million and 8 million Americans age 65 and older have mental health conditions or substance abuse problems. Among other actions, the IOM committee calls for a redesign of Medicare and Medicaid payment rules to guarantee coverage of counseling, care management and other mental health/substance abuse services. Following a 2008 IOM report on building the health care workforce to meet the needs of the nation's growing elderly population, Congress mandated that IOM conduct a complementary study focused on mental health/substance abuse workforce needs for this population.
FDA approves new safety requirements for certain opioid makers   07/10/2012
The Food and Drug Administration yesterday approved a Risk Evaluation and Mitigation Strategy for extended-release and long-acting opioids, drugs approved for moderate to severe persistent pain that require treatment for an extended period. The REMS will require more than 20 companies that manufacture these opioid analgesics to make education programs available to prescribers based on an FDA Blueprint, and to make FDA-approved education materials available to patients. "Misprescribing, misuse, and abuse of extended-release and long-acting opioids are a critical and growing public health challenge," said FDA Commissioner Margaret Hamburg, M.D. "The FDA's goal with this REMS approval is to ensure that health care professionals are educated on how to safely prescribe opioids and that patients know how to safely use these drugs."
Survey: 'Most Wired' hospitals use health IT to improve performance   07/10/2012
The nation's "Most Wired" hospitals are leveraging the adoption and use of health information technology to improve performance in a number of areas, according to Health Care's Most Wired 2012 Survey, released today. Among other key findings, the survey found 100% of the Most Wired hospitals check drug interactions and drug allergies when medications are ordered, while 90% use performance improvement scorecards to help reduce inefficiencies. The AHA conducts the survey in cooperation with McKesson Corp. and the College of Healthcare Information Management Executives. "As shown by these survey results, hospitals continue to demonstrate how IT not only can be used to improve patient care and safety, but it is also a means to improve efficiency," said AHA President and CEO Rich Umbdenstock. AHA's Hospitals & Health Networks magazine details the survey results in its July cover story, available at www.hhnmag.com.