CMS issues FAQs on new admission and medical review criteria policy   09/26/2013
The Centers for Medicare & Medicaid Services today issued new guidance in the form of several frequently asked questions on the admission and review criteria it adopted in the fiscal year 2014 hospital inpatient prospective payment system final rule. The agency reiterated that Medicare Administrative Contractors and Recovery Audit Contractors are not to review claims spanning more than two midnights after admission for a determination of whether the inpatient hospital admission was appropriate. CMS also announced that, for a period of 90 days, it will not permit RACs to review inpatient admissions of one midnight or less that begin on or after Oct. 1, 2013. In addition, the agency stated that MACs and RACs will not review any claims from critical access hospitals during this period. However, CMS will allow the MACs to review small samples of inpatient hospital claims with admission dates of Oct. 1 through Dec. 31, 2013 that span less than two midnights to determine whether the inpatient hospital admission was appropriate. If the MAC determines that the admissions were appropriate, it will cease further reviews for that hospital from Oct. 1 through Dec. 31, 2013, unless there are significant changes in billing patterns for admissions. “Today, CMS tried but failed to provide the hospital field with much needed information on the two-midnight policy,” said AHA President and CEO Rich Umbdenstock. “Unfortunately, the agency’s guidance only raises new questions and lacks clarity. Hospitals do not support the implementation of this regulation under these circumstances – too many aspects are fundamentally flawed. We believe that the only workable approach is to suspend this rule and immediately start dialog on a new policy direction that includes consideration of a payment option.”
House resolution recognizes essential role of rural hospitals   09/26/2013
Rep. Lynn Jenkins (R-KS) yesterday introduced a House resolution calling access to rural hospitals and other health care providers “essential to the survival and success of communities.” More than 46 million people “rely on rural hospitals and other providers as critical access points to health care,” House Resolution 356 notes. In addition to providing “vital care” to patients, rural providers “are integral to the local economies and are one of the largest types of employers in rural areas of the United States,” the measure states. In a letter of support for the resolution, AHA Executive Vice President Rick Pollack said, “Because of their small size, modest assets and financial reserves, and higher percentages of Medicare patients, rural hospitals disproportionately rely on government payments; unfortunately, Medicare payment systems often fail to recognize the unique circumstances of small and rural hospitals. The AHA has and will continue to advocate for appropriate payment on behalf of small and rural hospitals and critical access hospitals.” The House resolution mirrors Senate Resolution 26, which was introduced by Sens. Jerry Moran (R-KS) and Amy Klobuchar (D-MN) in February. 
Committees reach agreement on drug compounding legislation   09/26/2013
Leaders of the Senate Health, Education, Labor & Pensions Committee and House Energy & Commerce Committee last night announced a bipartisan agreement on legislation to help ensure the safety of compounded drugs and track their distribution. According to a HELP Committee description, the legislation distinguishes compounders engaged in traditional pharmacy practice from those making large volumes of compounded drugs without individual prescriptions. Compounders who wish to practice outside the scope of traditional pharmacy practice could register as outsourcing facilities, which would be subject to Food and Drug Administration oversight and publicized on the agency’s website, while those who choose to remain traditional pharmacies would continue to be primarily regulated by State Boards of Pharmacy. Among other provisions, the legislation would strengthen licensure requirements for wholesale distributors and third-party logistics providers; require detailed labeling on compounded drugs; and establish nationwide drug serial numbers within four years and electronic unit-level tracing within a decade, the committee said.
HHS: Some states to phase in SHOP application, enrollment periods   09/26/2013
Some states will phase in application and enrollment periods for the Small Business Health Option Program (SHOP), the Department of Health and Human Services announced today. Unlike individuals purchasing health coverage through state-based exchanges, small employers can enroll in insurance plans through the SHOP on a monthly basis throughout the year. In states with a federally facilitated exchange, the SHOP Marketplace will open Oct. 1, when small employers can start the application process and get an overview of available plans and premiums in their area, HHS said. All functions for SHOP will be available in November and if employers and employees enroll by Dec. 15, coverage will begin on Jan. 1, the agency said. HHS also announced an expanded education and outreach campaign for the program. More information on the SHOP application and enrollment process is available at
CDC: Hospitals, others increase worker flu vaccinations   09/26/2013
An estimated 83% of hospital workers report receiving a flu vaccine for the 2012-13 flu season, up from 77% in 2011-12 and 71% in 2010-11, according to a survey released today by the Centers for Disease Control and Prevention. The latest estimate includes 93% of hospital physicians, 87% of hospital nurses, 98% of hospital pharmacists and 81% of other hospital clinical personnel. Coverage for health care workers in all settings was 72%, up from 67% in 2011-12 and 64% in 2010-11. Hospitals achieved a higher vaccination rate than physician offices (73%) and long-term care facilities (59%). Coverage was 95% among workers in hospitals requiring vaccination, compared with 78% in those that promoted but did not require vaccination. To protect the lives and welfare of patients and hospital employees, the AHA supports mandatory patient safety policies that require either flu vaccination or wearing a mask in the presence of patients across health care settings during flu season.
HHS boosts stockpile to treat acute radiation syndrome   09/26/2013
The Department of Health and Human Services today awarded Amgen USA and sanofi-aventis $194 million in Project Bioshield contracts to increase the national stockpile of leukocyte growth factors, a potential treatment for acute radiation syndrome. Leukocyte growth factors are approved by the Food and Drug Administration to speed white blood cell recovery and reduce the risk of infection in cancer patients undergoing chemotherapy. While no drugs or products are approved by the FDA to treat acute radiation syndrome, leukocyte growth factors could be used after a radiological or nuclear attack with emergency use authorization from the agency.
Reminder: Medicare EHR incentive program deadlines approaching   09/26/2013
To attest to meaningful use of electronic health records for fiscal year 2013, hospitals participating in the Medicare EHR Incentive Program must complete their performance period by Sept. 30 and their attestation by Nov. 30. For hospitals reporting on their first year of participation, the performance period is 90 days; hospitals in their second or third year of participation report on a full fiscal year. Hospitals paid under the inpatient prospective payment system must attest to meaningful use by FY 2013 to benefit fully from the program’s incentives. For more information, including timelines, FAQs and other guidance on Stage 1 and 2 requirements for meaningful use, visit