Congress urged to protect hospital payments and patients' access to care   11/29/2012
About 200 hospital leaders came together on Capitol Hill today to send a strong message to lawmakers: Protect hospital payments and patients' access to care in any agreement aimed at addressing the fiscal cliff. "We need real, long-term solutions that strengthen our nation's health care system, not arbitrary cuts that threaten our ability to provide the care communities count on from us," said AHA Board Chair Teri Fontenot, president and CEO of Woman's Hospital in Baton Rouge, LA, who hosted the AHA Advocacy Day in Washington, D.C. Hospital leaders in attendance and many more participating virtually via webcast received a briefing on the current legislative climate and hospitals' priority issues for the lame-duck session. Those priorities include extending several Medicare provisions that have expired or will by the end of the year, and opposing harmful cuts such as reductions in payments for evaluation and management services in hospital outpatient departments, another across-the-board retrospective coding adjustment, and reductions in the amount of allowable Medicaid state provider assessments. After the briefing, hospital leaders delivered their advocacy message directly to lawmakers and their staff in meetings on Capitol Hill.
AHA-sponsored panel briefs Congress on impact of proposed E/M cuts   11/29/2012
At an AHA-sponsored policy briefing for congressional staff today on Capitol Hill, four hospital leaders explained the negative impacts for patients and communities if Congress acts on a proposal to reduce payments for evaluation and management services in hospital outpatient departments. The Medicare Payment Advisory Commission recommended capping total payment for non-emergency department E/M services in hospital outpatient departments at the rate paid to physicians for providing services in their private offices. It would reduce Medicare payments to hospitals by $7 billion over 10 years. MedPAC also is exploring whether to expand the proposal to other hospital outpatient department services. Noting that hospital outpatient departments have higher costs because of their standby and teaching roles and greater regulatory requirements, representatives from Franklin Community Health Network in Farmington, ME; Oregon Health & Science University in Portland; Geisinger Health System in Danville, PA; and Allegiance Health in Jackson, MI, said the proposed E/M cuts would severely limit patient access to care; reduce the outpatient programs their hospital could offer; and result in more patients seeking care in emergency departments. Case examples from the briefing participants will be posted soon at
Report, graphic highlight hospitals' unique standby role, challenges   11/29/2012
The AHA today released a report explaining the unique standby role hospitals play as providers of around-the-clock emergency, safety net and disaster response care, and the current reimbursement and staffing challenges to providing these critical services. An accompanying infographic details why hospital outpatient departments have higher costs than physician offices due to their standby and teaching roles, sicker patient population and greater regulatory requirements. To view the report and infographic, visit The Medicare Payment Advisory Commission is exploring whether to limit hospital outpatient department payments for certain conditions to the physician fee schedule payment, despite their already negative average Medicare margins.
Ad urges Congress to oppose additional cuts to hospital funding   11/29/2012
An AHA ad appearing today in Politico and Roll Call urges Congress to oppose additional cuts to hospital funding as it works to reduce the deficit. "America's hospitals are always open, serving our communities 24 hours a day, 7 days a week, 365 days a year," the ad states. "But even as hospitals face new challenges to provide high-quality care to everyone who needs it, Congress is debating additional cuts to hospital funding which would cost jobs and hurt access to care.…Oppose Hospital Cuts. Protect Patient Care."
CMS eases supervision for 22 outpatient therapeutic services   11/29/2012
The Centers for Medicare & Medicaid Services has issued a final decision reducing the supervision level for 22 outpatient services from direct to general supervision effective Jan. 1, an increase from the 15 services included in the agency's preliminary decision in September but fewer than the 28 recommended by the Advisory Panel on Hospital Outpatient Payment. The seven additional services include wound care and bladder irrigation services, as well as certain flu and other drug or therapeutic injections. The HOP Panel, which reviews and advises CMS regarding the appropriate level of supervision for individual hospital outpatient therapeutic services, will hold its next semiannual meeting in March 2013. AHA strongly encourages interested hospitals to identify outpatient therapeutic services that require only general supervision and request an opportunity to provide testimony during the meeting.
CMS extends Medicare EHR deadline for certain hurricane-affected areas   11/29/2012
The Centers for Medicare & Medicaid Services is providing a deadline extension for hospitals in the New York and New Jersey areas that have been adversely affected by Hurricane Sandy and are unable to meet tomorrow's deadline for submitting their fiscal year 2012 attestation for the Medicare Electronic Health Record Incentive Program. To qualify for the deadline extension, eligible hospitals must submit to CMS an extension application with complete information on their hospital, including the reason why it is unable to attest. Qualifying eligible hospitals will be able to enter their complete attestation data using the online CMS Attestation System in spring of 2013 and receive their full FY 2012 EHR incentive payment thereafter. To obtain a copy of the Hurricane Sandy Deadline Extension Application, contact the EHR Information Center at (888) 734-6433. Eligible hospitals that participate only in the Medicaid EHR Incentive Program should contact their state Medicaid agency for more information about applying for a deadline extension due to Hurricane Sandy. For all other hospitals, the deadline for attestation remains Nov. 30.
Panel discusses fiscal cliff, future of providers   11/29/2012
Panelists at a health care policy breakfast today in Washington, D.C., discussed the potential impact on health care providers of the recent national elections and congressional negotiations to avert an impending "fiscal cliff." Participants included Rich Umbdenstock, AHA President and CEO, who said hospitals already have absorbed substantial reimbursement cuts, even as they improve quality and keep down costs. "Blunt cuts are not reform," Umbdenstock said. "We've got to reform the health care system, and cuts on top of cuts are not going to help. They're just going to shift cuts once again."  Hosted by Politico Pro, the panel also included James Madara, CEO of the American Medical Association; Dan Mendelson, president and CEO of Avalere Health; and Gail Wilensky, senior fellow for Project HOPE.
OIG criticizes HHS oversight of Medicare EHR incentive payments   11/29/2012
The Department of Health and Human Services' Office of Inspector General yesterday recommended that the Centers for Medicare & Medicaid Services strengthen oversight of Medicare incentive payments for meaningful use of electronic health records. Specifically, OIG said CMS should conduct pre-payment review of documentation from selected "high risk" professionals and hospitals to verify the accuracy of their self-reported information. In comments in the report, CMS disagreed, stating that prepayment reviews would increase the burden on practitioners and hospitals and could delay incentive payments. Linda Fishman, AHA senior vice president of public policy analysis and development, concurs. "The OIG report contains no evidence of improper payments," Fishman said. "Hospitals take seriously their obligations to provide accurate reports to Medicare, and are working diligently to comply with the highly complex regulatory requirements in the meaningful use program. In addition, CMS is currently conducting audits of hospitals that have received meaningful use payments." The report reviews CMS oversight of self-reported meaningful use of certified EHR technology in 2011, before CMS began its audit program. OIG also recommended that CMS provide better guidance on documentation to support compliance and made recommendations to the Office of the National Coordinator to improve the meaningful use reports generated by certified EHRs to better document compliance.