CHA provides timely information to its members on a daily basis through CHA News, issued at 3 p.m. every day, Monday through Friday. This section contains a chronological listing of CHA News articles. For information by topic, please visit the Hospital Topics section.
Last week, Rep. Tim Walberg (R-MI) introduced H.R. 3633, the Protecting Health Care Providers from Increased Administrative Burdens Act, which would prevent the Office of Federal Contract Compliance (OFCCP) from extending jurisdiction over hospitals based solely on the fact that the hospital delivers health care services to individuals who are covered by TRICARE, FEHBP or another federal managed care program. In conjunction with the bill’s introduction, the House Subcommittee on Worker Protections held a hearing on the issue. F. Curt Kirschner, on behalf of the American Hospital Association, delivered compelling testimony outlining the history of OFCCP’s “jurisdictional grab” and its adverse impact on hospitals. Subsequent to the hearing, ranking member Joe Courtney (D-CT) signed onto the bill.
Now that the bill has bipartisan support, more members cosponsoring it will increase its chances of passing. CHA encourages members to contact their congressional representatives and urge them to cosponsor the bill. For congressional members’ contact information, visit www.house.gov/writerep.
Attached is a copy of H.R. 3633, along with a fact sheet developed by the House Committee on Education and the Workforce.
The U.S. Court of Appeals for the Fifth Circuit recently invalidated the controversial D.R. Horton, Inc. decision issued by the National Labor Relations Board (NLRB) last year. The NLRB’s decision concluded that an arbitration agreement requiring employees to waive their right to maintain joint, class, or collective employment-related actions violates Section 8(a)(1) of the National Labor Relations Act (NLRA). The Fifth Circuit rejected that conclusion, following the U.S. Supreme Court’s decision in AT&T Mobility LLC v. Concepcion (2011). Although the Fifth Circuit’s decision is not binding in California, it is nonetheless good news for California employers.
The Centers for Medicare & Medicaid Services (CMS) has released the attached guidance regarding the new inpatient admissions and medical review criteria identifying a potential exception to the two-midnight rule. Responding to stakeholder suggestions, CMS states that, in the rare case a physician expects patients with newly initiated mechanical ventilation will only require one “midnight” of hospital care, inpatient admission and Part A payment are appropriate. CMS notes the exception is not intended to apply to anticipated intubations related to minor surgical procedures or other treatment. CHA continues to seek input from the membership to share with CMS any additional categories of patients that should be added to the exceptions list. CMS urges suggestions to be emailed to IPPSAdmissions@cms.hhs.gov with “Suggested Exceptions to the 2 Midnight Benchmark” as the subject line.
Last week the National Uniform Billing Committee redefined a code in its billing data set to allow hospitals to denote inpatient claims meeting the CMS two-midnight benchmark through a combination of outpatient and inpatient services. Effective Dec. 1, hospitals can use Occurrence Code 72 on inpatient bills to denote the date span of contiguous outpatient hospital services that preceded the inpatient admission.
CHA has made several important changes to its recommended Model Medical Staff Bylaws & Rules. The document has been updated to reflect changes in Centers for Medicare & Medicaid Services requirements, California law, recent litigation, and other technical and editorial amendments. The updates also include provisions to address activation of the California Society of Healthcare Attorneys’ Hearing Officer selection service, and to accommodate hospitals that select accreditation by DNV Healthcare. Ann O’Connell of the Sacramento office of Nossaman LLP updated the manual on behalf of CHA.
As a membership service, CHA has mailed a complimentary CD to all member hospital CEOs. The CD, containing the model and related documents, will arrive this week. The files also are available for members at www.calhospital.org/model-medical-bylaws.
In a recent blog post, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) proposed a new timeline for the implementation of meaningful use for the Medicare and Medicaid electronic health record (EHR) incentive programs. The new timeline would extend stage 2 through 2016 and delay stage 3 until 2017 for providers who have completed at least two years of stage 2.
The delay is intended to give CMS more time to analyze feedback on stage 2 progress and outcomes to better inform stage 3 rulemaking. However, the announcement does not change certification requirements for 2014, and providers are still required to upgrade or adopt technology that meets the 2014 EHR certification standards, regardless of which stage of meaningful use they are in. CMS expects to release proposed rulemaking for stage 3 and corresponding ONC rulemaking for the 2017 edition of the ONC standards and certification criteria in the fall of 2014.
A new advisory from the Substance Abuse and Mental Health Services Administration (SAMHSA) reviews diabetes and its link with mental illness, stress and substance use disorders. The report focuses on ways to integrate diabetes care into behavioral health treatment, such as through screening and intake, staff education, integrated care and counseling support. Intended for professional care providers, program planners, administrators and project managers, the advisory is available free online for ordering or download.
Effective Jan. 1, 2014, the California Department of Public Health will have a new collection address for mailing payments associated with enforcement penalties for citations, immediate jeopardy administrative penalties, privacy breach penalties, adverse event penalties and nursing home per-patient-day penalties. More information and the new address are available in the attached All Facilities Letter.
With temperatures expected to reach subzero in some regions of California this week, the California Department of Public Health (CDPH) has issued an emergency preparedness advisory to health care facilities. Health facilities are required to maintain an emergency power source, which must be fully tested and functional in order to ensure availability in the event of a power outage. All disaster-related occurrences that threaten the health, safety or welfare of patients must be reported to CDPH. Any facility impacted by an emergency or disaster-related occurrence that results in an evacuation, transfer or discharge of patients, must also report to CDPH. See the attached All Facilities Letter for guidelines on reporting, winter weather health tips for vulnerable populations and current weather watch warnings.
Dr. Bonnie Zell joined the Hospital Quality Institute (HQI) this month as executive director of clinical improvement, as Michele Davenport Lambert completes her contract as director of the California Hospital Engagement Network (CalHEN) at the end of the year.
“We are very excited to have Dr. Zell join the team. She is exceptionally qualified and will contribute greatly to our statewide improvements,” said Julie Morath, CEO of HQI. “The ability to attract a candidate of Dr. Zell’s caliber speaks to the exciting work being accomplished in California.”
Scripps Health President and CEO Chris Van Gorder was honored this week with a distinguished service medal at the 2013 California Emergency Medical Services (EMS) Awards, hosted by the California Emergency Medical Services Authority (EMSA). Launched in 2007, the annual awards honor and recognize exceptional acts and service by individuals working or volunteering in California’s emergency medical system.
Van Gorder was given the medal for his statewide leadership as a member of the California Commission on EMS and for exceptional achievement and exemplary leadership in disaster medical response. Van Gorder and the Scripps Health disaster preparedness team developed the premier specialized California Medical Assistance Team and Hospital Administrative Support Unit, which serve as the model for California and national health systems and provide the cornerstone for the state’s Mobile Medical Assets Program. Van Gorder was also a part of the development team of the Hospital Incident Command System, which is used both nationally and internationally.
“Disaster preparedness and response, and strengthening the state’s emergency medical system, are vital for hospitals and the communities they serve,” said CHA President/CEO C. Duane Dauner. “CHA congratulates Chris Van Gorder and Scripps Health on this important achievement.”
The state of California has issued a survey available to all stakeholders interested in helping develop effective community planning processes related to the Mental Health Services Act (MHSA). The survey is part of an evaluation of the impact and effectiveness of community planning processes in all 58 California counties. Its major goals include gaining a better understanding of current processes and developing best practices for effective and inclusive MHSA planning. Anyone interested in responding to the survey can complete it online in English or in Spanish.
CHA encourages members to participate in the next open door forum being held by the Centers for Medicare & Medicaid Services (CMS) regarding the new inpatient admission and medical review criteria, commonly referred to as the two-midnight rule. The call is scheduled for Thursday, Dec. 19 from 10 a.m. – 11 a.m. (PT) and will give providers another opportunity to ask CMS questions and provide feedback on the finalized policy. To participate, call (866) 501-5502 and enter conference ID # 16505942. For additional information and resources regarding the policy, visit www.calhospital.org/resource/inpatient-admission-and-medical-review-resources.
As part of its comprehensive suicide prevention initiative, the California Mental Health Services Authority (CalMHSA) has launched a new mobile app, called MY3, to help individuals at risk for suicide quickly connect to their support network. Currently being promoted among mental health and other health care providers, the app is not intended as a substitute for professional medical advice, diagnosis or treatment, but as a safety net and lifeline tool.
The Department of Health and Human Services (HHS) published the attached notice in the Federal Register on Nov. 19, proposing a quality rating system (QRS) for qualified health plans (QHPs) offered through health insurance exchanges. The Affordable Care Act requires HHS to create a system enabling consumers to compare QHPs based on relative quality, price and enrollee satisfaction. The notice outlines a proposed methodology for selecting QRS measures, organizing such measures into broad categories meaningful to consumers (e.g., care coordination, preventive services, patient safety, etc.), and calculating statistically valid global ratings for each QHP (as is now done under the Medicare Advantage 5-star rating system).
Covered California yesterday released updated data on consumer interest in the marketplace and Medi-Cal, reporting that during the week ending Nov. 30, more than 374,000 unique visits were made to CoveredCA.com, and its service center received more than 62,520 calls. Covered California also reports that the number of enrollment applications started increased by nearly 46,000 — from 385,556 through Nov. 23 to 431,756 through Nov. 30.
Covered California plans to announce total enrollment for November later this month.
CHA President/CEO C. Duane Dauner was joined by 10 representatives of CHA member hospitals in Washington, D.C., Dec. 3 for the CHA and American Hospital Association hospital advocacy day. The group met with about half of the California Congressional delegation, including House Minority Leader Nancy Pelosi, House Majority Whip Kevin McCarthy, and Sens. Boxer and Feinstein.
The Centers for Medicare & Medicaid Services (CMS) has released the attached list of measures under consideration for adoption in future Medicare rulemaking, as required by the Affordable Care Act (ACA). The Measures Application Partnership (MAP), convened by the National Quality Forum (NQF), will review the list and provide recommendations to CMS through a process that allows multiple stakeholders the opportunity to weigh in on measure selection before rules are finalized. For the first time in three years, the MAP will allow the public to comment prior to the beginning of its workgroups and coordinating committee meetings. The early public comment period ends on Dec. 9. In addition, as in previous years the public will have an opportunity to comment on the MAP’s recommendations to CMS, to be issued in January.
The California ICD-10 Collaborative will host a conference call tomorrow, Dec. 4, from 10 a.m. – 11:30 a.m. (PT). The meeting will include a panel discussion with Anthem Blue Cross, Blue Shield of California, United/Optum and SCAN, focusing on their preparation for ICD-10. Participants may email questions to be addressed by the panel to firstname.lastname@example.org before or during the conference call.
Because of anticipated wide interest in the call and a limitation of 200 participants, attendees are encouraged to share call-in lines. For more information, including conference call number and access code, see the attached flyer.
CHA’s annual Post-Acute Care Conference will be held Jan. 30-31, 2014, at the Hilton Waterfront Beach Resort in Huntington Beach. This year’s conference theme, Creating Pathways of Care, addresses the need for providers to actively participate in the change process and establish their role in an integrated care system. The two-day program features topics to help providers plan for coming change.
Agenda highlights include how to improve care transitions and reduce readmissions, lessons learned from a pioneer ACO and post-acute care opportunities in population health management. Attendees will also hear from the new Medicare Administrative Contractor, learn about new quality and patient safety initiatives and transitioning dual eligibles under the Coordinated Care Initiative to a new system of care. Discounted sleeping rooms are available for $194. Tuition for the conference is $425 for members and $550 for nonmembers. For more conference information or to register, visit www.calhospital.org/post-acute-care-conference.
Under current law, physicians and non-physician practitioners (NPP) will see across-the-board reductions in payment rates based on a formula – the sustainable growth rate (SGR) methodology – that was adopted in the Balanced Budget Act of 1997. Without Congressional action, required by the end of the year, physicians will see payments cut in excess of 20 percent for services in 2014.
The Centers for Medicare & Medicaid Services (CMS) has finalized its CY 2014 conversion factor at $27.2006, reflecting a smaller reduction in the conversion factor than the 24.4 percent cut CMS projected in March.