CEO Message

CEO Message: Legislative Check-in — Where We Stand on the Biggest Bills

In the midst of COVID-19, the legislative session moves on. This has been a significant week for bills important to hospitals in California’s Legislature, as several continued or completed their political journey. 

First, the bad news: 

Hospital affiliations. A bill that would grant the Office of the Attorney General sweeping and unilateral powers to approve or reject hospital affiliations, including those with physicians, labs, and other entities, passed out of the Assembly Health Committee — barely, and by only one vote, as was the case in the corresponding Senate committee. We now move toward a strategy to defeat the bill on the Assembly floor or during the concurrence process between the two chambers and have already begun working on a strategy, if necessary, for a veto from the Governor. Stay tuned for an alert to make sure all legislators hear our voices. 

On the good news front: 

Surprise billing. A bill held over from 2019 that would protect patients from surprise billing (a provision hospitals support) but at the same time would set the rates to be paid to hospitals for services for out-of-network patients (a provision we oppose) is done for the year. We worked collaboratively with Dr. Pan, the Senate Health Committee chairman, as he ATTEMPTED to reshape the proposal into something workable. The sponsors of the bill — labor and consumer advocates — were unwilling to ACCEPT THE PROPOSED CHANGES and pulled their support and the bill. 

Seismic. A bill previously approved by the Senate Health Committee that includes a task force to re-examine California disaster readiness in light of pandemics like COVID-19 while creating a seven-year extension of the current 2030 seismic mandate, passed the Assembly Health Committee by a vote of 12-0.  It now heads to the Assembly Appropriations Committee. The bill is opposed by labor and other groups, so more work lies ahead. We’ll need your help to again elevate hospitals’ voices with legislators. Stay tuned for next steps. 

PPE. Two bills requiring hospitals to create minimum PPE inventories (spurred by the COVID-19 crisis) have merged into one seeking a six-month supply maintenance at the “normal” rate of PPE consumption. We’re working with the sponsors and authors to support adequate PPE supply, adjust for procurement challenges, and ensure local and state collaboration in PPE acquisition to meet the goal. 

Behavioral health patients on 5150 hold. CHA’s co-sponsored bill with the National Alliance on Mental Illness that allows involuntary hold assessments to be conducted via telehealth was voted out of the Senate Health Committee on Saturday. This is a tremendous opportunity to streamline care for patients on a 5150 hold. CHA continues to work with the co-sponsors to address any potential concerns. 

Nurse practitioners. The bill that would authorize nurse practitioners to practice to the full scope of their license, without physician supervision in certain settings, is set to be heard by the Senate Business and Professions Committee on Saturday. This will be a fight to the end, as it is the top bill opposed by the California Medical Association. 

Office of Health Care Affordability. The bill that would have created the Office of Health Care Affordability has been postponed until next year. CHA has been working on several facets of this bill, including hospital reporting and data analysis, and cost analysis. 

In the middle of the COVID-19 pandemic, it can be easy to lose sight of all the other legislative work going on, but the impact of these bills will have ramifications that will last well after COVID-19 has subsided. That’s why we remain vigilant on all fronts and will continue to keep you informed as the scenarios evolve. 

~ Carmela

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Federal Advocacy

CHA News Article

CHA Advocates for IMPACT Act ‘Reset’
For CFOs, COOs, post-acute care leaders

CHA is advocating that Congress include a ‘reset’ of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act in the next COVID-19 relief package. In a letter to Sens. Dianne Feinstein and Kamala Harris, CHA reaffirms support for the act’s goals, including the ongoing implementation of standardized patient assessment data elements and numerous new quality, outcome, and resource use measures.  

CHA News Article

CHA Submits Support Letter for Telehealth Act
For CEOs, government relations executives

On July 31, CHA sent a letter to Rep. Mike Thompson (D-St. Helena), voicing support for the Protecting Access to Post-COVID–19 Telehealth Act of 2020 (H.R. 7663). The bill would remove long-standing barriers to telehealth services and improve access to care for not just Californians but patients across the country.

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Regulations

CHA News Article

CMS Issues CY 2021 OPPS Proposed Rule
For CEOs, CFOs, government relations, quality & patient safety, and finance & reimbursement staff 

The Centers for Medicare & Medicaid Services (CMS) has issued its calendar year (CY) 2021 outpatient prospective payment system (OPPS) proposed rule. In addition to annual payment and quality updates, CMS proposes significant cuts for drugs purchased under the 340B drug savings program, would eliminate the inpatient-only (IPO) list over three years, expand the list of outpatient services subject to prior authorization, and make significant changes to the hospital star ratings methodology.

CHA News Article

CMS Issues FFY 2021 SNF PPS Final Rule

The Centers for Medicare and Medicaid Services (CMS) has issued the final rule for the federal fiscal year 2021 skilled-nursing facility (SNF) prospective payment system (PPS). In the final rule, CMS finalizes a 2.2% increase in SNF PPS per diem rates of 2.2%, modifies ICD-10 code mappings for patient classification, and makes updates to the SNF value-based program, the patient driven payment model case-mix methodology, and the SNF quality reporting program.  

CHA News Article

CMS Issues FFY 2021 IPF PPS Final Rule
For CFOs, behavioral health directors, government relations

The Centers for Medicare & Medicaid Services (CMS) has issued its federal fiscal year (FFY) 2021 inpatient psychiatric facility (IPF) prospective payment system (PPS) final rule. CMS finalized an overall payment increase of 2.3% — approximately $95 million — for IPFs, compared to FFY 2020.

CHA News Article

CMS Issues CY 2021 Physician Fee Schedule Proposed Rule
For CFOs, CMOs, finance & reimbursement staff, quality staff

The Centers for Medicare & Medicaid Services (CMS) has issued its calendar year (CY) 2021 physician fee schedule (PFS) proposed rule. In addition to addressing annual payment updates for Medicare Part B clinicians and changes to the quality payment program, CMS includes several proposals to make certain COVID-19 telehealth and scope of practice flexibilities permanent, and delays clinical laboratory reporting requirements – including for hospital outreach laboratories – until 2022.

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Quality & Patient Safety

CHA News Article

CHPSO Name Change Announced
For quality & patient safety staff

This week, the Hospital Quality Institute (HQI) issued a news release on the California Hospital Patient Safety Organization’s (CHPSO) name change, which was made to better reflect the organization’s work and membership. The new name is Collaborative Healthcare Patient Safety Organization. 

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CMS News Roundup

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Education

Publication

CHA Education Events

For more information about CHA education programs, visit www.calhospital.org/education.

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