CHA collaborates on policies and strategies for health care issues with the American Hospital Association and other national health care organizations. The association maintains a full-time presence in Washington, D.C., to effectively advocate on legislative and regulatory policy. CHA provides input on developing federal legislation and regulatory proposals, and helps shape national positions on important health care issues. Federal advocacy activities include the annual California Congressional Action Program held in Washington, D.C.
CHA collaborates on policies and strategies for health care
issues with the American Hospital Association and other national
health care organizations. The association maintains a full-time
presence in Washington, D.C., to effectively advocate on
legislative and regulatory policy. CHA provides input on
developing federal legislation and regulatory proposals, and
helps shape national positions on important health care issues.
Federal advocacy activities include the annual California
Congressional Action Program held in Washington, D.C.
Yesterday, the Senate passed
H.R. 6, the Substance Use-Disorder Prevention that Promotes
Opioid Recovery and Treatment (SUPPORT) for Patients and
Communities Act, by a vote of 98-1. The SUPPORT for Patients and
Communities Act is a bipartisan bill addressing the opioid crisis
and includes several Medicaid and Medicare reforms to help combat
The final bill now moves to the president’s desk, where it is
expected that he will sign it into law.
The Centers for Medicare & Medicaid Services (CMS) has published
electronic clinical quality measure (eCQM) flows for eligible
hospitals and critical access hospitals (CAHs) for the 2019
reporting period. This new resource was created in response to
The eCQM flows are designed to assist in interpreting the eCQM
logic and calculation methodology for reporting rates. They
provide an overview of each of the population criteria
components and associated data elements that lead to the
inclusion in or exclusion from the eCQM’s quality action
The Centers for Medicare & Medicaid Services (CMS) has published
updates to the electronic clinical quality measure (eCQM) value
sets for the 2019 reporting and performance periods. The updates
affect reporting for the Quality Payment Program, including
the Merit-based Incentive Payment System and advanced alternative
payment models; Comprehensive Primary Care Plus Program;
Inpatient Quality Reporting Program; and Medicare and Medicaid
Promoting Interoperability programs.
With these changes — which only affect the value sets for eCQMs —
CMS deleted expired codes and added relevant replacement codes
and newly available codes. All changes to the eCQM value sets are
available through the National Library of Medicine’s Value Set
Authority Center download tab.
On Sept. 18, President Trump signed into law the Dr. Benjy
Frances Brooks Children’s Hospital Graduate Medical Education
Support Reauthorization Act of 2018 (H.R. 5385), extending
payments to the Children’s Hospital Graduate Medical Education
Program through federal fiscal year 2023. Supported by CHA,
the program provides funding to qualifying children’s
hospitals for training pediatric physicians.
The legislation received bipartisan support, including the
following members of the California delegation:
On Sept. 22, the U.S. Department of Homeland Security (DHS)
proposed rule that would change “public charge”
policies. Under long-standing policy, the federal government
can deny individuals U.S. entry or any adjustment to their legal
permanent resident status (e.g., green card) if they are
determined likely to become public charges. The proposed rule —
which is narrower than the drafts that were leaked to the media
this spring — expands the list of programs that may be considered
to include not only cash assistance and long-term care but also
certain health care, nutrition and housing programs.
If the rule is finalized in its proposed form, the benefits
considered would be greatly expanded to include:
Non-emergency Medicaid — Medi-Cal, in California — with
limited exceptions for Medicaid benefits for treating an
“emergency medical condition,” certain disability services
related to education and benefits received by children of U.S.
citizens who will be automatically eligible to become citizens
Supplemental Nutrition Assistance Program, referred to
as CalFresh in California
Low-income subsidies for prescription drug costs under
Medicare Part D
Section 8 Housing Choice Voucher Program, Section 8
Project-Based Rental Assistance and public housing
The Centers for Medicare & Medicaid Services (CMS) has released
the attached proposed rule intended to reduce regulatory burden
for hospitals, critical access hospitals (CAHs) and other
providers. CMS proposes changes to its conditions of
participation (CoPs) — including its emergency preparedness CoPs
— and conditions for coverage.
With respect to its emergency preparedness policies, CMS proposes
Give facilities the flexibility to review their emergency
program every two years rather than annually, or more often at
Eliminate a duplicative requirement that the emergency
plan include documentation of efforts to contact local, tribal,
regional, state and federal emergency preparedness officials, as
well as participation in collaborative and cooperative planning
Give facilities greater flexibility in revising training
requirements to allow training to occur annually, or more often
at their discretion.
Increase flexibility for the inpatient provider testing
requirement so that one of the two testing exercises required
annually may be an exercise of the facility’s choice.
Reduce the number of testing exercises outpatient providers
are required to conduct annually from two to one.
Earlier this week, hospital representatives — including the
American Hospital Association, the Association of American
Medical Colleges, America’s Essential Hospitals and three
hospital plaintiffs — refiled a lawsuit seeking relief from
Medicare payment cuts to hospitals participating in the 340B Drug
Pricing Program. The cuts reduced Medicare payments by nearly 30
percent, or $1.6 billion, to certain hospitals for outpatient
drugs purchased under the 340B program.
Late last year, a federal district court
granted the government’s motion to dismiss an earlier lawsuit
that sought to prevent these payment cuts, which consequently
became effective Jan. 1, 2018. At the time, the judge who ruled
on the case did not address the case’s merits, instead holding
that plaintiffs must first present a concrete claim for
reimbursement to the Department of Health and Human Services. In
July, an appeals court further delayed ruling on the case because
no claims had been filed when the lawsuit to prevent the
cuts was initially filed.
The CHA member forum to discuss the Centers for Medicare &
Medicaid Services’ (CMS) outpatient prospective payment system
rule for calendar year (CY) 2019 has been
rescheduled for Sept. 14 at 10 a.m. (PT). The
proposed rule also includes payment updates for ambulatory
Members who have already registered will automatically
receive meeting materials and the dial-in number the morning of
During the forum, CHA will provide an overview of the proposed
rule and seek member input for its comments, which are due to the
agency Sept. 24.
Of note, CMS proposes to reduce the payment rate for hospital
outpatient clinic visits provided at all off-campus hospital
outpatient provider-based departments (HOPDs) to 40 percent of
the OPPS rate. This includes excepted and non-excepted off-campus
provider-based HOPDs. CMS also proposes to modify its policy
related to excepted off-campus provider-based HOPDs that expand
the families of services they offer.
The Center for Medicare & Medicaid Innovation has
announced the Integrated Care for Kids Model, a child-focused
model to “increase behavioral health access, respond to the
opioid epidemic and positively impact the health of the next
generation.” The new model aims to reduce expenses and
improve quality of care for children eligible for Medicaid and
the Children’s Health Insurance Program – through
prevention, early identification, and treatment of priority
health concerns such as behavioral health challenges and physical
health needs. The Centers for Medicare & Medicaid Services will
select up to eight participants for the model; participants
will be either a state Medicaid agency or a local entity called a
“lead organization.” More information is
CHA has prepared the attached summary detailing the Centers for
Medicare & Medicaid Services’ (CMS) proposed rule addressing rate
updates and policy changes to the Medicare outpatient prospective
payment system (OPPS) system for calendar year (CY) 2019.
On Jan. 17, Centers for Medicare & Medicaid Services
Administrator Seema Verma joined a public webcast hosted by
the American Hospital Association to preview administration
efforts to reduce regulatory burden on hospitals.
of the webcast is available. If you had previously registered,
hit “Click here to login” at the bottom of the page. Enter your
email address and click “Submit.” You will then be taken to the
If you did not register, fill out the required fields at the top
of the page. Once you click “Submit” you will be redirected to
CHA has compiled a list of quality measures required for public
reporting and performance-based programs for hospitals and other
post-acute care providers. The attached file includes a table
showing measures that are duplicated across federal reporting
programs, as well as a tab for each individual federal program,
including inpatient quality reporting, outpatient quality
reporting, value-based purchasing, readmissions reduction,
hospital acquired condition penalty, meaningful use, inpatient
psychiatric facility quality reporting, prospective payment
system-exempt cancer hospital quality reporting, ambulatory
surgical center quality reporting, and accountable care
organizations. The Excel workbook also includes post-acute care
quality reporting programs, including inpatient rehabilitation
facility quality reporting, long-term care quality reporting,
home health quality reporting and skilled-nursing facility
quality reporting programs.
The information in the document comes from various sources,
including Centers for Medicare & Medicaid final regulations and
the National Quality Forum, and will be updated as new measures
are added through the federal rulemaking process.
On Feb. 17, the House and Senate approved the payroll tax
conference report, which includes payment relief for physicians
using hospital payment cuts to offset the cost. The House vote
was 293-132, with 91 Republicans and 41 Democrats voting against
the measure. The California delegation supported
the bill with a vote of 41-10. Soon after the House
vote, the Senate passed the bill, 60-36. President Obama has
indicated he will sign the legislation today.
President Obama released his federal fiscal year (FY) 2013 budget
proposal, setting forth a plan for spending $3.8 trillion next
year. The proposal would reduce Medicare spending by $267 billion
and Medicaid spending by $50 billion over the next 10 years. The
President’s FY 2013 budget includes many proposals from his
February, April and September 2011 budget plans that would reduce
federal payments for hospital and post-acute-care services to
Medicare beneficiaries, including cuts to payments for bad debt,
rural hospitals and graduate medical education (GME).