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November
21, 2005
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Michigan Health & Hospital Association 6215 West St. Joseph Highway Lansing, MI 48917 (517) 323-3443 Fax: (517) 323-0946 |
IN THIS ISSUE Medicaid
Reform Committee Appointed
Medicaid Reform Committee Appointed
The Speaker of the Michigan House of Representatives, Rep. Craig DeRoche (R-Novi), recently appointed a special legislative committee on Medicaid reform and innovation. The committee will be chaired by Rep. Gary Newell (R-Saranac), who serves as current vice chair of the House Health Policy Committee and has prior experience serving as chair of the Appropriations Subcommittee on the Department of Community Health. Members of the committee include Reps. Bruce Caswell (R-Hillsdale), Ed Gaffney (R-Grosse Pointe Farms), Rick Shaffer (R-Three Rivers), Barb VanderVeen (R-Allendale), Shelley Goodman Taub (R-Bloomfield Hills), Kevin Green (R-Wyoming), Alma Wheeler Smith (D-Ypsilanti), George Cushingberry (D-Detroit), Andy Dillon (R-Redford), and Doug Bennett (D-Muskegon). The committee is charged with examining Michigan’s current Medicaid system; technology and other efficiencies to save and secure Medicaid funding; areas where patients need additional care that the state is currently not providing; and reforms to ensure the system remains viable for residents in the future. The MHA has been invited to provide input to the committee, which began preliminary work earlier this month. A timetable for committee action and final recommendations has not been reported. Members with questions should contact Dave Finkbeiner at the MHA. Hospitals Urged to Comment on Proposed Medicaid Co-Pay Policy
Last week, the MHA submitted its comments to the Medical Services Administration (MSA) regarding the proposed policy to implement beneficiary co-payments for certain Medicaid beneficiaries age 21 or older. The co-payments were approved as part of the final fiscal year 2006 Medicaid budget and will take effect Jan. 1, 2006, or upon approval by the Centers for Medicare & Medicaid Services. They include:
The beneficiary co-pay amount will be deducted from the MSA’s approved Medicaid payment amount, with the hospital responsible for collecting the patient co-pay. Due to the indigent status of most Medicaid enrollees, the MHA believes most enrollees will not have the resources to pay the required co-payments, which will translate into a significant increase in hospital bad debts. In addition, the resources required to pursue collection of patient balances is at least $10 per bill, and in many cases, hospitals will incur more cost than the funds collected, while further increasing their administrative burden. The MHA remains concerned about the negative financial impact of this policy on hospitals and encourages members to submit comments to Kathy Whited at the MSA prior to the Nov. 23 deadline. Members with questions should contact Vickie Seal at the MHA. Hospital Wage Data Review Deadline Quickly Approaching
Last month, the Centers for Medicare & Medicaid Services (CMS) released preliminary hospital wage data that will be used by the agency in developing the fiscal year 2007 Medicare wage index, which will become effective Oct. 1, 2006. The preliminary data was obtained from hospital cost reports for fiscal years ending between Sept. 1, 2003, and Aug. 31, 2004. It is crucial that hospitals review these data for accuracy and ensure that necessary corrections are made by the Dec. 5 deadline. Hospital revisions to the data, along with supporting documentation, must be received at the United Government Services office by the deadline (a postmark will not suffice). To assist hospitals in review of the data, the MHA recently distributed hospital-specific worksheets to hospital chief financial officers. The worksheets provided a comparison of hospital wage data for the past four years. Due to the vigilance of hospitals statewide during the past five years, Michigan hospitals have submitted more accurate data to the Medicare fiscal intermediary, which resulted in improving Medicare payments on a statewide basis. However, since the CMS computes the Medicare wage index annually, it is crucial that these efforts continue in order to maintain an accurate wage index for Michigan hospitals. Members with questions should contact Vickie Seal at the MHA. Senate Majority Leader Frist Visits MHA
The MHA recently hosted U.S. Senate Majority Leader Bill Frist (R-TN) at its Capitol Advocacy Center during his visit to Michigan. During the past year, the MHA has developed a more comprehensive federal advocacy program to better represent Michigan hospitals on Medicare and Medicaid funding and a host of other issues under consideration by Congress. At the event, Frist spoke about the federal budget reconciliation process, which is now entering final stages, and the importance of health care in that process. On a related note, the MHA will host a reception in Washington, DC, honoring the Michigan Congressional delegation and their staff on Dec. 5. Members should contact Brian Peters at the MHA for more information. Policy Issued on Prescription Drug Coverage for Dual-Eligible Beneficiaries
The new Medicare Part D prescription drug benefit, which takes effect Jan. 1, 2006, requires revisions to the Medicaid pharmacy benefit for Medicare/Medicaid dually eligible beneficiaries. As a result, the Medical Services Administration (MSA) recently issued a final policy bulletin, which also takes effect Jan. 1, for beneficiaries dually enrolled in the Medicare and Medicaid programs. Beginning on that date, dual-eligible beneficiaries will have prescription drug coverage provided through Medicare Part D rather than through the Medicaid program, except for select prescription drugs not covered by Medicare Part D. Drugs not covered by Medicare Part D, such as barbiturates, select vitamins and minerals, agents to promote smoking cessation, and over-the-counter drugs, will continue to be covered by Medicaid when the coverage criteria is met. However, Medicaid will not cover drugs that are not covered by the beneficiary’s Medicare Part D formulary. Since the drug coverage through the Part D benefit varies, based upon the formulary of each participating plan, it is essential that beneficiaries choose a plan based upon their prescription drug needs. Medicaid coverage parameters for drugs are listed on the Michigan Pharmaceutical Product List (MPPL), available at the First Health Services Corporation Web site. Questions regarding coverage and limitations of the Medicare Part D benefit should be directed to Medicare at (800) 633-4227 or to the Michigan Medicare/Medicaid Assistance Program at (800) 803-7174. Members with questions regarding the MSA policy bulletin should contact Vickie Seal at the MHA and those with questions regarding Medicare Part D educational and referral tools should contact Kevin Downey at the MHA. Partnership for Michigan’s Health Supports Smokefree Legislation
The Partnership for Michigan’s Health sent a letter of support for House Bills 4624-4625 and Senate Bills 394-395 to Michigan lawmakers last week. The legislation is aimed at ensuring smokefree workplaces for all Michigan citizens and the MHA Board of Trustees unanimously recommended at its June meeting that the MHA support the bills. The partnership, which is comprised of the Michigan State Medical Society, the Michigan Osteopathic Association and the MHA, communicated to lawmakers their concern about the health of individual workers and the aggregate increased health care costs to the state caused by secondhand smoke in the workplace. The letter also explained that secondhand smoke is a Group A carcinogen, that 80 percent of Michigan voters understand the importance of a smokefree workplace, and that 90 percent believe that secondhand smoke is harmful. In addition, the MHA contends that the legislation makes sense, given that Michigan is scrambling to find enough money to fund its Medicaid program and smoking causes $2.65 billion in increased health care costs in the state. Members with questions should contact Dave Finkbeiner at the MHA. Innovative Prevention Programs Sought
The MHA, along with the Michigan Association of Health Plans, the Michigan Osteopathic Association, the Michigan Primary Care Association and the Michigan State Medical Society, has joined with the National Kidney Foundation of Michigan to create a special Innovations in Health Care award. The award will recognize three programs or providers that offer the most innovative treatment or prevention programs in the areas of diabetes, cardiovascular disease (including physical activity and nutrition), and kidney disease (including dialysis and transplantation programs). Groups, programs and individuals may apply for the award, which includes a $1,000 cash gift. Applications are due Feb. 10 and the awards will be presented during the National Kidney Foundation of Michigan’s annual Champion of Hope dinner in Lansing on March 29, 2006. The MHA is a past recipient of the foundation’s Champion of Hope award, which recognized the contributions of Michigan’s nonprofit hospitals toward kidney disease prevention and treatment. For further information, contact Marlene Hulteen at the MHA. Hospitals Invited to Help Steer Michigan’s IT Future
CyberMichigan — an independent entity that provides analysis and long-term guidance on the direction of information technology in Michigan — has joined with the Michigan Department of Community Health and the Department of Information Technology to invite representatives of state hospitals and other health care stakeholders to attend the Michigan Health Information Network Inaugural Meeting. This meeting is the first event to bring all community stakeholders to the same table with the charge of creating a statewide health information network. There are also plans to bring together various work groups that will make specific recommendations on the topics of security and privacy, governance, technical issues, regional applications and clinical priorities. The conference is free of charge and will take place from 8 a.m. to 4:30 p.m. Dec. 14 at the Kellogg Hotel and Conference Center in East Lansing. Further information and online registration is available online. Members with questions should contact Jim Lee at the MHA.
Bronson Methodist Hospital, Kalamazoo, is the state’s sole recipient of the 2005 Michigan Quality Leadership Award. Modeled after the Malcolm Baldrige National Quality Leadership program, the Quality Leadership program is sponsored by the Michigan Quality Council and evaluates an organization for excellence in seven categories of performance. Bronson also received the award in 2001 and is the program’s only two-time honoree since it was established in 1993. Bronson President and Chief Executive Officer Frank J. Sardone said the award “verifies that our organization’s commitment to continuous improvement and clinical and service excellence is producing tangible results.” MHA HEALTH PAC Campaign Nears End
With
approximately one month remaining in the 2005 campaign, the MHA
HEALTH PAC has raised $192,354 toward its 2005 campaign goal
of $300,000. Fifty-seven
hospitals/health systems have met or exceeded their organizational
political action committee goals. Those
who would like to help Michigan elect health care champions
by contributing to
the HEALTH PAC campaign should
send
contributions by Dec. 16 to ensure they are reflected in this
year’s totals.
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