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February
20,
2006
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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 MHA Joins
International Coalition in Washington
MHA Joins International Coalition in Washington CMS Releases Final Occupational Mix Survey The CMS incorporated some comments received from the MHA, the American Hospital Association (AHA), and others regarding the proposed rule that was released in October 2005. These revisions include reducing the number of functional subcategories for licensed practical nurses and altering those for registered nurses. However, the agency did not extend the data collection period to 12 months or allow additional time for completion. The CMS was mandated by the Benefits Improvement and Protection Act of 2003, to collect data every three years regarding the occupational mix of hospital employees and to apply an adjustment to the hospital wage index, beginning in FY 2005. The current hospital wage index is based on 90 percent of the unadjusted average hourly wage and 10 percent adjusted to incorporate occupational mix. The CMS has not released the specific methodology that it intends to use for developing the occupational mix adjustment for future years. Members with questions should contact Vickie Seal at the MHA. Providers May Now Ask to End Contract/Relationship with Ultimed Providers seeking to end a contract or relationship with Ultimed HMO of Michigan, Inc., may now petition the Ingham County Circuit Court requesting approval to do so. The Order of Rehabilitation came in late January, after Ultimed failed to provide financial statements as mandated by the Michigan Department of Labor and Economic Growth's Office of Financial and Insurance Services (OFIS). The order essentially gives direction and management responsibilities to the OFIS commissioner as the court-appointed rehabilitator. Requesting to end a contract or relationship is counter to past practices of HMO rehabilitation, and the OFIS has indicated it would consider any petition filed, and that good faith requests would most likely be honored. Further, it appears that OFIS would not enforce the requirement that would keep providers from ending contracts/relationships with third parties that maintained a business relationship with the HMO. However, OFIS counsel reinforced that these arrangements could be ended without court approval. For more information, contact Joseph Chiappetta at the MHA. As previously reported, the Medical Services Administration (MSA) has announced that implementation of an ambulatory payment classification (APC) system to replace the current Medicaid fee-based payment system has been postponed from July 1 to Oct. 1, 2006, to allow more time for systems preparation and analysis. The MSA intends to distribute periodic updates to the APC work group, which is comprised of representatives from the MSA, hospitals, Medicaid health plans and the MHA, to identify various policy and system development issues and solicit input. The Medicaid APC system is expected to mirror the Medicare APC system, with adjustments for the pediatric and maternity populations. The new system will affect all hospitals, including critical access and children's facilities, as well as Medicaid health plans. The MSA recently updated the projected timeline, to reflect the Oct. 1 OPPS implementation date as follows:
In addition, the MSA has requested hospital input regarding topics and issues that are not specifically addressed in the previous proposed discussion document. A summary of issues identified and the MSA's responses will be available online. Members with questions should contact Vickie Seal at the MHA. Medicare OPPS Webinar Series Clarifies 2006 Rules
JCAHO Field Review of Medical Staff Standard
Last week, the Joint Council on Accreditation of Healthcare Organizations (JCAHO) announced the field review of Medical Staff standard 1.20 (MS.1.20) for hospitals and Critical Access Hospitals. The Joint Commission has been working to address two areas of concern regarding changes to this standard: the complexity of its language and the potential burden that might be placed on organizations that find it necessary to revise their medical staff bylaws. The planed implementation date of this revised standard is January 1, 2007. There has been substantial change to the language of MS.1.20 and this field review is being conducted to gather further information regarding the following:
The revised standard is available online and comments must be returned to JCHAO by March 10. For more information, please contact Sam Watson at the MHA. Hospital Billing and Reimbursement Focus of Series
The MHA Health Foundation is holding two workshops to help hospitals' billing, patient accounts, admitting and coding professionals manage and monitor the quality of documentation and the revenue cycle. An Introduction to Hospital Billing and Reimbursement will review various form locator boxes and general billing guidelines on the UB-92 (HCFA 1450) claim; describe the inpatient and outpatient charge structure; teach how to correctly interpret UB-92 codes, various service dates and charges; and more. Practical Application of Inpatient and Outpatient Claims will test participants' skills as they complete inpatient and outpatient UB-92 forms and compare their skills to demonstrated best practices. Various form locators and E-diagnosis codes will be examined. Both half-day sessions will be held on April 26 and 27. For more information, contact Leigh Anne Jewison at the MHA. Patient Safety Conference Discount Still Available
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Last
week in Washington D.C., the MHA joined
U.S. and Canadian chambers of commerce and businesses along the
U.S. northern border
in support of border crossing regulations that allow health care
workers to move freely between the United States and Canada,
in accordance with national security. Michigan is estimated to
have
more than 3,000 Canadian nationals regularly commuting to health
care jobs in the state. Inefficient and expensive border-crossing
requirements would impair workers from getting to their jobs,
and increase the difficulty of recruiting nurses and other skilled
health care workers to Michigan hospitals. Federal law will require
anyone, including a U.S. citizen, who crosses into the United
States
from Canada, Mexico and other North American countries, to possess
a passport or similar documentation by January 2007. The Borders
for Economic Security, Trade and Tourism (BESTT) coalition is
working closely with members of the Northern Border Congressional
Caucus
and other interested parties in opposition of requirements that
include new forms of documentation, including the recently-announced
PASS border crossing card. For more information about the BESTT
coalition and the pending rules on border crossing requirements,
contact 
The
Centers for Medicare & Medicaid Services (CMS) recently
released a final occupational mix 
Last
week, the Blue Cross Blue Shield of Michigan (BCBSM) Participating
Hospital Agreement Reimbursement Committee established an update
factor of 3.9 percent
for diagnosis-related group (DRG), per diem, and controlled charges for hospitals
with fiscal years beginning July 1, 2006. This represents a decrease
from the 4.0 percent factor established last quarter. One of the factors considered
by the committee, the national hospital input price index, decreased
from 3.8 percent
last quarter to 3.5 percent this quarter. The committee is comprised of hospitals,
BCBSM and independent representatives. For more information, contact 
Recently,
Medicare significantly changed the coding and reimbursement guidelines
for outpatient procedures related to infusion and injections and bronchoscopy.
The MHA Health Foundation is sponsoring two Webinars
to help hospitals maintain coding and revenue integrity. Stick
It To Me! Injections and Infusion, scheduled
for April 6 or 7, will examine Medicare's
2006 CPT and HCPCS injections and infusion code changes, outpatient PPS drug
payments, transmittal
785, and UB-92 examples
of ED, IV therapy and chemotherapy. Coding "CPR" for Bronchoscopy
Procedures,
scheduled for May 15 or 16, will examine
lung anatomy and pertinent CPT assistant instructions, code assignment, and
modifiers for CPT and APC revenue for bronchoscopy
procedures. For more 
The
Michigan Health and Safety Coalition patient safety conference,
Patient Safety is No Accident: Proactive Practice and Policy, scheduled
for March 29 and 30 at the Somerset Inn, Troy, features general
sessions on today's most critical
patient safety issues and concurrent sessions demonstrating effective, practical
approaches to improving patient safety. The early
registration discount will be ending March 1, so professionals from
health care providers, health plans, universities, state agencies and businesses
are encouraged
to register now.
Organizations interested in showcasing poster presentations on
patient safety best practices
or interested in sponsorship should submit an application immediately to confirm
participation by the deadline. More information on the Michigan Health and
Safety Coalition patient safety conference, poster presentation
guidelines and sponsorship
is available on the coalition's 
