IN THIS ISSUE

Community Health Budget Through First Legislative Committee

Last week, the Senate Appropriations Subcommittee on the Department of Community Health reported out the fiscal year 2006-2007 Medicaid budget to the full Senate Appropriations Committee for consideration. The Senate proposal, to date, mirrors the executive budget proposal with no additional cuts to hospital rates, graduate medical education (GME) or disproportionate share hospital payments. The plan also calls for an increase in the hospital tax and would fund the payments through the state's Medicaid health maintenance organizations (HMOs). The MHA continues to evaluate the concept of an additional hospital tax, but has consistently stated its opposition to the process of GME funding through the HMOs.

Furthermore, the Senate plan assumes additional general fund savings for the state from new rules under the federal Deficit Reduction Act. Nearly $10 million in general fund savings is assumed from the adoption of tighter asset rules and the implementation of co-pays and premiums allowed under the act. Co-pays and premiums would be $2 for physician office visits; $3 for emergency room visits; $50 for the first day of an inpatient hospital stay; and $1 for an outpatient hospital visit. The Michigan Department of Community Health (MDCH) is directed to establish co-payments for dental, podiatric, chiropractic, vision and hearing aid services. The full Senate Appropriations Committee will likely act on the Medicaid budget this week and final Senate action is expected to occur by the end of March.

The House Appropriations Subcommittee on the MDCH is considering the fiscal year 2006-2007 Medicaid budget simultaneously. Ned Hughes Jr., president, Gerber Memorial Health Services, Fremont, will present testimony on behalf of the MHA to the House subcommittee on March 29.

MHA members are encouraged to contact their state representative and senator to discuss hospital priorities regarding the Medicaid budget. Members with questions should contact Brian Peters at the MHA.

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Members Invited for Washington Visit

The American Hospital Association (AHA) will hold its 2006 Annual Membership Meeting in Washington, DC, April 30 through May 3. Large-scale cuts for federal funding to Medicare and Medicaid are gaining little ground in Congress. However, member action is needed on threats to specific programs like children's hospital graduate medical education, rural health funding and changes by the Centers for Medicare & Medicaid Services to several reimbursement methodologies. Hospital-acquired infection prevention, public reporting, tax-exempt status, and billing and collection practices are also at the forefront for many congressional committees, making the MHA-member presence and efforts on Capitol Hill critically important.

MHA members are invited to gather for dinner and a brief legislative update hosted by the MHA on Sunday evening during the AHA meeting. Final arrangements for this gathering are pending and will be sent to all meeting attendees. Hill visits to meet with members of Congress and their staff are scheduled for Tuesday and Wednesday, and materials and schedules for these visits will be provided by the MHA. The AHA meeting convenes Sunday afternoon with the annual AHA Political Action Committee luncheon, and continues with plenary sessions and briefings throughout the day on Monday and Tuesday. To register in advance of the meeting, registrations must be received by April 7. For more information about MHA-sponsored events during the AHA annual meeting, contact Laura Appel at the MHA.

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MHA Submits Comments on LTCH Proposed Rule

Last week, the MHA submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the 2007 Medicare proposed rule to update the long-term, acute-care hospital prospective payment system. Long-term, acute-care hospitals (LTCHs) treat severely ill and medically complex patients, offering specialized services and programs that are not otherwise available, and generally have a length-of-stay of 25 days or greater. LTCHs serve a significant percent of Medicare patients in Michigan and play an integral role in the continuum of care and in ensuring that patients receive appropriate care, based upon their specific medical condition.

Key provisions of the proposed rule would have a significant, negative financial impact on facilities and would jeopardize access to LTCH services for all patients. The MHA opposes several provisions, including:

• the short-stay outlier proposal, which is projected to reduce Medicare payments by more than 11 percent and which the association believes lacks evidentiary support
• the lack of an inflationary update for 2007 to cover the cost of caring for LTCH patients, who are the Medicare program's sickest beneficiaries
• the proposed 76 percent increase in the cost outlier threshold that would increase the amount of loss incurred by an LTCH before a case qualifies as a high-cost outlier

The MHA encourages members to submit their comments to the CMS electronically by 5 p.m. today. Members with questions should contact Vickie Seal at the MHA.

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Patient Safety Conference to Feature Report Release

The Michigan State Commission on Patient Safety is releasing its final report, which contains a detailed plan to improve the safety of Michigan's health care system, at the Michigan Health and Safety Coalition's annual patient safety conference on March 29 and 30 at the Somerset Inn, Troy. This comprehensive, cutting-edge conference will also highlight national patient safety trends and initiatives, including health information technology, and showcase successful patient safety practices by Michigan health care organizations. Several poster presentations will enhance the learning and networking experience. Registration has been extended until March 24. For more information, contact Leigh Anne Jewison at the MHA.

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Law Establishes Newborn Screening Committee

A bill that would create a state Newborn Screening Quality Assurance Advisory Committee was signed into law by Gov. Granholm late last month. Senate Bill 794, which was introduced by Sen. Tom George (R-Portage), became Public Act 31 of 2006 and took effect Feb. 23. Under the new law, the Michigan Department of Community Health (MDCH) must create a 10-person advisory committee that is required to meet and report annually on newborn screening tests. Through amendments to the Michigan Public Health Code, the Newborn Screening Quality Assurance Advisory Committee is empowered to initiate revisions to the list of genetic disease screening tests required for newborns and to propose a fee change based on the revisions. The revisions would take effect unless rejected by the MDCH or by the House or Senate standing committees on public health policy. The legislation replaces the current process, which necessitates statutory changes whenever the MDCH believes scientific evidence supports adding to or deleting from the conditions on the screening list. During committee deliberations in both legislative chambers, the MHA supported the bill, which provides for one MHA representative on the expert screening committee. Members with questions should contact David Finkbeiner at the MHA.

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Clarifying Injections, Infusion, Bronchoscopy Outpatient PPS Rules

This year, Medicare significantly changed the coding and reimbursement guidelines for infusion, injections and bronchoscopy outpatient procedures. The MHA Health Foundation is sponsoring two half-day Webinars to help hospitals accurately document, code, bill and maintain revenue for these services. Stick It To Me! Injections and Infusion, scheduled for April 6 and 7, will examine Medicare's 2006 Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) injections and infusion code changes, outpatient prospective payment system drug payments, transmittal 785, and UB-92 examples of emergency department, intravenous therapy and chemotherapy services. Coding "CPR" for Bronchoscopy Procedures, scheduled for May 15 and 16, will examine lung anatomy and pertinent CPT assistant instructions, code assignment, and modifiers for CPT and ambulatory payment classification (APC) revenue for bronchoscopy procedures. For more information, contact Leigh Anne Jewison at the MHA.

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BCBSM Announces Grant Funding for Nonprofit Free Clinics

Last week, Blue Cross Blue Shield of Michigan (BCBSM) announced it will earmark $1 million in grants during 2006 for nonprofit free clinics that provide care to Michigan's 1.1 million uninsured citizens. Proposals may be submitted until March 31 for grants ranging from $5,000 to $50,000, with funding priority based on need, plan objectives and activities.

Free clinics play an integral role in the region's health care network by providing care to patients who otherwise would likely delay seeking treatment, resulting in poorer health and expensive emergency-room visits and hospital stays. For information on submitting a proposal, contact Tyffany Shadd-Coleman at BCBSM at (248) 448-5045.

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Register Now for Cover the Uninsured Week Activities

MHA President Spencer Johnson will join Gov. Jennifer Granholm, other elected officials, and a variety of community leaders to kick off the activities supporting this year's Cover The Uninsured Week, scheduled for May 1-7. The news conference marking the commencement of these important efforts will be held April 26 at 10:30 a.m. in downtown Detroit and will focus on new data about the uninsured and actions to help address the growing problem.

A variety of events is scheduled for the week, and hospitals are encouraged to participate. Register to attend the news conference, interfaith breakfast, health authority community luncheon, and/or business leaders' luncheon by calling (313) 874-1677, faxing a registration form to (313) 874-5424, or by e-mail. Since seating is limited for these events, registrations must be received by April 14. For additional information, contact Sherry Mirasola at the MHA.

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Hospitals Warned of Environmental Fee Scam

Fraudulent payment vouchers that appear to be from the U.S. Environmental Protection Agency (EPA) have been received by some hospitals and commercial waste haulers in the state, alleging that fees are due to ensure compliance certification. These incidents have been reported to the Michigan State Police, the EPA, and the Michigan Department of Environmental Quality's Office of Criminal Investigations and are currently being investigated.

Hospitals that receive similar notifications are encouraged to contact the Office of Criminal Investigations and/or the Michigan State Police immediately. Members with questions should contact Sherry Mirasola at the MHA.

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Health Care Advocacy Day Set for May

Join the Michigan Association of Healthcare Advocates, the Michigan Council of Directors of Volunteer Services, Gift of Life Michigan and the MHA for Health Care Advocacy Day, to be held May 10 in Lansing. This annual event brings together hospital volunteers, chief executive officers, senior leaders and governing board members to speak with legislators about the importance of protecting affordable health care services for all Michigan residents and safeguarding health care jobs.

Keynote speaker Steve McCurley, co-editor of e-Volunteerism, will discuss the future of volunteerism and provide practical advice on how to create a dynamic, effective team as volunteers' roles in the hospital continue to evolve. Register by April 28 to take advantage of the opportunity to talk to lawmakers about the important issues facing the health care community. Questions should be directed to Courtney Lawson at the MHA.

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Effectively Managing Medical Affairs Focus of Workshop

Physicians are faced with growing medical leadership challenges. The MHA Health Foundation education program The Changing Role of Physicians: Leaders in Medicine and Management is designed to help physicians and other senior leaders administer complicated matters surrounding physician discipline and termination, including peer-review-protected investigations, employed vs. nonemployed physicians, interaction with human resources, conducting the medical staff hearing, nonquality terminations, and state and data bank reporting. The program will also explore expectations around pay-for-performance and quality, as well as strategies for innovative partnerships. The half-day session is scheduled for May 4 in Lansing and May 5 in Troy and is offered as a Webinar. An early registration discount is available through April 6. Contact Leigh Anne Jewison at the MHA for more information.

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State Seeks Input on Aging Services

The Michigan Office of Services to the Aging (OSA) will hold a series of forums around the state to solicit public input on the needs of older adults and their caregivers. Information gathered during the forums will have a direct effect on the development of the 2007-2009 State Plan for Aging Services. MHA members that provide acute and nonacute services to older adults may wish to provide oral or written testimony. The State Plan is a requirement of the Older Americans Act and guides the work of the OSA. Members with questions should contact the OSA at (517) 373-8230.

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• The MHA Patient Safety Committee and Quality & Compliance Committee meetings scheduled for Thursday have been canceled. For more information, contact Sam Watson at the MHA.

• In late February, the Medical Services Administration (MSA) distributed second-quarter fiscal year (FY) 2006 tax bills to hospitals for the quality assurance assessment program (QAAP), also known as the Medicaid access to care initiative (MACI). To avoid a penalty, hospitals are urged to ensure that their tax payments are remitted in full by the March 31 due date. The MSA distributed the corresponding second-quarter FY 2006 MACI payments to hospitals Feb. 15. Members with questions should contact Vickie Seal at the MHA.

• As the 2005-2006 flu season draws to a close, the state Flu Advisory Board, of which the MHA is a member, has made available information on prebooking influenza vaccine for the 2006-2007 flu season. In addition, the U.S. Centers for Disease Control and Prevention has provided planning guidelines for the possible occurrence of a flu pandemic.

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MHA Members can also refer to these items in our Weekly Mailing: AB 1144 Medicare Revenue Forecasting Tool:  April 18 Demonstration Call AB 1145 MHA 2006 Hospital Community Benefits Report & Toolkit Michigan Dept. of Environmental Quality April 6 workshop — Managing E-Waste in Michigan MHA Service Corporation SEARCH Newsletter — March issue MHA Health Care Advocacy Day brochure and registration