On Jan. 1, Rick Snyder was sworn in as Michigan's 48th governor. Snyder's inaugural remarks focused on the importance of reinventing Michigan, but also stressed that shared sacrifice by all will be required to move the state forward. Also taking the oath of office were Lt. Gov. Brian Calley, Attorney General Bill Schuette, Secretary of State Ruth Johnson, and Justices of the Supreme Court Robert Young and Mary Beth Kelly. Last week, Young was also elected by the seven-member Supreme Court to serve as the court's chief justice for the next two years.

Members of the 96th Legislature will be sworn in Wednesday during ceremonies at the state Capitol. An MHA-member call to action following the November election encouraged the hospital community to reach out to new lawmakers to begin the dialogue about the critical role Michigan's hospitals play in providing vital healthcare services. With another multibillion-dollar state budget deficit looming next year, now is the time to meet and urge elected officials to support policies that promote access, patient safety and quality improvements, as well as to provide adequate resources to maintain the healthcare safety net for all.

While formal legislative activity may not begin for a few weeks, activity at the Capitol is under way. The annual state revenue estimating conference will be held Friday, bringing together state officials and private-sector economists to determine a revenue forecast that must be used by the governor and Legislature as they develop budget proposals for fiscal year 2011-2012. On Jan. 19, Snyder will deliver his first State of the State address in the House chambers. It is expected the governor will begin to outline his legislative agenda and budget strategy for his first year in office during his remarks. Members with questions should contact Dave Finkbeiner at the MHA.

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The 112th U.S. Congress convened in Washington, DC, Wednesday. John Boehner (R-OH) was sworn in as Speaker of the House, which is now under Republican control. As widely reported, House Republicans are set to vote Wednesday on a straight repeal of the Affordable Care Act, including the individual mandate for healthcare coverage. A preliminary analysis from the Congressional Budget Office (CBO) estimates a repeal of the act would increase the federal deficit by $230 billion by 2021. The CBO also estimated that the reform package, as currently enacted, will reduce the deficit by $143 billion over 10 years due to revenue provisions such as changes to Medicare, insurer taxes and provisions related to high-cost health plans. A vote is also expected on a resolution requiring health committees to report alternative legislation to the existing law. The committees have no deadline to write the replacement bills, but they would have to achieve a standard "wish list" of Republican healthcare goals, including medical liability reform and expanded state control over Medicaid programs. The bills would also need to lower healthcare premiums and provide access to coverage for individuals with pre-existing conditions. Although the repeal measure is not expected to be addressed in the U.S. Senate, the Obama administration issued a letter to Boehner outlining the positive aspects of the act.

Thirteen new senators were sworn in last week and the Senate convened; however, no action in that chamber is expected before the president's State of the Union address, scheduled for Jan. 25. Senators will be in their home districts for two weeks, returning to Washington Jan. 24. For more information about federal action on healthcare reform, contact Laura Appel at the MHA.

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PriceWaterhouseCoopers' recent survey of healthcare chief executive officers found that most are developing alignment agreements with physicians and other health systems in preparation for healthcare reform. The MHA Health Foundation Winter Leadership Conference agenda includes several sessions on hospital-physician alignment, including a discussion on how small and rural hospitals can align with other providers while maintaining the independence necessary to serve their own unique communities; how a physician leader in a small family practice is using technology and Lean tools to redesign the practice for better patient care management; and how a physician-hospital organization is restructuring like an accountable care organization to prepare for pay-for-performance. The Winter Leadership Conference is scheduled for Feb. 21 and 22 at the Grand Traverse Resort & Spa. An early registration discount is available through Jan 21. Conference registration and hotel reservations can be completed online. For more information, contact Erin Steward at the MHA.
 

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As Michigan's new leaders look ahead to the fiscal challenges of the coming year, they can rest assured healthcare is part of the solution. Despite the economy, hospitals have assumed a greater role in not only improving the health of residents, but also generating jobs, economic stimulus and attracting patients from across the globe.

On Dec. 21, the Detroit Free Press published an article titled "Search for world's best healthcare is leading more people to Michigan." The story detailed the allure of Michigan hospitals and described their success in attracting out-of-state patients through innovation and specialization.

On Dec. 24, the Livingston Daily echoed these points in an editorial that emphasized the prestige and local economic benefits of Michigan's medical tourism: "(Michigan health systems) not only bring acclaim, they also bring in out-of-town visitors who use hotels, restaurants and other local businesses. The highly successful specialties provide great job opportunities for health-care careers."

healthcare's role in job creation was also highlighted in a recent special edition of WWJ-TV CBS Detroit's "Eye On The Future" programming, which included the "Medical Main Street" effort in southeast Michigan, the growing "Medical Mile" development in Grand Rapids and the opening of Eastern Michigan University's new Science Complex to train researchers in medical and scientific fields.

The MHA and its member hospitals look forward to working with the new Snyder administration and Legislature to generate awareness of hospitals' efforts that are already resulting in higher quality, greater efficiency, lower costs and healthier communities.

Next month, the MHA will release a report demonstrating Michigan community hospitals' dedication to their roles as safety net providers and economic engines. For more information, contact Kevin Downey at the MHA.

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healthcare providers have less than a year to prepare for the upgraded set of standards that govern the transaction regulations of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The Version 5010 transaction set will administer electronic submission of administrative transactions, such as claims, remittance, eligibility, and claims status requests and responses, effective Jan. 1, 2012. To assist with the transition to Version 5010 and compliance, the Centers for Medicare & Medicaid Services (CMS) is supporting an education effort, Get Ready 5010, that will inform the provider community of the steps needed to be ready for implementation.

Get Ready 5010 will kick off with a series of free webinars in January. The webinars will feature speakers from the CMS, providers and payer organizations, who will discuss the current level of readiness and plans for testing, how to prepare for testing, and version 5010 basics. Although there is no fee for participating in the webinars, registration is required.

The CMS is also hosting teleconference calls on the ICD-10 implementation and Medicare fee-for-service implementation of the HIPAA Version 5010 transaction standards. Registration is required at least 24 hours prior to the start of the teleconference, and the presentations will later be available for download from the CMS website.

A complete schedule of these educational events is listed below. For more information, contact Vickie Seal at the MHA.

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Effective Jan. 1, Medicare coverage for beneficiaries in the Michigan Public School Employee Retirement System changed to the Blue Cross Blue Shield of Michigan (BCBSM) Blue Plus Preferred Provider Organization (PPO). Following the transition, some BCBSM records are erroneously showing these enrollees are enrolled in both the Medicare Advantage (MA) PPO and a group supplemental contract. This could result in hospitals billing the incorrect insurance company for services provided since Jan. 1. Although the issue was unresolved as of Jan. 6, BCBSM is working on a solution. These patients' records can be identified by the prefix XYO in their patient identification numbers, displayed as MQA on the BCBSM Web-DENIS (Dial-in Eligibility Network and Information System) provider portal.

In addition, the added number of MA beneficiaries has resulted in longer wait times for precertification approvals. BCBSM has posted notices on Web-DENIS and will continue to provide ongoing updates. For further information, contact Marilyn Litka-Klein at the MHA.

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Clifton Gunderson, LLP, the company engaged by the Medical Services Administration (MSA) for the federally mandated Medicaid disproportionate share hospital (DSH) audits, will begin audit work for state fiscal year (FY) 2008 in early calendar year 2011. In conjunction with this, the MHA is hosting an education session for hospitals with representatives from Clifton Gunderson, LLP, and the MSA from 1 to 4 p.m. Jan. 26 at the MHA headquarters in Lansing. Clifton Gunderson will provide a formal presentation, followed by a question-and-answer period.

The MHA encourages hospital finance staff or their representatives to either attend the session or participate via audioconference. Those with specific questions for Clifton Gunderson to address should send them to Janet Ferrier at the MHA by Jan. 17; they will be forwarded to the company. Contact Janet Ferrier with questions regarding registration, while other questions should be directed to Vickie Seal at the MHA.

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Registration for the Centers for Medicare & Medicaid Services (CMS) Medicare incentive program for the meaningful use of electronic health records (EHRs) began last week. Michigan is also one of 11 states that are accepting registrations from eligible providers for Medicaid EHR incentive payments. Hospitals will have three registration options: Medicare only, Medicaid only, or both Medicare and Medicaid. All hospitals should register for both Medicare and Medicaid unless they are certain they will be eligible for only a single program. Once they become meaningful users and attestation has occurred, a hospital will not be able to change its registration status without contacting CMS directly. Additional information on registration for incentive payments from both programs is available on the CMS website.

Additionally, the Michigan Department of Community Health (MDCH) recently released two notices of proposed policy that establish the Michigan Medicaid EHR incentive programs for eligible professionals - Medical Services Administration (MSA) Policy 1054-EHR - and for hospitals - MSA Policy 1056-EHR. The MHA plans to provide comments to the MDCH and encourages members to review both policies and provide comments as needed. Comments on MSA Policy 1056-EHR are due to Meghan Sifuentes by Wednesday and those for MSA Policy 1054-EHR are to be delivered to the MDCH by Jan. 19. Members with questions should contact Jim Lee at the MHA.

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The healthcare fraud and abuse rules have changed under recently passed reform laws and have led healthcare finance professionals to be more sensitive to, and to try to better understand, the many rules that affect how they perform their professional duties. Familiarity with these rules is critical, since violations could lead to substantial monetary penalties and/or exclusion from participation in federal healthcare programs. Yet while healthcare providers must comply with all state and federal regulations, it is not always clear which laws are applicable to specific billing arrangements. The MHA Health Foundation webinar The healthcare Reform Act: Implications for Corporate Compliance will discuss the ramifications of these changes for healthcare providers and recommendations for steps to be taken now to strengthen compliance programs. Participants will cover topics such as reporting and returning overpayment, the federal Anti-Kickback Statute and the False Claims Act, recovery audit contractor expansion, self-referral disclosure protocol, physician ownership of hospitals, disclosing ownership for in-hospital ancillary services, and increased funding.

The webinar is scheduled from 10 to 11 a.m. Feb. 17 and has a connection fee of $195 per MHA-member organization. For more information or to register, contact Leigh Anne Jewison at the MHA.

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The Medical Services Administration (MSA) recently received federal approval of a policy to reinstate the Small Hospital Disproportionate Share Hospital (DSH) Pool and expand the Outpatient Uncompensated Care DSH Pool. The Medicaid Small Hospital DSH Pool, initially implemented in fiscal year (FY) 2005 and eliminated as part of the FY 2010 budget, will be reinstated and increased from $5 million to $7.5 million. In addition, the $60 million Outpatient Uncompensated Care DSH Pool will be expanded by $27 million. Consistent with current policy, the $27 million will be split evenly between the small-rural hospital and large-urban hospital components of the pool. Each eligible hospital's share of these pools will be determined based on the MSA's established policy for each pool.

While these DSH pool expansions are a one-time increase that will be paid during state FY 2011, payments from these pools will count against hospital-specific DSH ceilings for state FY 2010. While the MSA expects to make payments from these pools in late January or early February, hospital-specific payment amounts are not yet available. Members with questions should contact Jason Jorkasky at the MHA.  

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The Michigan Center for Rural Health presented the 2010 Michigan Rural Health Quality Improvement Award to many of Michigan's critical access hospitals in October. In 2010, the award's second year of presentation, it was expanded to honor facilities in three broad categories: Inpatient Clinical Performance Award, Outpatient Clinical Performance Award, and Customer Service Quality Award. Within each category, recognition was granted at two levels based on each facility's overall score within the given category. Those with scores above a set level in the category received the Quality Improvement Achievement Award, while hospitals that achieved scores of 95 or above were given the Award of Excellence. The MHA congratulates the 32 hospitals that were honored in one or more of the award categories. For more information, contact Amy Barkholz at the MHA.  

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On Dec. 17, the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) released a new set of resources to help hospital emergency planners develop, conduct and evaluate emergency preparedness exercises within their facilities. Meeting the needs of accredited and unaccredited hospitals ranging from acute care to critical access, these new resources are designed to strengthen hospitals' responses in the event of an actual emergency.

• The Hospital Preparedness Exercises Atlas of Resources and Tools describes nearly 200 resources and tools that are available to help emergency planners develop, carry out and evaluate hospital preparedness exercises. These resources and tools can be used throughout the exercise cycle to help hospital preparedness planners meet federal funding requirements and accreditation standards, as well as improve hospitals' preparedness systems.
• The Hospital Preparedness Exercises Guidebook accompanies the atlas, serving as a reference for those using the Atlas.
• The Hospital Preparedness Exercises Pocket Guide serves as a quick reference for hospital preparedness planners using the guidebook.

Members with questions about these new resources or hospital emergency preparedness should contact Morgan Brooks at the MHA.  

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The Centers for Medicare & Medicaid Services (CMS) has launched its annual survey measuring healthcare providers' satisfaction with the contractors who process and pay Medicare fee-for-service claims, such as Medicare fiscal intermediaries and administrative contractors. Sent to approximately 30,000 randomly selected Medicare providers, including hospitals, the 2011 survey will measure satisfaction with contractors in the areas of provider enrollment and inquiries, education, audit and reimbursement, claims processing, appeals and medical review. The MHA encourages members who received the survey to respond in a timely manner. Members with questions should contact Vickie Seal at the MHA.  

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• The MHA will host a legislative reception from 2 to 5 p.m. Wednesday at the MHA Capitol Advocacy Center in downtown Lansing. Newly elected lawmakers, who will take the oath of office that morning, will be welcomed to Lansing and receive timely information about healthcare issues. For more information, contact Stacy Dowdy at the MHA.