Tag: 340B

MHA Monday Report July 17, 2023

Monday Report
MHA Monday Report

MHA Service Corporation Board Highlights Solutions and Successes

The MHA Service Corporation board held its final meeting of the 2022-2023 program year focused on supporting the MHA Strategic Action Plan priorities of workforce sustainability, financial viability, achieving health equity and improving access …

capitol buildingGovernor Creates New Department to Support Workforce and Talent Development

The Michigan Legislature may be on summer recess but work in the state capitol continues. The governor made headlines the week of July 10 with the creation of a new state department, the Michigan Department of Lifelong Education, Advancement …

CMS Releases Proposed Rule to Update Home Health PPS

The Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule to update the home health prospective payment system (PPS) for calendar year 2024. The proposed rule includes updates to the …

Webinar Series Explores AI, Resilience and Other Topics

The MHA and other state hospital associations are hosting a webinar series in partnership with the Huron Consulting Group Aug. 10 through Nov. 9 from 1 – 2 p.m. EST. The content will help registrants …

HHS Releases 340B Proposed Remedy

The Department of Health and Human Services (HHS) recently released its proposed remedy for the unlawful payments cuts for certain hospitals that participate in the 340B drug discount program following the June 2022 unanimous Supreme …

Understanding Value-Based Payment Models Can Enhance Patient Care, Lower Costs

Over the last few decades, the healthcare industry has experienced a significant shift from fee-for-service  payments to value-based payments. Value-based care delivery models, which base payment on outcomes versus the number of services

MI care mattersMHA Podcast Explores Harmful Nurse Staffing Legislation

The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan on key issues that impact healthcare and the health of communities. On episode 31, MHA CEO …

The Keckley Report

Paul KeckleyThe Five Most Important Questions Hospitals Must Answer in Planning for the Future

“As hospital leaders convene in Seattle this weekend for the American Hospital Association Leadership Summit, their future is uncertain.

Last week’s court decision in favor of hospitals shortchanged by the 340B drug program and 1st half 2023 improvement in operating margins notwithstanding, the deck is stacked against hospitals—some more than others. …

Most hospitals soldier on: they’re aware of these and responding as best they can. But most are necessarily focused only on the near-term: bed needs, workforce recruitment and staffing, procurement costs for drugs and supplies and so on. Some operate in markets less problematic than others, but the trends hold true directionally in every one of America’s 290 HRR markets. …“

Paul Keckley, July 10, 2023

Adam CarlsonMHA in the News

Michigan Advance published a story July 9 on the healthcare priorities included in the fiscal year 2024 state budget. Adam Carlson, senior vice president, advocacy, MHA, is quoted multiple times in the story regarding funding …

MHA Monday Report Feb. 13, 2023

Monday Report
MHA Monday Report

MHA Board of Trustees Reviews State and Federal Advocacy Options to Further Strategic Priorities

The MHA Board of Trustees began its Feb. 8 meeting with a federal advocacy briefing from federal lobbyist Carlos Jackson with Cornerstone Government Affairs. Jackson highlighted the policy and funding threats and opportunities healthcare providers …

capitol buildingFiscal Year 2024 Executive Budget Recommendation Released

Gov. Whitmer released her executive budget recommendation Feb. 8 for fiscal year 2024. The proposed budget fully protects traditional hospital line items for Medicaid and the Healthy Michigan program, continues targeted rate increases from recent budget cycles and includes …

MHA and Rural Members Advocate on Capitol Hill

The MHA and rural hospital leaders visited Capitol Hill in Washington D.C. Feb. 7-9 to advocate for specific rural healthcare policies as part of the National Rural Health Association’s Rural Health Policy Institute event. …

Registration Available for MHA Keystone Center Safe Patient Handling Conference

Registration is now open for the MHA Keystone Center Safe Patient Handling Conference. The all-day event will take place April 13 at the Ann Arbor Marriott Ypsilanti at Eagle Crest. In partnership with the MHA Keystone Center, EarlyMobility.com …

January MA Enrollment Increases by 33,000 Beneficiaries

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.25 million in January, an increase of 33,000 beneficiaries since October. The January enrollment is spread across 48 MA plans that are currently operating in the state, …

The Keckley Report

Paul KeckleyWave Two Value-Based Care: The Five Market Shifts that Will Reset the Payment Environment for Providers

“Wave One of the Value Based Care environment was marginally effective: CMS’ alternative payment models showed promise but savings to Medicare fell short of expectations per MedPAC. Medicare Advantage enrollment grew but plan sponsors were overpaid by Medicare. Hospital avoidable readmissions and complications efforts have been successful but the pandemic economy decapitated hospital resources necessary to compete in the value-based environment. Wave One is a mixed bag. …

The Wave Two Value Agenda in U.S. healthcare will impact every player and be messy. The backdrop of the 2024 Campaign cycle and post-pandemic economy mean impetus will shift from resource-constrained Medicare to the private sector as both offer significant but distinct opportunities for lower spending. And the revolution of generative AI assures shortcomings of the system—diagnostic error, administrative waste, fraud—will be widely exposed. …”

Paul Keckley, Feb. 6, 2023

News to Know – Feb. 13, 2023

  • Prospective payment system hospitals are reminded that any requests for corrections to the January public use file data being used by the Centers for Medicare and Medicaid Services to develop the fiscal year 2024 Medicare wage index must be received, along with supporting documentation, by the Medicare Administrative Contractor by Feb. 15, 2023.
  • The MHA is offering its popular Healthcare Leadership Academy program on March 13-15 and May 15-16.
  • MHA Endorsed Business Partner Demand Workforce/Qodex will host a free 30-minute webinar on Mission Impossible: Let’s Talk About How to Heal Your Staffing Crisis at noon ET Feb. 22 to discuss healthcare trends in staffing including creative approaches to deliberately using your nursing workforce.

MHA in the NewsMHA CEO Brian Peters

The MHA received media coverage the week of Feb. 6 regarding a variety of topics, including the fiscal year 2024 executive budget recommendation, the role food insecurity has as a social determinant of health, the new state House Behavioral …

MHA Monday Report Feb. 6, 2023

Monday Report
MHA Monday Report

MHA Testifies During First House Health Policy Committee Hearing

The first hearing of the new legislative session for the House Health Policy Committee was held Feb. 2. Led by Chair Julie Rogers (D-Kalamazoo), new committee members heard testimony from advocacy organizations about the state of public health in Michigan. …

Implicit Bias Trainings Available to Meet LARA Requirement

The Department of Licensing and Regulatory Affairs revised Public Health Code – General Rules to allow asynchronous teleconferences or webinars as acceptable modality of training as part of the implicit bias training standards for all professions licensed or registered under …

MHA Ludwig Community Benefit Award Accepting Nominations

Hospitals taking part in local efforts to enrich the overall welfare of their communities are encouraged to nominate those programs for the 2023 MHA Ludwig Community Benefit Award. First presented in 1990, the annual award honors MHA-member healthcare …

MHA Annual Meeting Sponsorship Opportunities Available

Just as hospitals and health systems have changed their strategies to adapt to the new environment, MHA education programming and sponsorships have changed to deliver more value. The MHA team are designing in-person events tied to the priorities of the …

MHA Rounds Report - Brian Peters, MHA CEOMHA CEO Report — Medical Liability and Denney Damages

In last month’s CEO Report, we focused on the new political environment in Lansing, with a host of first-time lawmakers taking office, Democrats assuming majority control of both chambers of the legislature and a host of …

The Keckley Report

Paul KeckleyThe Big Tech Advantage in U.S. Healthcare

“This week, 100 of the Fortune 500 will report earnings for 2022 and heightened attention will be on four tech giants–Apple Inc., (AAPL); Amazon (AMZN) Meta Platforms Inc.(META) and Alphabet Inc.(GOOG). Comparatively, reports this week by Pfizer, Merck and Eli Lilly will get industry attention but news about these technology-giants will extend to a much wider audience. Why? …

2023 will be pivotal to U.S. healthcare’s future: it’s the transition year from pandemic adaptation buoyed by emergency-relief funds and opportunistic private equity plays in capital-starved sectors to a normalcy that’s unprecedented. … “

Paul Keckley, Jan. 30, 2023

Brian PetersMHA in The News

The MHA received media coverage the week of Jan. 30 regarding the 340B drug pricing program and the lack of child psychiatrists in northern Michigan. Crain’s Detroit Business published an op-ed Feb. 1 from MHA CEO Brian Peters on …

Media Recap: 340B & Child Psychiatry Access

Issues in Healthcare, MHA In The News, Top Issues - Healthcare
Brian Peters

Brian PetersThe MHA received media coverage the week of Jan. 30 regarding the 340B drug pricing program and the lack of child psychiatrists in northern Michigan.

Crain’s Detroit Business published an op-ed Feb. 1 from MHA CEO Brian Peters on how the 340B drug pricing program benefits hospitals. The placement of the op-ed follows recent criticism of the program in the media on how the program generates savings for hospitals and health systems.

“Michigan has some of the best state-level 340B protections in our country that prioritize access to care for vulnerable patients,” said Peters. “The program is funded through drug company discounts and not taxpayer dollars. Reducing the availability of 340B simply means even higher profits for drug companies. As the Michigan Legislature begins a new session, it is important to remember that for three decades, the 340B drug pricing program has received bipartisan support and helped hospitals from Detroit to the Upper Peninsula.”

In a separate story, Laura Appel, executive vice president of government relations and public policy, MHA, appeared in a story that looks at the shortage of child psychiatrists in rural and northern Michigan and the challenges it presents to children and families accessing care. The story originally written by Capital News Service was picked up by publications such as the Midland Daily News, Cadillac News, Ludington Daily News and City Pulse.

Members with any questions regarding media requests should contact John Karasinski at the MHA.

Comments Due for 340B Administrative Dispute Resolution Process

Member News

The U.S. Department of Health and Human Services (HHS) issued a proposed rule Nov. 30 to establish the 340B Administrative Dispute Resolution (ADR) process implementing a formal manner for resolving disputed claims. The ADR process would provide a forum for addressing overcharges by drug manufacturers and establish a deadline for ADR panel decisions. The ADR process is critical for ensuring integrity of the 340B program, which is vital for hospitals and the vulnerable patients they serve, particularly given the staffing challenges and unprecedented inflationary increases hospitals continue to experience. The MHA drafted its comments and encourages 340B hospitals to review the proposed rule and submit comments by 5 p.m. Jan. 30. Commenters should include the HHS Docket No. “HRSA-2021-000X” when submitting their letters.

Members with questions should contact Katie Jaskolski at the MHA.

MHA Monday Report Jan. 16, 2023

Monday Report
MHA Monday Report

capitol buildingNew State Legislative Session Begins

The new session for the 102nd Michigan Legislature kicked off during the week of Jan. 9 with swearing in ceremonies in both the House and Senate. Michigan Democrats in the majority started the session by introducing legislation to repeal right …

Rural Emergency Hospital Webinar on Requirements and Conversion Process

Hospitals interested in learning more about the new Rural Emergency Hospital (REH) designation are encouraged to attend an upcoming webinar from 12:30 p.m. to 2 p.m. ET Jan. 18 hosted by Mathematica and the Rural Health Redesign Center (RHRC) for …

MDHHS Expands Behavioral Health Service Providers Covered by Medicaid

The Michigan Department of Health and Human Services (MDHHS) issued a bulletin Jan. 5 to expand the types of providers who can perform Medicaid-covered, non-physician outpatient behavioral health services. Effective Feb. 4, Medicaid will cover and reimburse outpatient behavioral health …

Federal Court Rules on 340B Underpayment Remedy

A recent United States District Court for the District of Columbia ruling allows the Department of Health and Human Services (HHS) to propose a remedy for hospital 340B drug underpayments for calendar years 2018 to 2021. …

Hospitals Pursue Health Equity to Honor Martin Luther King Jr.

Rev. Martin Luther King Jr. once said, “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.” As we honor Dr. King today and the legacy he created striving for racial equality, the MHA and …

The Keckley Report

Paul KeckleyThe Escalating, Ironic Tension Between Insurers and Hospitals

“Blistering attacks on hospitals were a staple in media coverage in 2022. Comparatively, health insurers escaped unscathed. …

The near-term tension between hospitals and insurers will continue as affordability and transparency concerns mount. In tandem, government efforts to shift incentives to value-based payment models will expand as large employers and national plans implement more aggressive risk sharing agreements. The roles of the two sectors will converge in response to market demand. In anticipation, Deloitte, among others, merged its payer and provider practices to prepare its clients for the change. …”

Paul Keckley, Jan. 9, 2023

News to Know

MHA offices will be closed and no formal meetings will be scheduled Jan. 16 in honor of Martin Luther King Jr. Day.

Federal Court Rules on 340B Underpayment Remedy

Member News

A recent United States District Court for the District of Columbia ruling allows the Department of Health and Human Services (HHS) to propose a remedy for hospital 340B drug underpayments for calendar years 2018 to 2021. This is the latest 340B decision following the late September ruling where the District Court ruled to vacate the 340B payment cuts for the remainder of 2022 and ordered the Centers for Medicare and Medicaid Services (CMS) to halt the cuts immediately. Hospitals are required to submit adjustments for each 2022 claim paid at the lower rate. However, that prior ruling failed to address claims from 2018 through 2021, with the CMS indicating these years would be addressed in future rulemaking prior to release of the 2024 outpatient prospective payment system (OPPS) final rule. The 2023 OPPS final rule restored 340B payments to the average sales price (ASP) plus 6%, up from ASP minus 22.5%.

The HHS has indicated a proposed remedy is expected to be released by April. The MHA, along with the American Hospital Association and others, continues to advocate for a remedy that quickly restores payments to hospitals for 2018 through 2021, with interest, and which does not penalize any hospitals.

Members with questions should contact Katie Jaskolski at the MHA.

MHA Monday Report Sept. 12, 2022

Monday Report
MHA Monday Report

Healthcare Remains Michigan’s Largest Private-sector Employer Despite Pandemic Losses

The Partnership for Michigan’s Health reports healthcare directly employed nearly 572,000 Michigan residents in 2020, demonstrating that healthcare continues to be the largest private-sector employer in the state despite staffing losses attributed to the COVID-19 pandemic. The 2022 release …

Lt. Gov. Hosted at Capitol Advocacy Center

The MHA hosted Lt. Gov. Garlin Gilchrist II Sept. 7 at the Capitol Advocacy Center to connect with hospital affiliated legislative officers and MHA staff on current priorities of the administration. The meeting provided an opportunity for MHA members to share priorities and concerns and allowed for an incredible exchange of information, …

MHA Drafts Comments on 340B Provisions and REH Payment Policies

The MHA has drafted comments in response to the Centers for Medicare and Medicaid Services (CMS) proposed rule to update the Medicare fee-for-service (FFS) outpatient prospective payment system (OPPS) for calendar year 2023. The MHA submitted …

MHA Offering Basics of Case Management Boot Camp

The role of case management is central to many healthcare structures, including value-based reimbursement, bundled payments, care transitions and accountable care organizations. Case management is at the center of it all! The MHA Health Foundation …

Implicit Bias Trainings Available to Meet LARA Requirement

The Department of Licensing and Regulatory Affairs (LARA) revised Public Health Code Rules requiring implicit bias training for all professions licensed or registered under the Public Health Code took effect in June. Implicit Bias trainings …

Webinar Explores Guidelines for Strategic Planning

The role that boards, executive and medical staff members play in developing and executing organizational strategy represents some of their most nuanced and significant work in healthcare. While many approaches, terminology and philosophies exist around …

Virtual Nurse Preceptor Academy Supports New Employee Training and Retention

By using resources that prevent or alleviate transitional hardship and enhance new nurses’ clinical reasoning, preceptors can help improve new graduate nurse retention and patient outcomes. The MHA and the Michigan Health Council’s standardized, validated …

MHA CEO Report – Time to Focus on Cybersecurity

“The world-altering powers that technology has delivered into our hands now require a degree of consideration and foresight that has never before been asked of us.” ― Carl Sagan A long-held practice utilized by businesses of …

AHA Trustee Insights Outlines Financial Turnaround and Succession Planning

The latest edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), is now available. The June issue includes an article written by leading governance expert Jamie Orlikoff, who discusses the …

Paul KeckleyThe Keckley Report

In Campaign 2022, Healthcare Voters Will Matter More

“Today begins the countdown to election day November 8: in 63 days, voters will elect 36 Governors, 30 State Attorneys General, 27 Secretaries of State, 35 US Senators, 435 US House of Representatives and State Legislators in 46 states. It’s a consequential election for the country and for its healthcare industry…

Campaigns will avoid healthcare issues other than abortion. Conceding that healthcare is expensive and access uneven, most midterm campaigns will default to partisan themes…”

Paul Keckley, Sept. 6, 2022

News to Know

  • The Centers for Medicare and Medicaid Services recently released a final rule to update the Medicare fee-for-service inpatient prospective payment system for fiscal year 2023, which begins Oct. 1, 2022.
  • The deadline to provide contact information in preparation for the state’s anticipated grant program to implement an Emergency Department Medication for Opioid Use Disorder program has been extended to Sept. 23.

MHA in the News

MHA CEO Brian Peters

The MHA responded to several media requests the weeks of Aug. 28 and Sept. 5 which focused on the public release of the Economic Impact of Healthcare in Michigan report and other workforce issues. …

Lt. Governor Gilchrist II Hosted at the Capitol Advocacy Center

Member News

The MHA hosted Lt. Gov. Garlin Gilchrist II Sept. 7 at the Capitol Advocacy Center to connect with hospital affiliated legislative officers and MHA staff on current priorities of the administration. The meeting provided an opportunity for MHA members to share priorities and concerns and allowed for an incredible exchange of information, ideas and solutions to the issues many hospitals and health systems are currently experiencing.

Lt. Gov. Gilchrist meets with MHA members.

Lt. Gov. Gilchrist touched on several topics, but the focus was largely on workforce and talent development, workplace violence, health disparities, access to care and rural health. Time was also spent discussing the importance of the 340B drug discount program and expanding behavioral healthcare access. The impact of having a statewide leader understand and discuss these top tier issues with MHA members is unparalleled and creates an opportunity for the MHA to carry strong momentum into the lame-duck state legislative session this fall.

The MHA and MHA members continue to advocate for important healthcare improvements to support the care of Michigan residents and communities. Partnerships with state executive officials also help to build on existing collaborations, create new spaces for improvement and protect MHA priorities.

The MHA will continue to foster opportunities to connect members with state and federal leaders, producing strong information exchanges and advocacy for healthcare priorities. Members with questions should contact Adam Carlson at the MHA.

MHA Drafts Comments on 340B Provisions and REH Payment Policies

Member News

The MHA has drafted comments in response to the Centers for Medicare and Medicaid Services (CMS) proposed rule to update the Medicare fee-for-service (FFS) outpatient prospective payment system (OPPS) for calendar year 2023. The MHA submitted comments regarding the 340B provisions in mid-August urging the CMS to:

  • Restore payment rates for 340B drugs to average sales price (ASP) plus 6%.
  • Hold all hospitals harmless for 2018-2022 claims.
  • Find new funds to restore 340B payments to ASP plus 6% with no reduction to the outpatient conversion factor.

The MHA also prepared comments in response to the proposed payment policies for rural emergency hospitals (REHs), a new hospital designation established by the Consolidated Appropriations Act, for critical access hospitals and rural prospective payment system hospitals with fewer than 50 beds.

The MHA recently posted hospital-specific estimated impact reports of the OPPS proposed rule on the hospital association reporting portal (HARP) for members to access and encourages hospitals to review the impact of the proposed rule on their operations and submit comments to the CMS by 5 p.m. Sept. 13. The CMS is expected to release a final rule to update the OPPS, including finalization of REH payment policies around Nov. 1 for the Jan. 1, 2023 effective date.

The MHA will provide an updated impact analysis following release of the final rule. Members with questions should contact Vickie Kunz at the MHA.