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 an overview of the REH designation.

Participants will learn about REH requirements and the Centers for Medicare and Medicaid Services’ conditions for REH participation and payment. Presenters will also describe how the RHDC and its partners can assist entities through the REH conversion process and access ongoing transition support.

There is no cost to participate, but registration is required. Members with questions about the REH designation should contact Lauren LaPine.

MHA Monday Report Jan. 9, 2023

MHA Monday Report

capitol buildingGovernor Signs Several MHA Priorities Into Law

Gov. Whitmer signed several bills into law Dec. 22 that were supported by the MHA and passed during the lame-duck session. Among these were expansions to the Michigan Reconnect Program, legislation to allow for a new rural emergency hospital licensure …


Omnibus Spending Bill Includes Major Health Policy Measures

After the MHA’s recent visits to Capitol Hill to advocate for year-end member priorities, Congress has reached a major deal on a year-end omnibus legislative package. The package includes health policy measures related to Medicare and Medicaid provisions, telehealth and …


Webinar Series Reviews Critical Access Hospitals CMS CoPs Requirements

Critical Access Hospitals (CAHs) that accept Medicare and Medicaid payments must follow the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoP). The CMS CAH Manual has seen multiple changes to regulations and interpretive guidelines. …


MDHHS Releases Final Policy to Increase Rates for Certain Dental Procedures

The Michigan Department of Health and Human Services (MDHHS) recently released a final policy to increase the minimum Medicaid payment rates to $2,300 for covered dental services provided under general anesthesia at outpatient hospitals and $1,495 for services provided in …


MHA CEO Report — New Control in Lansing

As I put the proverbial pen to paper, the Michigan Legislature has completed the 2021-2022 legislative session and I am very pleased to report that in the lame-duck session, we successfully advanced several MHA-supported bills – and not a single MHA-opposed …


The Keckley Report

Paul KeckleyFour Major Reasons Why 2023 is a Make or Break Year for U.S. Healthcare

“2022 was an unanticipated tsunami for every sector in the U.S. health system. The economy stalled. Inflation raged. Demand recovered. Hourly wages went up but household financial liquidity went down. The political environment became more toxic and November election results assured more of the same. All impacted healthcare. …

Thus, 2023 is a make or break year in healthcare: these conditions assure old ways of doing business will no longer work. …”

Paul Keckley, Jan. 2, 2023


News to Know

U.S. Sen. Debbie Stabenow (D-Lansing) announced Jan. 5 she will not seek a fifth term in 2024. Sen. Stabenow was first elected to the U.S. Senate in 2000, following her service as an elected official in the U.S. House of …


MHA CEO Brian PetersMHA in the News

The MHA received media coverage during the weeks of Dec. 19, Dec. 26 and Jan. 2 on financial and staffing challenges impacting hospitals as well as the impact of a tripledemic of respiratory illnesses this winter. Below is a collection …

Webinar Reviews CMS CoPs Critical Access Hospital Requirements

Critical Access Hospitals (CAHs) that accept Medicare and Medicaid payments must follow the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoP). The CMS CAH Manual has seen multiple changes to regulations and interpretive guidelines. The MHA Health Foundation five-part webinar series Critical Access Hospitals’ Conditions of Participation: Ensuring Compliance will review in detail the guidelines that serve as a basis for determining compliance.

Topics that will be covered in detail include:

  • CMS requirements of the board’s duty to enter into a written agreement if the hospital wants to provide telemedicine services.
  • CMS list of emergency drugs and equipment that every CAH must have.
  • Requirements for pharmacists, including development, supervision and coordination of pharmacy activities.
  • Requirements for security and storage of medications, medication carts and anesthesia carts.
  • CMS infection control worksheet and how it may be helpful to CAHs.
  • Hospital visitation and patient information policies.

The webinars are scheduled from 10 a.m. to noon Jan. 17, Jan. 24, Jan. 31, Feb. 7 and Feb. 14. Members can register for a connection fee of $780 for the series. Individual webinars are $195 per session.

Members with questions should contact Erica Leyko at the MHA.

 

Omnibus Spending Bill Includes Major Health Policy Measures

After the MHA’s recent visits to Capitol Hill to advocate for year-end member priorities, Congress has reached a major deal on a year-end omnibus legislative package. The package includes health policy measures related to Medicare and Medicaid provisions, telehealth and hospital-at-home programs.

Lawmakers are blocking the implementation of the Statutory Pay-As-You-Go (PAYGO) sequester which would have required a 4% cut to Medicare payments. In addition, both the Medicare Dependent Hospital and enhanced low-volume adjustment programs are extended for two years. The Medicare hospital-at-home program and pandemic-era telehealth flexibilities are also extended for two years. There is a one-year delay in lab payment changes stemming from the Protecting Access to Medicare Act of 2014.

Regarding Medicaid, the package separates the enhanced federal medical assistance percentage (FMAP) and the Medicaid eligibility maintenance of effort from the declaration of the Public Health Emergency. Beginning in April, states may remove those who no longer qualify for Medicaid, regardless of when the COVID-19 public health emergency ends. The enhanced FMAP, currently a 6.2% addition to state Medicaid matching rates, is gradually phased out through 2023. These changes help fund a year of continuous coverage provisions for children at risk of losing health insurance and standardizing 12 months of postpartum coverage.

Passage of the final legislation is likely to happen by midnight on Dec. 23, 2022. The bill text is public, giving high likelihood to the healthcare provisions outlined above. However, there is a possibility for last-minute changes.

For more information about the year-end omnibus legislation contact Laura Appel at the MHA.

MHA Monday Report Dec. 19, 2022

MHA Monday Report

Michigan legislation modernized the scope of practice for certified registered nurse anesthetists (CRNAs) in 2022, eliminating the state requirement that a CRNA must work under direct physician supervision. CRNAs enhance the ability to deliver care in a multitude of scenarios, particularly in rural areas where anesthesia services may be limited. …


Webinar Series Reviews Critical Access Hospitals CMS CoPs Requirements

Critical access hospitals (CAHs) that accept Medicare and Medicaid payments must follow the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs). The CMS Critical Access Hospital Manual has seen multiple changes to regulations and interpretive guidelines. …


Latest AHA Trustee Insights Outlines Multitiered Governance Structures

The latest edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), is now available. The Dec. issue includes an article noting the uptick in hospital and health system mergers and affiliations and defining expectations for board members in a multitiered governance system. …


The Keckley Report

Paul KeckleyMedPAC Needs to Revisit its Analysis

“At its December 8-9 meeting, MedPAC considered future funding for hospitals and physicians along with other sectors in healthcare. The 17-member commission will vote on its recommendations at its meeting January 12-13 after staff makes some changes based on commissioner feedback and then submit its official recommendations to Congress in March for FY2024…

The lag indicators used by MedPAC to evaluate Medicare utilization and payments for physician and hospital services are accurate. However, they’re of decreasing relevance to the future of Medicare’s formula for paying providers.”

Paul Keckley, Dec. 12, 2022


News to Know

Due to the holidays, Monday Report will not be published Dec. 26 and Jan. 3. Monday Report will resume its normal schedule Jan. 9. Member alerts and MHA newsroom articles will continue to be published during that time to provide relevant updates to the MHA membership, as necessary.


MHA EVP Laura Appel speaks with WOOD TV8.MHA in the News

WOOD TV8 published a story Dec. 12 on the passage of Senate Bill (SB) 183, which includes language allowing rural emergency hospital (REH) licensure in Michigan. The bill passed Dec. 6 with overwhelming support in both the State House and Senate following collaboration between the MHA, the Michigan Department of Health and Human Services, the Michigan Department of Licensing and Regulatory Affairs and the Whitmer administration on making the necessary changes in state statute to allow for the new federal designation. …

MHA Webinar Series Reviews Critical Access Hospitals CMS CoPs Requirements

Critical access hospitals (CAHs) that accept Medicare and Medicaid payments must follow the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs). The CMS Critical Access Hospital Manual has seen multiple changes to regulations and interpretive guidelines. Since a hospital’s payment is based on compliance with the conditions, it is imperative hospitals make the necessary changes to remain in compliance.

The MHA Health Foundation webinar series Critical Access Hospitals Conditions of Participation: Ensuring Compliance is a five-part series that will review in detail the updated requirements and changes for CAHs. The webinars are scheduled for Jan. 17, 24, 31, Feb. 7 and 14 from 10 a.m. to noon.

Members can register for individual sessions for $195 or the full series for $780.

Members with questions should contact Erica Leyko at the MHA.

MHA Monday Report Dec. 12, 2022

MHA Monday Report

capitol building2022 Legislative Session Adjourns

The Legislature took their final votes for the 2021-2022 legislative session during the week of Dec. 5. Given the results of the election, very few bills passed during the legislative lame-duck session compared to a typical year. …


Media Join Hospital Viability Press Conference

The MHA conducted a virtual press conference Dec. 6 to discuss the economic and staffing challenges impacting hospitals across the state to generate awareness with lawmakers of these issues and the potential impact on access to timely, high-quality healthcare for Michiganders. …


MHA and Michigan hospital representatives pictured with Rep. John Moolenaar (R-Midland).

MHA Visits Capitol Hill with Member Hospitals for AHA Advocacy Day

The MHA visited Capitol Hill in Washington DC last week to emphasize year-end priorities to Michigan’s congressional delegation. The MHA and several hospital representatives met with House members and with U.S. Senator Debbie Stabenow to deliver the message that pending Medicare cuts are unsustainable and unacceptable. …


Rural Emergency Hospital Legislation Passed in Michigan

On Dec. 6th, the legislation needed for hospitals to begin converting to Rural Emergency Hospitals (REH) in Michigan was sent to the Governor’s desk for final approval. Due to the limited session days left, the language to allow for REH licensure in Michigan were officially included in Senate Bill (SB) 183. …


CMS Issues Proposal to Modify the Prior Authorization Process

The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule to modify the prior authorization process for certain payers. The proposal would require payers to: Include a specific reason when denying a request. Publicly report certain prior authorization metrics. …


MHA Workforce Webinar to Discuss Diverse Workforce Solutions

Understanding the workforce’s values, preferences, triggers and character traits is essential to developing relationships that create a healthy organization. This may sound basic, but many organizations continue to miss the mark. …


Keckley Report 

Paul KeckleyThe Transitioning of US Healthcare from A Virtuous to Vicious Cycle

“U.S. healthcare has moved into a vicious cycle marked by intensified competition and noticeable acrimony between major players. Growing tension between major health insurers and health systems is illustrative.

Virtuosity to insurers is predicated on the core belief that keeping providers honest and care affordable and their domain; its vicious pursuit is to attribute unsustainable health costs to hospital inefficiency and price gauging.

The virtuous cycle for hospitals is premised on community health and provision of services to those unable to pay; the vicious cycle is the unwelcome intrusion of insurers and private investors who put profit above all else by paying them less so they can keep more. …”

Paul Keckley, Dec. 5, 2022


News to Know

Medtel was approved for associate membership in Nov. 2022. Medtel was founded in 2016 with a mission to improve surgical care experiences and outcomes for patients and providers by developing and delivering technology solutions. …


Brian PetersMHA in the News

The MHA received media coverage the week of Dec. 5 following a virtual press conference Dec. 6 on the financial and staffing challenges impacting hospital viability, as well as topics including hospital capital improvements, mergers and acquisitions and respiratory illness hospital admissions driven by RSV and COVID-19. …

Rural Emergency Hospital Legislation Passed in Michigan

The legislation needed for hospitals to begin converting to Rural Emergency Hospitals (REH) in Michigan was sent to the Governor’s desk Dec. 6 for final approval. Due to limited session days left, the language to allow for REH licensure in Michigan was officially included in Senate Bill (SB) 183. After the REH amendments were adopted, SB 183 passed with overwhelming support in both the State House and Senate.

The MHA has been actively working with the Michigan Department of Health and Human Services, the Michigan Department of Licensing and Regulatory Affairs (LARA) and the Whitmer administration’s legal team on REH licensure during the legislative process and have received positive indications of the administration’s support for SB 183.

Member hospitals considering conversion to an REH are encouraged to review the final rules by the Centers for Medicare and Medicaid Services (CMS). Some key changes outlined in the final rule include:

  • Clarification that REHs can operate provider-based rural health clinics (RHCs) and that REHs are considered hospitals with less than 50 beds for purposes of the payment limit exception. Provider-based RHCs will maintain their excepted status upon a hospital’s REH conversion.
  • A roughly $4,000 per month increase in monthly facility payments due to a misstep in the methodology that the National Rural Health Association (NRHA) highlighted in the MHA comment on the proposed rule.
  • The CMS agreed with the NRHA that one-lane federal highways should be excluded from the definition of primary roads. Primary roads are now defined as state or federal highways with two or more lanes in either direction.

Additionally, the CMS has released initial information on the application process. There will also be an application process at the state level through LARA. This application is still in development.

Members considering converting to the REH designation should contact Lauren LaPine at the MHA for support in navigating this process.

 

 

 

 

 

CMS Issues Proposal to Modify the Prior Authorization Process

The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule to modify the prior authorization process for certain payers. The proposal would require payers to:

  • Include a specific reason when denying a request.
  • Publicly report certain prior authorization metrics.
  • Make decisions within 72-hours for urgent requests.
  • Make decisions within seven days for standard, non-urgent requests, which is twice as fast as existing Medicare Advantage response timelines.
  • Enable improved data exchange.

The proposal generally applies to Medicare Advantage, Medicaid and Medicaid managed care and Children’s Health Insurance Program (CHIP) and CHIP managed care plans, as well as qualified health plans on the federally facilitated exchanges. Members are encouraged to review the proposal and submit comments to the CMS by the March 13, 2023 deadline.

Members with questions should contact Jason Jorkasky at the MHA.

 

MHA Monday Report Dec. 5, 2022

MHA Monday Report

capitol buildingLame Duck Session Begins in Senate

The 2022 lame-duck session in the legislature got off to a slow start in the Senate during the week of Nov. 28. Several bills impacting hospitals saw unsuccessful votes on the floor, including legislation to make changes to the operation of the 340B drug pricing program and a package to integrate behavioral and physical health for state regulated insurance plans …


MHA Keystone Center 2021-2022 Annual Report Highlights Collaboration and Partnership

The MHA Keystone Center recently released its 2021-2022 Annual Report, which showcases the center’s commitment to working alongside members to improve safety and quality in healthcare. Through support from Blue Cross Blue Shield of Michigan, this report highlights …


Expanded Scope of Practice Creates Opportunities

To optimize cost savings, patient experience and staffing, hospitals and health systems are using multidisciplinary teams working to deliver care. Fortunately, new legislation expanded certified registered nurse anesthetists (CRNAs) abilities to practice without direct physician supervision. …


MHA CEO Report — Pediatric Capacity CrisisMHA Rounds Report - Brian Peters, MHA CEO

“Every child begins the world again.” ― Henry David Thoreau

In all of my life experiences to date, none have been so challenging in every sense as those times when my young children were hospitalized in the NICU, fighting for their very lives. We were incredibly fortunate to have positive outcomes with both of them, thanks to the efforts of our Michigan hospitals and the incredible people who work there every day …


The Keckley Report 

Out of Sight, Out of Mind: The 6 Populations that Lack Adequate Voice in the US Health SystemPaul Keckley

“Trade groups and lobbyists for high profile special interests will be active; others less noticed will be under-represented in lawmaking and budgeting. Six groups top this list for healthcare…

These populations are out of sight, out of mind in most consideration of the health system’s future, but they represent perhaps it’s greatest opportunities for innovation and public-private collaboration.”

Paul Keckley, Nov. 28, 2022


MHA in the News Laura Appel

The MHA received media coverage during the weeks of Nov. 21 and 28 on the capacity status of hospital pediatric units amid the surge of hospitalized pediatric patients with respiratory illnesses driven by respiratory syncytial virus (RSV) …