MHA Offering Occupational Mix Survey Webinar

The MHA is hosting an educational webinar at 10 a.m. Jan. 31 to assist hospitals in completing the 2022 occupational mix survey. The webinar is available free of charge but registration is required.

The survey must be submitted to the Medicare Administrative Contractor by June 30, 2023. Hospitals are required to complete the survey every three years, with results from the 2022 survey being used to adjust the Medicare wage index for fiscal years 2025, 2026 and 2027.

Hospitals are encouraged to review their completed 2019 survey and determine whether there have been payroll changes, new job codes or job descriptions added, etc., to streamline the completion process when sorting the required 2022 data into the various occupational mix categories. It is important to note that contact labor should be included in the various categories of the survey.

Members with questions should contact Vickie Kunz at the MHA. Members needing assistance with registration should contact Crystal Mitchell at the MHA.

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 an ambulatory surgical center (ASC).

The policy took effect Oct. 1, 2022 and was approved by the Centers for Medicare and Medicaid Services in early November. The policy modified the reimbursement methodology for dental services provided in these settings from the outpatient prospective payment system to a Medicaid fee schedule. Outpatient hospital and ASC fee schedules are available on the MDHHS website under the Billing and Reimbursement and Provider Specific Information tabs.

Members with questions should contact Vickie Kunz at the MHA.

News to Know – Nov. 21, 2022

  • DataGen is hosting a national webinar to review the 2023 Medicare fee-for-service outpatient prospective payment system final rule and hospital impact analysis at 3 p.m. on Nov. 30, 2022. This webinar is available free of charge but registration is required. The MHA will provide hospitals with an impact analysis of the final rule within the next few weeks. Members with questions should contact Vickie Kunz the MHA.
  • MHA Endorsed Business Partner NextJob is hosting a free webinar on Actionable Neuroscience Insights for Improved Workplace Performance at noon ET Dec. 7, 2022 to educate employees about the brain processes of perception, cognition and neuro-linguistics and share tips to help improve performance at work. MHA members are invited to register and share information about the webinar with their colleagues. To learn more, visit the business partner profile page for NextJob or contact Paul Dzurec at NextJob.

MHA Monday Report Nov. 7, 2022

MHA Monday Report

MHA Board of Trustees Advances Strategic Action Plan, Affirms Policy Panel Legislative Recommendations

The MHA Board of Trustees began their Nov. 2 meeting with a review of key communication strategies to assist hospitals and health systems to “tell their stories” about the unprecedented financial and workforce challenges they currently face and how they are adapting to meet the critical healthcare and economic development needs of their communities …


Logo for MI Vote Matters, Tuesday Nov. 8Healthcare Community Urged to Vote in Nov. 8 General Election

The MHA encourages its staff, members and other stakeholders in the healthcare community to vote in the state’s general election Nov. 8.- Polls will be open from 7 a.m. to 8 p.m. …


Parents Urged to Take Preventive Measures as Pediatric Beds Fill Up

Michigan children’s hospitals and pediatric healthcare leaders are raising awareness about a pediatric hospital bed shortage and urging the public to help prevent respiratory illnesses, which are rapidly spreading in the form of respiratory syncytial virus (RSV) and influenza …


CMS Releases Final Rule to Update OPPS

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service (FFS) outpatient prospective payment system (OPPS) effective Jan. 1, 2023 …


Provider Enrollment Requirements Reinstated Effective Dec. 1, 2022

The Michigan Department of Health and Human Services (MDHHS) issued MMP 22-38 COVID-19 Response: Termination of Bulletin MSA 20-28, which reinstates provider enrollment requirements …


CMS Releases Final to Update Medicare PPS Effective 2023

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service home health (HH) prospective payment system (PPS) effective Jan. 1, 2023 …


MHA Supports Increased Access to Affordable Post-Secondary Education

The MHA, along with stakeholders across diverse fields, supported record state investment in Michigan’s future workforce. On October 11th, the Governor signed Public Act 212 of 2022 establishing the Michigan Achievement Scholarship, and applications starting with students in the high school class of 2023 will now be eligible for increased state financial aid …


CE Credits Available for Unionization and Legal Guidelines Webinar

The webinar Dispelling Misinformation About Unionization and Legal Guidelines 8:30 – 10 a.m. ET Nov. 11 has been approved by HR Certification Institute® (HRCI®) for 1.5 hours …


MHA Rounds Report - Brian Peters, MHA CEOMHA CEO Report — Your Vote Matters

At the MHA, we often say that politics is not a spectator sport. It requires continual engagement and relationship building so that when you are in a crisis and need assistance, you have trusted friends you can turn to …


The Keckley ReportPaul Keckley

The Three Blind Spots in Hospital Strategic Plans

“For 40 years, I have facilitated Board Retreats for hospitals, health systems, insurance plans and medical groups. At no time has the level of uncertainty about the future for hospitals been as intense nor the importance of a forward-looking strategic vision and planning been as necessary as now. The issues are complicated: lag indicators about demand, clinical innovations, reimbursement, costs et al are a foreboding backdrop for these discussions. And three issues have surfaced as blind spots in the environmental assessments and deliberations preceding the plan …”

Paul Keckley, Oct 31, 2022


Michigan Harvest GatheringsNews to Know

Many Michigan hospitals are underway with their Michigan Harvest Gathering campaign which runs through Nov. 18. Online donations by hospital employees and community members to the Michigan Harvest Gathering program can be made through the Food Bank Council of Michigan’s website …


MHA in the News

The MHA received media coverage on the surge of RSV cases across Michigan’s pediatric hospitals during the week of Oct. 31. The coverage included several comments provided to news outlets and the distribution of a press release Nov. 4 to statewide media …

CMS Releases Final Rule to Update OPPS

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service (FFS) outpatient prospective payment system (OPPS) effective Jan. 1, 2023.

The rule restores 340B drug payments to the default rate, generally average sales price (ASP) plus 6%, up from the previous ASP minus 22.5%, in response to the recent federal Supreme Court (SC) ruling.  The CMS notes that the agency is still evaluating how to apply the SC’s decision in the American Hospital Association (AHA) v Becerra case which ordered the CMS to restore payments. The CMS will address this in future rulemaking prior to the 2024 OPPS proposed rule.  

The MHA, along with the AHA and others, continue to urge the Court to order the CMS to promptly repay hospitals harmed by the unlawful cuts implemented in 2018 and ensure that no hospitals are not penalized.  Other provisions of the final rule include:

  • Increasing the conversion factor by a net 1.7% after budget neutrality adjustments from $84.18 to $85.59 for hospitals that comply with the CMS outpatient quality reporting (OQR) program requirements.
  • Establishing the new rural emergency hospital provider type to allow critical access hospitals and rural hospitals with less than 50 beds to continue providing essential outpatient services while eliminating inpatient services.
  • Exempting rural sole community hospitals from the site neutral clinic visit cuts and instead paying the full OPPS rate for visits provided at grandfathered off-campus hospital outpatient departments.
  • Increasing the cost outlier threshold by 40% from $6,175 to $8,625, to maintain outlier payments at the targeted 1% of total OPPS payments, resulting in fewer cases qualifying for an outlier payment.
  • Removing 11 services from the inpatient only list and adding 8 services that were newly created by the American Medical Association Common Procedural Terminology Editorial Panel.
  • Implementing a permanent 5% cap on wage index decreases.
  • Adding four procedures to the Ambulatory Surgical Center covered procedures list.
  • Requiring prior authorization for an additional service category,­ facet joint interventions, beginning dates of service on or after July 1, 2023.
  • Continuing payment for virtual behavioral health services with an in-person service required within six months prior to the initiation of the virtual service and then annually thereafter, with exceptions made based on beneficiary circumstances. The CMS clarified that the requirement for an in-person visit within six months prior to the initial services is not required for patients who began receiving services during the public health emergency (PHE) or during the 151-day period following the end of the PHE.
  • Maintaining the current policy of providing separate payment for non-opioid pain management drugs and biologicals that function as supplies in the ASC setting.
  • Implementing a payment adjustment for costs incurred for domestically manufactured National Institute for Occupational Safety and Health (NIOSH)-approved surgical N95 respirators with payments provided biweekly as interim lump-sum payments and reconciled at cost report settlement for cost reporting periods beginning on or after Jan. 1, 2023.
  • Creating a new G-code for dental rehabilitation services that require monitored anesthesia and the use of an operating room and assigning it to APC 5871 (Dental Procedures), effectively increasing the payment from roughly $200 to approximately $2,000.
  • Changes to the hospital OQR program including:
  • Making the Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery (OP-31) measure voluntary rather than mandatory beginning with the 2025 reporting period and 2027 payment determination.
  • Aligning the patient encounter quarters for chart-abstracted measures to the calendar year for annual payment update determinations.
  • Adding a targeting criterion for measure data validation.

The MHA will provide hospitals with an updated impact analysis and additional details of the rule in the coming weeks.

Members with questions should contact Vickie Kunz at the MHA.

CMS Releases Final to Update Medicare PPS Effective 2023

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule to update the Medicare fee-for-service home health (HH) prospective payment system (PPS) effective Jan. 1, 2023. Key provisions include:

  • A net 1.0% decrease in the national 30-day standardized payment amount from $2,031.64 to $2,010.69 after budget neutrality adjustments, compared to the proposed 6.25% decrease. HHs that fail to comply with HH quality reporting program requirements are subject to a two percentage point reduction and are subject to a rate of $1,972.02.
  • A seven percentage point cut to all payments to achieve budget-neutrality for the Patient-Driven Groupings Model phased in over two years, with a 3.5 percentage point cut in 2023 and 2024.
  • A permanent 5% cap on wage index decreases.
  • Required submission of patient assessment data on all patients, regardless of payer, with a phased approach beginning Jan. 1, 2025, instead of 2024 as proposed.
  • Changes to the Expanded HH value-based purchasing model, including definitions for the baseline and model year and changing the baseline year for the 2023 program year to 2022 to use the most recently available data.

The MHA will provide members with an updated impact analysis and additional details of the final rule within the next few weeks. Members that have not received impact analyses in the past for affiliated, free-standing HH agencies are encouraged to provide the agency’s CMS certification number (also known as Medicare provider number), agency name and federal information processing standards code in order to receive an estimated impact analysis in the future.

Members with questions should contact Vickie Kunz at the MHA.

MDHHS Releases Proposed Policy on Medicaid Rates for Dental Services

The Michigan Department of Health and Human Services (MDHHS) recently released a proposed policy to increase Medicaid payment rates to $2,300 for dental services provided at outpatient hospitals and $1,495 for services provided in an ambulatory surgical center (ASC).

Pending approval by the Centers for Medicare and Medicaid Services, the policy would go into effect Oct. 1, 2022. The proposal states that services would move from the current outpatient prospective payment system to a Medicaid fee schedule. Services should be billed using dental surgery procedure code 41899 with payment based on the Medicaid fee schedule in effect on the date of service for the procedure code(s) billed. Outpatient hospital and ASC fee schedules are available on the MDHHS website under the billing and reimbursement and provider specific information tab.

Hospitals are encouraged to review the proposed policy and submit comments to the MDHHS by Nov. 23, 2022. Members with questions should contact Vickie Kunz at the MHA.

MHA Monday Report Oct. 17, 2022

MHA Monday Report

Legislative Policy Panel Convenes for Program Year

The MHA Legislative Policy Panel convened Oct. 12 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals …


MDHHS Releases Medicaid Rate Increase Policies

The Michigan Department of Health and Human Services (MDHHS) recently released two concurrent final and proposed policies to implement Medicaid rate increases included in the fiscal year (FY) 2023 budget for dates of service on and after Oct. 1, 2022 …


MHA Keystone Center Presents Annual Health Equity Summit

Registration is now open for the Michigan Health Equity Summit that will take place in-person at Lansing Community College West Campus and virtually from 9 a.m. to 3:30 p.m. ET on Nov. 3 …


ED MOUD Funding Available – Applications Due Dec. 16

The Community Foundation for Southeast Michigan (CFSEM) is partnering with the MHA Keystone Center, the Michigan Opioid Partnership (MOP) and the Michigan Department of Health and Human Services (MDHHS) to provide …


Webinar Prepares for The Joint Commission and CMS Health Equity Requirements

Recently, The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) announced their commitment in driving the next decade of health equity for people who are underserved. The commitment to advancing health equity …


MHA Podcast Explores Program Year Priorities with Michigan Medicine

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 …


MHA Race of the Week – Michigan Supreme Court

The MHA’s Race of the Week series highlights the most pivotal statewide races and ballot questions for Election 2022. The series will provide hospitals and healthcare advocates with the resources they need to make informed decisions on Election Day, including candidates’ views and background …


The Keckley Report

Paul KeckleyIs the Honeymoon Over for Medicare Advantage?

“The bottom line: in the next 2-3 years, regulatory scrutiny of Medicare Advantage will increase and funding by Medicare will decrease. Congress will press for a clear correlation between Medicare’s solvency and MA cost-savings. Thus, it’s likely Medicare Advantage plans will charge higher premiums, limit benefits, intensify medical management activities, share more financial risk with high-performing provider organizations and offer services to new populations. Their margins will shrink, access to capital and enrollment growth will be imperatives, and innovation in holistic cost-effective care management and affordability key differentiators.”

Paul Keckley, Oct. 10, 2022


Logo for MI Vote Matters, Tuesday Nov. 8News to Know

  • The last day to register online to vote in the Nov. 8 election is Oct. 24, 2022.
  • Early in-person voting by absentee ballot at a clerk’s office remains available.
  • Complimentary MI Vote Matters informational posters and the 2022 Candidate Guide are still available for MHA members.

MDHHS Releases Medicaid Rate Increase Policies

The Michigan Department of Health and Human Services (MDHHS) recently released two concurrent final and proposed policies to implement Medicaid rate increases included in the fiscal year (FY) 2023 budget for dates of service on and after Oct. 1, 2022. These include:

  • 2235-Practitioner proposes to update rates for physician neonatal and pediatric critical and intensive care services for certain current procedural terminology (CPT) codes from 95% to 100% of Medicare rates. Members are encouraged to review the proposed policy and submit comments to the MDHHS by Nov. 7, 2022.
  • 2234-Practitioner proposes to increase Medicaid rates for primary care services for CPT codes 99421 through 99423 and 99441 through 99443. The MDHHS indicates rates for the applicable CPT codes will increase from roughly 75% of Medicare to 88% of Medicare. These CPT codes include:
    • Established patient office or outpatient evaluation and management (E/M) visits.
    • Initial subsequent, discharge and other nursing facility E/M visits.
    • New and established patient domiciliary, rest home or custodial care E/M services.
    • New and established patient home E/M visits.
    • New and established patient preventive medicine services.
    • Online digital E/M services and E/M services provided via telephone.

Members are encouraged to review the proposed policy and submit comments to the MDHHS by Nov. 9, 2022.

Members with questions should contact Vickie Kunz at the MHA.

CMS Announces 2023 Medicare Premiums and Deductibles

The Centers for Medicare & Medicaid Services (CMS) recently announced the calendar year 2023 Medicare fee-for-service Part A deductible for inpatient hospital services will increase by $44 to a new total of $1,600. The Part A daily coinsurance amounts will be:

  • $400 for days 61-90 of hospitalization in a benefit period.
  • $800 for lifetime reserve days.
  • $200 for days 21-100 of extended care services in a skilled nursing facility in a benefit period.

The monthly Part A premium, paid by beneficiaries who have fewer than 40 quarters of Medicare-covered employment and certain people with disabilities, will increase by $7 in 2023 to a total of $506. Certain voluntary enrollees eligible for a 45% reduction in the monthly premium will pay $278.

The annual deductible for Medicare Part B will decrease by $7 to a total of $226, while the standard monthly premium for Medicare Part B will decrease by $5.20 to a total of $164.90.

Members with questions should contact Vickie Kunz at the MHA.