OHA Advocacy Network

Advocacy Report • Friday, February 22, 2008

Action for next week…

Wednesday

HB 456 - Health Care Reform: House Healthcare Access & Affordability Committee, Room 17 at 10 am (Proponent testimony on nursing instructors)

SB 221 - Energy Policy: House Public Utilities Committee, Room 313 at 1 pm (All testimony)

Thursday

SB 221 - Energy Policy: House Public Utilities Committee, Room 313 at 9 am (All testimony)

Political Do’s and Don’ts for Ohio Hospitals

With election season upon us, OHA and Friends of Ohio Hospitals, the political action committee for Ohio hospitals and health systems, would like to provide hospitals with a basic understanding of do’s and don’ts with respect to political activity.

Guidelines on Participating in Political and Lobbying Activity

Do’s and Don’ts of Political Activity

Community Benefit Stories and Reporting Needed

OHA is seeking data and compelling stories from hospitals for its 2008 community benefit report, scheduled to be unveiled at a news conference June 10 as part of OHA’s Annual Meeting. As recommended by the OHA Board Task Force on Community Benefits, OHA on Feb. 1 released a simple, electronic survey of five data elements, three of them--Medicaid loss or profit, charity care and community benefit activities--will be included in the OHA statewide aggregate report as community benefits, and two--Medicare losses not attributed to medical education and bad debt--will be listed as additional uncompensated care. OHA is asking hospitals to supply their own numbers from 2006 reports or audited financial statements, but, excluding the data element on community benefit activities, OHA will itself calculate the number hospital that is unable based on formula that are available on request. Additional information on the 2008 OHA Community Benefit survey is available from Charles Cataline.

OHA also needs help illustrating what hospitals really mean to their communities – looking beyond traditional community benefit activities such as health fairs to show the life-saving research, vital training of future caregivers, subsidized health care services and more that hospitals offer. Hospitals are urged to share information, photos and stories with Mary Sterenberg for possible inclusion in the report.

House Passes Maternity Licensure Bill

Legislation that would provide much-needed revisions to Ohio’s maternity licensure statute unanimously passed the House floor Tuesday and now heads to the Senate. House Bill 331, sponsored by Sen. Mark Wagoner (R-Toledo), is the result of collaboration between the OHA Maternity Licensure Task Force and the Ohio Department of Health. It combines the two current sets of requirements to reduce regulatory burden and confusion, lower costs and enhance maternal and newborn care in Ohio. The bill would impact the 121 active hospital maternity units and three functional maternity homes in Ohio. (Bridget Gargan, bridgetg@ohanet.org)

Senate Committee Passes Health Care Simplification Act

Tuesday the Senate Civil - Judiciary Committee unanimously passed Amended Substitute House Bill 125, the Health Care Simplification Act. OHA supports the bill, but expressed disappointment that lawmakers watered down a provision dealing with most favored nation clauses minutes before the committee vote. The bill as passed by the House called for a three-year ban on the use of most favored nation clauses in new contracts, with substantial changes to existing contracts also triggering the prohibition on MFNs. An amendment adopted in the Senate committee calls for a two-year moratorium for such clauses, and provides that changes to the contract within the two years would not allow for the MFN prohibition. In a letter to committee chairman David Goodman (R-Columbus), OHA expressed disappointment with the changes, stating that the language would allow many insurers to skirt the moratorium because the terms for most hospital managed care contracts are three years or more and the bill no longer allows for substantial changes to trigger the prohibition.

Despite concerns with the MFN language, OHA does support the legislation, as other provisions in the bill are positive for hospitals, physicians and other provider groups. HB 125 creates a committee to study the effects of most favored nation clauses on the availability, accessibility and affordability of health insurance. The legislation also makes several reforms to the managed care contracting process and requires health plans to provide a summary disclosure form for each contract. Health plans must also use a standard credentialing application form when credentialing physicians and adhere to streamlined credentialing time frames.

The bill, sponsored by Rep. Matt Huffman (R - Lima), now moves to the Senate floor for action. (Jeff Klingler, jeffk@ohanet.org; Mary Gallagher, maryg@ohanet.org)

OHA, OCHA Join to Testify Against Medicaid Freeze
In a public hearing last week, OHA and the Ohio Children’s Hospital Association (OCHA) issued joint testimony opposing the two-year Medicaid inpatient hospital rate freeze proposed by the Ohio Department of Job and Family Services. While both organizations applauded the recent decisions to restore dental benefits for adults enrolled in Medicaid, to restore a desperately needed Medicaid payment rate increase for physicians, and to cancel plans to recalibrate inpatient payment rates, OHA and OCHA testified that a two-year freeze on inpatient rates would increase the shortfalls hospitals are forced to accept when treating patients enrolled in Medicaid. In state fiscal year 2006, the most recent year for which complete data is available, Medicaid payments fell $305.7 million short of covering the costs of the services hospitals provided to patients enrolled in Medicaid. OHA has estimated that if Medicaid managed care contracts are tied to fee-for-service rates, the impact of the proposed freeze could be nearly $160 million over the two calendar years, 2008 and 2009, for which the freeze would be effective.

Beyond a general opposition to the proposed rate freeze, OHA and OCHA gave three suggestions to the department:

To reduce the freeze from two years to one year, and have the department reevaluate the state’s finances before deciding to freeze rates in 2009;
To study and implement an employed-physician upper payment limit program (Physician UPL) for public hospitals;
To bolster Medicaid payments to hospitals using funds from the recently reported class-action settlement with Merck;

In addition, OHA suggested:

To develop methodology for estimating the impact of this and future policies on both the fee-for-service and managed care arenas.

View a copy of the full testimony. OHA and OCHA hope to continue a productive dialogue with the department and the administration on ways to address the growing Medicaid payment shortfalls. OHA will keep its members informed of any response from the department, as well as the status of the rate freeze rule over the coming weeks. (Bridget Gargan, bridgetg@ohanet.org; Ryan Biles, ryanb@ohanet.org)

Not a Member of the Advocacy Network?

Being a member of the OHA Advocacy Network provides you access to information on government activity and assists the hospital industry in sending unified messages to elected officials. If you are not a current member, you can easily join on-line. Join today to start reaping the benefits of being a member of the OHA Advocacy Network.

The OHA Advocacy Network is a service of the Ohio Hospital Association, 155 E. Broad St., Columbus, OH 43215-3620, 614-221-7614, 614-221-4771 (fax)

Visit us on the Web at: www.ohanet.org

Direct questions on OHA’s advocacy agenda to:

Bridget Gargan, Vice President, State Policy & Advocacy (bridgetg@ohanet.org)

Jeff Klingler, Director, State Policy & Advocacy (jeffk@ohanet.org)

Jean Scholz, RN, Director, Health Policy (jeans@ohanet.org)

Rick Sites, General Counsel (ricks@ohanet.org)

Stacey Conrad, Manager, State Policy & Advocacy (staceyc@ohanet.org)

Jonathan Archey, Director, Federal Relations (jonathana@ohanet.org)

Laura Landis, Executive Assistant, State Policy & Advocacy (laural@ohanet.org)