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Monday, March 24, 2003
Bioterrorism Wall Chart Sent to EDs
A poster to assist emergency department personnel in quickly diagnosing potential cases of bioterrorism has been sent to hospitals around the country from an organization in Ohio. The reference tool, developed by the University of Findlay’s Center for Terrorism Preparedness, is a wall chart that features 12 biological agents and associated symptoms in a checklist format. Sent to 5,000 hospital emergency departments in the U.S., the chart includes appropriate infection control measures, covert assault clues, telephone numbers of key agencies and sources of additional online information.

The wall chart was funded by a grant from the Oklahoma City National Memorial Institute for the Prevention of Terrorism, a non-profit organization working to prevent and deter terrorism. Development of the poster has been planned for several months and is not specifically planned as part of the war effort. The wall chart can also be purchased from the Center for Terrorism by visiting http://seem.findlay.edu/terrorism/. (Carol Jacobson, carolj@ohanet.org)

Tuesday, March 25, 2003
CDC Issues Guidance on SARS Illness
The Centers for Disease Control and Prevention (CDC) and the World Health Organization have received reports of patients with Severe Acute Respiratory Syndrome (SARS) from several countries including the U.S. To date, there have been 39 suspected total cases in 18 U.S. states, with none in Ohio, and 487 cases in 14 countries worldwide.

The cause of these illnesses is unknown and is being investigated, with the initial hypothesis pointing to the coronavirus family as the cause. CDC believes the SARS pathogen may be naturally occurring, but is "keeping an open mind" about the possibility of terrorism. Symptoms include fever, myalgias, headache, sore throat, dry cough, shortness of breath, or difficulty breathing.

CDC is stressing the need for providers to institute isolation and airborne precautions in health care settings when a case of SARS is suspected. CDC has also issued a health update on the handling of SARS specimens and work practices for health care workers. Up-to-date information, CDC guidance documents and clinician-specific information are available at www.cdc.gov/ncidod/sars/. (Rick Sites, ricks@ohanet.org)

ODI Shuts Down Fourth Illegal Health Plan
The Ohio Department of Insurance (ODI) Friday issued a cease and desist order against TRG Health Plan, also known as TRG Marketing, LLC, or TRG Administration, requiring the unlicensed organization to immediately stop selling insurance products. This is the fourth health insurance scam to be confronted by action from ODI’s Illegal Health Insurance Operations Task Force and the task force is currently investigating the possibility of several additional illegal health plans in the state.

Consumers should be aware of the following warning flags and seek additional information when:

The plan operates like insurance but claims it is not

Informational materials avoid insurance terminology

The plan is covered on by “stop loss insurance” or refers to “reinsurance”

The plan offers unusually low premiums and/or generous benefits, low/no minimum requirements and loose/no underwriting guidelines

The plan is not licensed by ODI

For more information, view an ODI press release at www.ohioinsurance.gov/Newsroom/scripts/NewsRelease.asp. (Mary Gallagher, maryg@ohanet.org)

Wednesday, March 26 , 2003
OHA Opposes Medicare PPS Outlier Payment Rule
OHA is joining the American Hospital Association in opposition to a Centers for Medicare and Medicaid Services' (CMS) proposal to change the way Medicare calculates inpatient hospital PPS outlier payments.

In its March 5 proposed rule CMS states it is concerned hospitals are manipulating billed-charges to increase inpatient hospital PPS (IHPPS) outlier payments, and is responding by proposing new interim outlier payments that will be adjusted later at the point a hospital’s Medicare Cost Report for that fiscal period is settled. Further, CMS proposes to keep the 2003 IHPPS outlier “threshold” at over $33,500, as established in the Aug. 1, 2002, final rule.

OHA opposes the plan, because it will be confusing and very expensive for hospitals and Medicare contractors to administer, and it virtually guarantees outlier payments will drop below congressionally mandated levels. Copies of OHA's comments are being directed to the Congressional delegation. (Charles Cataline, charlesc@ohanet.org)

CMS Issues HIPAA Help
In light of providers’ recent concern over the release of protected health information to surveyors under the Health Insurance Portability and Accountability Act (HIPAA) privacy rule, the Centers for Medicare and Medicaid (CMS) has issued guidance on the release of this information.

According to CMS, health care providers do not need to enter into business associate agreements with state survey agencies. Under administrative simplifications to HIPAA, protected health information may be used and disclosed for health oversight activities, including inspection and licensure, and all programs in which the information is necessary for determining compliance with program standards. Health oversight agencies must limit use of protected health information to the minimum necessary to complete an inspection or survey. Individual authorization to use protected health information for oversight purposes is not required. (Rosalie Weakland, rosaliew@ohanet.org)

Thursday, March 27, 2003
Congress Hashes Out Proposed Medicaid Cuts
The U.S. Senate yesterday passed a 2004 budget resolution that does not include Medicare and Medicaid cuts. The House version of the budget, passed March 21, spared Medicare but retained a $93 million reduction in Medicaid spending. Members of both chambers will meet as early as next week to create a final budget resolution.

Budget talks earlier this month could have resulted in $9.2 billion in reductions to Ohio’s Medicare program and $3.7 billion to Medicaid over the next decade. Ohio’s U.S. Sens. Mike Dewine and George Voinovich responded to the concerns of the Ohio hospital advocates who spoke out against the cuts, signing a letter to Senate leadership in opposition of the reductions. To view the letter, visit www.ohanet.org/advocacy/federal/senateletter032503.doc.

OHA continues to encourage hospital CEOs and other advocates to call their congressional legislators, urging them to oppose reduced federal Medicaid spending. For a list of representatives and their phone numbers, visit www.ohanet.org/advocacy/federal/resources/congressional_delegation.asp. (Jonathan Archey, jonathana@ohanet.org)

Smallpox Vaccine on Hold for Heart Patients
The Centers for Disease Control and Prevention (CDC) is recommending that people who have been diagnosed with heart disease be temporarily deferred from receiving the smallpox vaccine while it investigates reports of heart problems in seven vaccinated health care workers, one of whom died after a heart attack. CDC said it will provide states with questions about heart problems to use in screening volunteers for the vaccine.

CDC is investigating whether there is any association between smallpox vaccination and the incidents. If associated, the death would be the first under the nation's voluntary smallpox vaccination program. A total of 25,645 people have been vaccinated in the civilian program, according to CDC. For more, visit www.cdc.gov/od/oc/media/pressrel/r030325.htm. (Carol Jacobson, carolj@ohanet.org)

Friday, March 28, 2003
Board Approves HCAP Model Recommendation
Among other actions, the OHA Board of Trustees at its last meeting recommended an HCAP model for the distribution of 2003 funds that reflects the $50 million loss in federal funding. Faced with a difficult decision as a result of the federal government’s failure to stop the falloff in HCAP funding, the Board approved a distribution model it believed to be both equitable and fair for all Ohio hospitals.

The Board also approved additional recommendations from the Medicaid Task Force, including opposition to reduced eligibility unless a private sector alternative is put in place, and also to efforts to require hospitals to accept payment for treating Medicaid managed care patients at the lesser of 95 percent or fee-for-service of billed charges if the hospital has no contract with the managed care organization.

The Board authorized the implementation of a sponsored deductible program for physician medical liability coverage and exploration into the establishment of a medical malpractice insurance company for the benefit of Ohio hospitals and physicians through either the creation of a new hospital-sponsored medical malpractice insurance company or the acquisition of an established medical malpractice insurance company.

In addition, Board members received an update on the progress of House Bill 71, legislation that would clarify public policy in Ohio to extend physician conflict-of-interest statutes to include inpatient hospital services, and shared their efforts to engage hospital trustees and other community leaders in this issue. (Jim Castle, jimc@ohanet.org)

Last Chance for AHA Survey
The deadline to complete the American Hospital Association survey has been extended to April 15. About half of Ohio’s hospitals have completed or are in the process of completing the survey. OHA encourages all Ohio hospitals to participate in the survey, which provides immediate trend reports upon completion. OHA uses the survey data in its advocacy efforts and will also use part of the data for a toolkit coming out this fall to help hospitals communicate their benefit to the community. The survey is online at www.ahasurvey.org. Direct questions to Virginia Swan, virginia@ohanet.org, or Dorothy Morgan, dorothym@ohanet.org.

Hospital Rep Sought for Task Force
The Ohio Department of Health is seeking a hospital representative for the Compassionate Care Task Force, created to evaluate pain treatment resources for chronic pain. The group will meet monthly for one year. Hospital interests in this issue include Joint Commission on Accreditation of Healthcare Organization standards on pain management, reimbursement and staff training. If you would like to nominate yourself or another hospital employee for the task force, please contact Stacey Walton at staceyw@ohanet.org or 614.221.7614.

Free Online Publication Available
Hospitals are eligible for free Web access for six months to the online publication Clinical Evidence, but only if they register soon. The publication, provided to hospitals through a collaborative of the American Hospital Association and UnitedHealth Foundation, contains the most up-to-date information on what’s proven to work in medicine. To take advantage of the online subscriptions, hospitals must register before April 4 at www.aha.org.