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Monday,
December 15, 2003
Ohio ranks 10th in the nation in spending on anti-smoking efforts, according to a recent study of the Campaign for Tobacco-Free Kids. Ohio’s dedication to the cause is crucial given another ranking-Ohio ranks 44th in the nation for tobacco use in 2003, according to UnitedHealth Foundation rankings.
Ohio spends about 61.5 percent of the minimum the Centers for Disease Control and Prevention recommends the state spend on tobacco prevention. Ohio’s Tobacco Use Prevention and Control Foundation will spend about $38 million this year and $56 million next year on anti-smoking efforts, including its four-year advertising campaign called Stand (www.standohio.org). However, Ohio legislators took $112 million this year from TUPCF’s budget to balance the state’s general fund. To date, $350 million has been diverted from tobacco prevention for the state budget. State lawmakers have promised to restore the full amount in 10 years.
National tobacco settlement money also funds grants for hospital pulmonary rehabilitation programs through OHA’s Foundation for Healthy Communities. Since 2001, the Foundation has awarded over 80 grants and renewals totaling nearly $1.2 million (www.ohanet.org/HealthyCommunities/tobacco/pastgrants.htm). (Lynne Ayres, lynnea@ohanet.org)
Tuesday, December 16, 2003
Beginning early and hitting hard, this year’s flu season may be the worst Ohio and the U.S. have experienced in recent years. Currently, Ohio is experiencing fewer flu cases than several other states but still has widespread activity according to the Ohio Department of Health (ODH).
Vaccines may be limited as many health care providers wind down their vaccination programs for this season, but the Centers for Disease Control and Prevention (CDC) is working to assess the availability of the flu vaccine and to transfer additional vaccines to locations still needing it. Providers or clinicians seeking additional vaccines and those with additional vaccines should contact ODH. CDC said more than 80 million people will be vaccinated for influenza this year, more than ever before. CDC is encouraged by the increased number of people who heeded recommendations to receive a flu shot. For more information on prevention, treatment and flu activity, visit the CDC Web site at www.cdc.gov/flu/ or the ODH Web site at www.odh.state.oh.us/Alerts/Flu/influ1.htm.
OHA and the metropolitan hospital associations are monitoring the situation and will ask the Centers for Medicare and Medicaid Services (CMS) to authorize the use of rehabilitation, psychiatric, and skilled nursing beds for acute inpatient care if flu cases become widespread and hospital capacity tight. Nick Baird, M.D., director of the Ohio Department of Health, must concur that the situation warrants declaration of a health emergency, which is necessary before CMS will issue a waiver allowing use of PPS-exempt beds. CMS has said it will not issue waivers for individual hospitals or by region, but only on a statewide basis. (Rick Sites, ricks@ohanet.org)
Wednesday,
December 17, 2003
AHA Calls for Billing Changes
The American Hospital Association (AHA) today released guidance to
hospitals on billing and collection practices, recently a hot topic in
the news following an investigation into 20 hospital systems’ billing
data by the U.S. House of Representatives House Energy and Commerce
Subcommittee on Oversight and Investigations.
AHA’s guidelines call for overall system change to better meet the needs of patients without insurance. Principles include: helping patients pay for their hospital care through communication of existing coverage options and help in qualifying for those options, more affordable care for patients with limited means, and fair and balanced billing and collection practices.
AHA is also calling on government to clarify and reduce barriers that make it more difficult for hospitals to assist patients in need. Also released today is a white paper, “Federal Regulations Hamper Hospitals’ Efforts to Assist Patients of Limited Means,” which further explores the nationwide problem and makes recommendations for change.
Hospitals continually work to meet the needs of their communities, including those with limited means. Last year America’s hospitals provided $22.3 billion in uncompensated care, including charity and other care for which payment was not received. Ohio hospitals provided $894 million in uncompensated care in 2001, the most recent year for which data is available. Additional tools and resources are available at www.aha.org under “Key Issues.” (Charles Cataline, charlesc@ohanet.org)
Lab Deadline Approaches
Laboratories accredited by the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) must annually submit documentation
attesting to enrollment in proficiency testing. The 2004 enrollment
attestation sheet is available on the JCAHO Web site and should be faxed
to the ORYX team at 630.792.4599 by Jan. 1, 2004. It is independent of
the attestation provided by the proficiency test program. For assistance
or complete instructions, please visit
www.jcaho.org/accredited+organizations/laboratory+services/index.htm
or contact JCAHO at 630.792.5085 or
oryx@jcaho.org.
Laboratories that are part of the Veteran’s Administration, Department of Defense, and laboratories accredited or inspected by an entity other than JCAHO are not required to submit the documentation. (Rosalie Weakland, rosaliew@ohanet.org)
Thursday,
December 18, 2003
A bill allowing the state to activate a last resort liability insurer if the medical malpractice insurance crisis intensifies is moving its way through the legislature. Substitute House Bill 282 yesterday passed the House Insurance Committee with further action pending in January.
The bill would allow the Ohio Department of Insurance (ODI) to transfer $12 million from the old Joint Underwriting Association (JUA) to fund a new Medical Liability Underwriting Association (MLUA) if ODI determines a substantial number of physician applicants for medical malpractice insurance are denied coverage and the situation threatens the availability of health care for Ohioans.
MLUA is based on the JUA, which was started in 1975 and ceased in 1993. It would issue policies with $1 million and $3 million limits for physicians meeting minimum eligibility and underwriting standards. Policyholders may be assessed to stabilize the reserve fund if necessary, but no other assessments are planned. Rates will be actuarially sound and subject to ODI approval. Thanks to advocacy efforts of OHA, hospitals will be represented on the MLUA board, which governs the program. OHA’s major concerns with the bill so far have been addressed and the association will continue to track the legislation and keep members apprised of its progress. For more about the medical malpractice insurance crisis, visit www.ohanet.org/med-mal/. (Bridget Gargan, bridgetg@ohanet.org; Rick Sites, ricks@ohanet.org)
Board Approves Stance on Regulatory Issues
At its last meeting, the OHA Board of Trustees endorsed positions on
several licensure and scope of practice issues. OHA will oppose the
current draft of legislation expected to be introduced in January
dictating nurse work hours. OHA supports the concept that each employee,
in conjunction with professional licensing authorities, should manage
his or her own work hours, rather than placing the burden with
employers. The Board reaffirmed OHA’s position to oppose and seek
amendments on House Bill 105, which would require the licensure of home
medical equipment service providers by the Ohio Respiratory Care Board.
OHA will not oppose House Bill 189, legislation to allow podiatrists to
independently admit patients to a hospital, because admitting criteria
ultimately resides with the hospital medical staff and governing board.
Looking at the specialty hospital issue, the Board approved the creation of a task force to study physician credentialing as well as next steps during the federal moratorium on new physician-owned specialty hospitals. The moratorium makes it unnecessary to seek enactment of similar state legislation currently proposed in House Bill 71. For more information, see an OHA news release at www.ohanet.org/media/news_release/.
The Board reaffirmed policies and procedures of the OHA Litigation Assistance Program and Special Litigation Fund, which supports OHA involvement in litigation involving member hospitals and in litigation used as an advocacy tool on behalf of OHA members.
The Board was updated on OHA’s new medical malpractice insurance company, which announced Susan Stanfield assumed the position of CEO beginning Dec. 16. OHA’s application to the Ohio Department of Insurance for licensure is moving fast and OHA expects the company to write policies early next year. To date, hospitals have invested over $1 million in the new company. Several other institutions have indicated interest in or committed to investing.
OHA staff also updated the Board on a statewide effort to raise awareness of hospitals’ positive contributions and educate Ohioans on the importance of the Ohio Supreme Court. The initiative is expected to be rolled out to members in January. (Jim Castle, jimc@ohanet.org)
Friday, December 19, 2003
OHA, ODH Request More Beds for Flu Patients
At OHA’s request, due to full hospitals in several regions of the state caused by influenza and related seasonal illness, the Ohio Department of Health has requested the Centers for Medicare and Medicaid Services grant permission for hospitals to use PPS-exempt beds to treat additional patients. OHA expects a response by Monday. (Rick Sites, ricks@ohanet.org)
CMS Offers Info on Medicare Provisions
The Centers for Medicare & Medicaid Services
(CMS) yesterday announced a payment rule for the Outpatient Prospective
Payment System provisions of the Medicare reform bill will be issued by
Jan. 1. Hospitals can apply for a one-time appeal of wage index
re-classification by Feb. 15. A notice detailing application specifics
and selection criteria will be published in the Federal Register
before the first of the year as well as rules for the payment of drugs
and physician fee schedule provisions.
Hospitals may be required to submit data for each of the Quality Initiative's 10 measures of care as early as April or May of 2004 to receive a full market basket update for Medicare inpatient PPS payments in fiscal year 2005. While hospitals must transmit data for all measures to receive the full update, the information will not be shared publicly unless data is available for 25 or more cases per year. CMS is finalizing the timeline, but encourages hospitals to enroll in the Quality Initiative at www.aha.org by clicking the “Quality Initiative” logo. (Jonathan Archey, jonathana@ohanet.org)
Hospitals Lead the Charge to a Healthier Ohio
The 2003 edition of United Health Foundation’s America’s Health:
State Health Ranking challenges Ohio to address certain risk factors
to spur significant improvement in the state’s overall health.
Ohio’s position in this study inched upward this year to 26th, after hovering at 27th overall in both 2001 and 2002. Ohio’s overall level of healthiness remains stable, but there are many opportunities for improvement and hospitals throughout the state are serving as catalysts for positive change.
Confronting Ohio’s large uninsured population, hospitals provided $716 million in uncompensated care to patients without insurance in 2001. In part due to the efforts of hospital advocates, 60,000 current Medicaid enrollees did not lose their health insurance in 2003 and Medicaid reimbursements to Ohio hospitals were protected. Ohio also has seen an increase in emphasis on healthy lifestyles from both the local and state levels.
As Ohio strives to meet the challenge of confronting risk factors and improving the overall health of its citizens, its hospitals continue leading the way to a healthier Ohio. For more information, see OHA’s December Healthbeat at www.ohanet.org/healthbeat/2003/healthbeat1203.htm.
Center for Education
Don't miss the following educational opportunities offered through the
OHA Center for Education. Visit
www.ohanet.org/education/education_programs.asp or call 614.221.7614
for more information.
Update Your Outpatient Revenue Cycle for 2004 - Two Special Sessions
Jan. 27: 2004 APC Rules and 2004 HCPCS Update - Columbus
Jan. 28: Ambulatory Surgery Reimbursement Landscape Under APCs -
Columbus
Mental Health Client Self Directed Care Center
Jan. 23 - Columbus
OSHRM 2004 Winter Conference
Jan. 9 - Columbus
The Medicare Prescription Drug, Improvement and Modernization Act of
2003
Jan. 8 - Columbus