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Monday,
January 26, 2004
Critical access hospitals (CAH) will receive additional reimbursement for services to Medicare beneficiaries and can use additional beds for acute care services under two new policies announced last week by the Centers for Medicare & Medicaid Services (CMS). The policies implement provisions in the Medicare Prescription Drug, Improvement and Modernization Act of 2003 aimed at supporting health care in rural areas.
Prior to these policies, Ohio’s 20 CAHs could not offer more than 15 beds for acute care; this number has now been increased to 25 beds designated as either acute care beds or swing beds. Payments to these hospitals for both inpatient and outpatient services will also increase from 100 percent to 101 percent of reasonable costs.
To be designated a CAH, a facility must undergo a survey conducted by the Ohio Department of Health on behalf of CMS. It must provide 24-hour emergency services, inpatient care and laboratory and radiology service. It must have no more than 25 acute-care or swing beds and keep patients an average of 96 hours or less. To view a list of Ohio CAHs, visit www.ohanet.org/about_oha/cah.asp. For more information, contact David Hendershot at 614.221,7614 or davidh@ohanet.org.
Tuesday, January 27, 2004
OHA will voice hospital concerns with legislation introduced in the Ohio House of Representatives today prohibiting hospitals from requiring registered nurses and licensed practical nurses to work overtime. The mandated prohibition of overtime outlined in House Bill 382, sponsored by Rep. John Widowfield (R-Cuyahoga Falls), could exacerbate the nursing shortage faced by many hospitals throughout the state and result in unsafe staffing of hospital beds, jeopardizing the health and safety of patients.
In December, OHA discussed an initial draft of the legislation with its Board of Trustees. The Board voted to oppose the draft legislation, however it did feel it is important that hospitals address concerns being raised by their nursing staffs, as well as concerns raised by a recent study of the Institutes of Medicine regarding nurse work hours. To that end, the Board asked the Ohio Organization of Nurse Executives (OONE) to develop safe-staffing principles to be shared with the OHA membership and used to evaluate any proposed legislative efforts on this issue. The safe-staffing principles will be finalized by OONE and approved by the OHA Board in February. For more details on OHA's concerns with the overtime legislation visit www.ohanet.org/advocacy/state/issues/letters/hb382letter.pdf
. (Jeff Klingler, jeffk@ohanet.org)U.S. Spending Bill Includes Health Care Funding
Congress this week approved a fiscal year 2004 spending bill with
$139.76 billion in discretionary spending for Labor, Health and Human
Services and Education department programs. The bill now goes to the
president for his signature.
U.S. Department of Health and Human Services appropriations in the bill include $142.7 million for nursing education programs and the Nurse Reinvestment Act ($30 million more than originally allocated), $724.3 million for maternal and child health block grants, $39.8 million for rural outreach grants and $8.9 million for rural health research. The security/bioterrorism appropriations include $1.63 billion for National Institutes of Health programs, $1.12 billion for the Centers for Disease Control and Prevention, and $518 million for hospital preparedness. The bill also includes $305 million for Children’s Graduate Medical Education.
For more information on federal issues impacting Ohio’s top health care issues, visit www.ohanet.org/advocacy/federal/default.htm. (Jonathan Archey, jonathana@ohanet.org)
Wednesday,
January 28, 2004
Value of Health Care Bountiful
The American Hospital Association today
released a report evaluating the true value of health care. The Value
of Investment in Health Care suggests that the value of improved
health care over the past two decades outweighs the additional health
expenditures that accompanied those improvements.
According to the study, each additional dollar spent on health care services in the past 20 years overall has produced health gains valued at $2.40 to $3, taking into account decreasing annual death rates, increasing life expectancy and declining disability rates, among other factors. Without those improvements, AHA estimates the U.S. would have saved $634 billion in health care costs, but at the cost of 470,000 lives, 2.3 million additional disabilities and 206 million more days spent in the hospital.
The study also looked at four specific conditions that are the most common causes of death and disability: heart attack, type 2 diabetes, stroke and breast cancer. Every additional dollar spent on each has produced health gains valued at $1.10, $1.49, $1.55 and $4.80, respectively. The study and more information are available on AHA’s Web site at www.aha.org.
Tort Reform Bill Moves Forward
An OHA-supported tort reform bill continues to move through the Ohio
General Assembly, being reported out of the Ohio Senate Insurance,
Commerce & Labor committee this week. House Bill 212, sponsored by Bill
Seitz (R-Cincinnati), would change the rate of interest on certain
contracts and judgments and the computation period for which prejudgment
interest is due in certain civil actions, among other things. The bill
now heads to the full Senate for a vote.
Prior to the Senate committee review, the legislation was amended by the House committee to require the county auditor to provide notice of the rate to the county’s clerk of courts, clarify that the rate remains in effect until the judgment or decree is satisfied and specify that judgments that are dormant can be revived only within 10 years after they become dormant rather than the current 21 years. Interest would not accrue on a dormant judgment, although the interest rate in effect when the judgment was entered is applied if it is revived within the 10-year period. (Bridget Gargan, bridgetg@ohanet.org)
Thursday,
January 29, 2004
An amendment emerged Wednesday in the Ohio Senate Health Committee prohibiting hospital governing boards from developing criteria to withhold privileges from physicians who are investors or owners in another hospital. The amendment was offered by Committee Chairman Lynn Wachtmann (R-Napoleon), who said the committee would hear testimony and consider the amendment as early as next week.
The issue of physician credentialing first emerged last summer in the physician-owned hospital legislation, House Bill 71. HB 71 was put on hold after Congress enacted an 18-month federal moratorium on new physician-owned hospitals in the Medicare prescription drug bill passed in November. Wachtmann indicated his amendment would be offered for House Bill 67, a fast-moving bill to remove the limit on lines of credit for which joint township hospitals may contract. The amendment is being supported by physician representatives.
OHA is opposed to the amendment, as it impedes the authority of a hospital governing board to attract and retain a full medical staff consistent with the hospital's mission and values. OHA staff and other hospital lobbyists have been meeting with members of the House and Senate to express opposition to the amendment. Hospital supporters wanting to voice their opposition via a letter or e-mail to their state legislators should visit OHA's advocacy center at http://capwiz.com/ohanet/officials/state/?state=OH. (Jeff Klingler, jeffk@ohanet.org)
Guidelines Issued on Quality Data Submission
The Centers for Medicare and Medicaid Services has issued guidelines for
submitting data on the 10 quality measures required for acute care
hospitals to receive a full inpatient update 2005-07. Hospitals that do
not submit data on all 10 measures beginning with January
1, 2004 discharges by July 1 will receive an update of market basket
minus 0.4 percent, as outlined by the recently passed Medicare
Prescription Drug, Improvement and Modernization Act.
Hospitals are encouraged to participate in the Quality Initiative: A Public Resource on Hospital Performance, a hospital initiative to voluntarily report quality data. Participating hospitals have the opportunity to preview their data to see how it will appear on the CMS Web site, and have 30 days to make corrections. For more information, visit www.aha.org. Hospitals already participating should make sure they sign up for QualityNet Exchange, the government-sponsored vehicle for electronic data submission, by June 1 through Ohio KePRO.
Additional information will be available at www.cms.gov/quality/hospital. (Rosalie Weakland, rosaliew@ohanet.org)
Kicking Up Hospitals' Advocacy
Plans to take Ohio hospitals to exciting new levels of advocacy and
public policy development were shared with hospital executives across
the state this week in an interactive videoconference viewed at 16
locations across the state. The campaign is intended to help shape
public opinion on issues important to hospitals, such as the medical
malpractice liability crisis, and help voters appreciate hospitals'
concerns. Hospitals are being asked to support the campaign and to
provide input on its focus and direction. Questions or comments may be
directed to OHA vice presidents Mary Yost and Bridget Gargan. (Mary
Yost, maryy@ohanet.org; Bridget
Gargan, bridgetg@ohanet.org)
Friday, January 30, 2004
CMS Releases HIPAA Provider Identifier Rule
The Centers for Medicare & Medicaid Services (CMS) last week released a final rule establishing the National Provider Identifier as the standard unique identifier for health care providers to use when processing claims and in other transactions. The identifier is expected to improve efficiency and reduce costs by eliminating the need for providers to maintain, track and use multiple identification numbers as assigned by the various health plans they bill. Each provider will be assigned its own identifier number.
The final rule was published in the Federal Register Jan. 23 and goes into effect May 23, 2005. Most providers required to submit standard electronic transactions under the Health Insurance Portability and Accountability Act (HIPAA) must obtain and begin using their National Provider Identifier in standard transactions by May 23, 2007. Small health plans have until May 23, 2008 to comply. Non-HIPAA-covered providers may obtain an identifier, but are not required to. CMS said providers need not apply for an identifier at this time, but will receive information on the application process closer to the effective date. (Charles Cataline, charlesc@ohanet.org)
Grant Opportunity for Incumbent Worker Training
OHA’s Research and Educational Foundation (REF) has received a $1.2
million grant to distribute to Ohio hospitals with programs encouraging
the training and education of currently employed health care workers, or
hospitals interested in establishing such programs. The grant, awarded
by the Ohio Department of Job and Family Services, will allow Ohio
hospitals to continue efforts to overcome health care personnel
shortages by training incumbent (current) employees in key shortage
areas such as registered and practical nursing, radiology technology,
and medical transcription.
Grant information was sent to all hospitals this week and interested hospitals can also view information and application materials at www.ohanet.org/workforce/. Applications are due March 30 and recipients will be announced by April 30. Contact Susan Zabo at 614.221.7614 or susanz@ohanet.org with additional questions.