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Monday, January 31, 2005
Bills Propose Small Employer Health Care Changes
The Ohio House and Senate last week introduced companion legislation proposing changes regarding flexible health benefit plans. House Bill 5, sponsored by Rep. Jim Raussen (R-Cincinnati), and Senate Bill 5, sponsored by Sen. Jay Hottinger (R-Newark) were prompted by the Ohio Department of Insurance (ODI). Consistent with federal law, the state bills would require that high deductible plans linked to Health Savings Accounts have deductibles of at least $1,000 per person and $2,000 per family, but would cap out-of-pocket expenses at $5,000 per person or $10,000 per family. Though the legislation raises current deductible limits, it requires that deductibles not apply to preventive health care services.

The legislation also mandates that providers may not charge patients more than the reimbursement rate the provider has negotiated with their carrier when an insured patient must pay for health care services out-of-pocket or with an HSA. It also allows insurers to sell health plans to small businesses without all of the benefits currently required under Ohio law if they also offer a plan with all mandated benefits.

ODI is currently accepting comments on language in the bills that would allow employers to choose between offering a flexible or a traditional benefit plan to employees, and OHA will monitor the progress of the legislation. Check for updates on current state legislation online at www.ohanet.org/advocacy/state/resources/Status126.doc. (Bridget Gargan, bridgetg@ohanet.org)
 

Tuesday, February 1, 2005
Medicaid Remains in the State Budget Spotlight
With this year’s budget debate drawing more scrutiny to Ohio’s Medicaid program, OHA continues to advocate against cuts to the program and emphasize its importance to Ohio’s hospitals—and to all Ohioans. Though it represents a large budget item, Medicaid provides health care coverage for one in seven low-income Ohioans and infuses $8.7 billion into Ohio’s economy.

A report issued last week criticized the Ohio Department of Job & Family Services for how it audits Medicaid providers and collects on overpayments. The Ohio Office of Inspector General released the report, online at www.watchdog.ohio.gov/investigations/2004210.pdf, stating the inefficiency of the department’s current auditing process costs the state millions of dollars. Though the report does not directly impact hospitals, it may add fuel to the discussion on what entity should hold responsibility for auditing Medicaid provider claims. Legislation introduced late last year, and reintroduced this session as Senate Bill 32, sponsored by Sen. Bob Spada (R-North Royalton), would give the state auditor increased responsibility to audit Medicaid claims. OHA has been in communication with the auditor’s office over the past several months on concerns with adjustments to payments.

The release of the report falls just before Gov. Bob Taft’s state of the state address slated for next week, where he will announce a spending plan that may include reduced Medicaid reimbursement to providers, cuts to enrollment for the working poor and the elimination of services. To learn more about the crucial contributions of Ohio’s Medicaid program, visit www.ohanet.org/medicaid/. (Bridget Gargan, bridgetg@ohanet.org)

Draft Patient Safety Goals Ready for Review
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) this week released the draft patient safety goals and requirements from which it will choose its 2006 National Patient Safety Goals. Several new goals for hospitals are proposed for 2006, as well as the inclusion of goals from other accreditation programs. Hospitals are encouraged to review the draft goals online at www.jcaho.org/accredited+organizations/field_reviews.htm  and submit comments by Feb. 25. To help OHA in its efforts to support Ohio’s hospitals, please also forward a copy of comments to Rosalie Weakland at rosaliew@ohanet.org.

Updated annually, the patient safety goals help health care organizations better protect their patients. The list of draft goals was developed by patient safety experts, nurses, physicians, risk managers, pharmacists, and other professionals. To view a related news release, visit www.jcaho.org/news+room/news+release+archives/06_npsg.htm, and for more information on the review, please contact Jennifer Hoppe, senior research associate, JCAHO, at 630.792.5936 or jhoppe@jcaho.org. (Rosalie Weakland, rosaliew@ohanet.org)

Editor’s Note: OHA recently upgraded its computer systems and consequently, the HEALTH e-NEWS Plus newsletter may appear in a slightly different format. We are working to complete this transition and ensure the newsletter continues to offer convenient information and direct links to other resources. Thank you for your patience as we make this change.
 

Wednesday, February 2, 2005
 Award Nominations Due February 11
Hospitals have just one week to nominate a health care hero for OHA’s 2005 Albert E. Dyckes Health Care Worker of the Year Award or another prestigious health care leadership award. Nomination materials are available online at www.ohanet.org/annualmeeting/Awards/. All nominations must be submitted electronically by Feb. 11 to Tiffany Himmelreich at tiffanyh@ohanet.org.

Every hospital is encouraged to nominate one individual for the Health Care Worker of the Year Award to be celebrated at the OHA Recognition Dinner June 20, in conjunction with the OHA Annual Meeting June 20-21, this year at a new location – the Hilton Columbus at Easton. The ultimate recipient of the award and four finalists will be named during the event.

Also honored at the dinner are recipients of OHA’s health care leadership awards including: Donald R. Newkirk Award, Distinguished Service Award, Meritorious Service Award, John Chapman Award, and William C. Kelley Safety Leadership Award. (Tiffany Himmelreich, tiffanyh@ohanet.org)

Final Ohio Billing Lawsuit Dropped
Plaintiffs voluntarily withdrew their federal lawsuit against the Cleveland Clinic, drawing a close to the final pending hospital billing lawsuit in Ohio. Earlier this month lawsuits against ProMedica Health System in Toledo and Catholic Healthcare Partners in Cincinnati, both of which also named the American Hospital Association (AHA), were dismissed. The Ohio dismissals and dropped lawsuits continue a trend among similar lawsuits against hospitals nationwide related to billing and collection practices. AHA offers additional information to members in the Mission Challenged…Hospitals Respond section of its Web site, available at www.hospitalconnect.com/hospitalconnect/registration/SingleSignOn/sso_auth.jsp?domain=AHA. (Jonathan Archey, jonathana@ohanet.org)

Advance Directives Packet, Forms Ready
A revised advance directives packet and new forms helping patients make end-of-life decisions are now available online. Created by the Ohio Hospice and Palliative Care Organization, “Advance Directives Packet: Choices, Living Well at the End of Life” includes new forms used to create a Living Will or Health Care Durable Power of Attorney, or to designate organ or tissue donation. Hospitals were required to begin using the new forms Dec. 16.

Hospitals can download the packet and forms at www.ohanet.org/publications/special/special.asp. Hospitals may also download an order form to request hard copies of the packet to distribute throughout the facility. Versions translated into Spanish will be posted to OHA’s Web site as soon as they are available. (Jean Scholz, jeans@ohanet.org)
 

Thursday, February 3, 2005
 Bush Outlines 2005 Health Care Agenda
In his state of the union address last night, President George W. Bush outlined the health care policy initiatives he will draw to forefront over the next year.  The president’s health care agenda focuses primarily on issues already under discussion, including:

  • Medical liability reform
  • Health savings accounts
  • Association health plans
  • Tax credits for purchasing health insurance
  • Expanding community health centers
  • Health information technology incentives
  • National Institutes of Health funding

OHA supports the increased access to health care, medical liability reform and technological advancement proposed in these initiatives, with legislation on liability reform expected to be introduced as early as the end of February.

Though President Bush did not mention potential spending reductions to Medicaid, U.S. Department of Health and Human Services Secretary Mike Leavitt spoke about Medicaid on behalf of the administration earlier this week. He projected Medicaid savings through paying less for prescription drugs and closing “loopholes” used to draw down additional federal Medicaid funding. He also suggested a shift in coverage, arguing it “would be better to provide health insurance to more people, rather than comprehensive care to a smaller group.”

The president’s state of the union address, combined with the fiscal year 2006 budget proposal he will unveil early next week, lay the groundwork for Congress’ agenda and debate for the next year. For more information on OHA’s federal advocacy, visit www.ohanet.org/advocacy/federal/. (Jonathan Archey, jonathana@ohanet.org)

OHA Not to Support PCF as Med Mal Fix
After study of an analysis provided by the Ohio Department of Insurance (ODI), the OHA Board of Trustees voted at its January meeting not to support a patient compensation fund (PCF) in Ohio, finding the costs to likely exceed the benefit of the program.  OHA’s decision not to support a PCF was based on several factors:

  • No research has been conducted on the impact of a PCF on self-insured entities, and Ohio’s self-insured hospitals report a PCF would not save them money and mandatory participation would actually increase costs to these hospitals.
  • The estimated savings of about 5 percent for physicians are not sufficient to justify creation of a new governmental entity.
  • The estimated savings are overly optimistic.

The common factor for states with stable markets and lower insurance rates appears to be strong damage caps and other tort reforms, and not a PCF. Recently enacted tort reform in Ohio, a new Ohio Supreme Court composition, new insurers and other new initiatives should improve the medical liability insurance market without the creation of a PCF. OHA submitted a letter to ODI last week commending its study of the issue and outlining its reasons for opposing the formation of a PCF in Ohio. To learn more about the medical malpractice insurance environment in Ohio, visit www.ohanet.org/med-mal/. (Rick Sites, ricks@ohanet.org)

Experts Discuss Med Mal Reform
Tomorrow, Feb. 4, a panel of experts will answer questions about medical malpractice reform during a live webcast of "Ask the Experts," a kaisernetwork.org program. Send questions in advance of the live program to ask@kaisernetwork.org. For more details, visit www.policyimpact.com/dailydigestpdfs/CARH/january2005/carh22jan31.pdf.

Friday, February 4, 2005
New Bioterrorism Web Site Launches Today
Hospitals have a new resource at their fingertips to keep Ohioans safe. A Web site launched today–www.PrepareOhio.com–will help hospitals access the latest information on mass casualty and disaster preparedness.

The site contains tools to assist hospitals in diagnosing and treating a variety of bioterrorism-related infectious diseases from anthrax to the plague, in addition to statewide and national protocols and readiness programs, training materials about standardized emergency overhead codes and the latest news and information. A members’ only section of the site will include an online bed tracking system and a learning library allowing hospitals to share best practices.

The Web site–www.PrepareOhio.com–is a collaborative effort of the Akron Regional Hospital Association, Center for Health Affairs, Central Ohio Trauma Systems, Greater Dayton Area Hospital Association, Greater Cincinnati Health Council, Health Council of Northwest Ohio and Ohio Hospital Association. It was developed under contract to the Ohio Department of Health with funding support from the Health Services and Resource Administration, U.S. Department of Health and Human Services, Grant #2 3RMC000502-00. See an OHA news release at www.ohanet.org/media/news_release/2005/bioterrorism020405.htm for more information. (Carol Jacobson, carolj@ohanet.org) 

Learn How Medicaid Affects all Ohioans
The 2003 data is in—and Medicaid continues to provide health care coverage for a high percentage of Ohioans. OHA offers an informational resource on Medicaid through a Web site dedicated to current news and other Medicaid-related resources. The site, www.ohanet.org/medicaid/, now contains additional information including an updated fact sheet on Ohio’s Medicaid program, which covers one in every six Ohioans, one in every three children and one in five seniors older than 85.