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Monday, March 7, 2005
Medicaid Payment Recalibration on Hold
The Ohio Department of Job and Family Services late last week re-filed the rule that would adjust Medicaid payments to hospitals, withdrawing it from today’s Joint Commission on Agency Rule Review (JCARR) agenda and changing the effective date of the proposed relative weights from April 1 to July 1. OHA, the Ohio Children’s Hospital Association and select Ohio hospitals and health systems had worked closely with legislative members of JCARR to express concerns about the rule—including the use of an incomplete database to recalibrate the weights resulting in underestimated fiscal impact. With the rule now on a delayed timeline, OHA is analyzing various strategies on next steps related to Medicaid payment recalibration. (Bridget Gargan, bridgetg@ohanet.org)

Seminar Focuses on Psychosocial Effects of Disaster

The Ohio Departments of Mental Health and Alcohol and Drug Addiction Services are hosting a conference to cross-train behavioral health providers and first responders on the psychosocial effects of terrorism and disaster. JOINING FORCES: Preparing Communities for the Behavioral Health Impact of Terrorism or Disaster will be held April 14-15, 2005 at the Holiday Inn Worthington. OHA is a co-sponsor of this event.

The conference will educate first responders, disaster recovery workers and local government officials on the behavioral health effects of terrorism or disaster on individuals and the community. Simultaneously, the conference will aim to educate behavioral health providers on the roles of first responders and recovery workers.

Registration materials are available on the Ohio Department of Mental Health’s Web site at www.mh.state.oh.us/jfconference.pdf or by contacting Tina O’Grady, ODMH All Hazards Coordinator at 614-466-6152 or o’gradyt@mh.state.oh.us. (Carol Jacobson, carolj@ohanet.org)

Tuesday, March 8, 2005
OHA Expresses Disappointment in Union Report
OHA took issue today with a report of the Service Employee International Union (SEIU) District 1199 alleging Ohio hospitals unfairly charge the uninsured. In a statement,OHA expressed concern that the union "has chosen to contribute to a lack of public understanding with a union-organizing ploy masquerading as a legitimate effort to impact health policy." OHA noted the report’s omission of the more than half a billion dollars Ohio hospitals provided to those who could not afford to pay for health care in 2003, the most recent year for which data is available. OHA also believes the report does not address the fundamental issue – ensuring hospitals, government, employers, insurance companies and all citizens work toward a long-term solution to provide uninsured individuals access to basic health care coverage. OHA’s statement is available online at www.ohanet.org/media/news_release/2005/SEIU_response.doc

In a news conference today, SEIU released its study, Twice the Price, and a new Web site, www.careforohio.org, along with a legislative proposal to prohibit hospitals from charging uninsured individuals earning up to 250 percent of the federal poverty level no more than it costs to provide care, and capping charges to uninsured patients at 25 percent of their annual income. Rep. Barbara Sykes (D-Akron) said she plans to introduce the legislative proposal as an amendment to the state budget in the next couple weeks. OHA will analyze the legislation once the bill’s language is available. (Bridget Gargan, bridgetg@ohanet.org)

Nursing Education Grants Offer Funding Source

As an added way to address the nursing shortage in Ohio and nationwide, the Nurse Education Grant Program (NEGP) will soon begin to provide funding to nurse education programs that partner with other educational programs or health care facilities to increase nursing student enrollment capacity. Accumulation of funding began in January 2004 and will continue through December 2013. During this time, $10 of each nurse license renewal fee is deposited in the NEGP fund to create funding for grants and other costs of the program. Grants run for two years with a maximum grant award of $200,000 per grant per cycle, and the funding may be used to hire clinical faculty and preceptors and purchase educational equipment. The program does not guarantee grant renewal.

The Request for Proposal for NEGP grants will be available on April 3 through the Ohio Board of Nursing Web site at www.nursing.ohio.gov/index.htm and awards from the first grant cycle will be distributed in September.

Wednesday, March 9, 2005
OHA Lauds MedPAC’s Support of Moratorium Extension
The Medicare Payment Advisory Commission (MedPAC) yesterday recommended the extension of the current moratorium on self-referral to new limited-service, physician-owned hospitals until Jan. 1, 2007. MedPAC included this and other recommendations in a report to Congress issued in conjunction with yesterday’s Senate Finance and House Ways & Means committee hearings on the issue.

MedPAC’s recommendations reinforce the concerns of hospitals and others surrounding limited-service, physician-owned hospitals. The report found these specialty hospitals harm their communities and local full-service hospitals by offering primarily those treatments with a high level of reimbursement—disrupting the financial balance of community hospitals and threatening their ability to treat patients with conditions that are poorly-reimbursed. To protect the financial vitality of Ohio’s full-service community hospitals and their ability to provide care to their communities, OHA continues to seek a permanent moratorium on limited-service, physician-owned facilities. OHA will also provide testimony for the record regarding yesterday’s House Ways and Means Committee hearing.

The MedPAC report also recommended payment refinements to the Medicare inpatient prospective payment system and granting gainsharing abilities between physicians and hospitals. In visits with Ohio’s congressional delegation during recent weeks, OHA has urged Congress to permanently extend the moratorium and then pursue the Medicare payment and gainsharing recommendations as separate and independent issues. (Jonathan Archey, jonathana@ohanet.org)

JCAHO Warns Hospitals of Surveyor Impersonators

Earlier this month, at least two hospitals nationwide have reported situations with individuals posing as Joint Commission on Accreditation of Healthcare Organizations (JCAHO) surveyors to the national accrediting organization. According to a letter from JCAHO to all accredited organizations, the individuals reportedly arrived at the facilities at approximately 3 a.m. asking to survey different areas of the hospital. In both cases, hospital staff questioned the impostors, who then left the facility.

JCAHO reminds hospitals to request JCAHO surveyors show their JCAHO identification badge upon arrival at the facility. Surveyors arriving unannounced will also have an official JCAHO letter explaining the visit.

Hospitals experiencing a similar situation should contact Joe Cappiello, JCAHO vice president, accreditation field operations, at 630.792.5757. (Rosalie Weakland, rosaliew@ohanet.org)

Thursday, March 10, 2005
Bill Would Require Med Mal Arbitration
A bill proposing a mandatory medical liability arbitration process has been introduced by Sen. Kevin Coughlin (R-Cuyahoga Falls). Senate Bill 88 would require any Ohioan bringing a medical liability lawsuit against a health care provider to first pursue the claim through a mandatory arbitration panel, which would be established through a ten-year pilot program. The panel would include three lawyers, two selected individually by opposing counsel and one jointly selected.

The panel closely resembles a plan in last session’s House Bill 215, which was rejected by lawmakers concerned the process would increase rather than reduce costs. OHA supports initiatives that reduce costs and create a more efficient medical liability system, and is in the process of analyzing the bill.

On the heels of the bill’s introduction, the Ohio Medical Malpractice Commission this week discussed a possible recommendation that the Ohio Supreme Court create a specialized court to handle medical liability claims on a pilot basis, intended to process claims more effectively before judges who would have greater familiarity with the technical issues in medical negligence lawsuits. The commission is also considering other recommendations including public funding for patient safety and medical error reduction initiatives. (Bridget Gargan, bridgetg@ohanet.org; Rick Sites, ricks@ohanet.org)

OHA Seeks Alternative to Electronic Drug Recordkeeping Rules

OHA this week sent a letter to the executive director of the Ohio Board of Pharmacy expressing continued concern with the barriers hospitals face with the board related to electronic drug recordkeeping. OHA again requested that a task force of board and hospital representatives be created to examine the unique situation of hospital systems in implementing regulation for the electronic documentation of prescription, dispensing and administration of drugs. Community hospitals represent a unique entity, and the current rules are unrealistic in this setting. Ohio’s hospitals seek to work with the pharmacy board to develop alternatives that satisfy the board and meet hospitals’ need to advance the use of electronic health records.

Friday, March 11, 2005
House Budget Proposal Could Mean Medicare, Medicaid Cuts
The House Budget Committee yesterday marked up a proposed Federal Fiscal Year 2006 budget proposal that would require $18 billion in cuts over five years from programs under jurisdiction of the House Ways & Means Committee, with a $4 billion cut in the first year. Though the cuts do not specifically cite Medicare, the committee will most likely need to shoulder Medicare with a large portion of the cuts to achieve a reduction of this magnitude. Because the Bush administration did not outline cuts to Medicare in his budget proposal, the significant cuts proposed by the Budget Committee are an unexpected and unwelcome surprise to hospitals, beneficiaries and others who rely on Medicare reimbursement.

The Budget Committee also instructed the House Energy and Commerce Committee to cut $20 billion over five years from those programs over which it controls discretionary spending—likely signifying cuts to Medicaid. OHA sent a letter to each member of Ohio’s Congressional delegation early this week opposing cuts to Medicaid in the budget resolution.

Still in the early stages of budget process, the House budget resolution now moves to the House floor, while the Senate is expected to complete its own version of an FFY06 budget resolution sometime in the next week or two. Once both versions are passed and reconciled, the congressional committees of jurisdiction will begin debating how to keep federal spending within the resolution’s limits. Throughout the process, OHA will continue to lobby strongly against cuts to both Medicare and Medicaid. (Jonathan Archey, jonathana@ohanet.org)