OHA - HEALTH e-NEWS

Monday, May 2, 2005
Congress Passes Budget Resolution with Potential Billions in Medicaid Cuts
Congress late last week passed a fiscal year 2006 budget resolution that calls for a potential $10 billion in Medicaid spending reductions over five years and also exposes Medicare to potential cuts. A new one-year Medicaid commission, supported by Ohio Sen. Mike DeWine (R-OH) and many others in the delegation, will examine and recommend cost-saving proposals before the House Energy and Commerce and Senate Finance Committees implement the cuts starting in 2007.

The first budget resolution agreed to by both the House and Senate since 1997, the 2006 budget resolution is not the final word, but it does set guidelines for lawmakers as they make specific decisions on spending for federal fiscal year 2006. While some of the $10 billion could come from savings achieved by states' getting Medicaid prescription drugs at a lower price, it is unclear which parts of the program will bear the remaining spending reductions. A more complete picture will emerge as the national Medicaid study commission completes its work and the federal appropriations are set—tasks that are expected to be completed by Sept. 16. OHA will continue to advocate for the protection of Medicare and Medicaid funding for Ohio's hospitals and the patients they serve, and will keep members apprised of the ongoing federal budget process. For more information on federal issues impacting Ohio’s hospitals, visit www.ohanet.org/advocacy/federal/. (Jonathan Archey, jonathana@ohanet.org)

Congress Digs Into Hospitals’ Tax Exemption

Congress continued its look into the tax-exempt status of the nation’s hospitals at a full hearing of the Ways and Means Committee April 20. Led by Chairman Bill Thomas (R-CA), the committee began reviewing all tax-exempt organization, including hospitals, last June.

During the hearing, Thomas indicated the need for more clear definitions of what qualifies an organization as tax-exempt and how it should be regulated. The committee recognized the need for an updated system, but had an understanding that qualifying as tax-exempt enabled charitable organizations to contribute innumerable benefits to their communities – benefits that would be lost if they were stripped of their tax-exempt status.

The General Accounting Office has called for periodic congressional review of the tax-exempt sector to look at criteria and transparency, although it recognized the huge array of charitable services and jobs provided by these organizations.

In response to the hearing, OHA submitted testimony for the record to the committee outlining the level of hospitals’ uncompensated care in addition to the many other benefits hospitals provide to their communities. Find a copy of the letter at www.ohanet.org/advocacy/federal/resources/thomas_050205.pdf. OHA anticipates legislation regulating tax-exempt organizations will be introduced yet this year. Learn how to communicate about your hospital’s many benefits in the online Community Benefit Toolkit, available at www.ohanet.org/cbtoolkit/. (Jonathan Archey, jonathana@ohanet.org)

Tuesday, May 3, 2005
Bill Makes ED Reimbursement to Providers Contingent on Patient Condition
House Bill 152, sponsored by Rep. Louis Blessing (R-Cincinnati) and currently in the House Health Committee, offers amendments to Hospital Care Assurance Program services and Medicaid reimbursement for services rendered in a hospital emergency department. OHA has concerns with HB 152, which would make reimbursement for emergency room treatments contingent on whether a patient has an emergency medical condition as defined in EMTALA. EMTALA was created to ensure that patients with emergency medical conditions receive proper treatment, not to address a hospital’s decision to treat a patient who does not fit the qualifications as an emergency. Under the proposed legislation, hospitals would receive reduced reimbursement—being financially punished for choosing to treat patients in their emergency rooms who may not have emergency medical conditions.

OHA also has concerns with language in the bill outlining how hospitals or health care practitioners should determine whether a patient has an emergency medical condition. OHA continues to examine the legislation and has expressed concerns to the bill’s sponsor. To track the progress of these bills and other ongoing legislation that could impact Ohio’s hospitals, visit www.ohanet.org/advocacy/state/resources/Status126.doc. (Bridget Gargan, bridgetg@ohanet.org)

Hospitals Should Monitor Legitimacy of Info Requests

An Ohio hospital recently experienced a fraudulent request for information when a man in military uniform visited an Ohio hospital human resources department asking questions about hospital disaster preparedness and surge capacity. Though he showed identification and claimed to be gathering information for the military, the hospital asked the man to return later to speak with a more appropriate staff member and he left without incident. The hospital reported the incident to local law enforcement and learned that the request for information was not legitimate. Though the Ohio National Guard is beginning to assess Ohio’s hospital bed capacity, no one is currently performing site visits.

In response to this incident and recent fraudulent inspectors nationwide, the Central Ohio Regional Hospital Emergency Preparedness Committee’s Safety and Security Subcommittee will address this issue at its May 12 meeting. The subcommittee will draft a template policy for dealing with requests for information and determining the legitimacy of such requests. If a hospital currently has a policy in place and would like to share, contact Marshal Bickert, Regional Hospital Emergency Preparedness Coordinator, at mbickert@goodhealthcolumbus.org. Hospitals needing additional information should contact Carol Jacobson at OHA at 614.221.7614.

Seminar Offered for Emergency Department Staff

As the number of uninsured and underinsured Americans increases, hospital emergency departments (ED) become frontline health system access points. ED visits have increased exponentially over the past 10 years, to a point of reaching capacity or experiencing frequent overcrowding.

In a 2004 American Hospital Association survey, 24 percent of all hospitals nationwide reported EDs at capacity and another 24 percent reported EDs over capacity. In 2002, Ohio hospitals reported over five million emergency outpatient visits, a 7.6 percent increase since 1992. And the average hospital facility’s age has increased from 7.9 years in 1990 to 9.8 years in 2002, with declining reimbursements and increasing costs consuming potential funding for updates and renovations. As EDs face this increasing demand, current systems are strained and many ED staffs are challenged to implement rigorous patient safety and risk management techniques based on key patient safety indicators.

On May 18, OHA, in cooperation with OHIC Insurance Company, will offer a seminar to assist hospitals with proven strategies to address current ED patient volume. Learn how to improve patient to physician times, increase admissions from the ED and ensure patient safety and satisfaction. For more information or to register, visit www.ohanet.org/education/education_programs.asp. (Joe Ruggles, joer@ohanet.org)

Wednesday, May 4, 2005
National Advanced Directives Site Launched
Following national attention to advance directives, the American Hospital Association (AHA) this week launched www.PutItInWriting.org, a Web resource in Spanish and English that provides hospitals and consumers with easy-to-use information on advance directives. The site includes a glossary of terms, downloadable version of AHA’s Put It In Writing brochure, and a wallet card a patient can carry to alert heath care workers the patient has an advance directive. It also includes tips for communicating wishes with family and friends and a link to the American Bar Association’s (ABA) Web guide, 10 Legal Myths About Advance Directives. One of the myths, according to the ABA, is that a lawyer is needed to do an advance directive.

Advance Directives Packet: Choices, Living Well at the End of Life, an Ohio-specific advance directives packet to help patients and their families make end-of-life decisions, is available on OHA’s Web site at www.ohanet.org/advocacy/state/issues/advance_directives.htm. The packet was created by OHA, the Ohio Hospice and Palliative Care Organization, Ohio State Medical Association and Ohio Osteopathic Association. (Rick Sites, ricks@ohanet.org)

Forum Solicits Input on Trauma Triage Rules

The state Trauma Committee will conduct an open forum May 11 at 11 a.m. to solicit input and comments from the public and Emergency Medical Services community regarding the current trauma triage rules. The meeting will be held at the Ohio Department of Public Safety in Columbus, in room 134.

The rules can be downloaded online at www.ems.ohio.gov/rules.htm under “ORC and OAC Combined” and written comments and feedback will be accepted until 5 p.m. May 6 to be considered at the May 11 meeting. Comments should be sent to the Ohio Department of Public Safety, Trauma Committee, Division of EMS, 1970 W. Broad St., Columbus, OH 43223, e-mailed to mglenn@dps.state.oh.us or faxed to 614.466.9461. The May 11 meeting is an information gathering session and the State Board of Emergency Medical Services will conduct an official public hearing prior to filing any revisions to these rules.

Thursday, May 5, 2005
Operating Surgeon Can Supervise Nurse Anesthetist
The Centers for Medicare & Medicaid Services (CMS) this week clarified that a second surgeon is not needed to supervise a certified registered nurse anesthetist (CRNA) who is administering anesthesia. Clarifying its interpretive guidelines for hospital anesthesia conditions of participation, CMS said the operating surgeon may supervise a CRNA who is working on the same patient. The agency issued interim changes to the guidelines to clarify wording that confused many hospitals and surveyors until the guidelines can be updated on its Web site. CMS also clarified that physicians do not need to be specially privileged to supervise someone administering anesthesia, but that the hospital should spell out in its statement of privileges the type and complexity of procedure that each category of practitioner may supervise. (Rosalie Weakland, rosaliew@ohanet.org)

Providers Asked to Comment on Health Record Technology

The Certification for Healthcare Information Technology has released proposed requirements for certifying health record products in the outpatient setting. Hospitals are encouraged to submit comments, which will be used to refine the requirements before the certification program is finalized and tested this summer. Visit www.cchit.org/publiccomment1.htm to submit a comment online by May 18. (David Engler, davide@ohanet.org)

Hospital Receives Critical Access Designation
Hocking Valley Community Hospital in Logan was granted Critical Access Hospital (CAH) designation, effective April 1, 2005. The federal CAH program entitles select small, rural hospitals to Medicare cost-based reimbursement. To become a CAH, hospitals must provide 24-hour emergency services along with inpatient care, laboratory and radiology services, and meet other specific criteria.

Hocking Valley Community Hospital is the 31st Ohio hospital to receive the designation. For a complete list of Ohio CAHs, go to www.ohanet.org/about_oha/cah.asp. (David Hendershot, davidh@ohanet.org)

Friday, May 6, 2005
Annual Meeting Luncheon Focuses on Federal Policy
As part of the 2005 OHA Annual Meeting, Congressman Ted Strickland, U.S. Representative for the 6th Ohio Congressional district, will speak at a Membership/Advocacy Luncheon. Strickland will discuss health care policy at the federal level. The luncheon, slated for 11 a.m. to 1 p.m. on Monday, June 20, requires an additional fee and a ticket to attend.

Other meal functions at this year’s annual meeting include an OHA Compliance Officers Network Luncheon/SOHA on Monday, June 20, from noon to 1:15 p.m; ACHE Breakfast on Tuesday, June 21, from 7:15-8:30 a.m.; HFMA/COPAM Luncheon on Tuesday, June 21, from noon to 1:15 p.m.; Public Relations Luncheon on Monday, June 20, from noon to 1:15 p.m.; and the OHA Recognition Dinner on Monday June 20 at 6 p.m. To learn more about and register for the OHA Annual Meeting and the related events listed above, visit www.ohanet.org/annualmeeting/.

Labor Law Seminar Around the Corner

Hospitals are encouraged to check out an upcoming labor relations workshop in the OHA/Jones Day Labor Law and Contract Programs series May 19 in Columbus. Participants in the seminar will receive updates on activities of the California Nurses Association and Service Employees International Union reports on contract settlements, and the latest information on the Family and Medical Leave Act and Fair Labor Standards Act. Hospitals not subscribed in the Labor Law Project can attend for $125 per person. There is no additional fee for Labor Law Project participants. Contact Debbie Wolfe at 614.221.7614 or debbiew@ohanet.org to register.