Wednesday, March 12, 2008
Hospitals, Local Union Disappointed by California-based Union Tactics
Health care workers in Springfield, Lima and Cincinnati will not have the opportunity to vote this week on whether to unionize despite an innovative election process developed cooperatively by Catholic Healthcare Partners and the Service Employees International Union (SEIU), District 1199. The health system and local union worked together to establish a process that would allow hospital employees to choose whether or not to join the union without pressure from either side and without interrupting their ability to care for patients – factors that often occur during traditional union election campaigns. With the elections slated for today and Friday, the California Nurses Association stepped in, objecting to the voting process and sending members to talk to hospital employees as they worked to care for patients. CHP obtained a restraining order in Lima against these tactics, but the CNA efforts forced the cancelation of this week’s elections. View an SEIU news release for more information. (Mary Gallagher, maryg@ohanet.org)

House Passes Nurse Staffing Bill
By a 91 to 1 vote, the Ohio House of Representatives today passed House Bill 346, legislation regarding hospital nurse staffing plans that is supported by OHA, the Ohio Nurses Association and the Ohio Organization for Nurse Executives. Read more in tomorrow’s HEALTH e-NEWS Plus or visit OHA’s state health care issues Web site to learn more about the nurse staffing issue.

House, Senate Pass Provider Credentialing, Contracting Legislation
The Ohio House and Senate have passed House Bill 125, the Health Care Simplification Act, sponsored by sponsored by Rep. Matt Huffman (R - Lima). OHA supports the bill, which includes a two-year moratorium on the use of most favored nation clauses in hospital provider agreements with health plans and creates a committee to study the effects of most favored nation clauses on the availability, accessibility and affordability of health insurance. The legislation also makes several reforms to the managed care contracting process and requires health plans to provide a summary disclosure form for each contract. Health plans must also use a standard credentialing application form when credentialing physicians and adhere to streamlined credentialing time frames. The bill now heads to the governor. (Jeff Klingler, jeffk@ohanet.org; Mary Gallagher, maryg@ohanet.org)

Hospitals File Lawsuit to Stop Federal Medicaid Cuts
Several national hospital organizations yesterday asked a federal court to prevent the Bush Administration from implementing a proposed Medicaid regulation that would cut $5 billion in funding to safety net hospitals nationally. Congress last year enacted a moratorium that prevents the Centers for Medicaid & Medicare Services’ (CMS) from issuing the final rule, but the moratorium is set to expire May 25 without intervention from Congress or the courts. The suit asks the court to reject the Centers for Medicaid & Medicare Services’ regulation and litigants also continue to work with Congress to seek a legislative solution to the proposed cuts.

Medicaid is the health insurance program for one of every six Ohioans and Medicaid accounts for about 16 percent of a typical Ohio hospital’s admissions, outpatient and ED visits. At the state level, reimbursement for care provided to Medicaid patients has been frozen since 2005 and hospitals faced more than $321 million in Medicaid losses in 2005. Cuts at the federal level would add to this shortfall, compromising hospitals’ ability to care for their communities.

The suit to stop the CMS rule was filed by a coalition led by the National Association of Public Hospitals and Health Systems, the American Hospital Association, the Association of American Medical College and supported by the National Association of Children’s Hospitals. View a news release for more information. (Mary Gallagher, maryg@ohanet.org)
 

Thursday, March 13, 2008
OHA, ONA, OONE Supported Nurse Staffing Bill Clears House
By a 91 to 1 vote, the Ohio House of Representatives yesterday passed House Bill 346, legislation regarding hospital nurse staffing plans that is supported by OHA, the Ohio Nurses Association (ONA) and the Ohio Organization for Nurse Executives (OONE). In preparation for Wednesday’s vote, OONE members accepted a challenge from OHA to write letters to their state representatives urging a “yes” vote on the bill. OONE members did an outstanding job by writing 221 letters, contacting 82 of 99 House members.

The bill requires hospitals to create a nursing care committee with nurses representing all types of nursing services offered by the hospital. The committee will develop recommendations for a nurse staffing plan that is consistent with current private or governmental accreditation standards. Hospitals would be required to significantly consider the recommendations when establishing staffing plans, and they must provide the nursing staff with a copy of the staffing plan, free of charge, and provide it to others who request it for a nominal fee.

OHA will continue to push for enactment of the “common sense” nurse staffing legislation, sponsored by Rep. Jim Hughes (R-Columbus) as the bill now moves to the Ohio Senate for consideration. OHA met with Sen. Sue Morano (D-Lorain) on Monday to discuss the legislation as she is registered nurse that serves on Senate Health, Human Services & Aging Committee. Morano indicated that the bill is “a step in the right direction,” by giving direct care nurses a voice in the staffing development process. She also indicated a desire to strengthen the role of hospital nursing care committees so that they may evaluate the staffing plan after it is implemented and address and resolve comments or concerns raised by direct care nurses. To learn more about the nurse staffing issue visit OHA’s state health care issues Web site. (Jeff Klingler, jeffk@ohanet.org; Jean Scholz, jeans@ohanet.org)

Vote on Proposed Geriatric Triage Criteria Delayed Until May
Hospitals have additional time to submit comments on proposed changes to the current geriatric triage rules, which were authorized by a 2000 law designed to implement a statewide trauma system. At its meeting this week, the state Trauma Committee did not vote on the new criteria, which include the addition of indicators for EMS and emergency department personnel to use in deciding if an injured geriatric patient should be sent to a trauma center for treatment. The EMS Office of Research and Analysis estimated the effects of the new geriatric trauma triage criteria on hospitalizations of geriatric trauma patients.

The Trauma Committee will consider the changes at its May meeting. Upon approval from the Trauma Committee, the rule will be sent to the State Emergency Medical Board, which begins a 75-day process that includes a public hearing on the proposed changes and submission to and review by the legislative Joint Committee on Agency Rule Review. Please share suggested changes and letters of support or opposition by April 14 with Bridget Gargan at bridgetg@ohanet.org.

BWC Sends Notices to Hospitals Affected by OHA Lawsuit
Those hospitals that were affected by the lawsuit OHA successfully brought against the Ohio Bureau of Workers Compensation should have received notices and listings of claims from the Bureau. Addressed to hospital chief financial officers, the Bureau communication includes spreadsheets with detailed information about the affected claims and estimated adjustment amounts as well as a settlement agreement and release. OHA and its legal counsel negotiated the included settlement agreement. 

In 2005, OHA claimed, and the courts agreed, that the Bureau's fee plan was improperly implemented and was invalid. Hospitals and other affected facilities will be reimbursed for claims that were underpaid from Oct. 1, 2005, through March 2007, for inpatient claims and through August 2007 for outpatient claims. The Bureau is progressing on the aggressive timeline it committed to meet at the OHA Board's February meeting. The Bureau expects to finalize all payments by mid-June. Questions should be directed to the Bureau at HospitalFeeAdjustments@bwc.state.oh.us.  (Charles Cataline, charlesc@ohanet.org; Mary Gallagher, maryg@ohanet.org)
 

Friday, March 14, 2008
Medicaid Providers Must Use Tamper-Resistant Prescription Pads Starting April 1
A new federal requirement set to go into effect April 1 states that all prescriptions for Medicaid fee-for-service patients must be written on tamper-resistant prescription pads. Paper for the prescription pads must have at least one tamper-resistant feature as outlined by the Centers for Medicaid & Medicare Services (CMS) and defined by the state of Ohio. Beginning Oct. 1, these same prescriptions must be on paper that meets all three baseline characteristics of tamper-resistant pads. CMS outlined the three baseline characteristics as those that: (1) prevent unauthorized copying of a completed or blank prescription form; (2) prevent the erasure or modification of information written on the prescription by the prescriber; or (3) prevent the use of counterfeit prescription forms.

Individual states are responsible for defining specific features that meet the baseline characteristics in order for a prescription to be considered tamper-resistant in that state.  Watch Ohio’s Web site at http://jfs.ohio.gov/ohp/bhpp/omdp/POS.stm for updated information on acceptable tamper-resistant features. Additional information on CMS’ requirements is available at http://www.cms.hhs.gov/DeficitReductionAct/30_GovtInfo.asp.

Please note that electronic prescriptions, faxed prescriptions and prescriptions sent over the telephone are exempt from this requirement.  Failure to comply with this requirement could result in a withholding of Medicaid reimbursement. (Charles Cataline, charlesc@ohanet.org)