MHA News Now

Read the Summer 2013 edition of Mississippi Hospitals magazine

The latest edition of Mississippi Hospitals magazine is available for download here. You can also read our ePub edition . Read articles about:

• Milestone da Vinci Robotic-Assisted Surgery Performed at Wesley Medical Center 
• Kathryn Webb Inducted Into Mississippi Nurses Association Hall of Fame 
• Local Girl Scout Donates Artwork to Ocean Springs Hospital
• Baptist Cancer Center Opens New Chemotherapy Infusion Center
• Cautionary tale becomes success story
• New robot assisted bariatric surgery procedure helps patients control their weight
• First robotic vertical sleeve gastrectomy in Mississippi performed at Central Mississippi Medical Center (CMMC)
• Neshoba County General Hospital – Nursing Home Announces New Outpatient Infusion Unit
• Forrest General Healthcare Foundation Begins Campaign To Build Hospice House in Hattiesburg
• St. Dominic’s Acquires Educational Patient Simulators
• Anderson Transitions Patients into a Lifestyle of Fitness
• Wesley Medical Center First Hospital in Mississippi to Offer Breakthrough Nuclear Camera Technology

For more information on how to have your hospital news featured in this magazine, contact Shawn Rossi at (800) 289-8884, (601) 368-3237 or srossi@mhanet.org.

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AHA urges MedPAC to re-evaluate LTCH proposals

The American Hospital Association on June 13 expressed deep concern with Medicare Payment Advisory Commission research on a potential reform approach that would eliminate the long-term care hospital prospective payment system and make all payments for LTCH services under the inpatient PPS.

“We are deeply concerned that the commission has not adequately justified the need for such extreme reforms, especially considering how drastically they differ from its prior goal of using criteria to define the type of patient who is appropriate for admission to an LTCH,” AHA Senior Vice President of Public Policy Analysis and Development Linda Fishman wrote in a letter to MedPAC. “Rather than continuing on this radical path toward elimination of the LTCH PPS, we urge the commission to consider more reasonable reforms that would maintain the LTCH PPS for a narrower range of appropriate cases.”

MedPAC staff discussed this reform at its April meeting and defined a new subcategory of patients – chronically, critically ill patients. In its letter, AHA said MedPAC’s proposed CCI criterion “is arbitrary and excludes appropriate LTCH patients,” and that the commission “presented no clinical rationale for excluding from the CCI category many cases with the highest acuity levels.”

CMS Issues Health Insurance Exchange Proposed Rules

Most of the proposal focuses on program integrity for state marketplaces and insurance companies offering coverage in the federally facilitated exchanges. The rule intends to safeguard federal money and consumers.

Read more here.

MHA to host an Inpatient Medical Necessity Workshop in August

On August 6, the Mississippi Hospital Association will host an Inpatient Medical Necessity workshop at the MHA Conference Center in Madison from 8:30 a.m. until 4 p.m.  The instructor will be Jean Ann Hartzell Minzey, RHIA, CHA, CPC.

This program is designed to discuss and define an inpatient and medical necessity both upon admission and continued stay. Specifically, we will emphasize the documentation needed to evaluate “medical necessity, intensity of service and severity of illness."  

With the high level of retrospective denials, learning the key definitions and documentation components will assist the facility in choosing the right level of care and the appropriate patient classification. The cost is $135 for MHA members and $190 for non-members.

Register online here. For more information, contact Judith Forshee at (800) 289-8884, (601) 368-3216 or jforshee@mhanet.org. 

AHA webinar Wednesday to review latest RAC survey data

Hospitals are invited to review results from the American Hospital Association's latest RACTrac survey and learn more about the initiative during a webinar on June 19 at 2 p.m. Eastern Time. The free web-based survey helps gauge the impact of Medicare recovery audit contractors and helps AHA advocate for needed changes to the program.

The latest results include new data on RAC medical necessity reviews and appeals. For more on the AHA's RACTrac initiative, visit www.aha.org/ractrac.

AMA reports on claims processing performance of large insurers

The American Medical Association on June 17 released its sixth annual report on the claims processing performance of the nation’s largest health insurers. This year’s report looks at the timeliness, transparency and accuracy of claims processing by Medicare and seven commercial insurers: Aetna, Anthem Blue Cross and Blue Shield, Cigna Corp., Health Care Services Corp., Humana Inc., Regence, and UnitedHealthcare.

While error rates for commercial insurers on paid medical claims dropped from nearly 20% in 2010 to 7.1% in 2013, AMA estimates that more than $43 billion could have been saved if commercial insurers consistently paid claims correctly. Claim denials by the commercial insurers declined from 3.5% in 2012 to 1.8% in 2013, while Medicare had the highest denial rate at 4.9%.

This year’s report includes a new index ranking the commercial insurers according to the level of unnecessary cost they contribute to the billing and payment of claims.

[ via AHA News Now ]

MHA hosting transition care management workshop in July

On July 16, the Mississippi Hospital Association will host Transition Care Management at the MHA Conference Center in Madison. The instructor will be Linda Easterly, MS, BSN. 5.0 continuing nursing education hours will be provided.

Register online here. For more information, contact Judith Forshee at (800) 289-8884, (601) 368-3216 or jforshee@mhanet.org. 

Nominate Your Hospital Programs for the 2013 Charitable Services Awards

Jackson Healthcare sponsors the Annual Hospital Charitable Service Awards which recognizes hospitals around the nation for their community benefit and outreach programs that are serving the community. In four years, they have awarded over $300,000 across 30 hospital programs from across the nation.

Nominations for the 2013 Awards are now open. The deadline to nominate is August 23, 2013. To request an application and learn more, click here.

CMS has Released Updated Resources with Changes to Stage 1 Meaningful Use Objectives, Measures, and Exclusions

Changes to Stage 1 Measures
Beginning in 2013, there are several changes to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs' Stage 1 meaningful use objectives, measures, and exclusions. These changes took effect on October 1, 2012, for eligible hospitals and critical access hospitals (CAHs), and on January 1, 2013, for eligible professionals (EPs). Although some of the changes to meaningful use objectives, measures, and exclusions are optional, others are required.

Stage 1 Changes Resources

In order to help providers understand the changes to Stage 1 of meaningful use, CMS has released several resources with detailed information on the affected sections of the program.

• 2013 Stage 1 Changes Tip Sheet — Explains the changes for the 2013 program year and which providers are affected
• Updated Stage 1 Specification Sheet Table of Contents for EPs and for eligible hospitals and CAHs — lists all the Stage 1 core and menu objectives, with direct links to each individual measure specification sheet
• Updated Stage 1 Specification Sheet zip files for EPs and for eligible hospitals and CAHs —contain PDFs for download of all of the core and menu objectives for EPs and eligible hospitals and CAHs

 Want more information about the EHR Incentive Programs? 

Make sure to visit the EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

PERM Cycle 2 Provider Education Webinar/Conference Calls

CMS is hosting Payment Error Rate Measurement (PERM) provider education webinar/conference calls for Medicare providers who also provide Medicaid and CHIP services. Complete details are available in the webinar/conference calls announcement.

Presentations will include:

• The PERM process and provider responsibilities during a PERM review
• Frequent mistakes and best practices
• The Electronic Submission of Medical Documentation, esMD program

To join the meeting:

• Registration is not required, however, space is limited
• All webinars are from 3-4pm ET
• Audio: 877-267-1577, Meeting ID# 4964
  • Tuesday, June 18 — Webinar 
  • Tuesday, July 2 — Webinar 
  • Wednesday, July 17— Webinar

OIG recommends changes to Medicare laboratory fee schedule

State Medicaid plans and federal employee health plans paid between 18% and 30% less than the Medicare Clinical Laboratory Fee Schedule for the top 20 clinical laboratory tests in 2011, according to a new report from the Department of Health and Human Services’ Office of Inspector General. OIG estimates that Medicare could have saved $910 million by paying health care providers at the lowest of the surveyed rates.

The report recommends that the Centers for Medicare & Medicaid Services seek legislation that would allow it to set lower payment rates for tests under the fee schedule, and consider legislation to allow copayments and deductibles for the tests. In the report, CMS said it is exploring whether it has authority under the current statute to revise payments for laboratory tests.

[ via AHA News Now ]

Organ transplant network revises lung allocation policy for children under 12

The Organ Procurement and Transplantation Network on June 10 revised for one year the national lung allocation policy for transplant candidates under age 12 while it considers the issue further. The revised policy allows a lung transplant program to submit a request to a national lung review board for a candidate under 12 to have an additional listing, at the same hospital, for offers from adult and adolescent donors based on the existing Lung Allocation Score for adolescent and adult candidates.

The pediatric candidate also would retain their priority for pediatric donors, which includes immediate access to matching donors within a 1,000-mile radius of the donor hospital. As of yesterday, 1,659 candidates were listed for a lung transplant nationwide, 30 of whom were age 10 or younger.

OPTN is operated by the United Network for Organ Sharing under a contract with the Department of Health and Human Services.

[ via AHA News Now ]

CDC updates guidance on MERS virus

Health care providers should evaluate for Middle East Respiratory Syndrome patients who develop unexplained severe acute lower respiratory illness within 14 days of traveling from the Arabian Peninsula or neighboring countries, according to a notice issued June 7 by the Centers for Disease Control and Prevention. That’s up from 10 days previously, because the incubation period for the novel coronavirus may be longer than previously estimated, CDC said. The notice includes updated guidance on MERS surveillance, laboratory testing, case definitions and infection control.

The virus has infected 55 people in eight countries in the past year, more than half of whom have died. No cases have been reported in the U.S. to date.

On June 13, CDC will host a webinar for clinicians on how to recognize and prevent the spread of MERS. For more on the virus, visit www.cdc.gov/coronavirus/MERS.

[ via AHA News Now ]