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The Governor signed AB 188 (Jones, D-Sacramento/Alquist, D-Santa Clara/Steinberg, D-Sacramento) on Nov. 5. Co-sponsored by CHA, the bill provides the necessary appropriations for the state to seek federal approval to implement AB 1383 (Jones, D-Sacramento/Alquist, D-Santa Clara). AB 1383 assesses a fee on hospitals for the purpose of securing matching federal funds to make supplemental Medi-Cal payments to hospitals and to provide the state with $320 million in annual funding for children’s health care coverage.

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Orders are now being accepted for the new California Hospital Compliance Manual. This highly anticipated manual is the only publication written for hospital compliance officers that integrates California law with federal law on high-risk compliance areas.

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The Government Accountability Office (GAO) has released a report that found the many varying requirements of the four types of contractors Medicare uses to conduct post-payment reviews imposes an administrative burden on providers. GAO reviewed the different requirements for post-payment review for Medicare Administrative Contractors (MACs), Zone Program Integrity Contractors (ZPICs), Recovery Audit Contractors (RACs) and Comprehensive Error Rate Testing (CERTs) to assess how the differences between the programs impede efficiency and effectiveness. GAO also found that RACs, who are paid fees contingent on the amount of claims recouped or adjusted, conducted almost five times as many reviews as the other three contractors combined, whose reimbursement is not dependent on the amount of their claims reviews. The GAO recommended that the Centers for Medicare & Medicaid Services review the differences between programs to determine those that can be made more consistent and take actions to reduce those differences within an established and publicized timeline. The report is available at www.gao.gov/products/GAO-13-522.
The report’s findings echo the concerns California’s hospitals have expressed about the administrative burden associated with the RAC program. CHA continues to advocate for H.R. 1250, the Medicare Audit Improvement Act, and urges members to contact their representatives to co-sponsor the bill.  More information is available at www.calhospital.org/advocacy-alert/urge-representatives-support-changes-rac-program-delay-cuts-medicare.
 

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Covered California will hold its next regional town hall meeting Aug. 30 in Sacramento, co-hosted by U.S. Reps. Doris Matsui, John Garamendi and Ami Bera; California Senate President pro Tem Darrell Steinberg and Sen. Lois Wolk; and Assemblymembers Roger Dickinson, Ken Cooley, Mariko Yamada and Richard Pan. Covered California board members and Executive Director Peter Lee will lead discussions, including an update on the exchange’s progress and current plans; outreach and community education strategies; and stakeholder feedback, questions and comments.

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In response to stakeholder requests, the Centers for Medicare & Medicaid Services has announced it will make hospital-level results for hospital acquired conditions (HACs) and PSI-11 available to the public in late September. Hospitals should expect to receive a preview of their reports by Aug. 26, in order to review the information prior to its public release. Hospitals can review their confidential reports via My QualityNet. If hospitals have problems accessing their reports, they should contact the QualityNet help desk at qnetsupport@sdps.org. Because the HACs are not included in the hospital inpatient quality reporting program, they will not be posted on Hospital Compare, but will instead be posted to data.cms.gov.

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Today marks the official transition from Palmetto to Noridian Administrative Services for Medicare Part A fee-for-service claims in California; Part B implementation will begin Sept. 16. It was announced earlier this year that Noridian received the Medicare Administrative Contractor award for processing Part A and Part B fee-for-service claims in Jurisdiction E, which includes California. To assist with the transition, hospitals may want to attend one of Noridian’s online training opportunities, including its Ask the Contractor teleconference series. For more information about training events, visit https://med.noridianmedicare.com/web/jea/education/act.

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Representatives from San Mateo County EMS Agency and San Francisco General Hospital and Trauma Center will speak about the Asiana plane crash and response at the closing session of CHA’s upcoming Disaster Planning Conference, to be held Sept. 23-25 in Sacramento. Participants will gain critical insight into the operational and logistical coordination required during a mass casualty incident response, from first responder triage and treatment to patient care at area hospitals.
Other general session presentations include the Boston Marathon bombing response and recovery; the Hurricane Sandy evacuation; updates from the Department of Health and Human Services Assistant Secretary for Preparedness and Response, the California Department of Public Health and the California Emergency Medical Services Authority; and thought-provoking presentations on understanding legal issues and the role of leadership after a disaster. In addition, the program features 16 different breakout sessions, an update on the 2013 statewide medical and health exercise, and a half-day pre-conference workshop titled “Utilities Management: Preserving Critical Systems.”

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According to results from the American Hospital Association’s quarterly RACTrac survey, recovery audit contractor (RAC) reviews continue to increase for hospitals. AHA reports that medical record requests have increased by 47 percent, while complex audit denials have increased by 58 percent since the fourth quarter of 2012. In addition, 45 percent of hospitals that participated in the survey experienced overturned denials through use of the discussion period.
AHA will host a webinar on Sept. 19 to review the RACTrac survey results as well as recent Centers for Medicare & Medicaid Services regulations that impact the RAC program. For more information, visit www.aha.org/ractrac. A copy of the survey report is attached.