The newsroom includes access to CHA News, which provides timely information to members every Monday and Thursday and is at the core of CHA benefits. In addition, it is also home to resources such as toolkits and talking points designed to help member hospitals and health systems communicate with internal and external audiences on a range of current health care-related issues. Links to CHA media statements and press releases can also be found here.  

Changes Proposed for Drug Discount Safe Harbor Protections

The Department of Health & Human Services’ Office of Inspector General (OIG) has issued a proposed rule that would remove the Anti-Kickback Statute safe harbor protection for drug rebates paid by drug makers to pharmacy benefit managers (PBMs), Part D plans and Medicaid managed care organizations.

The proposed rule would also create new safe harbors to protect discounts offered to patients at the pharmacy and for fixed fee service arrangements between manufacturers and PBMs.

CHA is currently reviewing the proposed rule and has issued a summary, prepared by Health Policy Alternatives. Comments are due to OIG by 2 p.m. (PT) on April 8.

CHA Helps Reduce Behavioral Health Stigma With Powerful New Video

In an effort to help reduce the stigma around behavioral health issues, CHA has released a new video featuring five accomplished health care executives who have faced mental health challenges. The powerful “truth telling” video is the product of the keynote session at CHA’s recent Behavioral Health Symposium. 

Titled “5 Guys Talking,” the video highlights the importance of increasing access to behavioral health services and support – and the equally important task of reducing stigma so that more people will seek help.  More Americans now have access to behavioral health coverage, but most still lack the care they need due to stigma, flaws in the mental health system and a lack of coordinated resources.

CHA will share the video broadly in order to reach legislators, other elected leaders and key stakeholders with the video’s important public policy message. CHA appreciates the panelists, listed below, for taking the courageous step to tell their stories publicly for the first time at the December Behavioral Health Symposium. 

  • Michael Fitzgerald, MS, PMHCS-BC, executive director, behavioral health services, El Camino Hospital
  • Paul Rains, RN, MSN, president, St. Joseph’s Behavioral Health Center
  • Mitch Gluck, MSW, MBA, assistant hospital administrator, San Diego County Psychiatric Hospital
  • Scott Robertson, MA​, director, behavioral medicine services, Glendale Adventist Medical Center
  • Clayton Chau, MD, PhD, regional executive medical director, Providence St. Joseph Health
  • Moderator: Vincent Wales, CHA

For these bold executives, uncovering secrets and sharing their personal stories is a means of reducing stigma and pointing the way towards hope and recovery.

CHA Board Approves 2019 Advocacy Priorities

In its first meeting of the year on Jan. 31, the CHA Board of Trustees discussed and approved CHA’s 2019 advocacy priorities, which include leading efforts to improve coverage and access to health care; exploring new approaches to making health care more affordable; ensuring adequate state and federal funding for hospitals; reducing stigma and improving access to behavioral health care; strengthening the health care workforce and increasing funding for graduate medical education; and easing statutory and regulatory burdens for providers. 

The board also received a report on federal and state regulatory and legislative proposals, along with an update on CHA’s long-range policy development. In addition, board members engaged in a discussion about improving public confidence in hospitals through effective, proactive, relevant and transparent community benefit activities.

Tom Nickels, executive vice president, government relations and public policy for the American Hospital Association, presented his view of federal political changes and challenges, which included lack of bipartisanship, intra-party fragmentation, and positioning for 2020. Nickels noted that health care, particularly cost transparency and drug pricing, will continue to be at the forefront.

Jason Kinney, public affairs and political communications consultant, shared his view of the post-2018 California political stage and transition of the governorship to Gavin Newsom. With health care as one of his top three policy priorities, Gov. Newsom has emphasized reinstating the individual mandate for health coverage in California, increasing subsidies under the exchange, improving subsidies for coverage issued through the exchange, expanding coverage under Medi-Cal for individuals under age 26, and the creation of both a state surgeon general position and a statewide collaborative to purchase prescription medications.   

Finally, Chair Calvin Knight, president and CEO, John Muir Health, stressed the importance of contributing to the California Hospital Association Political Action Committee (CHPAC) and meeting the CHPAC hospital campaign goals.

Registration Open for Hospital Employee Safety and Workers’ Compensation Seminar

CHA’s annual members-only Hospital Employee Safety and Workers’ Compensation Seminar – set for March 14 in Costa Mesa and March 20 in Sacramento – will include facilitated roundtable discussions, a question and answer session on the various workers’ compensation challenges hospitals face daily, and a discussion of the toll California wildfires took on two hospitals’ leadership and staff.

From discussions about resolving information lapses in medical certifications and getting second opinions, to determining when leave is no longer reasonable and managing the termination process, the roundtable sessions will give attendees a valuable opportunity to see what colleagues at other hospitals are doing.

This seminar is developed specifically for health care professionals working in human resources, employee/occupational health, workers’ compensation and risk management nursing leadership.

CMS Grants Exceptions to Certain Quality Reporting Requirements for Counties Affected by California Wildfires

The Centers for Medicare & Medicaid Services (CMS) has granted exceptions under certain Medicare quality reporting, value-based purchasing and payment programs to providers located in Butte, Los Angeles and Ventura counties, which have all been designated by the Federal Emergency Management Agency as major disaster areas (DR-4407) due to the impact of the California wildfires.

Providers in those counties will be granted an exception and are not required to submit a request. 

A summary of the exceptions is listed below. More detailed information is included in a CMS memo.

Post-Acute Care Providers

  • All quality reporting program (QRP) reporting requirements, including the reporting of data on measures and any other data requested by CMS for the post-acute care QRPs

Inpatient Hospitals

  • Reporting requirements under the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS)
  • Influenza Vaccination Coverage Among Healthcare Personnel measure
  • All Hospital Inpatient Quality Reporting Program chart-abstracted measures, including clinical population and sampling data and National Healthcare Safety Network (NHSN) Healthcare-Associated Infection (HAI) measures
  • Clinical Data Abstraction Center (CDAC) records for chart-abstracted measures and HAI validation templates

Outpatient Hospitals

  • Submission deadline for all Hospital Outpatient QRP chart-abstracted measures
  • CDAC records for chart-abstracted measures

Ambulatory Surgical Centers

  • Data collection and submission requirements for all measures during the annual submission period for 2018 for the Ambulatory Surgical Center QRP

MIPS-Eligible Clinicians

  • MIPS-eligible clinicians will be automatically identified, and no action is required.
  • MIPS-eligible clinicians who are subject to the Alternative Payment Model scoring standard are not covered by the automatic extreme and uncontrollable circumstance policy, but may apply for an exception in the Promoting Interoperability performance category.

PPS-Exempt Cancer Hospitals

  • Chart-abstracted data and NHSN HAI data
  • HCAHPS reporting requirements
  • Influenza Vaccination Coverage Among Healthcare Personnel measure

CHA Outlines Worksheet S-10 Concerns, Urges CMS to Delay Current Deadline for Cost Report Audits

Last week, CHA sent a letter to the Centers for Medicare & Medicaid Services (CMS) outlining concerns about the use of Worksheet S-10 data in the Medicare uncompensated care (UCC) payment distribution methodology. CHA urged CMS to delay the current deadline for cost report audits.

CHA believes that if CMS proceeds with expected plans, Medicare UCC payments from hospitals that have undergone Worksheet S-10 reviews could be redistributed to those that have not; these redistributions could be substantial. Such an inappropriate redistribution would significantly impact many providers’ financial viability and, therefore, threatens Medicare beneficiaries’ ability to access care.    

In the letter, CHA urged CMS to:

  • Rescind guidance that has been issued to the Medicare administrative contractors (MACs) and their subcontractors related to current adjustments to Line 22 on federal fiscal year (FFY) 2015 Worksheet S-10; this guidance reflects an inappropriate interpretation of expected versus actual payments received.
  • Delay the current Jan. 31 deadline for MACs to submit the amended cost report data reflecting these and other adjustments. This delay would allow time for correction so that the file used for FFY 2020 rulemaking is not compromised.
  • Fully address, through notice and comment rulemaking, the significant policy issues that these reviews have uncovered and their implications for FFY 2020 Medicare UCC payments so that stakeholders can provide substantive analysis and thoughtful comments to help guide the agency’s next steps. 

For the past several months, CHA has convened providers, cost report experts and Noridian (California’s MAC) in an effort to proactively identify key reporting issues that remain unaddressed by the agency. CHA thanks members for their invaluable feedback, which helped inform the letter.   

DHCS Clarifies Guidance on Network Certification for Medi-Cal Managed Care Plans

The Department of Health Care Services (DHCS) has released All Plan Letter 19-002, which details reporting requirements for Medi-Cal managed care health plans (MCPs) during the annual network certification process.

Each MCP must provide DHCS with supporting documentation demonstrating its capacity to serve the anticipated membership in its service area; DHCS then provides evidence of compliance to the Centers for Medicare & Medicaid Services.

As previously reported in CHA News, the network adequacy filings are one of the required characteristics to be considered a network provider. APL 19-002 supersedes 18-005, which was referenced in the final network provider guidance released in APL 19-001.   

All required information must be submitted to DHCS by March 19.

CHA Supports Commission’s Recommendations to Grow, Diversify California’s Health Care Workforce

Expanding education and training, increasing diversity, and boosting capacity are crucial steps for ensuring California’s health care workforce can meet patient needs into the future, especially in underserved communities, according to a newly released report from the California Future Health Workforce Commission. CHA supports the commission’s 30 recommendations and the path it outlines to develop a workforce prepared to meet critical future needs.

The commission’s new report, “Meeting the Demand for Health,” outlines the need for a comprehensive, statewide infrastructure designed to educate and produce a steady pipeline of professionals who can care for California’s growing and aging population.

“Health care is nothing without the women and men called to service in this profession,” said CHA President & CEO Carmela Coyle. “This new report affirms something we have known for years: that if we do not collectively invest in developing a new generation of diverse, well-trained, and well-educated health care professionals, we will fall short in our promise to care for all Californians.”

Even though hospitals devote substantial resources to attract, train and retain health professionals, the state faces a notable shortage of workers to provide primary care, prevention, behavioral health, and geriatric care. The commission recommends spending up to $3 billion over the next 10 years to increase California’s health care workforce by 47,000 professionals by the year 2030. 

The recommendations would nearly eliminate the psychiatry shortage by that date and address geographic disparities that jeopardize access to care for millions of Californians.

The California Future Health Workforce Commission was co-chaired by Janet Napolitano, President of the University of California, and Lloyd Dean, CEO of CommonSpirit Health. CHA’s Cathy Martin, vice president of workforce policy, and Sheree Lowe, vice president of behavioral health, were also closely involved in preparation of the report.

Covered California Releases Report on Options for Improving Affordability

Today, Covered California submitted a report to the Legislature titled “Options to Improve Affordability in California’s Individual Health Insurance Market,” outlining options to improve affordability for low- and middle-income Californians. 

Over the past several months, Covered California worked with academic experts and a workgroup composed of stakeholders and legislative staff to produce the report, which will inform ongoing policy discussions about health care affordability. Developed pursuant to Assembly Bill 1810 (Chapter 34, Statutes of 2018), the report presents a range of policy options for improving affordability, as well as estimated outcomes such as enrollment increases and cost reductions for consumers. 

The options include expanding the amount of premium and cost-sharing support for consumers, instituting an individual mandate penalty at the state level, and establishing a reinsurance program. The policy options contained in the report include both a comprehensive market-wide approach as well as several discrete options that could be targeted to different segments of the market based on policy priorities and budget limitations. The report estimates that, depending on the approach and options, the policies could result in an additional 750,000 Californians gaining coverage (compared to potential enrollment in 2021 without the policies). The various approaches and increase in enrollment could allow consumers to save thousands of dollars in health care costs. 

Last week, CHA submitted comments to Covered California on its draft version of the report, reiterating readiness to partner with Covered California and the Legislature to build upon the Affordable Care Act by implementing premium and cost-sharing subsidies, an individual mandate and penalty, and reinsurance. CHA urged Covered California to examine each option to determine how it might impact total enrollment, coverage rates, choice of coverage, and new funding for proposed subsidies, as well as the effect on federal premium tax credits. CHA commended Covered California for its leadership in this area, noting that it looks forward to future collaboration to ensure that all Californians have access to health care coverage. 

OSHA Log 300A Deadlines Require Attention Today

Employers should be aware that important state and federal Occupational and Health Safety Administration (OSHA) deadlines require them to post 2018 Log 300A today at their work sites, and submit them electronically by March 2.

There has been much confusion with respect to an employer’s obligation to submit various OSHA record-keeping forms. While the dust has not fully settled, the following requirements are currently in place:

  • California law requires employers to post their 2018 OSHA Log 300A beginning Feb. 1 and through April 30. The Log 300A document must be displayed in a common area where notices to employees usually are posted. Employers must also make a copy of the summary available to employees who move from worksite to worksite, as well as employees who do not report to any fixed establishment on a regular basis. 
  • Federal law now requires employers to submit their 2018 OSHA Log 300A electronically no later than March 2, 2019. This includes employers with 20 to 249 employees in the specific industries: general medical and surgical hospitals, psychiatric and substance abuse hospitals, ambulatory health care services, and other health care providers.

Last week, the federal Occupational Safety and Health Administration (OSHA) issued a final rule rescinding its requirement that specified health care employers electronically submit OSHA Logs 300 and 301. Employers must, however, continue to complete and maintain those logs at the workplace.

It is possible that California will resurrect the obligation to electronically submit Logs 300 and 301. In 2018, Assembly Bill 2334 added Labor Code 6410.1, requiring Cal/OSHA to convene an advisory committee to evaluate how to protect the goals of the 2016 federal OSHA rule if that rule was rescinded. Because the federal OSHA rule has now been rescinded, Cal/OSHA is expected to convene an advisory committee. CHA will participate in the advisory committee process.  

Press Contact

Jan Emerson-Shea
Vice President, External Affairs
(916) 552-7516

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