The newsroom includes access to CHA News, which provides timely information to members every 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.
Newsroom
CMS Proposes Changes to Medicare Advantage, Part D Prescription Drug Programs
Earlier this month, the Centers for Medicare & Medicaid Services (CMS) issued the attached proposed rule updating Medicare Advantage and the Part D prescription drug program for contract year 2019. Among the proposed changes, CMS would codify the current Quality Star Rating System for Medicare Advantage and Part D plans, eliminate the “meaningfully different” standard that Medicare Advantage organizations must meet if they offer multiple plans in the same county and change the open enrollment period to Jan. 1 through March 31.
CMS also solicits comments on how Part D plan sponsors — through their pharmacy benefit managers — negotiate drug price concessions from drug manufacturers, network pharmacies and other entities. Specifically, CMS is interested in learning if Part D plans and their pharmacy benefit managers are lowering premiums and cost-sharing for beneficiaries because of the savings generated from price concessions.
CMS Provides Guides for Post-Acute Care and Hospice Quality Reporting
The Centers for Medicare & Medicaid Services (CMS) has posted quality reporting program quick reference guides for several post-acute care settings, including long-term care hospitals, inpatient rehabilitation facilities, home health agencies and hospice. The guides include frequently asked questions, information on help desks and links to additional resources.
House Passes Budget Resolution
The House narrowly passed the Senate’s fiscal year 2018 budget resolution, House Concurrent Resolution 71, by a vote of 216-212 with 20 Republicans voting “no.” The budget resolution allows Congress to use the reconciliation process, which only requires a majority vote, to move forward on a tax reform bill that could increase the deficit by $1.5 trillion. CHA will continue to monitor tax reform legislation, expected to be unveiled in the coming weeks.
CMS Extends Deadline for Revised Worksheet S-10 Data to Jan. 2
The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for hospitals to submit amended cost reports for federal fiscal years (FFY) 2014 and 2015 to account for recently issued changes to the instructions for Worksheet S-10. CMS has instructed Medicare administrative contractors to accept revised cost reports until Jan. 2, 2018. Previously, CMS required hospitals to submit this information by Oct. 31. Worksheets received by Dec. 2 will be reflected in the cost report data file that would typically be used to develop FFY proposed rules. However, if a hospital submits data after Dec. 2 but by Jan. 2, 2018, the data will be reflected in the cost report data file that is typically used to develop the FFY final rules.
CHA recently held an executive briefing, featuring faculty from Toyon Associates, to explain the revised instructions to Worksheet S-10 and provide hospitals with the information needed to make decisions on how best to position themselves to improve performance under the revised instructions. A recording of the executive briefing and additional resources on Worksheet S-10 are available on CHA’s website.
CJR Hospitals Must Elect Track 1 or 2 Participation by Oct. 24
The Centers for Medicare & Medicaid Services (CMS) has notified hospitals participating in the Comprehensive Care for Joint Replacement (CJR) Model that they must make selections to participate in either Track 1 or Track 2 of the model by Oct. 24 at 5 p.m. (PT). Track 1 of the CJR model is considered an Advanced Alternative Payment Model (APM) under requirements of the Medicare Access and CHIP Reauthorization Act (MACRA). Participation in Track 1 requires hospitals to attest to the use of Certified Electronic Health Record Technology, as defined in 42 CFR Section 414.1305, to document and communicate clinical care to their patients or other health care providers, and to submit a financial arrangement list of CJR collaborators. CJR collaborators of the Track 1 participant hospitals and the practice collaboration agents of CJR collaborators are eligible to earn a 5 percent APM incentive payment under the Quality Payment Program, provided they achieve threshold levels of participation in Advanced APMs to attain qualifying APM participant (QP) status for a year.
CMS also notes that hospitals that previously selected Track 2 participation may revise their election to Track 1. Track selection can be made by filling out the attached Excel spreadsheet and sending it to CJRSupport@cms.hhs.gov. A document providing additional instructions is attached.
Labor and Employment Law Seminar Begins Next Week
CHA’s annual members-only Labor and Employment Law Seminar begins Monday in Sacramento. Also held Oct. 25 in Costa Mesa, the program will cover a diverse array of topics impacting human resources personnel, legal counsel and risk managers, nursing directors and others. Participants will learn about the latest developments in wage and hour law, wrongful discharge and employment discrimination, determining exempt status for hospital information technology staff, and co-employment issues.
In addition, program faculty will discuss how to conduct effective workplace investigations and update attendees on federal and state legislation. For complete information and to register, visit www.calhospital.org/labor-employment.
CMS Formally Withdraws Three Proposed Rules, Including Part B Drug Model
The Centers for Medicare & Medicaid Services (CMS) formally has formally withdrawn a number of proposed rules, including the Medicare Part B Prescription Drug Model that was opposed by CHA and not finalized by the Obama Administration. In addition, CMS withdrew a proposed rule that would have specified qualifications practitioners must meet to furnish and fabricate prosthetics and custom-fabricated orthotics. In comments on the proposed rule, CHA urged CMS to withdraw the proposal and is pleased to see the agency do so.
Finally, CMS also withdrew a proposed rule that would have revised certain conditions of participation for health care providers, conditions for coverage for suppliers, and requirements for long-term care facilities to revise certain definitions and patients' rights provisions to ensure they are consistent with the Supreme Court decision in United States v. Windsor. CMS believes that a subsequent Supreme Court decision on same-sex marriage, Obergefell v. Hodges, "has addressed many of the concerns raised" in the original rule.
Resources
FFY 2019 Uncompensated Care Payments to Come From 2014, 2015 Worksheet S-10 Data: Worksheet S-10 audits have begun for select hospitals (September 2018)
S-10 Audit Letters
CHA Executive Briefing (October 16, 2017)
CMS Issues Revised Instructions for S-10 Worksheet
The Centers for Medicare & Medicaid Services (CMS) has updated its instructions for Worksheet S-10. The update, attached, clarifies definitions and instructions for uncompensated care, non-Medicare bad debt, non-reimbursed Medicare bad debt and charity care to include uninsured discounts. It also modifies the calculation relative to uncompensated care costs. The changes are effective for cost reporting years from Oct. 1, 2013, onward. CHA is currently reviewing the revisions and will provide members with more detail in the coming weeks.
In addition, CMS has extended the deadline for hospitals to revise and submit amended cost reports for federal fiscal years (FFY) 2014 and 2015 from Sept. 30 to Oct. 31. CHA urges members to review Worksheet S-10 of their FFY 2014 and 2015 cost reports and submit amendments to their respective Medicare administrative contractors before the Oct. 31 deadline. More information is available in the attached MLN Matters article.
CHA Submits Comments on Hospital Star Ratings
On Sept. 27, CHA submitted the attached comments on the Enhancements of the Overall Hospital Quality Star Ratings report, which proposed improvements to the overall star rating methodology.
In the letter, CHA urges CMS to remove the hospital star ratings until all comments are responded to and errors are addressed. CHA also shares concerns about CMS using the contractor who developed and implemented the five star methodology to also conduct the evaluation of it.
CHA strongly supports alternative approaches to an overall five star rating, as well as the proposal to remove hospitals that do not meet the public reporting thresholds for measures from its k-means clustering analysis, which adversely affects the star ratings categories.
CHA also supports CMS’ proposal to run the k-means clustering analysis to convergence, ensuring that each observation within a cluster is more similar to the other observations within that cluster than to observations in the other clusters.
CHA is pleased that CMS has announced it is postponing the October 2017 update of its Overall Hospital Quality Star Ratings as it continues to examine potential changes to the methodology based on public feedback. While data from the October Star Ratings Preview Reports will not be published on Hospital Compare, Star Ratings released in December 2016 will remain on the site until the next update.
