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
CHA Submits Letter to HHS on 340B Program
CHA has submitted the attached letter to the Department of Health and Human Services in response to the 340B section of its Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs.
In the letter, CHA argues that the administration’s focus on the 340B drug discount program as part of a plan to lower drug prices is misplaced. CHA describes the importance of the 340B program in providing essential medications and access to health care for California’s most vulnerable populations.
To highlight the program’s importance, CHA offers specific examples of how California’s hospitals have used the savings from the program to fund vital patient care services -- including mobile health clinics, chemotherapy infusion centers, Hepatitis C treatment and inner-city primary care centers.
CHA encourages members to use the letter as a template to submit their own comments. Comments are due Monday, July 16 by 2 p.m. (PT) and may be submitted online.
CMS Requests Information About Stark Law’s Impact on Care Coordination
The Centers for Medicare & Medicaid Services (CMS) has issued the attached request for information (RFI) seeking recommendations on how to address the burdens of the physician self-referral law – also known as the Stark Law – as well as feedback on how the law impedes care coordination. CMS notes it is particularly interested in information about the structure of arrangements between parties that participate in alternative payment models or other novel financial arrangements; the need for revisions or additions to exceptions to the physician self-referral law; and definitions of terminology related to alternative payment models and the physician self-referral law.
Responses to the RFI are due by Aug. 24. Additional information is available on CMS’ website.
‘Extreme and Uncontrollable’ Circumstances Policy Finalized for CJR Hospitals
The Centers for Medicare & Medicaid Services (CMS) finalized, without changes, its "extreme and uncontrollable" circumstances policy for hospitals participating in the Comprehensive Care for Joint Replacement (CJR) Payment Model, previously set forth in an interim final rule.
The attached final rule provides flexibility in determining episode spending for CJR hospitals located in areas impacted by a major disaster declaration for performance years three through five. The policy will become effective July 9.
CMS determined at least 22 CJR hospitals were located in areas affected by the Northern California wildfires, which include Butte, Lake, Mendocino, Napa, Nevada, Orange, Sonoma and Yuba counties. The extreme and uncontrollable policy will apply to CJR participant hospitals whose CMS certification number has a primary address located within an area that has been issued a waiver in accordance with section 1135(g) of the Social Security Act and is in a county, parish or tribal government with a major disaster declaration under the Stafford Act.
CHA Comments on Direct Provider Contracting Model Request for Information
CHA has prepared the attached comment letter on a potential alternative payment model that would allow direct provider contracting between payers and primary care or multi-specialty groups within the Medicare fee-for-service, Medicare Advantage and Medicaid programs. Responding to a request for information from the Centers for Medicare & Medicaid Services (CMS), CHA's comments provide a number of guiding principles for the development of alternative payment models, including some specific considerations for direct provider contracting models. In addition, CHA urges CMS to carefully review additional comments submitted by providers in California, who for decades have been leaders in managing primary and specialty care through multiple public and private sector initiatives. Members are encouraged to use CHA’s letter to develop their own comment letters, due May 25.
CHA Submits Joint Letter on Medicaid Access to Care Monitoring Requirements
The California Hospital Association, the California Association of Public Hospitals and Health Systems, Private Essential Access Community Hospitals, Inc., the California Children’s Hospital Association and the District Hospital Leadership Forum have submitted the attached joint letter on the Centers for Medicare & Medicaid Services (CMS) proposed rule on fee-for-service access to care monitoring requirements within the Medicaid program. The proposed rule would amend the process by which states document whether Medicaid payments in fee-for-service (FFS) systems are sufficient to enlist providers to assure beneficiary access to covered care and services consistent with existing statute.
In the letter, the organizations oppose an exemption from the FFS access standards, regardless of the managed care penetration rate, as it eliminates safeguards that promote a more transparent data-driven process. The letter also outlines concerns with proposals related to an exemption for states with high managed care enrollment, exemptions for nominal rate reductions, relief from public notice of rate reductions and the need for greater CMS oversight of state Medicaid programs.
Comments on the proposed rule are due by 2 p.m. (PT) on May 22.
Trump Administration Releases Blueprint to Lower Drug Prices
President Trump last week released a blueprint that identifies immediate actions and further opportunities within federal payment programs to lower drug prices. In releasing the blueprint, officials from the Department of Health and Human Services identified four major goals:
Addressing the increase in list prices of drugs
Maximizing the potential of government programs and private payers to leverage negotiating power
Tackling high out-of-pocket costs
Ensuring the practices of foreign markets are not disadvantaging American innovation
The Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs calls for greater transparency of drug prices, better informing consumers about prescription drugs, promoting the use of generic drugs and experimenting with value-based payment through the Center for Medicare & Medicaid Innovation. CHA is reviewing the blueprint’s policy proposals and anticipates additional rulemaking and subregulatory guidance to be released over the coming weeks. Today, the department released a request for information seeking stakeholder feedback to "to help shape future policy development and agency action." Future member engagement on these important policy issues is likely.
CMS Seeks Information on Direct Provider Contracting
The Centers for Medicare & Medicaid Services (CMS) this week issued the attached request for information on a potential alternative payment model that would allow direct provider contracting between payers and primary care or multi-specialty groups within the Medicare fee-for-service, Medicare Advantage and Medicaid programs. The model would differ from existing primary care models, allowing practices to take on two-sided financial risk. Under the potential model, CMS would pay a fixed per-beneficiary, per-month payment to cover a range of services, allowing flexibility in the delivery of other billable services. Practices would also be eligible for performance-based incentives for total cost of care and quality. CMS seeks comments on provider experience with direct provider contracting and how this model could be used to reduce expenditures and preserve or enhance the quality of care for Medicare, Medicaid and Children’s Health Insurance Program beneficiaries. Comments are due May 25.
Emergency Department Toolkit
Special resource toolkit developed by CHA’s EMS/Trauma Committee and the Center for Behavioral Health. Designed to help staff provide support to patients in the ED with psychosis and/or substance abuse disorders, this toolkit provides access to articles, policies, management techniques, assessment tools and more. Click the topic tabs below to access resources and information.
CMS Proposes Regulation to Alleviate State Burden
The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule that would provide states with greater flexibility in how they meet access to care requirements within the Medicaid program.
The proposed rule addresses concerns associated with the 2015 final rule — which CHA commented on — that requires states proposing to reduce or restructure Medicaid fee-for-service payment rates to collect data through an Access Monitoring Review Plan and solicit input on the potential impact on beneficiaries’ access to care.
CMS proposes to exempt states with an overall Medicaid managed care penetration rate of 85 percent or greater from most fee-for-service access monitoring requirements; California’s current Medi-Cal managed care penetration rate is 80 percent.
CMS Provides Updates for Post-Acute Care Quality Reporting
The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates about post-acute care quality reporting programs, including training opportunities, public reporting details and reminders of data submission and review deadlines. Following are the recent updates for inpatient rehabilitation facilities, long-term care hospitals and hospice providers:
Inpatient Rehabilitation Facilities
Provider Preview Reports
Provider preview reports are now available for inpatient rehabilitation facilities (IRFs). IRFs have until April 5, 2018, to review their performance on quality measures based on data from quarter 3 of 2016 to quarter 2 of 2017, prior to their posting to the IRF Compare website in June 2018. Access instructions for the provider reports are available online. Corrections to the underlying data will not be permitted during this time. However, providers can request review by CMS during the preview period if they believe their data are inaccurate.
