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 Responds to Request for Information on Revised Clinical Laboratory Regulations
CHA has submitted the attached comment letter in response to the Centers for Medicare & Medicaid Services (CMS) request for information on revisions to the Clinical Laboratory Improvement Amendments of 1988 regulations. CMS — in consultation with the Centers for Disease Control and Prevention, state surveyors and other stakeholders – has identified a number of areas within the regulations that could be updated to better reflect current knowledge, changes in academic context and advancements in laboratory testing.
In the letter, CHA urges CMS to adopt regulations that provide the most flexibility for laboratory directors to make personnel decisions that address their workforce needs, based on an individual’s experience and educational background. CHA also supports giving CMS a greater level of discretion for Category 1 proficiency testing referral violations, particularly when sanctions are applied for laboratories following their standard operating procedures. In addition, CHA supports the recommendations of the Clinical Laboratory Improvement Amendments Advisory Committee Virtual Crossmatch Workgroup to update histocompatibility regulations, reflecting advancements in the field. Comments on the request for information are due March 12.
CHA DataSuite Releases Medicare Cost Report Model Update
CHA DataSuite has issued the fourth quarter 2017 update of the Medicare cost report model, which provides hospitals with commonly sought after data elements from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System database. The model highlights hospital utilization data, inpatient and outpatient data, overall hospital statistics and uncompensated care data.
Worksheets include:
S-3 Part I – utilization data
S-10 – uncompensated care data
G-3 – overall revenue and expense data
E Part A – hospital inpatient data
E Part B – hospital outpatient data
E-3 Part V – critical access hospital inpatient services data
E-4 – hospital direct graduate medical education and end stage renal disease outpatient direct medical education data
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, and reminders of data submission and review deadlines.
Inpatient Rehabilitation Facilities
Data Submission Deadline Approaching
Assessment data for the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) and data submitted to CMS via the Center for Disease Control and Prevention National Healthcare Safety Network for July-September (Q3) of calendar year 2017 are due no later than 11:59 (PT) on Feb. 15.
Long-Term Acute Care Hospitals
Data Submission Deadline Approaching
Assessment data for the Long-Term Care Hospital Continuity Assessment Record and Evaluation (LTCH CARE) and data submitted to CMS via the Center for Disease Control and Prevention National Healthcare Safety Network for July-September (Q3) of calendar year 2017 are due no later than 11:59 (PT) on Feb. 15.
Training
Materials from the December 2017 Long-Term Care Hospital Quality Reporting Program provider training are now available under “Related Links” on CMS’ dedicated long-term care hospital web page.
CMS Seeks Comments on Clinical Laboratory Personnel Requirements
The Centers for Medicare & Medicaid Services (CMS) has issued the attached request for information on updating personnel requirements, testing standards and industry fee structures under the clinical laboratory improvement amendments. Among the personnel requirements listed, CMS seeks comment on whether it should codify in regulations the current guidance that a bachelor’s degree in nursing is considered equivalent to a bachelor’s degree in biological sciences for the purposes of educational requirements for moderate and high-complexity testing personnel under the clinical laboratory improvement amendments.
CMS notes that these regulations have not been meaningfully updated since 1992. The topics listed in the request for information are areas that the Centers for Disease Control and Prevention, state agency surveyors and other stakeholders have identified as needing to be updated to better reflect current knowledge and advancements in laboratory testing. CMS intends to consider public responses to the request for information when it drafts proposals to update the existing regulations. Comments are due March 12.
CHA Releases Draft Model of 2017-19 Hospital Fee Program
As reported in CHA News last week, the Department of Health Care Services (DHCS) recently sent hospitals invoices covering the first six fee-for-service cycles of the 2017-19 Hospital Fee Program. The attached draft model incorporates those invoiced amounts, as well as the supplemental fee-for-service payment amounts approved last month by the Centers for Medicare & Medicaid (CMS) services. Notably, the “Gain.Contribute” tab in the model includes a summary, by state fiscal year, of the estimated fee and payment amounts for the 30-month program period. CHA is in the process of creating hospital-specific fee and payment schedules, which will be distributed within the next week.
It is important to note that the managed care components of the program have not been approved by CMS and, therefore, the payment amounts in the draft model are very preliminary. Furthermore, the supplemental Medi-Cal managed care payments made through the new directed payment mechanism have been estimated using inpatient utilization data publicly reported to the Office of Statewide Planning and Development for fiscal years ending in 2015. However, in actuality, the directed payments will be made for inpatient and outpatient services provided to in-network patients during the current state fiscal year.
Hospitals Must Respond to Hospital Fee Program Survey by Feb. 9
Last week, the Department of Health Care Services Disproportionate Share Hospital Unit emailed a survey to private hospitals that participate in the hospital fee program. The Calendar Year 2016 Quality Assurance Fee Survey seeks information related to hospital fees and payments during calendar year 2016 of the hospital fee program; results will be used to calculate Medi-Cal disproportionate share hospital payments for state fiscal year 2018-19. If a hospital fails to respond to the survey by Feb. 9, the department will use internal data to estimate the fees and payments from the hospital fee program, which may impact eligibility or payment amounts.
CMS Announces Bundled Payments for Care Improvement Advanced Model
The Centers for Medicare & Medicaid Services (CMS) has announced the creation of a new voluntary advanced alternative payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced). Under the BPCI Advanced model, participants will take on financial risk for a 90-day clinical episode with a single retrospective bundled payment. CMS has determined the model qualifies as an advanced alternative payment model under the requirements of the Medicare Access and CHIP Reauthorization Act for the purposes of payment incentives under the physician Quality Payment Program. The attached request for applications includes additional information on the model, and CMS will hold an open door forum with a question and answer session on Jan. 30 from 9-10 a.m. (PT). Registration is open on CMS’ website.
CHA Provides Update on 2017-19 Hospital Fee Program
As reported in CHA News last month, the Centers for Medicare & Medicaid Services approved the supplemental fee-for-service payments and overall tax structure of the 2017-19 hospital fee program. CHA is working with the Department of Health Care Services (DHCS) to update the draft model so hospital-specific implementation schedules can be distributed by the end of this month. DHCS expects the first round of invoices will be sent to hospitals within the next month, with a due date in late February. As soon as the exact timing is finalized, CHA will notify members via CHA News.
Now that the fee-for-service component of the program has been approved, DHCS has turned its attention to the managed care components of the program. As previously reported in CHA News, the new federal Medicaid managed care rules require significant changes to how supplemental Medi-Cal managed care payments are made through the hospital fee program. Effective July 1, 2017, roughly half of the supplemental Medi-Cal managed care payments must be transitioned to a directed payment methodology. Under the directed payment method, supplemental payments can be made only to network providers based on utilization in the encounter data file from the current rate year.
Clarification Issued on Revised Worksheet S-10 Instructions
In response to several questions submitted by CHA and others, as well as questions asked during a recent open door forum, the Centers for Medicare & Medicaid Services has released the attached document clarifying its recently revised instructions for Worksheet S-10 of the Medicare cost report. CHA reminds hospitals that the deadline to submit amended cost reports for federal fiscal years 2014 and 2015 is Jan. 2. Worksheets received by Dec. 2 will be reflected in the cost report data file used to develop federal fiscal year proposed rules. Hospital data submitted after Dec. 2 but by Jan. 2 will be reflected in the cost report data file that is typically used to develop the federal fiscal year final rules. Additional resources for Worksheet S-10 are available on CHA’s website.
CMS Publishes Protocols for IMPACT Act Measure Test
The Centers for Medicare & Medicaid Services (CMS) has published data collection protocols for the current beta test of standardized patient assessment data, as required by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). The data — which will be collected at admission and discharge in long-term care hospitals, inpatient rehabilitation facilities, skilled-nursing facilities and home health agencies — will be tested for potential inclusion in the four currently administered post-acute care instruments.
