As senior policy analyst, Megan Howard is responsible for providing leadership on federal regulatory issues related to health care finance, quality and patient safety, and hospital and post-acute provider related issues. Based in CHA’s Washington, D.C. office, Megan works with CHA’s vice president, federal regulatory affairs, CHA’s senior vice president, federal relations, CHA issue managers and national hospital associations on analysis and policy development for advocacy purposes.
Prior to joining CHA, Megan worked as staff in the U.S. House of Representatives. Megan has a bachelor’s degree in political science from the University of California, Santa Barbara.
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The budget trailer bill adopted as part of the state’s final 2015-16 budget amends Section 1220 of the Business and Professions Code pertaining to clinical laboratories. Specifically, the budget trailer bill allows clinical laboratories to establish an alternative quality control program that meets federal regulations under the Clinical Laboratory Improvement Act and that may include the use of alternative quality control testing procedures already recognized by the Centers for Medicare & Medicaid Services (CMS). Until now, the California Department of Public Health has interpreted regulations in a way that did not recognize federally approved alternative quality control methods, requiring labs to perform frequent quality control tests, which are substantially more expensive than the current federally recognized equivalent quality control (EQC) procedures and the impending individualized quality control plans (IQCPs).
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Last night the House of Representatives passed the Bipartisan Budget Act of 2013. The Senate is expected to do so today, and the President has indicated he will sign the measure. The vote in the House was 332-62; nine Californians voted against passage. The legislation contains both good news and bad news for California’s hospitals.
Also this week, the House Ways and Means and Senate Finance Committees reported bipartisan legislation to repeal the sustainable growth rate (SGR) for physician Medicare payments. They will continue to work toward a permanent solution during the first quarter of 2014. The financing mechanisms for offsetting the cost of repeal have not been released. Payments to hospitals continue to be vulnerable as the committees look for as much at $150 billion over the next 10 years to pay for the SGR repeal.
CHA has provided the attached summary of the Bipartisan Budget Act of 2013 with additional information about the hospital-related provisions.
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CHA President/CEO C. Duane Dauner was joined by 10 representatives of CHA member hospitals in Washington, D.C., Dec. 3 for the CHA and American Hospital Association hospital advocacy day. The group met with about half of the California Congressional delegation, including House Minority Leader Nancy Pelosi, House Majority Whip Kevin McCarthy, and Sens. Boxer and Feinstein.
Sheree Lowe has been Vice President of Behavioral Health at CHA since 2002. In this capacity, she staffs CHA’s Center for Behavioral Health (CBH) Advisory Group and represents the interests of Acute Psychiatric Hospitals (APH), behavioral health units in medical/surgical hospitals, and Chemical Dependency Recovery Hospitals (CDRH) providing both in and outpatient mental health and substance use disorder services – commonly referred to as behavioral health. Since 2010, she has also advocated on matters relating to behavioral health in our community hospital emergency departments. She also represents the interests of hospital-based outpatient clinics (HBOC) providing primary care services. Currently, she staffs the Behavioral Health Action Coalition, a CHA/NAMI-CA co-founded coalition made up of over 50 statewide organizations focused on elevating both the hospital and community behavioral health delivery system in California.
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Gov. Jerry Brown’s 2013-14 state budget proposal, released Jan. 10, includes a delay in implementing the Coordinated Care Initiative (CCI), which will transition individuals eligible for both Medicare and Medi-Cal —dual-eligibles — into managed care. It will also integrate long-term care services and supports into managed Medi-Cal. CCI implementation is now scheduled for September 2013, rather than June 2013 as originally planned. Under the revised timeline, beneficiaries will receive notice of changes no sooner than June 2013. Beneficiary enrollment schedules have also been modified and will vary among the designated counties: in Los Angeles County, enrollment will be phased in over 18 months; in the County of San Mateo, beneficiaries will be enrolled at once; and in Orange County, County of San Diego, County of San Bernardino, County of Riverside, Alameda County, and the County of Santa Clara, enrollment will be phased in over 12 months.
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The House Appropriations Subcommittee on Labor, Health and Human Services (HHS), Education, and Related Agencies held a mark-up of its fiscal year 2013 appropriations bill today, reducing the HHS discretionary budget by $1.3 billion below current levels. If signed into law, the bill would restrict use of any HHS funds to implement the Affordable Care Act and would rescind funds authorized for the Consumer Operated and Oriented Plan (CO-OP) Program, Center for Medicare & Medicaid Innovation, Prevention and Public Health Fund and Patient-Centered Outcomes Research Trust Fund. The legislation also would eliminate the Agency for Healthcare Research and Quality effective Oct. 1, 2012. Members of the California congressional delegation on the subcommittee voted along party lines, with Rep. Jerry Lewis (R) joining the majority to pass the bill, and Reps. Lucille Roybal-Allard (D) and Barbara Lee (D) opposing the bill. While the legislation will likely pass the full appropriations committee, it will not pass the Senate. CHA expects a final budget to be resolved in a conference committee.
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The California Hospital Association (CHA) is pleased by today’s Supreme Court decision upholding the Affordable Care Act (ACA). California’s hospitals have long supported the goal of expanding coverage to the uninsured. Today’s ruling means that California will continue to make progress towards this goal.
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CHA has joined with California’s safety-net hospitals on the Disproportionate-Share Hospital (DSH) Task Force to send a letter to members of the California congressional delegation urging them to protect the Medicaid program from any additional cuts to hospital payments. As the House searches for spending reductions to offset the elimination of cuts to defense spending, proposals have emerged to reduce states’ ability to use Medicaid provider taxes and DSH payments. These programs provide critical means for hospitals to bolster their ability to preserve health care services for the state’s most needy patients. CHA will continue to advocate against further cuts to hospitals as the House continues its budget reconciliation process. The DSH Task Force letter is attached.
