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Yesterday, CHA met with representatives from the Centers for Medicare & Medicaid Services (CMS) at its headquarters in Baltimore to discuss the Medicaid managed care rules finalized in May 2016 and January 2017 and, specifically, their impact on the Quality Assurance Fee (QAF) program.
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CHA’s 2020 Report on Legislation summarizes the year’s most significant health care-related bills and serves as a reference tool to help hospitals comply with new laws. Hospital leadership teams are encouraged to review the report so they can take any necessary steps to implement new requirements.
Statutory changes become effective Jan. 1, 2021, unless otherwise noted. Each measure is categorized by subject and indicates which hospital team members might be involved in compliance (see legend at bottom of each page). In addition, the laws are indexed by author, bill number, and staff role.
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As part of the House budget resolution process, the Energy and Commerce Committee announced earlier today the Common Sense Savings Act of 2016 (H.R. 4725), legislation introduced by Health Subcommittee Chairman Joe Pitts (R-PA) to reduce the federal deficit by almost $25 billion through cuts to Medicaid, the Children’s Health Insurance Program (CHIP) and the Prevention and Public Health Fund. The legislation, opposed by CHA, would:
Eliminate the enhanced federal Medicaid matching funds available for the coverage of prisoners as a result of the Affordable Care Act’s Medicaid expansion. States would continue to be allowed to receive federal funds for Medicaid coverage for prisoner inpatient services, but at the traditional federal matching rate.
Reduce the amount of the non-federal share that can come from providers by gradually reducing the Medicaid provider tax threshold from its current 6 percent of the net patient service revenues to 5.5 percent (the amount that was in place until Oct. 1, 2011).
Eliminate the 23 percentage point increase in the CHIP matching rate implemented in the Affordable Care Act.
Repeal the Prevention and Public Health Fund, which amounts to more than $14 billion over the next 10 years.
Close a loophole in a current statute that has allowed lottery winners to retain taxpayer-financed Medicaid coverage.
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.