Kansas Hospital Association Legislative Update July 29, 2008.
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Transcript of Kansas Hospital Association Legislative Update July 29, 2008.
![Page 1: Kansas Hospital Association Legislative Update July 29, 2008.](https://reader036.fdocuments.us/reader036/viewer/2022083010/5697bff31a28abf838cbc6ee/html5/thumbnails/1.jpg)
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Legislative Update
July 29, 2008
![Page 2: Kansas Hospital Association Legislative Update July 29, 2008.](https://reader036.fdocuments.us/reader036/viewer/2022083010/5697bff31a28abf838cbc6ee/html5/thumbnails/2.jpg)
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Medicare Legislation – HR 6331
• Reimbursement for CAH Lab Payments– Beginning 1/1/09 CAHs receive cost-based
reimbursement for clinical lab services• Physician Payment Fix
– Prevents a reduction and freezes 2008 fee schedule payment rates at current levels
• Medicare Rural Hospital “FLEX” Program– Extends FLEX program through Sept 30, 2010.
• Ambulance Services– For July 1, 2008 through 2009, reinstates add-on
payment for ground ambulance services; 3% for rural and 2% for urban.
![Page 3: Kansas Hospital Association Legislative Update July 29, 2008.](https://reader036.fdocuments.us/reader036/viewer/2022083010/5697bff31a28abf838cbc6ee/html5/thumbnails/3.jpg)
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HPSA/MUA Proposed Rule
• Proposed rule in Feb. 28, 2008 Federal Register
• Combines HPSA/MUP formula• Utilized “2 tier formula”
– Based upon population to provider ratio of 3,000:1• Several factors incorporated
– Barrier Free Population– Definition of Provider– High Need Indicator
– 2nd Tier excludes providers under certain programs• July 23, 2008 Federal Register withdraws
proposed rule• New proposed rule to be developed
![Page 4: Kansas Hospital Association Legislative Update July 29, 2008.](https://reader036.fdocuments.us/reader036/viewer/2022083010/5697bff31a28abf838cbc6ee/html5/thumbnails/4.jpg)
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RHC Proposed Rule• Proposed changes include:
– Location Requirements:• Be located in “non-urbanized” area• Be located in a shortage area (HPSA; MUA; Governor’s
designated shortage areas)• Provides exceptions to the location requirements
– Staffing Requirements:• Eliminates the restrictions on the RHC contracting with non-
physician providers
– Payment Requirements:• Revises pymt methodology to be consistent with statutory
requirements that set Medicare pymt at 80% of reasonable cost
– Health, Safety, and Quality:• Requires RHCs to establish a QAPI program
![Page 5: Kansas Hospital Association Legislative Update July 29, 2008.](https://reader036.fdocuments.us/reader036/viewer/2022083010/5697bff31a28abf838cbc6ee/html5/thumbnails/5.jpg)
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CAH Relocation GuidelinesCMS’ Formal Guidance • 75% Rule
– Same Service• Services available under similar terms/times
– Same Population• Zip Code Analysis; hospitals may use different methodology
– Same Employees• Medical staff, direct employees and FT contract staff count• J-1 visa; NHSC employees may be excluded• High turnover facilities may provide additional documentation
• Necessary Provider Designation – must meet same criteria
• CMS now provides preliminary determinations based on CAH letters of attestations and projections
• Final approval only will be granted once the hospital has relocated and evidence confirming compliance is provided
• Contact KHA if considering Relocation; Large Renovation
![Page 6: Kansas Hospital Association Legislative Update July 29, 2008.](https://reader036.fdocuments.us/reader036/viewer/2022083010/5697bff31a28abf838cbc6ee/html5/thumbnails/6.jpg)
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Legislative Outlook - 2009
• Health Reform (Part II?)– Tobacco tax increase– Statewide smoking ban– Premium Assistance or SCHIP
• “Medicaid Transformation”– Identified by KHPA– Subcommittee to discuss possibilities
• Workforce Related Issues– Wichita Center for Graduate Medical Education– Nursing/Allied Health Shortages
![Page 7: Kansas Hospital Association Legislative Update July 29, 2008.](https://reader036.fdocuments.us/reader036/viewer/2022083010/5697bff31a28abf838cbc6ee/html5/thumbnails/7.jpg)
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What Can You Do?
• Meet with your Legislator– Invite to hospital– Need help, let KHA know
• Find the connections– Trustees– Staff– Other community members