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By Ginger - Site Admin on Thursday, August 28, 2014 9:23 AM
On August 27, AHA submitted the comment letter to the Centers for Medicare and Medicaid Services (CMS) on its proposed rule for the calendar year (CY) 2015 outpatient and ambulatory surgery center (ASC) prospective payment systems (PPS). The letter urges the agency to carefully reconsider its proposed methodology of creating a Healthcare Common Procedure Coding System modifier to track services furnished in off-campus, provider-based hospital outpatient departments. It also recommends changes to the implementation of its new set of claims-level comprehensive ambulatory payment classifications to ensure that it does not negatively and disproportionately impact certain types of hospitals that have specialized case mixes. In addition, AHA opposes CMS’ proposal to require a physician order for all inpatient admissions as a condition of payment under the agency’s general...
By Ginger - Site Admin on Thursday, August 28, 2014 9:12 AM

In regards to acknowledgement testing with providers, Change Request (CR) 8858 instructs Medicare Administrative Contractors (MACs) to promote three specific acknowledgement testing weeks with providers, and provide data and statistics to the Centers for Medicare and Medicaid Services (CMS) to demonstrate readiness for the International Classification for Disease 10th Edition Clinical Modification (ICD-10) transition.

For additional information, visit

By Ginger - Site Admin on Thursday, August 28, 2014 8:56 AM
On August 27, AHA submitted a comment letter to the Centers for Medicare and Medicaid Services (CMS) on its proposed rule for the calendar year (CY) 2015 physician fee schedule. In the letter, AHA expresses its support for CMS’ proposal to add seven new codes to its list of approved Medicare telehealth services and encourages the agency to consider adding other services in future rulemaking. AHA also commends CMS for recognizing the need to pay for services related to chronic care management, but suggests the agency re-examine whether the rate of $41.92 adequately reimburses providers for the full scope of services. In addition, AHA urges the agency to carefully reconsider its proposed methodology of creating a Healthcare Common Procedure Coding System modifier to track services furnished in off-campus, provider-based hospital outpatient...
By Ginger - Site Admin on Wednesday, August 27, 2014 9:25 AM
In June,the Cabinet for Health and Family Services proposed significant changes to 900 KAR 6:070 (The Certificate of Need Regulation on Formal Review). The proposed changes included removal of the requirement for an applicant to demonstrate geographic need during the formal review process. There are five separate and distinct criteria identified in statute that an applicant must meet for a Certificate of Need (CON) to be awarded including criteria in the State Health Plan and demonstration of need in the area where the services is being proposed, which are two separate criteria. The Cabinet proposed that an application would meet the geographic need criteria if the application was consistent with the need identified through criteria in the state health plan and the inventory of service utilization published annually. This proposed change, if made final in regulation, would have eliminated the separate geographic...
By Ginger - Site Admin on Wednesday, August 27, 2014 9:14 AM
To keep providers updated with information on the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, the Centers for Medicare and Medicaid Services (CMS) has recently added three new FAQs to the CMS FAQ system.

New FAQs:

For the certification criteria that providers must have in place to meet the Clinical Decision Support (CDS) objective, what type of interventions must the EHR technology trigger to meet the criteria? For this and for the Eligible Provider and Eligible Hospital Core Measures related to the Objective “use clinical decision support to improve performance on high-priority health conditions,” are “pop-up” alerts the only type of intervention that a provider can use to meet the CDS objective? Read the answer. I am an eligible professional. What should I do if my patients...
By Ginger - Site Admin on Tuesday, August 26, 2014 8:58 AM
On September 17, KHA is kicking off a collaborative improvement project focusing on improving care and outcomes (including reducing readmissions) for pneumonia patients. This is a particularly tough challenge for small and rural hospitals as pneumonia patients often have comorbidities and other barriers to follow up care. The September 17 conference will be presented by Mary Guyot with Stroudwater Associates. Guyot is a long-time faculty for KHA Swing Bed programs and other quality education. She has 40 years of experience in nursing care and hospital leadership.The brochure, available at, includes program details and registration information. The conference is open to all small and rural hospitals.

On September 18, KHA will host a conference for Critical Access Hospitals (CAHs). The program will assist...
By Ginger - Site Admin on Tuesday, August 26, 2014 8:30 AM
Congressman John Yarmuth at KHA Summer Series MeetingKHA's Summer Series of Congressional meetings in the congressmen’s districts kicked off Tuesday morning, August 26 in Louisville with Third District Congressman John Yarmuth.

The Series provides members the opportunity to stay in contact locally with the Kentucky congressional delegation and discuss important legislative and regulatory issues currently before the U.S. Congress that are critical to Kentucky’s hospitals. With the nation’s health care system in the midst of change with the Accountable Care Act (ACA), hospitals still need help to continue to deliver quality care as they work to improve community health, patient quality and satisfaction, all while reducing costs. This meeting will provide you the opportunity to discuss your issues and concerns with your Congressman.

The next...
By Ginger - Site Admin on Thursday, August 21, 2014 8:51 AM

Eligibility in the 340B Drug Pricing program is reviewed annually by the Office of Pharmacy Affairs (OPA) and Covered Entities are required to recertify as a part of this process. Hospitals and safety net providers are currently up for recertification, and they must complete the process by September 10.

OPA recently sent email notifications about the recertification process to the Primary Contact and Authorizing Official for each Covered Entity. If your facility participates in 340B, please look for the email and begin the recertification process.

If you need assistance with the recertification process, visit the OPA web page on recertification, which includes key information about the process and a step-by-step guide to recertification.

By Ginger - Site Admin on Wednesday, August 20, 2014 8:16 AM

The Centers for Medicare and Medicaid Services (CMS) has released a new webcast with information on clinical documentation and coding from the “Road to 10” tool, which was designed to help physician practices transition to ICD-10. Accessible through the “Road to 10” link on the CMS website, the webcast discusses how transitioning to ICD-10 will impact documentation and coding in physician practices. This is the third webcast in the new “Road to 10” series. Three more webcasts will follow—all aimed at helping providers get ready for ICD-10 by the October 1, 2015, compliance date.

Visit the CMS ICD-10 website to get started on the “Road to 10” today.

By Ginger - Site Admin on Tuesday, August 19, 2014 8:35 AM
Although the ink on the new quality improvement organization (QIO) contracts is less than three weeks old, AHA has reported hearing from hospitals all over the country that there are problems with the two new Beneficiary and Family Centered Care QIO Contractors. Patients, their families and hospitals are having a hard time getting through to the QIO to adjudicate an appeal when a beneficiary does not feel ready to go home, but the hospital believes they are ready to be discharged. Not only are there problems reaching representatives via the call line, but responses from the QIOs are slow in coming and are often miscommunicated (e.g., a response is sent only to the family, and not to the hospital). AHA has received accounts of extended lengths of stay of a week or more past the original discharge date, and other such issues. Fortunately, a relatively few number of patients appeal their discharges, so this has not yet become a massive problem, but it is an unnecessary one and troubling to both the patients and the...
By Ginger - Site Admin on Monday, August 18, 2014 8:13 AM
KHA will host two webinars regarding inpatient prospective payment system (IPPS) rules on August 28 and September 9.

2015 IPPS Final Rule Thursday, August 28 3:00 p.m. (ET)

KHA's Washington-based Medicare consultant, Larry Goldberg, will present this program on the 2015 IPPS Final Rule. Goldberg has over 40 years of health care experience and is a well-known, respected expert in Medicare and health care financial legislation and regulations. He will focus on the payment update factors as well as the impact of the Centers for Medicare and Medicaid Services' (CMS') proposal on hospital-acquired conditions, hospital readmissions and value-based purchasing. His presentation will last 90 minutes including time for questions and answers.

Other 2015 PPS Rules Tuesday, September 9 11:30 a.m. (ET)

In addition to the annual IPPS update, CMS also issued final rules updating the skilled nursing, inpatient rehabilitation, hospice and psychiatric facility PPS requirements. Goldberg...
By Ginger - Site Admin on Friday, August 15, 2014 7:53 AM
KHA has created a report examining the latest utilization trends for hospitals in Kentucky. The report (available at includes data from the first quarter of 2009 through the first quarter of 2014.

With the addition of data from 2014, the impact of the Medicaid Expansion is demonstrated in the shift of total cases for Self Pay and Charity to Medicaid. For the types of cases examined, both inpatient and outpatient, this shift is evident.

Acute adult and pediatric cases continue to trend downward. Psychiatric and chemical dependency cases have an overall upward trend, but have experienced three quarters of continued decline. Conversely, physical rehabilitation cases trend slightly up, with increases in cases over the last three quarters.

The trend for outpatient cases with surgical procedures has remained flat. The large drop in the first quarter of 2013 reflects under-reporting by a major provider. Historically,...
By Ginger - Site Admin on Thursday, August 14, 2014 8:53 AM

The 2014 Healthcare Coalition Conference will be held September 30-October 1 at the Owensboro Convention Center. The conference brochure (available at details the event with information about the national and regional presenters and vendors who will represent the health care fields of engineering/facilities, security/safety and materials management.

For more information about the Healthcare Coalition Conference or to register, visit or call (888) 886-9364.

By Ginger - Site Admin on Thursday, August 14, 2014 8:30 AM
The Kentucky Hospital Research and Education Foundation (KHREF) will host three webinars in September regarding topics related to the Centers for Medicare and Medicaid Services' (CMS) Conditions of Participation (CoP):

CMS’s New Hospital CoP MedicationAdministration and Safe Opioid Use - September 3 CMS Quality Assessment and Performance Improvement (QAPI) Hospital CoP Standards and CMS QAPI Worksheet - September 17 CMS Hospital CoPs: The Final 2014 Regulations for Hospitals - September 24 Visit the corresponding links above from program details and registration information.

If you have any further questions, contact Carol Walters at KHA (502-426-6220 or 800-945-4542 or via email...
By Ginger - Site Admin on Wednesday, August 13, 2014 8:14 AM

The Kentucky Chapter of the American College of Healthcare Executives (ACHE) will host an educational event on September 11 at the Newport Aquarium. The program, "Possibilities, Probabilities and Creative Solutions" will be presented by Kevin O'Conner and will include breakout discussions with ACHE sponsors from Ohio and Kentucky on hot topics in health care. Attendance will earn 3 hours of face-to-face continuing education credits for ACHE members who participate.

Registration is available at

By Ginger - Site Admin on Monday, August 11, 2014 8:06 AM
The Interim Joint Committee on Health and Welfare met in Frankfort on August 4. During the meeting, Cabinet for Health and Family Services (CHFS) Executive Director of Policy and Budget Beth Jurek discussed the July 1 Executive Order to reorganize CHFS and the administration of Medicaid. She stated the Cabinet is restructuring the department to reflect the change to managed care from fee for service in order to ensure managed care organizations (MCOs) are meeting the requirements of the contracts and monitor the way that clients are receiving services. CHFS is reducing the number of divisions from eight to six, which according to Jurek, will be a net decrease, with no increase in the agency. CHFS is also consolidating information technology services.

The Committee also discussed and approved the Executive Order to reorganize the Health Benefit Exchange. Under the plan, the Office of Health Information Exchange will be included in the newly established Kentucky Office of Health Benefit and Health...
By Ginger - Site Admin on Thursday, August 07, 2014 9:26 AM
KHA will host two Swing Bed Seminars for Prospective Payment System (PPS) hospitals and critical access hospitals (CAHs) at the Hilton Garden Inn Northeast in Louisville as follows:

PPS Hospitals - October 7-8

CAHs - October 9-10

Follow the corresponding links above for program details and registration information.

Mary Guyot with Stroudwater Associates will instruct both courses. The seminar is supported by the Rural Hospital Flexibility Program in an effort to keep costs as low as possible for rural hospitals.

If you have any questions, please contact Elizabeth Cobb at KHA (502-426-6220 or 800-945-4542 or via email at

By Ginger - Site Admin on Wednesday, August 06, 2014 8:25 AM

At a meeting on September 14, 2011, the ICD-9-CM Coordination and Maintenance (C&M) Committee implemented a partial freeze of the ICD-9-CM and ICD-10 (ICD-10-CM and ICD-10-PCS) codes prior to the implementation of ICD-10, which would end one year after the implementation of ICD-10. The implementation of ICD-10 was delayed from October 1, 2014, to October 1, 2015, by final rule CMS-0043-F issued on July 31, 2014. 

A notice from CMS is available at The notice details who will be affected and what you need to know along with links to additional information to prepare.

By Ginger - Site Admin on Monday, August 04, 2014 8:54 AM
The Centers for Medicare and Medicaid Services (CMS) has issued a final rule that will update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2015.

The document is currently on display at the Federal Register office. Publication is scheduled for Aug 5. A copy is currently available at This link will be superseded after publication.

In addition, CMS has issued a final rule to update the Medicare Inpatient Psychiatric Facilities (IPFs) PPS for FY 2015. The rule is scheduled to be published in the August 6 Federal Register. A copy can currently be downloaded at link will change upon publication later this week.

By Ginger - Site Admin on Monday, August 04, 2014 8:42 AM

KHA is hosting its Summer Series of Congressional meetings in the congressmen’s districts to provide members the opportunity to stay in contact locally with the Kentucky congressional delegation and discuss important legislative and regulatory issues currently before the U.S. Congress that are critical to Kentucky’s hospitals. With the nation’s health care system in the midst of change with the Accountable Care Act (ACA), hospitals still need help to continue to deliver quality care as they work to improve community health, patient quality and satisfaction, all while reducing costs. This meeting will provide you the opportunity to discuss your issues and concerns with your Congressman.

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