The Cabinet for Health and Family Services (CHFS) in partnership with the Medicaid managed care organizations (MCOs) is once again sponsoring forums across Kentucky in August and September. These forums are designed to allow any and all health care providers (including behavioral health and substance use providers) who have contracts with MCOs and serve Medicaid consumers to meet face-to-face and discuss concerns about proper billing, prior authorizations, prompt pay, appeals processes or any other specific issues related to the continued implementation of Managed Care. In attendance will be senior level staff from each MCO, senior staff from the Department for Medicaid Services and Department for Behavioral Health, Developmental and Intellectual Disabilities.

CHFS encourages pre-registration 5 days in advance of the forum of your choice. You may also register on-site. Online registration is available at http://chfs.ky.gov/forumreg.

The forums will be held at the dates and locations listed below....

The U.S. House of Representatives Ways and Means Health Subcommittee will host a hearing to discuss rural health care disparities created by Medicare regulations on Tuesday, July 28 at 10:00 a.m. (ET) in Washington.

Oral testimony at this hearing will be from invited witnesses only; however, any individual or organization may submit a written statement for consideration by the committee and for inclusion in the printed record of the hearing.

To submit comments, please visit http://waysandmeans.house.gov/committeesubmissions/.

On August 12, from 2:00 p.m. to 3:00 p.m. (ET), KHA will host a webinar for the Small Rural and Critical Access Hospital Forum. Attendees will hear a state and federal policy update along with a special presentation by Pete Lawson, of Raymond James, on rural hospital financing in the post-ACA world.

Administrators should have received an e-mail with webinar access information on Friday. If you did not, or you have additional questions, please contact Elizabeth Cobb at KHA (ecobb@kyha.com).

The Foundation for a Healthy Kentucky is hosting the Annual Howard L. Bost Memorial Health Policy Forum Monday, September 28 in Bowling Green. This year, the Forum focuses on policy and environmental opportunities to boost population health and improvement in health outcomes. Also included are "TED-style” presentations. For more information, visit http://www.healthy-ky.org/content/news-events/events/bost-health-policy-forum.

The HMO Indicators Report by KHA is now the Kentucky MCO and HMO Financial Results Report. The report has been restructured to include more concise information on all health care management organizations (HMOs) and Medicaid managed care organizations (MCOs) doing business in the state.   The Medicaid MCOs will be presented side-by-side for a quick comparison with the remaining HMOs doing business in Kentucky presented similarly. The indicators will be updated on a quarterly basis as the data becomes available from the Kentucky Department of Insurance.

A full report for the quarters through all of 2014 is now available. The document can be found in the Members Only section of www.kyha.com under Special Publications and Presentations.

If you have any questions regarding the Kentucky MCO & HMO Financial Results Report, please contact Steve Miller at KHA (502-426-6220 or 800-945-4542 or via e-mail at smiller@kyha.com).

State Auditor Adam Edelen is overseeing an investigation into Kentucky's process of sexual assault evidence kits. As part of this work, the Auditor's office has distributed an electronic survey for hospitals to complete. If your hospital has not yet completed this survey, please take a moment to make sure that this survey is completed by you or someone in your hospital by Friday, July 31.

Please see the message from the State Auditor below with a link to the survey:

Dear Hospital Administrator,

 

As you may be aware, Senate Joint Resolution 20, passed by the 2015 General Assembly, directed my office to report on the number of untested sexual assault evidence kits in the possession of Kentucky law enforcement. We are asking that a representative from your hospital complete this brief online survey https://www.surveymonkey.com/r/APAhospitalsurvey....

While ICD-10 is almost here, you still have time to get ready, but you must get ready now. Each day this week the Centers for Medicare and Medicaid Services (CMS) has been highlighting 1 of the 5 recommendations to help you begin testing: 1) Why Test Now, 2) How to Get Started, 3) Testing with Trading Partners, 4) Types of Testing, and 5) Testing Tips. Yesterday's information on Types of Testing is shared below:

Acknowledgement Testing In acknowledgement testing, providers and other submitters, like clearinghouses, submit claims with ICD-10 codes and ICD-10 companion qualifiers. While claims are not adjudicated, submitters receive an acknowledgement that their claim was accepted or rejected.

Tip: Be sure to use ICD-10 qualifiers, which differ from ICD-9 qualifiers. Some providers have reported that ICD-10 qualifiers had to be manually set up in their systems.

Beyond testing with Medicare as described below, you can check with your commercial health plans, clearinghouses and billing...

KEPRO is the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for more than 30 states, including Kentucky. On July 28 from 10:00 – 11:00 a.m. (ET), KEPRO will host a webinar for Kentucky hospitals to discuss their role and answer any questions.

KEPRO will also briefly discuss the recent Centers for Medicare and Medicaid Services (CMS) Outpatient Proposed Rule which would expand their role on the Two-Midnight Rule policy. Specifically, CMS has decided to use QIOs, rather than Medicare Administrative Contractors (MACs) or Recovery Auditors, to conduct the first-line medical reviews of providers who submit claims for inpatient admissions.

For instructions on how to register, visit http://www.new-kyha.com/Portals/5/NewsDocs/KEPROMeetingRegistration.pdf.

If you have any questions, please contact Elizabeth Cobb at KHA (ecobb@kyha.com)....

The most recent Kentucky State Improvement Model (SIM) July Stakeholder Meeting was held last Wednesday, July 8, in Frankfort. The final presentation from this meeting can be found on the Kentucky SIM website: http://chfs.ky.gov/ohp/sim/.

As previously noted, the July workgroups scheduled for July 21 – July 23, have a different schedule and format than previous months. Please note that the Payment Reform, Integrated & Coordinated Care and Quality workgroups will be combined into a single, full-day panel format with presentations by Kentucky stakeholders. Please see below for the July workgroup schedule.

Workgroup

Date

Time

Location

Agenda Topics

On July 22 at 2:30 p.m. (ET), KHA will host a webinar on the new Fair Labor Standards Act rules. Nearly every employer in the nation will be affected by the U.S. Department of Labor’s (DOL) proposed revisions of the FLSA overtime exemptions. Their impact will touch not only how employers classify their exempt and non-exempt employees, but also organizations’ bottom line profits. Employee claims for unpaid overtime continue to be the most significant employment liability risk for employers. The revised overtime regulations coming out of Washington will mean even more liability and confusion for employers across the country. With these being some of the most significant changes to the workforce in nearly 50 years, this education will be of vital importance to hospitals.

This webinar will be led by Tammy McCutchen, former DOL Wage and Hour Administrator. She is now an attorney at the Littler Workplace Policy Institute® in Washington, DC, but previously was the principal at DOL who drafted the FLSA while...

The proposed calendar year (CY) 2016 payment rule for the Medicare Outpatient Prospective Payment System (OPPS) was published in the July 8 Federal Register. The proposed rule includes annual updates to the Medicare fee-for-service (FFS) outpatient payment rates as well as proposed regulations that implement new policies.

The Healthcare Association of New York State (HANYS) has shared a high-level summary of the proposed rule.

A copy of the Federal Register (FR) and other resources related to the OPPS are available on the Centers for Medicare and Medicaid Services (CMS) website. Comments on all aspects of the proposed rule are due to CMS by August 31 and can be submitted electronically at http://www.regulations.gov...

Two new surgical ratings/rankings became available to consumers today, and AHA has provided a Member Advisory with details on both.

First, ProPublica, an independent, investigative journalism group, published a new story rating surgeons and a database scorecard. USA Today and other Gannet-owned papers featured the new database yesterday and other media outlets may follow suit. The database features “death and complication rates” for surgeons for eight elective surgical procedures and is searchable by hospital and surgeon. In its story, ProPublica shared the overall learnings from this analysis. The AHA was given the opportunity to review their analytic approach and overall findings, but not the specific ratings, and found ProPublica’s analysis and methodology faulty overall.

...

What percentage of your newborn screening specimens get to the state lab within 96 hours? On July 29 at 9:30 a.m. (ET), KHA, in partnership with the Kentucky Department for Public Health’s Division of Laboratory Services, will host a webinar on best practices to improve turnaround times for newborn screening specimens. The goal, as a state, is for all birthing hospitals to have 95 percent of their specimens to the state lab within 96 hours, by July 1, 2016.

This informational webinar will feature background and best practices information from state lab representatives, along with speakers from Taylor Regional Hospital and Baptist Health Lexington who will share their secrets for success.

The webinar will be repeated on August 18 at 2:00 p.m. (ET). To register for either session, please visit https://www.surveymonkey.com/r/KS9XD5R.

For more information, contact Donna Meador...

KEPRO is the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for more than 30 states, including Kentucky. On July 28 from 10:00 – 11:00 a.m. (ET), KEPRO will host a webinar for Kentucky hospitals to discuss their role and answer any questions.

KEPRO will also briefly discuss the recent Centers for Medicare and Medicaid Services (CMS) Outpatient Proposed Rule which would expand their role on the Two-Midnight Rule policy. Specifically, CMS has decided to use QIOs, rather than Medicare Administrative Contractors (MACs) or Recovery Auditors, to conduct the first-line medical reviews of providers who submit claims for inpatient admissions.

KHA will share dial-in information as soon as it becomes available. Please save the date.

If you have any questions, please contact Elizabeth Cobb at KHA (ecobb@kyha.com).

Five Kentucky hospitals were named to Hospitals and Health Networks Magazine's Most Wired list for 2015. Results from the 17th annual Most Wired Survey show that hospitals and health systems are making progress in utilizing information technology to connect with patients.

• King's Daughters Medical Center, Ashland
• Marshall County Hospital, Benton
• Our Lady of Bellefonte Hospital, Ashland
• St. Elizabeth Healthcare, Edgewood
• Ephraim McDowell Regional Medical Center, Danville - on the list for "Most Improved"

On Tuesday, July 14, KHA will host a two-hour Members Only Webinar from 10:30 a.m. to 12:30 p.m. (ET) to present the results of a year-long project involving analysis of Medicaid claims data across all sites of service. As part of the Association's Medicaid Reform Strategy, KHA engaged the national consulting firms of Dobson/DaVanzo and Milliman to obtain Kentucky’s Medicaid claims data from the Centers for Medicare and Medicaid Services (CMS) and perform this analysis to assist the membership as they consider new risk-based approaches to Medicaid payment. The analysis and an accompanying chartbook, which will later be made available to the membership, can be used as hospitals work to improve efficiencies in care delivery and negotiate with the MCOs.

Al Dobson of Dobson/DaVanzo and Rebecca Johnson of Milliman will conduct the webinar. Below is an overview of the presentation. Please make note of the presentation of data on episodic payments, which is something being considered by the Cabinet for...

On June 26, the Internal Revenue Service (IRS) issued a document clarifying the rule it issued in December 2014 which limits tax-exempt hospitals' collection practices and requires hospital financial assistance policies to include lists of providers delivering care and whether those providers are covered by the policy.

After a request from the AHA and the Association of American Medical Colleges to remove the provider list requirement because of its confusing wording and the burden it places on providers, the IRS has released the clarification in an effort to make the rule easier for providers to follow.

The 13th Annual Mid-South CAH Conference will be held in Nashville on August 19-21. Details on the agenda, registration information, host hotel and more are available at https://www.signup4.net/public/ap.aspx?EID=20153355E&OID=50.

KHA, through support from the Rural Hospital Flexibility Program, will host a Rural Hospital Quality Leader Boot Camp for small rural and critical access hospital patient safety and quality leaders August 5 and 6. The 1 ½ day program includes training on TeamSTEPPS skills followed by a general quality leadership education workshop. The program will help quality leaders hone their communication and leadership skills as well as improve focus on best practices, data collection and benchmarking and engaging team members and leaders.

The event will be held at Shaker Village of Pleasant Hill in Harrodsburg. For details, view the event brochure. Online registration is available at https://secure.kyha.com/imispublic/....

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 updated an FAQ about the Stage 2 Summary of Care objective.

An important update was added regarding the NIST EHR-Randomizer Application:

Question: When reporting on the Summary of Care objective in the Medicare and Medicaid EHR Incentive Program, how can eligible professionals and eligible hospitals meet measure 3 if they are unable to complete a test with the CMS designated test EHR (Randomizer)?

...