The KHA Certificate of Need (CON) Committee is in the process of reviewing the State Health Plan and CON regulations, and discussing the need to update and improve portions of the program in order to streamline and modernize CON in Kentucky. Two events have prompted this thorough review.

First, the Bevin administration and the Office of Health Policy are focusing on reducing red tape which impedes appropriate growth and business activities. KHA member hospitals would like to be proactive partners in this effort. Secondly, the Office of Health Policy announced in the February CON Newsletter that comments on the 2017 State Health Plan will be accepted between March 1 and March 31. KHA is working towards this deadline in getting final recommendations from the CON Committee and reviewed for approval by the KHA Board of trustees. The KHA Board did approve some CON Committee recommendations during the February 23 Board meeting, but there are other areas of the plan that are being reviewed and discussed....

The Cabinet for Health and Family Services (CHFS) has issued an emergency regulation, 900 KAR 5:020E, to reverse changes made to Certificate of Need (CON) criteria for ambulatory surgery centers (ASCs) in the 2015 update to the State Health Plan. KHA counts this as a major victory and commends Governor Matt Bevin and CHFS Secretary Vickie Yates Brown Glisson for their leadership on this issue.

In 2015, significant and problematic changes were made to the State Health Plan under the Beshear administration, which created numerous exceptions to the ASC criteria. These exceptions allowed for the unnecessary proliferation of ASCs regardless of existing capacity available in ASCs and hospital outpatient surgery departments or need for new services identified in the population. KHA expressed grave concern about those changes in 2015 to the Beshear administration and before the Administrative...

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...

The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule to update the Hospital outpatient prospective payment system (OPPS) and the ambulatory surgical center (ASC) payment system for calendar year (CY) 2015. CMS states that the proposed rule, which contains a 60-day comment period ending September 2, would update the payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments and ASCs beginning January 1, 2015.

KHA's Washington liaison Larry Goldberg has prepared an analysis and commentary on the proposal, which is available at http://www.new-kyha.com/Portals/5/NewsDocs/03Jul2014OPPSProposed.pdf.