As reported last week in the KHA News blog (article 1, article 2), the United States Pharmacopeia (USP) notified stakeholders that it is postponing the official effective dates of several new and revised standards pertaining to pharmaceutical handling until further notice while it reviews appeals to the standards. KHA urged the USP to delay this implementation and has also urged the Kentucky Board of Pharmacy not to adopt the new USP standards at this time.

The Joint Commission has released an official statement regarding the USP delays:

The Joint Commission is aware of the United States Pharmacopeia (USP) statement released on September 23 regarding the delay of implementation...

As reported yesterday in the KHA News blog, the United States Pharmacopeia (USP) notified stakeholders that it is postponing the official effective dates of several new and revised standards pertaining to pharmaceutical handling until further notice while it reviews appeals to the standards. KHA contacted the Joint Commission this morning to clarify how this would impact their surveys.

Their official statement has not yet been released; however, until the Joint Commission knows more about the delay in implementation of USP 797 and 800 standards, there will be no changes to the way they survey medication compounding.

KHA will distribute any updated information to members as soon as it is available.

Yesterday, the United States Pharmacopeia (USP) notified stakeholders that it is postponing the official effective dates of several new and revised standards pertaining to pharmaceutical handling until further notice while it reviews appeals to the standards. Those standards include general chapters (Pharmaceutical Compounding – Nonsterile Preparations), (Pharmaceutical Compounding – Sterile Preparations), and (Radiopharmaceuticals – Preparation, Compounding, Dispensing, and Repackaging). In addition, due to the pending appeals, USP new general chapter (Hazardous Drugs Handling in Healthcare Settings) will remain official, but only informational and will not be applicable until the appeals process is complete.

KHA submitted a letter...

KHA was successful in achieving favorable amendments to the Medicaid telehealth regulation. The Department for Medicaid Services (DMS) has issued revisions to its proposed regulation on telehealth service coverage and reimbursement.

KHA is very pleased that the regulation maintains payment parity. DMS will pay for telehealth services at 100% of the amount payable for an in-person service. Medicaid managed care organizations (MCOs) must reimburse the same amount as the department unless the MCO and provider have negotiated a different rate. DMS made several changes to their proposed rule in response to comments from KHA and other organizations.

A copy of the revised rule is available at http://www.new-kyha.com/Portals/5/NewsDocs/907KAR3_170.pdf. The revised rule must be reviewed by two legislative committees before it becomes final and effective which should occur by early November.

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KHA submitted comments on proposed changes to 907 KAR 3:170 establishing payment rules for Medicaid coverage of telehealth services. Due to a filing error, 907 KAR 3:170 was withdrawn. As a result of this error, the Statement of Consideration of received comments will not be prepared or filed.

This administrative regulation will be refiled before July 1, 2019. DMS has shared that that several parts of the administrative regulation will be changed from the previous version, some reflecting comments received from KHA and members.

KHA is pleased with these anticipated improvements and will keep the membership updated.

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

CMS has posted frequently asked questions concerning the Medicare Outpatient Observation Notice (MOON). The “MOON FAQs” are available on the CMS website at www.cms.gov/bni.

As a reminder, the requirement for Hospitals and critical access hospitals (CAHs) to use MOON began on March 8, 2017.

The Medicare Outpatient Observation Notice (MOON) requirements went into effect February 20.The following information and resources will help hospitals ensure they are meeting the requirements correctly.

On August 6, 2015, Congress enacted the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act) which requires hospitals, including critical access hospitals (CAHs), to provide written and oral explanation to individuals who receive observation services as outpatients for more than 24 hours. The process for delivery of this notice, the Medicare Outpatient Observation Notice (MOON), was addressed in rulemaking, and the resulting regulations are located at 42 CFR Part 489.20(y).

The MOON must be delivered to beneficiaries in Original Medicare (fee-for-service) and Medicare Advantage enrollees who receive observation services as outpatients for more than 24 hours....

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...

The Cabinet for Health and Family Services (CHFS) has agreed to withdraw the Kentucky National Fingerprint Background Check Program. Former Governor Steve Beshear signed the emergency regulation in November 2015 to require fingerprint background checks on all new employees of long-term care facilities.

This regulation affected hospitals with home health agencies and hospice not located on the hospital's campus.

Reading copies of new regulations about tuberculosis (TB) testing in long-term care settings and for health care workers, in both Word and PDF formats, are now available. These two regulations became effective on Friday, March 4. Facilities have 180 days (i.e., by August 31, 2016) to become compliant with these new regulations. CDC guidelines are the foundation of these new regulations.

TB Testing for Residents in Long-Term Care Settings - Word - PDF   TB Testing for Health Care Workers - Word - PDF The final formatting of these regulations is in transition and will be posted online in about a month. These reading copies have a larger font and have line numbers but have the same text as the marked up versions that are online: http://www.lrc.ky.gov/kar/frntpage.htm.

If you have additional questions or comments about either of these regulations, please contact Dr. Robert Brawley, chief of the Infectious Disease Branch of the Kentucky Department for Public Health (Robert.Brawley@ky.gov) and cite the page number and line number of the relevant attached files. Your questions and comments will be used to develop responses to Frequently Asked Questions (FAQs). FAQs will be distributed as part on DPH educational programs about these two regulations....

On July 7, Medicaid regulations became final and took effect to cover occupational therapy on an outpatient basis in hospitals as well as outpatient behavioral health services including intensive outpatient, partial hospitalization, individual and group therapy. KHA worked with the Department for Medicaid Services to achieve positive amendments to the regulations for these services to be covered in an outpatient hospital setting.

Also becoming effective on that date were new regulations covering behavioral health services and occupational, physical and speech therapy services provided by independent providers.

If you have any questions concerning the new regulations, please contact Nancy Galvagni at KHA (502-426-6220 or 800-945-4542 or via email at ngalvagni@kyha.com).

The Kentucky Department for Public Health (KDPH) has been reviewing the state regulation on requirements for health care worker tuberculosis (TB) testing. The Department has circulated language that would require annual TB testing for all hospital employees. KHA has gathered comments and input from hospitals and submitted comments on this issue to KDPH and the Office of the Inspector General (OIG).

KDPH has requested a meeting with hospital infection preventionists (IPs), employee health nurses and other relevant hospital staff to discuss the concerns hospitals have communicated as well as offer dialogue about the increased incidence of TB and related public health concerns. KDPH and the OIG hope that the discussion will bring about a consensus on the most practical and effective policy to meet everyone's needs.

KHA will host a meeting on July 29 at its headquarters in Louisville from 1:00 - 3:00 p.m. (ET). There is room for 30 to attend in person and others may participate via conference...