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Vol. 43, Number 11

           

March 19, 2012


IN THIS ISSUE

Lawmakers Urged to Restore Small and Rural Hospital Fund
State Legislature Responds to Advocacy on Graduate Medical Education Funding
HHS Issues Final Rule on Health Insurance Exchanges
Orientation Sessions Begin Today for New MI Bridges System
Webinar Focuses on Evaluation and Management Coding
Members in the News
Friday is Deadline for Medicaid DSH Audit Request
Sign Up to Sponsor the MHA Annual Membership Meeting by March 26
News to Know

Lawmakers Urged to Restore Small and Rural Hospital Fund

David Finkbeiner (left), MHA senior vice president, Advocacy, looks on during Covert’s testimony.

Gov. Rick Snyder’s executive budget proposal for fiscal year (FY) 2013 did not include $29.5 million created in the FY 2012 Medicaid budget to assist small and rural hospitals. Rob Covert, president & chief executive officer (CEO), Oaklawn Hospital, Marshall, testified Thursday before the Senate Appropriations Subcommittee on the Michigan Department of Community Health (MDCH) that the fund must be reinstated to protect the financial viability of small hospitals and services for the patients they serve.

Covert explained to the subcommittee that Medicaid pays only 46 percent of the cost of delivering care, but with the additional funding in 2012, Oaklawn received reimbursement for 59 percent of the cost. Since 45 percent of the 700 babies delivered at Oaklawn are covered by Medicaid, the 13 percent improvement in funding helps to assure that labor and delivery services can continue in Marshall.

In addition, Covert indicated the hospital employs 30 physicians, who provide access to care in rural and underserved areas. The percentages of patients who are Medicaid recipients in the physician practices range from 36 percent to 17 percent, compared to a national average of 3.75 percent for a family practice office. He stressed that the additional funding is critical to keeping those physician practices open.

In view of the prudent decision to provide small and rural hospital funds in FY 2012, when there was a $1.5 billion state budget deficit, lawmakers were urged to consider the wisdom of continuing the additional funding when a significant revenue surplus is projected in FY 2013. In closing, Covert reminded the subcommittee that, while the funding pool will not solve all reimbursement problems, it will assist dozens of small and rural hospitals. Those hospitals are typically the largest employers in their counties and make significant contributions to both the healthcare of their citizens and the economic growth of their communities.

Advocacy messages on the small and rural funding pool that Covert outlined were reinforced by Steve Barnett, president and CEO, McKenzie Health System, Sandusky; Tim Johnson, CEO, Eaton Rapids Medical Center; and Kevin Price, vice president and chief operating officer, Sparrow Clinton Hospital, St. Johns, during meetings with 15 lawmakers held Thursday.

Earlier this month, Kevin Splaine, president, Spectrum Health Medical Center, Grand Rapids, testified before the House Appropriations Subcommittee on the MDCH on the importance of the small and rural funding pool, as well as the need for the Legislature to restore graduate medical education funds that were reduced in Snyder’s budget recommendation. In response to budget deliberations in both the House and the Senate, the MHA issued a Hospitals-ACT action alert calling on members to contact their lawmakers to communicate the critical role of hospitals in access to care and the prosperity of the state. Members with questions should contact Dave Finkbeiner at the MHA.

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State Legislature Responds to Advocacy on Graduate Medical Education Funding

The House Appropriations Committee, chaired by Rep. Chuck Moss (R-Birmingham), reported a fiscal year (FY) 2012 supplemental appropriation bill, House Bill (HB) 4289, last week. Included in the bill is funding of $3.0 million (general fund), $8.9 million (gross), to reinstate a portion of the $14.7 million gross graduate medical education (GME) program reduction that was included in the FY 2012 budget. With this funding restoration, a top advocacy priority of the MHA has been addressed by the committee. While the MHA and members pushed for full restoration, the governor and lawmakers have been reluctant to hold hospitals “harmless,” given reductions made in other departments. HB 4289 now moves to the full House for consideration. Hospitals are urged to thank Appropriations Committee members for their recognition of the importance of GME funding and to press members of the House to support the bill as passed by the committee.

Also last week, the state Senate favorably reported Senate Bills (SBs) 414 and 415, sponsored by Sen. Mike Green (R-Mayville) and Sen. Tupac Hunter (D-Detroit) respectively, along with SB 981, sponsored by Senate Majority Leader Randy Richardville (R-Monroe). Together, SBs 414 and 415 would require health insurers and health maintenance organizations to provide coverage for autism spectrum disorders. SB 981 would create the Autism Coverage Incentive Act to require the creation and implementation of an autism incentive program. As previously reported, the MHA supports SBs 414 and 415. The bill package now moves to the House Families, Children and Seniors Committee for consideration. For more information, contact Chris Mitchell at the MHA.

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HHS Issues Final Rule on Health Insurance Exchanges

Last week, the U.S. Department of Health and Human Services released a more than 600-page final rule on health insurance exchanges that will serve as a marketplace for individuals and small businesses looking to purchase coverage starting in 2014. The rule sets the framework and structure for state-based health insurance exchanges and outlines standards for health plan participation, enrollment eligibility, insurance affordability programs and more. The MHA Health Reform Resource Center is reviewing the rule and will provide member hospitals and health systems with a more robust summary of the rule in the near future. Members will also be kept apprised of MHA comments on the rule.

The final rule gives states flexibility in the establishment of exchanges and the certification criteria for health plans. In addition, for states that do not have an operational exchange by the 2014 deadline, the final rule indicates that still further guidance will be issued to address federal exchanges and federal-state partnership exchanges.

The final rule will be published in the March 27 Federal Register and will be effective within 60 days of publication. However, parts of the rule were issued as interim; comments will be accepted on those sections for 45 days after publication.

At the February meeting of the MHA Board of Trustees, the association was directed to support the appropriation of the $9.8 million federal allocation to Michigan for the development of a state exchange. The appropriation of these funds in a timely manner will help ensure Michigan is not refused additional federal dollars for exchange development that will be granted later this year.

The legislation establishing a state-based exchange in Michigan, which the MHA supports, is stalled in the state House of Representatives. The Legislature has expressed concern about moving forward with the legislation until a U.S. Supreme Court decision is made in June regarding whether the Affordable Care Act will be upheld and to what degree. Members with questions should contact Laura Appel at the MHA.

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Orientation Sessions Begin Today for New MI Bridges System

Starting today, orientation webinars are being hosted by the Michigan Benefits Access Initiative (MBAI) for community organizations, healthcare providers and others who are interested in learning more about the recently launched MI Bridges system. The new system allows beneficiaries and community partners to apply for and access all Michigan Department of Human Services (MDHS) assistance programs, including Medicaid and food assistance. The orientation webinars will cover the goals of the initiative, provide an overview of the MI Bridges technology and discuss levels of engagement for interested organizations.

The webinars are scheduled by region, with two time slots offered for each. Hospitals and health systems that wish to participate should click the corresponding link to pre-register for the webinar in their area. To confirm an organization’s region, review the lists on the MDHS website.

The MBAI is a public-private partnership among the Michigan Association of United Ways, other private organizations, and the MDHS whose goal is to improve the economic stability of low-income families by reforming and improving online access to public benefits.

The new MI Bridges program should lead to faster response times and fewer delays in service access, reduced administrative burdens and an improved user experience.

As community stewards, hospitals have become increasingly involved in helping patients gain access to services and coverage through their involvement in initiatives such as Enroll Michigan, which helped enroll approximately 1,600 eligible children in the state’s free and low-cost insurance plans in 2011. MHA members that participate in the MI Bridges orientation sessions, being offered at no charge, will be able to take advantage of the enhanced system to further improve community health and access to coverage for their patients.

Members with questions or that would like training, but cannot attend one of the webinar sessions listed above, should contact Ruthanne Sudderth at the MHA.

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Webinar Focuses on Evaluation and Management Coding

Knowledge is power when it comes to Evaluation and Management (E/M) coding and documentation. Too many hospitals and physicians are chronically under-coding for their services because the rules are vague. A working knowledge of the E/M coding is the best way to ensure optimal compliance and adequate reimbursement on the time and effort it takes to code these services. In other words, if hospitals and physicians accurately bill for their services, there is a better chance they will get paid for what they really do. The MHA Health Foundation webinar Evaluation and Management Coding for Hospitals and Physicians: Best Practices will outline challenges and solutions to E/M coding and billing in the areas of physician and hospital billing, variations for emergency departments and provider-based clinics, and the expectations of the Centers for Medicare & Medicaid Services, as well as share case studies to demonstrate proper E/M billing. The webinar is scheduled from 9:30 to 11 a.m. May 8, and MHA members can register for a connection fee of $195. For more information, contact Leigh Anne Jewison at the MHA.

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Members in the News

Conway

The National Quality Forum (NQF) and The Joint Commission last week announced that Henry Ford Health System, Detroit, has received the 2011 John M. Eisenberg Patient Safety and Quality Award for innovation in patient safety and quality at the local level. From April 2008 through June 2011, the system’s No Harm Campaign has resulted in a 26 percent reduction in harm events and a 12 percent reduction in the occurrence of mortality systemwide. The campaign is spearheaded by William A. Conway, MD, the system’s chief quality officer. Eisenberg Award honorees will receive the awards April 5 at the NQF’s Annual Conference and Membership Meeting in Washington, DC. Past award winners from Michigan include the MHA Keystone Center for Patient Safety & Quality, Lansing, in 2009, and Darrell A. Campbell, Jr., MD, chief medical officer, University of Michigan Hospitals and Health Centers, Ann Arbor, in 2007.

Hamilton Mullany
Terry Hamilton has been appointed president of St. John Macomb-Oakland Hospital, Warren, a position he has held on an interim basis since December. Hamilton joined St. John Providence Health System in 2007 as senior vice president of operations for the Warren-based system. He arrived at St. John Providence with 18 years’ experience in healthcare finance, consulting and operations. He holds a bachelor’s degree in economics from Wabash College, Crawfordsville, IN, and a Master of Business Administration degree from the University of Michigan, Ann Arbor.

Joe Mullany has been hired as president of the Detroit Medical Center (DMC) effective April 2 and will report directly to DMC chief executive officer Mike Duggan. Mullany has served as president of the New England region of DMC’s parent organization, Vanguard Health System, since joining Vanguard in 2005. Previously he was a vice president at Essent Healthcare in Nashville, TN, and corporate vice president and president of the Mississippi division of Florida-based Health Management Associates.

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Friday is Deadline for Medicaid DSH Audit Request

This is the final week for hospitals to submit federally required information for the Medicaid disproportionate share hospital (DSH) audits for state fiscal year (FY) 2009. In mid-February, audit consultant firm PHBV Partners LLP (formerly Clifton Gunderson) distributed the audit request list to hospitals that received Medicaid DSH payments for FY 2009. This request was sent electronically to the PHBV Partners hospital contact from the 2008 audits. All hospitals that received Medicaid DSH payments for FY 2009 are subject to the audit.

Last month, the MHA hosted an educational session to review the plan, and both a transcript and PowerPoint slides from the session are available online for review.

Hospitals are asked to submit the requested items to PHBV Partners by the Friday deadline and are encouraged to contact Joe Lackey at PHBV Partners with any questions regarding the request list or their ability to meet the deadline. The Medical Services Administration (MSA) distributed FY 2009 DSH payments to hospitals based on a state-estimated DSH ceiling for each hospital. PHBV Partners will use actual data to complete a provider data summary schedule for each hospital to help them understand the key factors that impacted any change in their individual DSH ceilings. The consultant will submit its final report to the MSA by Sept. 30. Beginning with the audits of DSH payments for FY 2011, hospitals will be subject to DSH payment recoveries if audits indicate DSH payments exceeded their actual DSH ceilings. These audits will begin in FY 2014.

The reports for the 2005, 2006, 2007 and 2008 audits are available on the MSA’s website. Members with questions should contact Vickie (Seal) Kunz or Nathanael Wynia at the MHA.

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Sign Up to Sponsor the MHA Annual Membership Meeting by March 26

The MHA Annual Membership Meeting, scheduled for June 27 through 29 at the Grand Hotel on Mackinac Island, brings together hundreds of healthcare decision-makers. This is the most important healthcare meeting of the year, with 95 percent of the chief executive officers of Michigan hospitals and health systems attending. Attendance at this prestigious event is limited to MHA members, sponsors and invited guests.

To be listed in the MHA Annual Membership Meeting brochure as a sponsor, organizations must submit an Intent to Sponsor form (found on page 15 and 16 of the 2012 MHA Corporate Sponsorship and Advertising program brochure) by March 26. Acknowledgment in the brochure is a great way to be recognized as a supporter of Michigan hospitals. While sponsorship opportunities remain, they are selling quickly. Contact Erin Steward at the MHA to discuss this year’s opportunities.

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MHA Members can also refer to these items in our Weekly Mailing:

AB1319 Michigan’s Proposal to Integrate Care of People Dually Eligible for Medicare and Medicaid 
MHA MHA Patient Safety & Quality Symposium Early Registration Discount Ends March 20 
MHA MHA Partners with ACPE on Physician Leadership Development 
MHA New MI Bridges System Orientation Sessions Announced
MHA Upcoming MHA Events
Michigan Health & Hospital Association
6215 West St. Joseph Highway • Lansing, MI 48917
(517) 323-3443 • Fax: (517) 323-0946
www.mha.org

©2003-2012 by the Michigan Health & Hospital Association. All rights reserved. Materials may not be reproduced without permission.