January 12, 2004

MHA's Monday Executive Briefing
January 12, 2004

In this week's issue...
- State News -
1. Your help needed for grassroots advocacy
2. 2004 Mississippi Congressional Candidates
3.Barbour asks 500 state employees for resignation
4.Barbour names five more directors
5.Bill calls for changes on health board
6.Clark to push election reform
7.Tuck names committee to hear contested Senate race
8.House chooses leaders from far north, south Mississippi
9. Medicaid director takes post as special assistant at UMC
10.Tuck, McCoy say conferences will stay open
11.Barbour taps two former lawmakers as legislative liaisons
12. Moore to join Phelps Dunbar
13. Court Notice
14. Broadwater announces candidacy
15. Barbour, Riley will tout states at summit
16. Barbour inaugural events feature stars of country, jazz, R&B
17. McCoy wants new committees
18. Ex-Speaker of the House wrapping up his political career
19. Governor-Elect Haley Barbour announces several administration appointments
20. Thompson to back Dean for president in '04
- National News -
21. Preview period begins for Quality Initiative participants
22. Bush seeks new provision in immigration laws, particularly for undocumented aliens
23. CMS publishes OPPS interim final regulation
24. CMS occupational mix survey due Feb. 16
25. No Senate action on omnibus appropriations bill until late January; billions at stake
26. CMS sets geographic reclassification procedures
27. Acting CMS administrator named
28. HHS publishes semiannual regulatory agenda

- State News -

1. Your help needed for grassroots advocacy
  In the past two years, MHA has depended heavily upon our e-mail network to transmit urgent information on key advocacy issues. This grassroots network is an important component of MHA’s advocacy program. In order to get ready for the 2004 legislative session, we need the name, title and e-mail addresses of the staff that you consider key contacts at your hospital. We also have issue-specific lists for CEOs, CFOs, CNOs and DONs, executive staff, human resources, purchasing/materials management, risk management, human resources, marketing and public relations, hospice and home care, facility managers, behavioral health and health care educators. Please send us the information on employees in your hospital you would like to add to those e-mail lists.(It makes a powerful impact on legislators and their decisions when a major issue is up for a vote and the legislator hears resoundingly from those affected.)
  In addition to expanding our grassroots network with hospital staff members, MHA is making a special effort to include hospital trustees in our network. Hospital trustees are effective advocates because they are perceived as working only for the good of their community when talking to an elected official about a hospital issue. They are a valuable addition to our grassroots team and  it is important that we make every effort to get trustees involved. If possible, please nominate at least two trustees from your Board who would be interested in staying informed on important issues and would be willing to make contact with an elected official at a critical time.
  For more information or to send your list of names, contact Shawn Lea at by phone at (601) 368-3237, by fax at (601) 368-3200 or by e-mail at slea@mhanet.org .

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2. 2004 Mississippi Congressional Candidates
   Friday, January 9, was the deadline for Mississippi candidates to qualify to run for U.S. House of Representatives in 2004.Party candidates submit qualifying papers to their respective parties; Independent candidates submit qualifying papers to the Secretary of State's Office. The Democratic and Republican parties will conduct primary elections on March 9 to select nominees for all four House of Representatives posts, as part of the presidential preference primary. A run-off election for congressional nominees will be held, if necessary, on March 30. The general election will be held on November 2.
  The following list of candidates is based on information provided by the parties at the close of business Friday, January 9. No information was received from the America First, Constitution, Green, Libertarian, and Natural Law parties.
-U.S. House - First Congressional District :Barbara Dale Washer of Hattiesburg (Reform), Roger F. Wicker of Tupelo (Republican)
-U.S. House - Second Congressional District :James Broadwater of Jackson (Republican), Clinton B. LeSueur of Greenville (Republican), Shawn O'Hara of Hattiesburg (Reform), Stephanie Summers-O'Neal of Jackson (Republican), Bennie Thompson of Bolton (Democrat)
-U.S. House - Third Congressional District :Jim Giles of Pearl (Independent), Lamonica L. Magee of Foxsworth (Reform), Charles "Chip" Pickering, Jr. of Flora (Republican)
-U.S. House - Fourth Congressional District :Tracella Lou O'Hara Hill of Hattiesburg (Reform), Michael Lott of Petal (Republican), Steven A. McCaleb of Long Beach (Republican), Randy McDonnell of Biloxi (Republican), Karl Cleveland Mertz of Long Beach (Republican), Gene Taylor of Bay St. Louis (Democrat)
  The qualifying deadline for Democratic and Republican Party presidential candidates not already recognized by the Secretary of State for the March 9 presidential primary election is January 15. The following presidential candidates currently are slated to appear on primary ballots:
- Republican Party: George W. Bush
- Democratic Party: Carol Moseley Braun, Wesley Clark, Howard Dean, John Edwards, Dick Gephardt, John F. Kerry, Dennis Kucinich, Joseph Lieberman, and Al Sharpton
   Independent candidates for President and presidential candidates nominated by minor parties must notify the Secretary of State by September 3, 60 days before the general election.

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3. Barbour asks 500 state employees for resignation
   Governor-elect Haley Barbour has told hundreds of state employees that he expects their resignations before he takes office on Tuesday. It's Barbour's latest move to install his own administration. About 500 employees in state government have no state service protection. The process of dealing with those positions, in one form or another, repeats itself with each new administration. More than 30-thousand employees are protected under the state Personnel Board.
   Barbour informed the 500 employees by letter that he did not want to disturb the day-to-day operations of state government. Barbour's letter says, "I ask that you remain in your position and continue to perform your duties unless you choose to voluntarily leave or you are notified by me of the acceptance and effective date of your resignation." Barbour's transition team says failing to respond will be interpreted as a resignation.In addition to the entire staff at the Mississippi Development Authority, Barbour can replace the upper echelon of workers at agencies such as the Department of Human Services, the Department of Public Safety, and the Department of Corrections.

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4. Barbour names five more directors
   Gov.-elect Haley Barbour tapped former U.S. Attorney George Phillips to lead the Mississippi Bureau of Narcotics, replacing former television executive Frank Melton. Barbour on Friday also appointed J.K. "Hoopy'' Stringer as state fiscal officer, Don Taylor as director of the Department of Human Services and Charles Chisolm as head of the Department of Environmental Quality. The appointments require Senate confirmation. Barbour also named Wallace Conerly as interim Medicaid director today.
  Chisolm stays on the job he has had for the past four years. Taylor returns to a job he had from 1995 to early 2000 under Republican Gov. Kirk Fordice. Stringer moves over from the state Personnel Board, where he has been director for the past decade.  Barbour said Taylor brings experience to a department in need of overhaul.
  Phillips said Donald Butler, a former chief of the Mississippi Highway Patrol and former MBN director, will serve as MBN's deputy director.Stringer, 63, of Brandon, said he'll work as part of a team to help Barbour tackle the state's fiscal problems. Mississippi has suffered from a slumping economy and tight budgets the past three years.Chisolm, 60, of Brandon, has more than three decades' experience in environmental regulation. Democratic Gov. Ronnie Musgrove appointed Chisolm as DEQ director in 2000, promoting him from head of the agency's pollution division.Taylor replaces Thelma Brittain, who was the third DHS director during Musgrove's term. Stringer replaces Margaret Hill, the second state fiscal officer in the past four years. Stringer said John Mulholland, deputy director of the Personnel Board, will be the Personnel Board's acting director. The Personnel Board's five-member board of directors will choose an executive director.
   Conerly, recently retired from the University of Mississippi Medical Center, will serve in an interim capacity until a permanent Medicaid director is found.

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5. Bill calls for changes on health board
    State lawmakers may be looking at ways to restructure the state Board of Health this Legislative session. Sen. Deborah Dawkins of Pass Christian plans to introduce legislation in the next month that would require the 13-member board to have representatives from a variety of health-care fields and more lay people.
  The bill also stipulates stiff penalties for Board of Health members or health department employees who receive a bribe or any financial benefit from anyone who does business or is regulated by the Board of Health. A person convicted of a bribe could be fined $10,000 or sentenced to one year in jail.Currently, the 13-member board includes only one consumer representative. Critics have said the board is stacked with too many people with financial interests in health care.
  The board members are appointed by the governor and serve staggered terms. Dawkins' bill says current members would serve out their remaining terms. The board decides which health-care providers can open facilities, such as nursing homes or specialized operating rooms. The board's responsibilities also include developing the state's health plan and overseeing its policies and regulations. It also hires the state's chief health officer.
  Dawkins said the addition of three consumer advocates, one of whom must be older than 60, will help with oversight of the health department. The board's only consumer representative, Janice Conerly, said the board needs more consumer representatives. She became an advocate for accident victims in need of rehabilitation after her daughter suffered brain injuries.
  Dawkins said the penalties portion of the legislation was inserted to make it clear that people who serve on the Board of Health should not receive any financial benefit from the agency. Sen. Gloria Williamson, a Democrat from Philadelphia, already has backed the bill and several other legislators may sign on in coming weeks, Dawkins said. Other bills to restructure the board have been introduced in the Legislature in the past few years, but have not passed.

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6. Clark to push election reform
     Secretary of State Eric Clark plans to push for sweeping election reforms this legislative session, in part because federal funding may be available to implement them. Clark said voter rolls in many Mississippi counties are full of people "who have died, moved away or gone to jail." A study he pushed for five years ago showed that 44 of the state's 82 counties "have more registered voters than people on rolls." Problems like these, he said, leave too much room for voter fraud.
   Past efforts at reform failed in part, Clark said, because there was no money to fix problems. But the federal Help America Vote Act, spawned by problems in Florida with the 2000 presidential election, could, if fully funded, provide Mississippi $34 million to buy new voting machines, start a statewide voter registration database that would keep county rolls updated and make other improvements.
  Clark, speaking to business leaders at the Capitol for the Mississippi Economic Council's annual legislative day, also promised to help lawmakers find common ground in the fight over voter identification. One side says voter ID could eliminate fraud, but the other remembers days when Mississippi used voter regulations to keep black people from voting and is leery of new regulations.
  One thing Clark didn't mention in his speech to the MEC was campaign finance reform. But afterward, he said that was just because he ran out of time. "My office is going to introduce a campaign finance bill to deal with technical issues," he said, "then we are going to get into the issue of undisclosed issues ads." Clark said he would also work with the Legislature on clarifying state laws on candidates disclosing sources of campaign funds.

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7. Tuck names committee to hear contested Senate race
    Lt. Gov. Amy Tuck has appointed a five-member committee to review the contested District 29 Senate race in Hinds County. The committee members are Sen. Terry Burton, R-Newton, who will serve as chairman; Sen. Cindy Hyde-Smith, D-Brookhaven; Sen. Tommy Robertson, R-Moss Point; Sen. Ralph H. Doxey, D-Holly Springs; and Sen. Lynn Posey, D-Union Church.
   Democrat Dewayne Thomas was certified the winner in the Senate race, but incumbent Sen. Richard White, R-Terry, challenged the outcome of the Nov. 4 election, citing ballot concerns. The committee's first meeting was Wednesday. Senators didn't say when they'll make a decision.
  White has questioned an attorney general's opinion that effectively sealed the race for Thomas. The opinion allowed 546 uninitiated ballots in Hinds County Precinct 94 to be counted, as well as uninitiated ballots throughout the county. Thomas was declared the winner with 8,926 votes to White's 8,791.

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8. House chooses leaders from far north, south Mississippi
   The Mississippi House chose its top leaders from opposite ends of the state Jan. 6 as lawmakers convened their 2004 session and launched a four-year term. Rep. Billy McCoy, a Democrat from Rienzi near the Tennessee border, was unanimously elected House speaker. Rep. J.P. Compretta, a Democrat from the coastal city of Bay St. Louis, won the House's second-highest position, speaker pro tempore. Three other representatives ran for pro tem, and Compretta was elected on a third calling of the House roll.
  Compretta represents a fast-growing part of the state that has been clamoring for a stronger voice in government, and his election as pro tem changes the dynamics of a House where a Black Caucus member has been pro tem for the past decade. Compretta is white. Longtime Rep. Robert Clark, D-Ebenezer, was the first black lawmaker to serve as pro tem. Neither he nor four-term Speaker Tim Ford, D-Baldwyn, sought re-election to the Legislature last year, leaving the top leadership positions open.
  Rep. George Flaggs, D-Vicksburg, a Caucus member, survived three roll call votes but lost to Compretta, 85-36, on the fourth and last call. The vote was split largely along racial lines, but some whites voted for Flaggs and some blacks supported Compretta. On the other end of the Capitol, the Senate re-elected Sen. Travis Little, R-Corinth, as president pro tempore.

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9. Medicaid director takes post as special assistant at UMC
   Rica Lewis-Payton, the Medicaid executive director who steered the agency through four difficult years, has accepted a job as a special assistant to the vice chancellor of the University of Mississippi Medical Center. Lewis-Payton's selection for the newly created position must be approved by the state College Board before it is official.
  Lewis-Payton is one of the many agency heads whose appointments are coming to an end since Republican Haley Barbour defeated Democratic Gov. Ronnie Musgrove last year. While Barbour has named some holdovers from Musgrove's administration, Lewis-Payton had said she would not stay on if asked.
  In the new position, she would assist Dr. Dan Jones, who recently succeeded Dr. Wallace Conerly, the vice chancellor for health affairs. Jones said Lewis-Payton would work to stem high rates of hypertension, diabetes, obesity and infant mortality in Mississippi. She would coordinate efforts for the university's clinical and research programs, while helping to garner more federal and private funds.Lewis-Payton, whose last day with Medicaid is Jan. 13, said her new start date would be some time next month. Barbour has not named a replacement.

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10. Tuck, McCoy say conferences will stay open
   Lt. Gov. Amy Tuck and House Speaker Billy McCoy told The Associated Press on Jan. 5 they intend to keep requiring open conference committees. A requirement for open conference committees expired last month, with the end of the past legislative term. Tuck, a Republican, and McCoy, a Democrat, said they want to revive the rule this term.
  In conference, three House members and three senators work on final versions of bills. The meetings usually are held at the end of the legislative session. Conferences remained closed for decades in the Mississippi Legislature, with only a few chairmen opting to let the public see the final give-and-take.
  In 2001, the House and Senate voted to require all general conference committees to be open to the public until the end of the term in December 2003. Dates, times and places for meetings had to be posted in advance. Conferences for appropriations bills were still allowed to be closed because Rep. Charlie Capps, D-Cleveland, then chairman of House Appropriations, said opening conferences would complicate lawmakers' work and could prolong the sessions.
  McCoy said he'll require the incoming House Appropriations chairman to have open conferences. Tuck was less specific about whether appropriations conferences should be open, saying the House and Senate should at least continue "what we've done in the past." But, Senate President Pro Tempore Travis Little, R-Corinth, said he would support opening the appropriations conferences.

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11. Barbour taps two former lawmakers as legislative liaisons
   Mississippi Gov.-elect Haley Barbour has added three legislative liaisons to his staff, including a former Democratic lawmaker, a spokesman for the Republican said on Jan. 5. Former state Sen. Neely Carlton, a two-term Democrat from Cleveland, did not seek re-election last year. Also chosen by Barbour were former state Rep. Andrew Ketchings and Preston Powell, who worked for Lt. Gov. Amy Tuck's re-election campaign. The three will work with the Legislature to try to get Barbour's agenda approved, said spokesman Quinton Dickerson.

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12. Moore to join Phelps Dunbar
   Attorney Gen. Mike Moore joined  the Jackson-based Phelps Dunbar law firm on Jan. 8, the same day he stepped down from his state post. Moore said he's happy to stay in Mississippi and would be challenged when he joins the firm. He will continue to stay busy with national organizations, including the Boys and Girls clubs.
  Moore will work in the firm's litigation group and focus on dispute resolution. The firm is home to about 270 lawyers in eight offices, including Jackson, Tampa, Baton Rouge, Tupelo, Gulfport and New Orleans.Moore, a former Gulf Coast district attorney, was first elected Mississippi attorney general in 1987. He served four terms, but decided not to seek re-election last year. He endorsed incoming Attorney Gen. Jim Hood, a north Mississippi district attorney and former assistant attorney general.

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13. Court Notice
   Controversial Justice Chuck McRae ended his stormy tenure on the state's highest court on Monday. McRae was replaced by Jess Dickinson, who beat McRae and one other candidate in a November 2002 election. Due to an oddity in Mississippi election law, McRae served a year after he was defeated. The lag caused a great deal of friction among McRae and several other justices.Justice Bill Waller was named Monday as a presiding justice, replacing the position held by former Justice McRae.

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14. Broadwater announces candidacy
   A third candidate is joining the race for the Republican nomination for the Second Congressional District seat. James Broadwater has no experience in elected office but says he can provide the leadership necessary for the job. Broadwater announced his candidacy Saturday afternoon on the steps of the capitol building. The Southern Baptist minister and Hinds County teacher describes himself as a conservative Christian candidate. He says his teaching experience will help him improve education in the second district. If elected, Broadwater says he'll try to remove liberal U.S. judges.
  The primary is March 9th. The Second Congressional District runs from the Mississippi delta to parts of west Jackson and into southwest Mississippi . Clinton Leseur and Stephanie O'Neil are also seeking the nomination. The winner will likely run against Democratic incumbent Bennie Thompson.

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15. Barbour, Riley will tout states at summit
   The governors of Mississippi and Alabama will headline a leadership summit next month on economic development. The Feb. 6 event is hosted by the Commission on the Future of East Mississippi and West Alabama. It will be held at the University of West Alabama. Gov.-elect Haley Barbour, who will be sworn in as Mississippi's chief executive on Jan. 13, and Alabama Gov. Bob Riley are expected to talk about development opportunities, including the proposed bi-state industrial park initiated last year.
  "With their commitment, we expect our second summit to rival last year's," said Phil Sutphin, chairman of the commission and president of East Central Community College in Mississippi. Sutphin said the organization will release data showing the East Mississippi-West Alabama region's economic performance over the past year.
  The 41-member Commission on the Future includes the heads of eight area colleges, and a representative of the Mississippi Band of Choctaw Indians. The commission's purpose is to assess conditions across the region, identify key issues of importance, recommend regional strategies to address the issues, and communicate its findings to the region.

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16. Barbour inaugural events feature stars of country, jazz, R&B
   Big names from country, jazz and rhythm and blues are scheduled to perform at Gov.-elect Haley Barbour's inaugural dances. Two invitation-only galas are set for 7 p.m. Jan. 13. One will be at the Mississippi Coliseum and the other will be next door at the Mississippi Trade Mart. Both are on the state fairgrounds.
  Performers at the coliseum event are Jackson native and noted jazz singer Cassandra Wilson; country musician Brad Paisley; and Jackson pop-rock band These Days. The ball at the coliseum will be hosted by former Miss Mississippi and Miss America 1959 Mary Ann Mobley and her husband, actor Gary Collins.
  At the Trade Mart, another inaugural ball will feature Percy Sledge, swing band Big Bad Voodoo Daddy and local band The Bluz Boys. Actress Sela Ward, a Meridian native, will host the Trade Mart event.Invitations are not required, but $25 or $40 tickets are needed, for a musical performance Jan. 12 at the Mississippi Coliseum. It will feature country performers Kenny Rogers, the Gatlin Brothers and Greenville native Steve Azar. James Gregory, a standup comedian, also will perform.
  Hosts for the musical evening will be WLBT-TV anchor Maggie Wade and actor Gerald McRaney, a Collins native. Tickets can be purchased by calling the Barbour Inaugural Committee office at 601-957-0347 or 601-957-0414.

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17. McCoy wants new committees
   Speaker of the House Billy McCoy is already implementing key reforms. McCoy plans to create six new committees to address issues he believes merit greater attention in the Legislature. The speaker-to-be wants to create six new committees: Forestry; Gaming; Medicaid; Tourism; Marine Resources; and Ports, Harbors and Airports. In the past, legislation related to these issues was handled by other House committees. The full House will be asked to approve the creation of any new committees.

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18. Ex-Speaker of the House wrapping up his political career
   Mississippi's past Speaker of the House is adjusting to life after the legislature. Tim Ford recently stepped down from the post after 16 years and stepped into a law practice. Ford is currently serving on Governor Elect Haley Barbour's transition team. His new employer is the Balch and Bingham law firm. He will be based in Jackson.

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19. Governor-Elect Haley Barbour announces several administration appointments
   On Tuesday, December 23, Governor-elect Haley Barbour announced appointments to his administration for the positions of Commissioner and Deputy Commissioner of the Mississippi Department of Public Safety; the Commissioner of the Mississippi Department of Corrections; the Chief of the Mississippi Highway Patrol; the Director of the Mississippi Emergency Management Agency; and the Adjutant General.
   Governor-elect Barbour announced the following appointments to his administration:
Rusty Fortenberry—Commissioner, Mississippi Department of Public Safety
Melvin Maxwell—Deputy Commissioner, Mississippi Department of Public Safety
Chris Epps—Commissioner, Mississippi Department of Corrections
Marvin Curtis—Chief, Mississippi Highway Patrol
Robert Latham—Director, Mississippi Emergency Management Agency
Harold Cross—Adjutant General
Click here to watch the press conference.

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20. Thompson to back Dean for president in '04
   Rep. Bennie Thompson said on Dec. 22 that he's going to endorse Howard Dean. "I will make an endorsement, probably by the first of the year," Thompson said. "I've looked at all the candidates. And Dean, in my estimation, has the best chance of beating Bush."Unlike the other Democratic candidates, Dean is "willing to discuss controversial issues," Thompson said.  "He's brought energy to his campaign that's unmatched by any of the others," Thompson said. "He doesn't take the most popular position according to the pollsters, but they're positions of principle."Mississippi's other Democrat, Rep. Gene Taylor, has endorsed former Gen. Wesley Clark, who visited Mississippi earlier this year and last week.
  Although the first Democratic primary is in New Hampshire, where Dean is leading the polls, the former Vermont governor is fighting hard to win South Carolina because he would demonstrate the ability to win the racially diverse constituency of a Southern state. Since 1964, the only Democrats who have won the White House — Lyndon Johnson, Jimmy Carter and Bill Clinton — carried at least a few Southern states.
  An American Research Group poll released Monday showed Dean had the support of 16 percent of Democratic voters in South Carolina. Wesley Clark and Al Sharpton were at 12 percent and North Carolina Sen. John Edwards was at 11 percent. Dean alienated some Southern black voters with his promise to be the candidate for "guys with Confederate flag decals on their pickup trucks."
  In addition, Dean's chances in South Carolina were dimmed by Rep. James Clyburn's endorsement of Rep. Dick Gephardt, D-Mo., earlier this month. All nine Democratic candidates courted Clyburn, an influential black politician in South Carolina. But Dean's candidacy received a boost last week with an endorsement from Rep. Elijah Cummings, D-Md., chairman of the Congressional Black Caucus.
  Two black Democrats, Al Sharpton and former Illinois Sen. Carol Moseley Braun, also are running for president. But black lawmakers aren't rallying around either one, said political science professor Merle Black of Emory University. That wasn't the case when Jesse Jackson ran for president in 1988 and 1984, Black said.
   Earlier primaries in New Hampshire, South Carolina, Arizona and other states may have anointed a Democratic front-runner by the time Mississippi Democrats have the chance to vote on March 5. But Mississippi's Democratic Party chairman, Rickey Cole, said he's hopeful the state still will have impact, especially if Texas' March 2 primary is delayed because of the redistricting fight in that state.

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- National News -

21. Preview period begins for Quality Initiative participants
  Hospitals that submitted quality data to the Centers for Medicare & Medicaid Services before Dec. 18 as part of The Quality Initiative can now preview their data before it's posted to a CMS Web site in mid-February. Effective yesterday, hospitals have 30 days to review their quality data, available at the password-protected www.qnetexchange.org Web site. There, they also can compare their performance on each of the initiative's 10 quality measures with the national average and 90th percentile. Hospitals that have questions about their data, or that submitted data before Dec. 18 but do not have data available are urged to contact their Quality Improvement Organization. The Quality Initiative is a national, public-private partnership to share information about the quality of care hospitals provide. For more on the initiative, visit www.aha.org , and click on the "Quality Initiative" logo.

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22. Bush seeks new provision in immigration laws, particularly for undocumented aliens
   President Bush proposed Wednesday what his administration described as "a new temporary worker program to match willing foreign workers with willing U.S. employers when no Americans can be found to fill jobs." The plan appears to focus on undocumented aliens within the U.S. but also would permit some foreigners to enter the U.S. if they have been offered a job here. Press reports said Bush also will seek to increase the number of Green Cards issued to resident foreigners by an unspecified amount. The proposed temporary worker program wouldn't replace current immigration rules, and the president stressed that it isn't an amnesty program. Press reports suggested that Bush's plan will face strong opposition from some factions in Congress even though the concept is backed by other members, particularly in border states such as Arizona.

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23. CMS publishes OPPS interim final regulation
   CMS published in the Federal Register on Jan. 6 its outpatient prospective payment system (OPPS) interim final regulation for 2004. The rule, prompted by last year's Medicare prescription drug bill, supercedes a previous final rule issued by CMS and has a 60-day comment period ending March 8. CMS estimates these changes will cost $150 million. The rule extends the hold-harmless payments for small rural hospitals with 100 or fewer beds through Dec. 31, 2005. In addition, these hold-harmless payments are extended by the prescription drug bill to cover sole community hospitals in rural areas. The rule defines a class of separately payable drugs called "specified covered outpatient drugs" that in 2004 and 2005 is subject to payment floors and ceilings that vary by type of drug (sole source, innovator multiple source and non-innovator multiple source). And the rule changes payment rates for pass-through drugs and biologicals for 2004 and future years. The reg can be found in the CMS section here  .

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24. CMS occupational mix survey due Feb. 16
   The Centers for Medicare and Medicaid Services has developed a survey that collects data on paid employee hours for 20 different occupation categories of hospital employees. Data from the survey will be used to adjust the hospital wage index to account for differences in the types of caregivers employed by hospitals.
   Instructions for completing the survey and submitting the data were sent to all prospective payment system hospitals by fiscal intermediaries.The survey must be completed and returned to fiscal intermediaries by Feb. 16. The American Hospital Association have expressed concerns about the time frame provided to hospitals and the ability of hospitals, CMS and fiscal intermediaries to ensure the validity and accuracy of the newly collected occupational mix data to be used for inpatient payments beginning Oct. 1.
  Other key dates in 2004 concerning the occupational mix development are:
*Feb. 16 - Deadline for hospitals to forward the completed survey (on the Excel hospital reporting form) to their intermediaries.
*March 1 - Deadline for fiscal intermediaries to transmit their hospitals' occupational mix data to CMS's Division of Acute Care. Intermediaries must compile and transmit the data to CMS on the Excel data collection form that CMS will e-mail to all fiscal intermediaries in January. Intermediaries must notify state hospital associations regarding hospitals that fail to respond to the occupational mix survey. The purpose of the letter is to inform the association and its member hospitals that a hospital's failure to complete the occupational mix survey can result in distorting an area's occupational mix/wage index value.
*March 8 - Approximate release of the occupational mix public use file on the CMS Web page.
*March 15 - Deadline for hospitals to submit requests for corrections to errors in the March occupational mix public use file. Hospitals must submit their requests to both their fiscal intermediaries and CMS. Intermediaries and CMS will only consider requests to correct errors due to CMS or the intermediaries' mishandling of occupational mix data that hospitals submitted by Feb.16. Intermediaries must receive the correction requests and supporting documentation by this date.
*April 16 - Deadlines for fiscal intermediaries to transmit final corrected occupational mix survey data (in Excel format) to DAC for inclusion in the final wage index. Intermediaries must also notify hospitals regarding hospitals' March 15 correction requests by this date.
  The remainder of the occupational mix development timetable will follow the standard hospital wage index development timetable. For survey instructions and additional information, click here.

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25. No Senate action on omnibus appropriations bill until late January; billions at stake
  Hospitals will have to wait until at least Jan. 20 before learning the fate of federal spending for nursing education, Children's Graduate Medical Education, and other key health programs, as contained in the fiscal 2004 omnibus appropriations conference report. Though the House approved the $820 billion spending package -- which provides funding for the Department of Health and Human Services along with 10 other Cabinet departments -- on Dec. 8, the Senate decided to delay consideration of the bill until Congress reconvenes Jan. 20. Meanwhile, spending will remain at FY 2003 levels under a continuing resolution that expires Jan. 31. The spending measure could remain a contentious issue, say insiders, and additional resolutions could keep spending at FY 2003 levels until well into 2004. At stake are billions in spending for key health programs, including $518 million for hospital preparedness; $142.7 million for nursing education programs such as the Nurse Reinvestment Act, $30 million more than initially allocated; $305 million for Children's Graduate Medical Education, $15 million more than last year; and an additional $1 billion for the National Institutes of Health. For highlights of the House-passed bill, visit http://appropriations.house.gov.

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26. CMS sets geographic reclassification procedures
   The CMS has established procedures for hospitals to request a new geographic classification that would boost the hospitals' Medicare payment rates. Scheduled for publication in the Jan. 6 Federal Register, the notice carries out provisions of the recently passed Medicare reform bill, which authorizes $900 million for hospitals that have been inadequately reimbursed based on area wage indexes. Hospitals must file a request for reclassification by Feb. 15, the CMS said. Reclassifications approved by the Medicare Geographic Classification Review Board will be effective for three years beginning April 1. For more, click here. 

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27. Acting CMS administrator named
   Dennis Smith has been named as interim head of the Centers for Medicare & Medicaid Services (CMS), following the resignation of Tom Scully as administrator Dec. 15. Smith will serve as acting administrator until a new administrator is nominated and sworn in. Leslie Norwalk will remain as CMS’ deputy administrator and chief operating officer, and continue as the agency’s point person in implementing the Medicare prescription drug bill signed by President Bush on Dec. 8.

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28. HHS publishes semiannual regulatory agenda
   The Department of Health and Human Services has published it semiannual regulatory agenda, summarizing proposed and final rules planned by the department in the next 12 months, as well as longer term plans. The notice can be found here under "Health and Human Services Department."

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