March 21, 2005
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MHA's Monday Executive Briefing
March 21, 2005
In this week's edition...
State News
1. Lawmakers put credit rating at risk by borrowing from trust fund, more bond projects
2. Update on Medicaid
National News
3. Attorneys general taking an interest in healthcare issues
4. HealthLeaders top leadership teams in health care
5. Congress to reintroduce cap repeal legislation
6. Senate acts to protect Medicaid from budget cuts
7. Florida case dismissed
8. Survey: Confidentiality essential to errors reporting
State News
1. Lawmakers put credit rating at risk by borrowing from trust fund, more bond projects
Mississippi currently has good credit, but if recent legislative actions become a long-term trend, that stable rating could be at risk, analysts warn. For the full story from The Sun Herald, click here.
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2. Update on Medicaid
After a lengthy debate, the House of Representatives voted to send the Medicaid bill back to the conference committee for further negotiations last week. This means that House and Senate negotiators will have to return to the Capitol this week and try to work out additional revisions to the bill. The main areas of concern in the House were the removal of the PLADs category on December 31, 2005, and the number of prescription drugs available to beneficiaries (dropped to five from seven). A copy of the House vote to recommit the bill is here. (Please note that a "YEA" vote was a vote to send the bill back to conference; a "NAY" vote was a vote to adopt the conference report.) A comparison of the different Medicaid bills is here.
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National News
3. Attorneys general taking an interest in healthcare issues
Blame it on Enron. Blame it on Philip Morris. Blame it on AHERF, HCA and Tenet. The continuing involvement of America's state attorneys general in healthcare issues is surely attributable in part to a smorgasbord of recent scandals. If administered truth serum, some AGs might well admit, like Macbeth, that they have "no spur to prick the sides" of this new hobbyhorse except "vaulting ambition." Certainly that's what their more derisive detractors say, observing the well-worn path from the top legal chambers of various states to the governor's mansion. Beat up on the healthcare industry, cynics charge, and the voters will reward you with higher office. For the full story from HealthLeaders.com, click here.
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4. HealthLeaders top leadership teams in health care
The second annual search for the HealthLeaders Top Leadership Teams in Healthcare is under way. HealthLeaders recognizes the nation's best senior health leaders whose teamwork makes healthcare better.
Entries are being accepted in these three categories: Health Systems/Large Hospitals, Small Hospitals and State/Regional Health Plans. Nomination deadline is March 31, 2005. For details and entry form, click here.
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5. Congress to reintroduce cap repeal legislation
Members of the U.S. Senate and U.S. House of Representatives are reintroducing legislation to repeal the financial cap on Medicare outpatient physical therapy benefits, according to a press release from the American Physical Therapy Association (APTA). Passages of the Medicare Access to Rehabilitation Services Act of 2005 would repeal the cap that was originally instituted through the Balanced Budget Act of 1997. The current moratorium is set to expire December 31, 2005, allowing the cap to be implemented on January 1, 2006 by CMS. Current law provides for two caps on rehabilitation benefits, one for physical therapy and speech therapy, and a separate cap for occupational therapy.
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6. Senate acts to protect Medicaid from budget cuts
The Senate voted 52 to 48 last week to shield Medicaid from $14 billion in potential federal budget cuts as it neared final action on a fiscal year 2006 budget resolution. The amendment offered by Sens. Gordon Smith, R-OR, and Jeff Bingaman, D-NM, would restore some $15 billion in five-year savings from programs under the jurisdiction of the Senate Finance Committee and calls for a commission to study and come up with recommendations for reforming Medicaid next year. While the Senate staved off cuts to Medicaid, the House adopted a budget plan that could lead to significant Medicare and Medicaid reductions. The House resolution directs the House Ways and Means Committee to find $18 billion in five-year savings in its programs, which include Medicare, and the House Energy and Commerce Committee to achieve $20 billion in five-year savings in its programs, which include Medicaid.
The outcome now rests with a House-Senate conference committee that will meet to reconcile differences between the budget resolutions after Congress returns from its spring recess. Providers praised the Senate resolution. President Bush ignored the Senate plan and praised the House for a budget resolution that "closely follows my budget proposal and reflects our shared commitment to be wise with the people's money." The House resolution, which passed 218-214, did not contain specific proposals to achieve the $20 billion in Medicaid savings.
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7. Florida case dismissed
The U.S. District Court of the Middle District of Florida on March 14 dismissed all federal claims with prejudice against the Florida Hospital Healthcare System, Inc. in Orlando, and the AHA. The claims challenged the hospital's tax-exempt status and alleged unfair billing and collection practices. In his dismissal, the judge said that obvious policy reasons exist against presuming an implied contract between the government and the hospital based on not-for-profit status; specifically, "the responsibility for determining the qualifications of an entity for tax-exempt status would be shifted from the IRS to the court, resulting in a morass of confusion." In dismissing the EMTALA claims, the judge held that "… mere inquiry into a patient's ability to pay prior to screening or the rendering of treatment does not result in a delay of those services. This is clearly recognized by the Regulations of the Department of Health and Human Services …" As with similar cases on this iss ue, the court declined to exercise jurisdiction over state claims and dismissed them without prejudice, leaving the door open for those claims to be refiled in state court.
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8. Survey: Confidentiality essential to errors reporting
Hospital chief executive officers and chief operating officers generally thought nonconfidential, mandatory errors reporting would do more harm than good, according to a report in Wednesday's Journal of the American Medical Association. Sixty-nine percent of CEOs and COOs surveyed said a nonconfidential, mandatory system would discourage reporting of patient-safety incidents internally. Seventy-nine percent said they thought it would encourage lawsuits, and 73% said it would have no effect or a negative effect on patient safety. Responses were received from 203 of 320 randomly selected hospitals in six states -- two states with mandatory, publicly disclosed reporting; two with mandatory but confidential reporting; and two without mandatory systems.
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