IHA Daily Briefing: Dec. 4

Gov.-Elect Announces Infrastructure Committee
New PCS Form Now Available
Report Details Healthcare Reform Opportunities
CMS Finalizes Hospital VBP Adjustment Factors
Briefly Noted

Gov.-Elect Announces Infrastructure Committee
Today, Governor-elect JB Pritzker and Lieutenant Governor-elect Juliana Stratton announced the formation and members of the transition’s Restoring Illinois’ Infrastructure Committee. The Restoring Illinois’ Infrastructure Committee will be chaired by Congresswoman Cheri Bustos (D-IL, 17th), Congressman Dan Lipinski (D-IL, 3rd), Congressman-elect Jesús “Chuy” Garcia (D-IL, 4th), state Sen. Martin A. Sandoval (D-11th), and state Rep. Jay Hoffman (D-113th) and consists of 45 members.

“Illinois’ role as a transportation hub for the nation is a critical component of our economy,” said Pritzker. “My administration will prioritize a comprehensive 21st Century Capital Bill to build the infrastructure we need to restore Illinois’ place as an economic leader.”

The committee is the10th of several working groups of the transition made up of subject-matter experts who will advise and guide the incoming Pritzker-Stratton administration.


New PCS Form Now Available
The Illinois Department of Healthcare and Family Services (HFS) has made available the updated Physician Certification Statement (PCS) form that a hospital must complete and provide to an ambulance provider prior to transport of a non-emergency patient. Hospitals must have this new form implemented by Feb. 1, 2019.

The updated PCS requirements are in response to challenges that ambulance providers have had in receiving a correct or completed PCS from some hospitals. The PCS is an important document for ambulance providers, particularly when transporting Medicaid patients as many Medicaid Managed Care Organizations and HFS will deny the ambulance provider’s claim without a completed PCS.

This form was developed in collaboration with IHA as part of the enactment of Public Act 100-0646. Detailed information about new requirements for hospitals can be found in an August IHA memo.


Report Details Healthcare Reform Opportunities
Yesterday, the Trump Administration released a report, Reforming America’s Healthcare System through Choice and Competition, prepared by the U.S. Depts. of Health and Human Services, Labor and Treasury. The report, developed in response to a Presidential 2017 executive order, reviews existing state and federal laws, regulations, requirements, and policies that impede healthcare choice and competition.

Four key areas outlined in the report are:

  • The Importance of Choice and Competition in the Healthcare Markets;
  • Trends in Market Consolidation;
  • Government Healthcare Policies and their Effect on Competition; and
  • Enabling Consumer-Driven Healthcare.

The report lauds telehealth as “having great potential to improve access in underserved locations, reduce costs, and generate improve short- and long-term health outcomes.” Yet, it acknowledges a variety of regulatory barriers that have impeded telehealth from achieving its full potential. The report criticizes hospital mergers and acquisitions (pg. 18), noting that recent consolidations have led to less competitive markets. Related to the Certificate of Need (CON) program (pg. 50), the report takes a firm position that the current laws are outdated, saying “Available evidence suggests that CON laws have failed to produce cost savings, higher quality healthcare, or greater access to care, whether in underserved communities or in underserved areas.”

Other topics covered in the report include: increasing scope of practice laws; improving interstate compacts for licensure of professionals; boosting price transparency; reducing funding for graduate medical education; scaling back regulations on physician-owned hospitals; and continuing reforms to the health insurance market.

The report ends with a list of recommendations for the various topics addressed.


CMS Finalizes Hospital VBP Adjustment Factors
Yesterday, the Centers for Medicare & Medicaid Services (CMS) published the final federal fiscal year 2019 hospital-specific Value-Based Purchasing (VBP) program payment adjustment factors on its website. CMS states that nationally, the highest increase given was 3.67 percent, while the lowest decrease was 1.59 percent.

To access your specific adjustment factor, scroll down to Table 16B which contains the complete list; the data is sorted by CMS Certification Number (formerly the Medicare Provider Number). Illinois hospitals’ Certification Numbers begin with “14.”  A CMS fact sheet includes more details.


Briefly Noted
Last week, Congresswoman Robin Kelly (D-IL, 2nd) was elected unanimously to serve as the Region IV representative to the House Democratic Steering and Policy Committee. By serving in this leadership role, Cong. Kelly will help set the Democratic agenda, make recommendations for committee assignments and advance key policy initiatives through hearings.

“I am deeply humbled and grateful to my neighbors and colleagues for this vote of confidence in me. I will work hard to put the bread-and-butter issues that matter to Midwest families front and center in the Democratic agenda for the 116th Congress,” Kelly said in a press release.

The Dept. of Health and Human Services (HHS) released a draft version of its Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs. HHS will accept public comments on the draft strategy until Jan. 28.