IHA Daily Briefing: Feb. 10

Monday, February 10, 2020
President Trump Releases 2021 Budget Proposal
IL Supreme Court Justice Thomas Announces Retirement
Register Now: IHA Legislative Reception Feb. 18
SUD/OUD Funding for Rural Communities
Register for CMS Webinar on Patient Rights

President Trump Releases 2021 Budget Proposal
President Trump released his fiscal year (FY) 2021 budget proposal today, outlining future policy priorities for his administration, including reductions in social safety net programs and foreign aid, and higher outlays for defense and military veterans. The $4.8 trillion proposed budget would increase military spending by 0.3% and decrease non-defense spending by 5%.

Among proposals especially harmful to hospitals are:

  • Expansion of site-neutral payment policies, including:
    • Paying all off-campus hospital outpatient departments (HOPDs) under the Physician Fee Schedule (reduction of $47 billion over 10 years);

    • Paying on-campus HOPDs at the physician rate for certain services (reduction of $117.2 billion over 10 years);

  • Reforming Graduate Medical Education (GME) payments by consolidating spending from Medicare, Medicaid, and the Children's Hospital Graduate Medical Education Program into a single grant program for teaching hospitals and distributing payments based on the number of residents and the portion of inpatient days accounted for by Medicare and Medicaid days (reduction of $52 billion over 10 years);
  • Reducing Medicare coverage of bad debt (reduction of $33.6 billion over 10 years);
  • Modifying payments to hospitals for uncompensated care by establishing a new process to distribute payments based on a share of charity care and non-Medicare bad debt, as reported on Medicare cost reports (reduction of $87.9 billion over 10 years); and
  • Unifying post-acute care payments (reduction of $101.5 billion over 10 years).

A combined $422 billion in savings would come from an overhaul of mandatory Medicare and Medicaid spending, including new work requirements for Medicaid and food stamps benefits, and changes to Medicare prescription drug pricing. Savings would also be captured by addressing improper Medicare and Medicaid payments, such as "weaknesses in provider screening, enrollment and identification, as well as beneficiary eligibility determinations in Medicaid."

The budget includes a 10% funding decrease to the U.S. Dept. of Health and Human Services, 9% cut to the Centers for Disease Control and Prevention, 8% reduction to the Dept. of Agriculture, and 15% cut to the Dept. of Housing and Urban Development.

The budget continues funding for the administration's initiative to eliminate HIV in the U.S.; increases funding for state opioid response grants by $1.6 billion; and adds $74 million in new resources to improve maternal health. The budget also proposes to expand access to telemedicine services by offering increased flexibility to providers serving rural and vulnerable patient populations, and proposes "to address the trend of rural hospital closures, [by allowing] critical access hospitals to voluntarily convert to rural standalone emergency hospitals and remove the requirement to maintain inpatient beds."

While the president's budget signals his administration's policy priorities, it is considered dead on arrival in Congress. Spending decisions for the first months of FY 2021 are likely to be punted until after the election, which means Congress will need to pass a stopgap measure early this fall to prevent a government shutdown.

Additional budget-related documents can be found on the Office of Management and Budget website. A White House fact sheet provides a synopsis of the president’s budget proposal concerning health and wellness.

IL Supreme Court Justice Thomas Announces Retirement
Justice Robert R. Thomas today announced his retirement from the Illinois Supreme Court effective Feb. 29. The 67-year-old justice became the first Chief Justice from DuPage County when he was elected to that post from 2005-2008.

“Justice Thomas was the Chief when I joined the court and he cultivated a welcoming and professional environment. His great sense of humor made a challenging job more enjoyable for everyone,” Chief Justice Anne M. Burke said. “He led key court initiatives in the areas of professionalism, civility, continuing legal education and transparency. On behalf of the Supreme Court and the entire Judicial Branch, we thank him for his service to the judiciary and wish him the best in the next stage of his storied career.”

“It has been a great honor and privilege to have served on the Illinois Supreme Court as well as on the appellate and circuit courts over the past 32 years,” Justice Thomas said. “While I will miss the collegial atmosphere with my colleagues on the court, I am ready to return to the practice of law and help clients achieve justice.”

One of the major accomplishments during Justice Thomas’ tenure as Chief was the establishment of the Supreme Court Commission on Professionalism, an outgrowth of the Special Supreme Court Committee on Civility, which was formed in 2001.

“The Lord has truly blessed me. Starting with my fantastic wife, Maggie, three great kids, Brendan, Jonathan and Jessica, and eight soon to be nine grandchildren. With a football career that included a National Championship at Notre Dame and 10 years with the Chicago Bears,” Justice Thomas said. “With the tremendous honor and privilege of serving as Chief Justice of the Illinois Supreme Court. And now, the opportunity to practice law at Power and Rogers with my son, Jonathan, alongside the best trial lawyer in the country, my close friend, Joe Power. I have been truly blessed.”

The Supreme Court has appointed Appellate Justice Michael J. Burke to fill Justice Thomas’ seat effective March 1 through Dec. 5, 2022. Justice Burke has been a member of the Second District Appellate Court since 2008.

Register Now: IHA Legislative Reception Feb. 18
Plan to attend IHA's Legislative Reception in Springfield on Tuesday, Feb. 18 (the evening prior to the Governor's Budget Address). The reception will be held at Maldaner's from 5 to 8 p.m. To RSVP, click here.

As we begin a new year with the Illinois General Assembly returning to Springfield for their spring session, the hospital community faces many challenges, including ongoing state budget pressures, proposals to impose costly new mandates and continuing efforts to reduce denials and administrative burden associated with Medicaid managed care. IHA's Legislative Reception is a prime opportunity for you to meet with your state legislators to discuss critical healthcare issues.

Mark your calendars and plan to attend other key IHA events this spring:

  • IHA Federal Advocacy Day, Tue., April 21 during AHA's Annual Meeting, Capitol Hill, Washington D.C.;
  • IHA's State Advocacy Day, Wed., April 29 in Springfield; and
  • IHA's Quality Advocacy Showcase, Thurs., April 30 in Springfield.

Make sure to contact your state legislators to let them know you are attending the reception and look forward to seeing them there.

SUD/OUD Funding for Rural Communities
The Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy (FORHP) has released the notice of funding opportunity for the Rural Communities Opioid Response Program-Implementation (HRSA-20-031), awarding $1 million for a three-year period to approximately 89 rural organizations.

Award recipients are charged with implementing a set core of substance use disorder (SUD) and opioid use disorder (OUD), prevention, treatment and recovery activities that align with the U.S. Dept. of Health and Human Services’ (HHS) Five-Point Strategy to Combat the Opioid Crisis.

Though not required, HRSA encourages award recipients to leverage workforce recruitment and retention programs like the National Health Service Corps (NHSC). NHSC-approved sites provide outpatient, primary healthcare services to people in health professional shortage areas. Learn more about becoming an NHSC site and NHSC site benefits.

Applications are due April 24. Review the grant notice and HRSA press release for complete details.

Register for CMS Webinar on Patient Rights
As hospitals rigorously work to protect patient rights, it is important to understand and comply with the applicable requirements of the Centers for Medicare & Medicaid Services (CMS).

CMS Hospital Conditions of Participation Made Easy, a five-part webinar series, continues on Feb. 13 and focuses on patient rights, including:

  • Consent;
  • Interpreters;
  • Exercise of patient rights;
  • Grievances;
  • Privacy;
  • Ligature risks;
  • Abuse and neglect; and
  • Visitation.

Nurse attorney Sue Dill Calloway, RN, MSN, JD, will answer your tough questions in the second installment of the series—offered to IHA members through the Georgia Hospital Association.

The next webinars are on:

  • Feb. 20: Nursing and pharmacy;
  • Feb. 27: Quality assessment and performance improvement; and
  • March 5: Infection control, discharge planning and rehabilitation.

This program is designed for leaders and staff in:

  • Administration;
  • Operations and facilities;
  • Health information management;
  • Finance;
  • Nursing and clinical care;
  • Compliance and legal affairs;
  • Quality improvement and risk management;
  • Patient advocacy; and
  • Government relations.

Register here.

Please note: While you can attend any individual webinar, there is a registration discount available if you register for all five sessions. Visit our fees page to learn more.