IHA Daily Briefing: July 10

Tuesday, July 10, 2018

Register Today: Medicaid MCO Webinars in July
IHA Medicare Proposed Rules Estimated Impacts Issued
HHS Secretary Focuses on 340B

Register Today: Medicaid MCO Webinars in July
In mid-June, Medicaid Managed Care Organizations (MCOs) began accepting a new, universal “provider roster” for claims payments. On July 24-26, IHA and the Illinois Association of Medicaid Health Plans (IAMHP), who together created the provider roster, will offer three complimentary webinars to help hospital staff successfully use the new document.

Registration is now open for Medicaid MCO Universal Provider Roster Template Training on:

  • Tuesday, July 24 from noon to 2 p.m.;
  • Wednesday, July 25 from 2-4 p.m.; and
  • Thursday, July 26 from 8-10 a.m.

We encourage staff at IHA-member hospitals and health systems to attend one of the three webinars, particularly those responsible for:

  • Collecting and submitting provider information to MCOs;
  • Handling provider enrollment and credentialing; and
  • Medical staff operations.

The webinars also are intended for staff from credentialing verification organizations who work with provider enrollment information.

For hospitals, using the new provider roster improves the accuracy of information needed to receive reimbursement from MCOs and streamlines the process. The new document is also used to identify care coordination efforts and address requirements of the Centers for Medicare & Medicaid Services.

Presenting the webinars will be Paula Dillon, Director of Managed Care at IHA; Samantha Olds-Frey, Executive Director of IAMHP; and roster experts from Medicaid MCOs. The webinars will provide a live demonstration of the new template, including discussion of its instructions, and offer time for questions and answers.

Because the webinars will present the same information, participants only need to register for one of them. Register today.


IHA Medicare Proposed Rules Estimated Impacts Issued
Yesterday, IHA distributed on its website via the C-Suite, hospital-specific estimates of the impact of changes in Medicare payments for member Inpatient Long Term Care Prospective Payment System (LTCH-PPS) hospitals and Inpatient Skilled Nursing Facility Prospective Payment System (SNF-PPS) hospital units for federal fiscal year (FFY) 2019.

The reports (which also include estimates for both Illinois and the U.S., report descriptions and a summary of the rule), illustrate estimated changes in Medicare payments between certain provisions of the proposed FFY2019 rules and the final FFY2018 rules.

On June 22, IHA submitted to CMS its official comment letter on the proposed LTCH-PPS proposed rule.


HHS Secretary Focuses on 340B
In a speech to the 340B Coalition summer meeting in Washington, DC Monday, U.S. Health and Human Services Secretary Alex Azar said “change is coming to prescription drug pricing,” including the 340B drug pricing program.

“When a government program, or a system like drug pricing, isn’t working for the American people, President Trump doesn’t accept excuses—he wants fixes,” said Azar. “That is why I am so optimistic about the prospects of positive change in American healthcare over the next several years. We will make progress on long-standing priorities, like moving to value-based care and rationalizing our system of drug pricing, because the President will accept no less.”

Azar said that “the gap between prices paid by 340B entities and the compensation they receive has, in many cases, grown far too wide. That was the reason why the administration restructured reimbursement under Part B for 340B drugs—the first-ever major reform to reimbursement under 340B [i.e., cutting payment from average sales price plus 6 percent to 22.5 percent less than the average price]. The new payment level is still above the average price actually paid by 340B entities, but it is closer to reality.”

Azar said changes are essential to the future of the 340B program, but “leaving a program as it is, within the rapidly changing context of healthcare, quickly renders it outdated.”

A hearing on “Opportunities to Improve the 340B Drug Pricing Program” will be held Wednesday by the U.S. House Energy and Commerce Health Subcommittee.