IHA Daily Briefing: Sept. 12

Thursday, September 12, 2019
IHA, ICAHN Submit Surprise Medical Bills Letter
Summary on New Specialty Care Models Available
IHA Emergency Prep Exercise Tackles Cybersecurity
Briefly Noted

IHA, ICAHN Submit Surprise Medical Bills Letter
IHA and the Illinois Critical Access Hospital Network (ICAHN) recently sent a letter to the Illinois Congressional delegation urging delegation members to protect patients from surprise medical bills and oppose legislation that sets payment rates for hospitals in federal law. The letter states that once patients are protected from surprise bills, which may occur after receiving emergency care or certain out-of-network services at an in-network facility, the standard process of negotiation between providers and health plans is the most equitable approach to ensure hospitals are fairly reimbursed and to ensure access to care in rural communities.

Rural hospitals and communities could be especially harmed by a rate-setting approach, which would put downward pressure on hospital resources and remove the incentive for health plans to establish adequate coverage networks.  Another approach under consideration would require hospitals to guarantee to patients and health plans that facility-based practitioners would be considered in-network. This approach could severely limit the ability of physicians to negotiate contract terms with insurers and leave hospitals to make up the difference between what the practitioner charges and the amount paid by the health plan. This so-called "network matching" approach could exacerbate the challenges rural hospitals have in recruiting and retaining an adequate physician workforce.

IHA members are reminded to continue to contact their Congressional representatives and ask them to oppose rate-setting and other harmful proposals that would negatively impact rural hospitals and the patients and communities they serve. To email your members of Congress, click here

This month, the U.S. House Ways and Means Committee and the Education and Labor Committee are expected to markup legislation.  Separate bills recently passed by two health committees rely on a government rate-setting approach to pay providers: the No Surprises Act (H.R. 3630) and the Lower Health Care Costs Act (S. 1895).

See IHA's position paper on surprise medical bills.

Summary on New Specialty Care Models Available
Today, IHA published a summary of two Centers for Medicare & Medicaid Services proposed specialty care models specific to radiation oncology and end-stage renal disease. The models are specific to Medicare beneficiaries, and if selected, providers would be required to participate beginning calendar year 2020. IHA is submitting comments on the proposed care models, which are due Sept. 16.

IHA Emergency Prep Exercise Tackles Cybersecurity
A cyberattack could cost your organization $1 million—at least.

Protect your organization from being a target by attending the 2019 IHA Emergency Preparedness Exercise on Wednesday, Nov. 6, from 10 a.m. to 1:30 p.m. This interactive webinar, exclusively for IHA members, will simulate a cyberattack so hospital leaders and staff can identify opportunities to strengthen internal response plans.

The exercise will emphasize maintaining an effective environment of care with a significant impact to facility infrastructure. It will also offer an optional track on facility evacuation and functional needs populations, including pediatric patients.

Expert presenters will help you:

  • Recognize the signs of a potential cyber threat;
  • Enhance your hospital's ability to meet specific hospital, health system or regional demands;
  • Improve capacity and capability to prepare for and respond to incidents that stress normal hospital daily operations; and
  • Build strong response plans for ransomware, malware, phishing scams and other potential cyberattacks or data breach.

The solutions shared will benefit hospital professionals in:

  • Clinical Engineering;
  • Emergency Preparedness;
  • Facilities and operations;
  • Food and Nutrition;
  • Information Technology;
  • Security; and
  • Other members of the Incident Command Team.

Participating in IHA's exercise helps meet a requirement of the Centers for Medicare & Medicaid Services that hospitals demonstrate completion of two preparedness exercises per year. IHA will complete all required Homeland Security Exercise and Evaluation Program documents on your behalf.

Visit our event page for information on continuing education credits and registration fees. Register today.

Briefly Noted
West Side United, a Chicago nonprofit launched by six hospitals and health systems primarily on the West Side, is collecting applications for two neighborhood grants totaling $725,000. The first grant will distribute a total of $500,000 to West Side for-profit businesses. Businesses must be based in West Side community areas, including Austin, Belmont Cragin, East Garfield Park, Humboldt Park, Pilsen, the Near West Side, North Lawndale, Little Village, West Garfield Park and West Town. The second grant will distribute a total of $225,000 in grants to West Side 501(c)(3) not-for-profit organizations that are positively impacting their neighborhoods. This grant supports the organization’s mission to address inequalities in healthcare, education, economic vitality and the physical environment. Nonprofits do not have to be located on the West Side; however they must serve at least one of the neighborhood’s listed above. Applications for the first grant will be accepted through Oct. 31; the application deadline for the second grant is Oct. 18.

AHA has released a readiness advisory on the Ebola outbreak in Africa. The Centers for Disease Control and Prevention reports that the outbreak in the Democratic Republic of the Congo continues, with nearly 3,000 cases and nearly 2,000 deaths, as of Aug. 26. AHA asks that hospitals review their emergency preparedness plans and protocols in case Ebola makes its way back to the U.S. Illinois has four hospitals designated as Ebola treatment centers: Ann & Robert H. Lurie Children’s Hospital of Chicago, Carle Foundation Hospital, Northwestern Memorial Hospital, and Rush University Medical Center.