December 1, 2017
ICE and Hospitals
The number one goal and responsibility of every hospital is to take care of people. That means getting patients the care they need when they need it and, according to the Emergency Medical Treatment and Labor Act, in the emergency department that means screening and stabilization every patient who comes through those doors. Recently, the spotlight has been placed on incidents in other states in which the U.S. Department of Homeland Security's Immigration and Customs Enforcement entered hospitals in search of a patient. In one case, an undocumented 10-year-old girl in Texas who was being transferred to one hospital to another in an ambulance was detained by ICE agents.
 
While there has been no such case in Maryland as of yet, the incident caused concern: what are the rights of government agents looking for undocumented patients, what are the patients' rights, and what are the rights of hospitals? To help answer those questions, MHA's Thursday morning Member Call yesterday focused on guidance provided by Maryland's Office of the Attorney General in response to a request by Delegates Brooke Lierman and Joseline Pena-Melnyk. The guidance included ICE's own policy, which considers hospitals to be, along with schools, churches and other health care centers, "sensitive locations" where arrests, interviews, searches and surveillance should not occur, with some exceptions, including "when there is an immediate need for enforcement action." The call was informative, with Sandra Brantley andZenita Hurley from the AG's office sharing helpful tools and resources that can help establish best practices and training, including:
 
 
Take a look at the Attorney General's Office guidelines and resources, and be sure to seek the guidance of your hospital's legal counsel. And rest assured that MHA staff will continue watching this issue closely. 

CEOs Sign Letter to Hogan on Sick Tax
All of Maryland's hospital CEOs have signed a letter asking Governor Hogan to reduce the sick tax, a top priority for hospitals in the coming legislative session. The letter calls the $35 million spend-down "a critical first step in the elimination of a tax" that increases hospital bills and artificially inflates health care spending in the state, and notes that eliminating the tax will "contribute to our shared efforts" to achieve the goals of the new enhanced total cost of care model. 
Letters on Rate Year 2020 QBR and ED Wait Times Sent to HSCRC
MHA this week sent two letters to the Health Services Cost Review Commission, one on the commission's draft recommendations for updating the Quality-Based Reimbursement Program for rate year 2020 and the second addressing the policies and activities that the commission is considering in response to emergency department wait times. Find both on MHA's website.
Deadline for 340B Recertification is Dec. 6
Hospitals that participate in the 340B drug savings program must recertify by Dec. 6 or they will be terminated from the program. The Health Resources and Services Administration is required to recertify annually all participating covered entities enrolled in the 340B program to ensure they are appropriately listed on the 340B database and that covered entities remain compliant with the 340B program requirements. This year, HRSA unveiled a new recertification process, and any hospital that recertified or started the recertification process before Nov. 3 must complete a new recertification by Dec. 6. For questions about the recertification process, visit the HRSA website or contact the 340B Prime Vendor Program at (888) 340-2787 or at apexusanswers@340pvp.com.
AHA Award for Community Collaboration - Get Recognized!
The American Hospital Association invites hospitals and health systems partnering with community organizations to help residents be healthier to apply for the AHA NOVA Award. Previous award recipients have organized a health and wellness alliance to fight childhood asthma, operated a mobile medical clinic to serve lower-income children, and worked with community partners to expand dental care - emergency and preventive - for uninsured residents. Visit www.aha.org/nova to learn more.Applications are due Dec. 8, and awards will be presented at the 2018 AHA Leadership Summit in San Diego.
MHCC Announces Grant Applications for Telehealth
The Maryland Health Care Commission has made available its Announcement for Grant Applications for the Telehealth Round Six - Telehealth for Medication Management and Reconciliation. The commission will fund, on a competitive basis, a single application over an 18-month period to implement and test a telehealth use case that optimizes medication management and reconciliation through telehealth to improve care coordination via a certified electronic health record integrated with the Chesapeake Regional Information System for our Patients. The goal of the grant is to advance pharmacist support to aid Maryland health care professionals in managing therapeutic regimens for their patients, facilitate medication compliance/adherence for patients, and provide educational information to patients and their caregivers regarding their medications. The grant also aims to test the availability of a reconciled medication list made available to care teams through CRISP. Funding is for a total of $150,000 and requires a 1:1 financial match rate. A Letter of Intent from the prime applicant is appreciated by 5 p.m. on December 11, 2017, via email to angela.evatt@maryland.gov. Grant applications are due to MHCC by 5 p.m. on January 15, 2018. More information is available here.
CMS Announces 2018 Medicare Premiums and Deductibles
The Medicare Part A deductible for inpatient hospital services will increase by $24 in calendar year 2018, to $1,340, the Centers for Medicare & Medicaid Services announced last week. The Part A daily coinsurance amounts will be $335 for days 61-90 of hospitalization in a benefit period; $670 for lifetime reserve days; and $167.50 for days 21-100 of extended care services in a skilled nursing facility in a benefit period. The monthly Part A premium, paid by beneficiaries who have fewer than 40 quarters of Medicare-covered employment and certain people with disabilities, will increase by $9 in CY 2018, to $422. The standard monthly premium for people with Medicare Part B will be $134 for 2018, the same amount as in 2017. Some beneficiaries who were held harmless against Part B premium increases in prior years will have a Part B premium increase in 2018, but the premium increase will be offset by the increase in their Social Security benefits next year, according to CMS. Also, the Department of Health and Human Services last week announced the Medicaid and Children's Health Insurance Program federal medical assistance percentages for fiscal year 2019. The notice provides state and territorial FMAP percentages for Medicaid, CHIP and disaster-recovery FMAP adjustments. The FMAPs are effective Oct. 1, 2018, through Sept. 30, 2019.
What Your Patients Want You to Know
 
At the Maryland Healthcare Education Institute (MHEI), we're continuing to develop innovative ways to support your educational needs.

Reduce Lighting Energy Costs Up to 50 Percent
 
Lighting accounts for 30 to 60 percent of annual electric costs for many facilities, and many new advances in lighting technology can help your organization conserve energy and save money.

Study: Medicaid Expansion Helped Health for Chronically Ill Adults
 
The Affordable Care Act's Medicaid expansion was associated with improvements in mental health and access to care among low-income adults with chronic conditions, according to a study published this week in the Journal of General Internal Medicine. 

THE WEEK AHEAD
Tuesday, December 5
MHA Behavioral Task Force meeting

Wednesday, December 6
Patient Bill of Rights Roundtable Discussion
TOP NEWS FROM THE WEEK
Capital Gazette, By Phil Davis, November 25
 
Baltimore Business Journal, By Reed Abelson, November 26
 
Baltimore Business Journal, By Morgan Eichensehr, November 27
 
Baltimore Business Journal, By Morgan Eichensehr, November 27
 
The Baltimore Sun, By Meredith Cohn, November 28
 
The Baltimore Sun, By Andrea K. McDaniels, November 28
 
The Baltimore Sun, By Andrew Michaels, November 28
 
The Washington Post, By Arelis R. Hernandez, November 30