January 13, 2019
Maryland a Contrast to Federal Dysfunction
No matter your political leanings, it is obvious that Washington, D.C., is plagued by dysfunction and gridlock. The ongoing partial government shutdown, which began in December, is the third to have occurred in 2018 and, as of Saturday, is the longest in our nation’s history.

Maryland’s hospitals should be spared from the direct effects of the shutdown, largely because federal funding for the programs that make up the pillars of our health care system — Medicare, Medicaid, and the Affordable Care Act — is set through September.

However, the shutdown has real consequences for many people in our communities, who are going without pay. Maryland reported a spike in unemployment claims tied to the federal closure, and an anticipated delay in issuance of tax refunds announced by the IRS also could create further financial strain.

MHA’s main focus, of course, is with Maryland’s government. With the 90-day session of the Maryland General Assembly already underway, it is helpful to note the collaborative relationship among our partners at the state level — a clear departure from the current federal political climate.

That bipartisan spirit in Maryland led to the successful negotiation of the new Total Cost of Care Model, which took effect January 1. We expect it will continue as we work to ensure the model meets the needs of the communities we serve.

Your Maryland Hospital Association will uphold that spirit of collaboration in Annapolis as we look for our state-level partners to support our advocacy agenda, including the continued spenddown of the Medicaid assessment, an improved liability climate, modernization of certificate of need, and many more concerns.
Bob Atlas
President & CEO
Commissioners Hear Concerns with Medicare Data Reporting
As part of this month’s public meeting, the Health Services Cost Review Commission received a report from Executive Director Katie Wunderlich about errors the state uncovered in the Centers for Medicare and Medicaid Services reporting of Medicare beneficiary counts included in Medicare hospital and total cost of care savings calculations. She emphasized the need for the issue to be resolved by next month’s commission meeting. As reported in Newsbreak the commission also took final action on its readmission reduction incentive program and its proposal to provide Medicare Advantage plans with the 2 percent Medicare sequestration payment reduction effective January 1, 2019.
CMS Change to Clinical Lab Reporting
In the 2019 physician fee schedule final rule (see pages 59672-59676 of the November 23, 2018 Federal Register), the Centers for Medicare and Medicaid Services made an important change to the Clinical Laboratory Fee Schedule (CLFS) that will require many hospitals to report private payer rates for CLFS services. If a hospital bills Medicare on a 14x type of bill (TOB) for more than $12,500 in CLFS services for the January 1, 2019 through June 30, 2020 period, the hospital will be required to collect data on private payer prices and the volume of laboratory services paid at that price for the same time period. Hospitals will be required to report that data to CMS from January 1, 2020 through March 31, 2020. CMS will have a call January 22 at 2 p.m. to discuss the new requirements for hospital outreach laboratories to collect and submit private payer data for the Clinical Laboratory Fee Schedule. To register for this call, click here.
Hospitals Receive Fake CMS Non-Compliance Notifications
On January 1, hospitals were required to post on their websites their hospital chargemaster information in compliance with a new price transparency law. The American Hospital Association has learned that some hospitals are receiving notices that they are not in compliance with this new requirement. These notices appear official but are not being sent in coordination with the Centers for Medicare & Medicaid Services (CMS). They are an attempt by a business to sell their services to hospitals. Please notify Mike Robbins, Senior Vice President of Rate Setting at the Maryland Hospital Association, if you have received a non-compliance notice.
Md. Hospitals Invited to Submit Abstracts for Conference
All Maryland hospitals are invited to submit value-based quality improvement, research, or educational curriculum abstracts for the 2019 Architecture of High Value Health Care National Conference. The conference, hosted by the High Value Practice Academic Alliance and the American Hospital Association, will be held in November in Baltimore. The deadline to submit abstracts is April 8. For details, click here.
Resources Available as Legislative Session Gets Underway
A record 60 new legislators took office last Wednesday as the 439th session of the Maryland General Assembly convened in Annapolis. Legislators will engage in several high-profile issues this year including the continued work of the Kirwan Commission, a health insurance individual mandate, prescription drug affordability, increasing Maryland’s minimum wage, and legalizing sports betting and recreational marijuana. During session, your Maryland Hospital Association will provide key Annapolis updates along with a weekly bill tracking chart in this section of the Toward Better Health newsletter. You can also find session materials including infographics, position papers, and other resources on MHA’s website.
Committee Releases Annual Report, Recommendations for Supporting Sexual Assault Survivors
The Maryland Sexual Assault Evidence Kit Policy and Funding Committee (SAEK Committee) issued its first annual report this month. The report expands on the preliminary recommendations shared by the committee last April, including proposals recommending the state provide all qualifying victims of sexual assault with access to the full 28 days of HIV prophylactic treatment with no out of pocket cost. Additional recommendations include supporting the sustainability and workforce of hospital-based sexual assault programs, establishment of a statewide tracking system and clarifying laws around sexual assault evidence kit testing and procedures. Your Maryland Hospital Association was actively involved in the drafting of the report and will be supporting bills introduced during the 2019 legislative session to move the recommendations forward. MHA is committed to supporting the committee’s efforts to develop statewide polices, increase access to justice for survivors of sexual assault, and serve as a part of our communities’ response to violence.

To access the full report, click here .

MHA Contact: Jennifer Witten , Vice President, Government Affairs 
MAHCE Event Focuses on Leading a Culture of Safety
The Maryland Association of Healthcare Executives will host an educational and networking event January 17. The event, Leading a Culture of Safety, will offer insight into how health care leaders create and sustain the type of organizational culture needed to ensure patient and workforce safety and inspire health care leaders on the journey to zero harm. For details or to register, click here.
Md. Announces Steps to Address Heroin, Opioid Epidemic
Gov. Larry Hogan’s administration announced it would expand its efforts to fight the state’s heroin and opioid epidemic, including an executive order to study the correlation between mental illness and substance use disorders. Efforts include additional funding to address substance use disorders and capital projects, as well as a $2.5-million investment in the Maryland Opioid Operational Command Center that will be used for community and local government prevention and education, enforcement, and treatment and recovery programs statewide. The Maryland Hospital Association (MHA) recently submitted a report entitled Emergency Discharge Protocols for Patients with Substance Use Disorders and Opioid Overdoses in Maryland’s Hospitals to The Maryland General Assembly and to the Maryland Department of Health. Click here to access the report.
MHA to Survey Members
The Maryland Hospital Association (MHA) is initiating its annual survey of members. Your organization’s leadership received letters last month to schedule 20-minute phone interviews to help us ensure that MHA’s work reflects your needs. Your feedback, gathered through our annual survey, helps us gauge our performance and effectiveness in representing you. Thank you in advance for your candor and input into MHA’s performance. If you have questions or did not receive information about the survey, please contact Kathy Gotwalt.
Want to receive your Toward Better Health
newsletter via text message?
Click here to sign up.
Maryland Hospital Association | www.mhaonline.org