The Informer. Attachments: NDHA Contacts. October 13, This edition of The Informer sponsored by: NDHA Associate Member

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1 The Informer October 13, 2017 In This Edition: President s Report Washington Update Medical Services Provider Enrollment Required Physician Recruitment Agency Awards Substance Abuse Prevention Grants to 10 Public Health Units 2017 PAC Update Congratulations! Annual Convention App Statistics and Surveys Attachments: Click on link to view attachments: publications/ Medical Services Provider Enrollment Requirement Attachment This edition of The Informer sponsored by: Associate Member President s Report ~ Jerry Jurena 83rd Annual Business Meeting: Last week in Fargo, the North Dakota Hospital Association hosted its 83rd Annual Convention & Trade Show. We had 115 people registered and 34 vendors at the Trade Show. The planning process for the event started in November The process was led by Pam Cook, Director of Education, who worked with a committee of nine others: Reed Reyman CHI St. Alexius Health Dickinson; Ann Fiala NDHRMS Coverys; Barb Pritchard Vogel Law Firm, Fargo; Julie Baustad NDONE & Heart of America, Rugby; Marcie Schulz Sakakawea Medical Center, Hazen; Angie Lockwood UND Center for Rural Health, Grand Forks; Marnie Walth Sanford Health Bismarck; Alfred Sams St. Andrew s Health Center, Bottineau; and Kathy Skager NDONE & Sanford Hillsboro. I want to thank the committee for taking time to help Pam with the process and I want to acknowledge and give Pam a special thank you for making it all come together. Thank you all. We are still reviewing the written evaluations and, at this point, they are all positive. From the comments I heard at the Annual Convention and the early summary of the evaluations, I would say the convention was a success. I was told by several that it was a great convention, the education was spot on, and the networking was great. We had a lot of new CEOs this year and comments from those attending were that this was a great way to meet people and make connections. In regards to sponsors, we had the following companies participate: Contacts Phone: Fax: Web Site: Jerry Jurena, President Tim Blasl, Vice President Callen Cermak, Finance Manager Lori Schmautz, Executive Assistant Pam Cook, Education Director Melissa Hauer, General Counsel A portion of this publication is supported by The Center for Rural Health s Medicare Rural Hospital Flexibility Program. Visit their site at Diamond Level: HSIsolutions Sanford Health Gold Level: Health Care Insurance Services Coverys Bronze Level: Blue Cross Blue Shield of North Dakota EAPC McGough Construction MMIC First American Healthcare Finance Athena Health IDeACOM Mid-America Avera ecare North Central States Regional Council of Carpenters Lunch: Quality Health Associates of North Dakota Wednesday Evening Social: Eide Bailly Please take the time to send these companies a thank you note. They make the conference affordable and enjoyable.

2 Washington Update ~ John Flink Page 2 With congressional action to repeal and replace the Affordable Care Act (ACA) stalled, the Trump administration this week stepped in with two executive actions that threaten to undermine coverage provided under the ACA. The first was an executive order intended to circumvent the ACA by making it easier for individuals and small businesses to buy alternative types of health insurance with lower prices, fewer benefits and weaker government protections. Specifically, the order directs three federal agencies to rewrite federal rules for association health plans a form of insurance in which small businesses of a similar type band together through an association to negotiate health benefits. These plans have had to meet coverage requirements and consumer protections under the ACA, but the administration is now likely to exempt them from those rules and let such plans be sold from state to state without insurance licenses in each one. In addition, the order is designed to expand the availability of short-term insurance policies, which offer limited benefits as a bridge for people between jobs or young adults no longer eligible for their parents health plans. Finally, the order calls for an investigation of whether provider and hospital mergers are contributing to higher health care costs. The second announcement was that the Trump administration will no longer provide the cost-sharing reduction (CSR) payments that help offset co-payments and deductibles for low-income enrollees in the ACA marketplace. Almost 6 million people almost half of enrollees who obtain coverage through the marketplace qualify for the CSR payments, according to news reports. The administration has been authorizing the CSR payments on a month-by-month basis following a federal court ruling that the payments were not appropriated properly by Congress. Critics, who the Washington Post said include state insurance commissioners, most of the health-insurance industry and mainstream policy specialists, predict that a proliferation of these other kinds of coverage will have damaging ripple effects, driving up costs for consumers with serious medical conditions and prompting more insurers to flee the law s marketplaces. Part of Trump s action, they say, will spark court challenges over its legality. Together these two decisions could seriously destabilize the individual insurance market by taking younger and healthier people out of the exchanges and undermine the ACA s ability to provide coverage. In other news this week, the House Energy and Commerce Oversight and Investigations Subcommittee heard testimony from several hospital representatives about the 340B drug discount pricing program. The panel wants to know how hospitals quantify their savings under the program and how they use the money. Hospital witnesses stressed that savings are used to increase access to prescription drugs for low-income patients and to expand other services needed by low-income residents of their communities. This is the panel s second hearing on 340B. This summer, it questioned the Health Resources and Services Administration, which manages the program, on its oversight and auditing practices. Lawmakers gave no indication of what legislation might be sought in the months ahead. Rep. Cramer serves on the Energy & Commerce Committee but not on the O&I Subcommittee. Medical Services Provider Enrollment Requirement All ordering, prescribing, or referring providers for Medicaid recipients that are contracted with a Managed Care Organization (MCO), but NOT currently enrolled with traditional Medicaid, will be receiving directions from the MCO instructing them on the process to meet federal requirements that they also enroll with traditional Medicaid. Also, any new provider that contracts with a Medicaid or CHIP MCO will receive directions to enroll with ND Medicaid. Their MCO claims will not pay until they complete that enrollment. See attachment for more information.

3 Page 3 Physician Recruitment ~ Kevin Malee Administrators Gather... The North Dakota Hospital Association held its 83rd Annual Convention and Trade Show this past week in Fargo, ND and several healthcare leaders (administrators and CEOs) from around the State and region attended the event. Joe Torrillo was the opening keynote speaker who discussed how he was buried alive twice on September 11, 2001, and Bruce Christopher was the closing keynote speaker who discussed the power of a positive attitude in are we having fun yet?. There were ample opportunities to visit and share stories with speakers and attendees and I always enjoy hearing what s going on in everyone s shop. This meeting is invaluable in gathering some of the latest healthcare news and networking with your colleagues from the region. One of the highlights for me was the Strolling Lunch with the Exhibitors, where conference participants have an opportunity to enjoy a wonderful lunch while networking with friends and co-workers from around the State in the exhibit hall. A special thanks to Jerry Jurena and his team at in providing an excellent educational event and providing a forum for administrators to gather and visit with their colleagues from around the State and region. If I can assist you in your physician recruitment efforts, please contact me at northdakotarec@comcast.net or Agency Awards Substance Abuse Prevention Grants to 10 Public Health Units BISMARCK, N.D. - The North Dakota Department of Human Services Behavioral Health Division is awarding substance abuse prevention grants to 10 communities and continues to support other community-level prevention efforts by hosting training today and Thursday for other grantees. New Substance Abuse Prevention Community Grant program funding will be awarded to Cavalier County Health District, Custer Health, Dickey County Health District, Fargo-Cass Public Health, Grand Forks Public Health, Lake Region District Health Unit, Nelson-Griggs District Health Unit, Richland County Health Department, Towner County Public Health District and Walsh County Health District. Each public health unit will receive about $70,000 to implement evidence-based substance abuse prevention efforts from November 2017 through September Communities will identify local data-driven priorities focused on underage drinking, adult binge drinking, and prescription opioid abuse and consequences, and will select evidence-based strategies to implement, such as responsible beverage service training, enforcement activities and prescription drug take back. To be effective, prevention efforts must be community-specific, data-driven and involve a multi-faceted approach using proven strategies, the department s Prevention Administrator Laura Anderson said. While North Dakota ranks fourth in the nation for binge alcohol use among adults age 26 and older, the state is making progress. Anderson said 25.8 percent reported binge drinking in the past 30 days, compared to 22 percent nationally according to the National Survey on Drug Use and Health. This is a decrease from 29 percent in Local public health units and tribal governments in North Dakota who are not currently funded by the North Dakota Strategic Prevention Framework Partnership for Success Grant or the North Dakota Substance Abuse Prevention and Treatment Block Grant were invited to apply. The division also continues to support training for other current grantees. Community Anti-Drug Coalitions of America representatives were in Mandan Wednesday, October 11 and Thursday, October 12 providing free training for Partnership for Success community grantees who are implementing evidence-based substance abuse prevention strategies targeting underage drinking. Communities interested in implementing substance abuse prevention efforts are encouraged to visit nd.gov or to the division at ndprmc@nd.gov.

4 2017 PAC Update Page 4 The Political Action Committee (PAC) gives individuals who care about hospital issues the opportunity to speak with a strong, unified voice. The PAC makes contributions to state and federal candidates, from both political parties, who support the goals of hospitals PAC Goal: $15,800 Total Contributions: $9,300 Thank you to the following individuals for their leadership and support of this year s PAC campaign. Dave Molmen Brad Wehe Dennis Reisnour Dr. William McKinnon Heather Strandell Jerry Lepp Jeff Drop Mariann Doeling Keith Heuser Becki Thompson Kurt Schley Angie Svihovec Andrew Lankowicz Tod Graeber Tim Sayler Pat Branco Theo Stoller K.C. DeBoer Robert Black Dan Kelly Jerry Jurena Tim Blasl Melissa Hauer Kim Granfor Pete Antonson Darrold Bertsch Dr. Craig Lambrecht Roger Baier Jodi Atkinson Cody Barnhart Ben Bucher Bev Vilhauer Ashley Medical Center, Ashley CHI Fargo CHI St. Alexius Health Carrington Medical Center CHI Mercy Health, Valley City CHI Oakes Hospital, Oakes CHI St. Alexius Health, Bismarck CHI St. Alexius Health, Bismarck CHI St. Alexius Health Devils Lake Hospital, Devils Lake CHI St. Alexius Health Garrison Memorial Hospital Essentia Health, Fargo Heart of America Medical Center, Rugby Jacobson Memorial Hospital, Elgin Jamestown Regional Medical Center Linton Hospital McKenzie County Healthcare Systems, Watford City HSI Solutions Northwood Deaconess Health Center, Northwood Sakakawea Medical Center, Hazen Sanford Medical Center Bismarck Sanford Mayville Medical Center St. Andrew s Health Center, Bottineau St. Luke s Hospital, Crosby Towner County Medical Center, Cando Wishek Hospital Our Club Level Contributors: Ben Franklin Club Chairman s Club Capitol Club Dave Molmen Jerry Jurena Angie Svihovec Keith Heuser Tim Blasl Dan Kelly Andrew Lankowicz Tim Sayler Mariann Doeling Kurt Schley Melissa Hauer Darrold Bertsch Cody Barnhardt Dr. Craig Lambrecht Ben Bucher Jeff Drop

5 Page 5 Congratulations! Congratulations to the following individuals, facilities and their staff for their great work! 2017 Top 20 Critical Access Hospital Winners for ND CHI St. Alexius Health Carrington St. Luke s Medical Center, Crosby West River Regional Medical Center, Hettinger 2017 Top Critical Access Hospital Best Practice in Patient Satisfaction for ND St. Luke s Medical Center, Crosby St. Luke s Medical Center in Crosby is the first hospital in North Dakota to win two awards in one year! ACHE Distinguished Service Award - for collecting over 75 points in volunteer service to ACHE Mark Waldera, Essentia Health, Fargo Keith Heuser, CHI Mercy Health, Valley City ACHE - ND Regent s Award - Senior Executive Mariann Doeling, CHI St. Alexius Health Carrington Medical Center, Carrington ACHE - ND Regent s Award - Early Careerist Cody Barnhart, St. Luke s Medical Center, Crosby Annual Convention App Statistics & Surveys ~ Pam Cook This was the first year implemented an app for convention. Overall, I feel it was a success. I want to share some interesting statistics that were tracked about usage of the app: Total number of unique uses across devices - 76 Total number of actions across all users taken with the app (i.e., - sessions, speakers, exhibitors etc.) 2.45k User Contributors- Total number of attendee messages and social shares 239 Total time spent in minutes, users used the app 1.87k Total number of taps for all navigation icons 1.13k EVALUATION TOOLS Don t forget to complete the evaluation tools attached to each speaker in the app. They are called Surveys, and unfortunately it s a little tricky to find them. Tap on the speaker name, scroll down until you see the title of the session. There should be a > to tap by the session name. That will take you to another page...scroll down until you see Survey and tap on it. That will take you to the evaluation form for that particular session. You will have to do that same process for each session you attended. Your input is valuable so please take a few moments to complete the surveys. Thank you!