Arkansas PAC Contributions Recognized

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1 January 10, 2006 Volume 13, Number 1 Arkansas PAC Contributions Recognized During 2005, the Arkansas Hospital Association Political Action Committee (AHAPAC) received $27, in contributions, primarily from hospital executives and employees throughout the state. These donations, which are shared between the Arkansas Hospital Association and the American Hospital Association, make possible the financial support those organizations are able to provide to political candidates seeking state or federal elective offices. Contributions of any amount from all contributors to the AHAPAC are seriously needed and deeply appreciated. However, special acknowledgement is given individuals who contribute at certain threshold levels. Those individuals qualify for recognition as members of the American Hospital Association s Capitol Club or its Chairman s Circle. Capitol Club membership is awarded for individuals who contributed $250 or more to AHAPAC during the year, while the Chairman s Circle membership is earned with a $500 donation. Individuals from Arkansas who qualified for membership in each of these clubs in 2005 are shown below. Arkansans who contributed at least $500, becoming members of the AHAPAC s 2005 Chairman s Circle are: Don Adams, Arkansas Hospital Association Robert Bash, Bradley County Medical Center Roger Busfield, Arkansas Hosp. Assoc, Retired David Cicero, Ouachita County Medical Center Paul Cunningham, Arkansas Hospital Assoc. Dean Davenport, BKD, LLP Stephen Erixon, Baxter Regional Medical Ctr. Dan Gathright, Baptist Health Med. Ctr.-Arkadelphia Russell D. Harrington, Jr., Baptist Health Michael D. Helm, Sparks Health System Tim Hill, North Arkansas Regional Medical Center Beth Ingram, Arkansas Hospital Association Luther Lewis, Med. Center of South Arkansas Phil Matthews, Arkansas Hospital Association John Neal, Stuttgart Regional Medical Center James E. Newman, St. Edward Mercy Medical Center Scott Peek, Chambers Memorial Hospital Ron Rooney, Arkansas Methodist Medical Center Bo Ryall, Arkansas Hospital Association Members with minimum contributions of $250 who qualify for membership in the 2005 Capitol Club are: Robert P. Atkinson, Jefferson Regional Med. Ctr. Chris Barber, St. Bernards Medical Center Gary Bebow, White River Health System JoAnn Butler, Arkansas Hospital Association Tina Creel, AHA Services, Inc. Harrison Dean, Baptist Health Med. Ctr.-NLR David Dennis, St. John s Hospital - Berryville Nancy Fodi, Southwest Regional Medical Center Joel Klein, The BridgeWay Ray Kordsmeier, Conway Edward Lacy, Baptist Health Med. Ctr.-Heber Springs Jimmy Leopard, Medical Park Hospital Mike McCoy, Saint Mary s Regional Med. Center Ray Montgomery, White County Medical Center Larry Morse, Johnson Regional Medical Center Kristy Noble, St. John s Hospital - Berryville Ben Owens, St. Bernards Healthcare Kirk Reamey, Ozark Health Medical Center John Robbins, Conway Regional Medical Center Allen Smith, Baptist Health Russ Sword, Ashley County Medical Center James Teeter, Arkansas Hospital Association, Retired Doug Weeks, Baptist Health Medical Center-Little Rock Paul Cunningham, Editor Phil E. Matthews, President/CEO; 419 Natural Resources Drive; Little Rock, Arkansas 72205; ; facsimile

2 AHA Notebook 2 January 10, 2006 AAHT s Governance Leadership Conference April 7 Do you know the importance of your hospital s benefit to the community? Because of national sensitivities, rising healthcare costs to employers and consumers, the numbers of growing uninsured, Medicare and Medicaid policy failures, a shrinking tax base in your local community, and a population health crisis, community benefit is more important now more than ever before. Tyler Norris, president of Community Initiatives, Inc., a Boulder, Colorado-based firm dedicated to improving health and healthcare outcomes, will be the featured speaker at the Arkansas Association of Hospital Trustees (AAHT) annual Governance Leadership Conference Friday, April 7 at the Embassy Suites in Little Rock. Norris will discuss the emphasis on communities, collaborative governance, health promotion and disease prevention, links between community health improvement activities and healthcare service, as well as the need for developing the leadership and community will to catalyze change initiatives. In addition, the conference will feature presentations on the role of governance leaders on the various quality and patient safety initiatives your hospitals are engaged in. A slate of officers for the AAHT also will be presented for vote at the annual meeting. Please mark your calendar for this April 7 conference and encourage your hospital trustees and management staff to attend. A workshop brochure with registration information will be mailed soon. Because the meeting is targeted to both new and veteran trustees, a registration discount will be provided for hospitals bringing three or more individuals. Contact Beth Ingram at (501) with questions about the meeting. Ruling Grants Class-Action Lawsuit Status Pulaski County Circuit Court Judge Timothy Fox filed a December 29 order granting classaction status to uninsured patients who claim that they pay a higher price for care at nonprofit hospitals than most insured patients. Judge Fox s ruling specifies that the class will include all uninsured and underinsured patients who received treatment from Baptist Health after February 3, 2000, paid at least 50% of their bills and did not receive a discount. More than 2,000 patients a year will qualify as belonging to the class, according to Brad Walker, a Little Rock attorney representing the plaintiffs. With the ruling, Fox becomes only the second judge in the country to grant such class-action status to uninsured patients. Baptist Health plans to appeal the class certification to the Arkansas Supreme Court. If the ruling stands, both parties will have two weeks to submit a plan to notify the members of the class and give them a chance to opt out of the lawsuit. A similar class certification hearing will be held in Pulaski County on January 20 in Walker s lawsuit against St. Vincent Health System. During the past two years, attorneys across the country have filed hundreds of lawsuits concerning hospital billing and collection practices of non-profit hospitals, including about 60 suits filed by Mississippi attorney Richard Scruggs, who has actions pending against Baptist Health and litigation regarding St. Mary s Hospital in Rogers and Washington Regional Medical Center in Fayetteville. None of those other lawsuits has received class certification. Walker s lawsuit against Baptist Health is narrower in scope than most of Scruggs suits.

3 AHA Notebook 3 January 10, 2006 House, Senate Pass Budget Bill Prior to returning home the week before Christmas, members of Congress dealt with the Fiscal Year 2006 budget package ironed out earlier by House and Senate conferees. The House voted approval December 19 for the Deficit Reduction Act (DRA) that, among other things, preserves full updates for Medicare inpatient and outpatient payment rates, calls for up to an eight-month moratorium on new limited-service hospitals while the Centers for Medicare & Medicaid Services develops a strategic plan, and extends the 60% threshold of the second-year phase-in of the 75% Rule for inpatient rehabilitation hospitals for an additional year. The Senate debated into the early hours of December 21 before passing the budget bill by a margin, with a tie-breaking vote from Vice President Dick Cheney. But, while the Senate-approved legislation was essentially the same as that passed by the House, Senate Democrats and some Republicans used procedural maneuvers to strip it of some minor, nondeficit-reduction provisions, none of serious importance to hospitals. Consequently, the bill can t go to the president for signature and enactment until the House reconsiders it. That could occur this week. Go to for an American Hospital Association summary of key Medicare and Medicaid provisions approved by both the House and Senate. Some Medicare Rule Changes Delayed The Centers for Medicare & Medicaid Services (CMS) implemented several Medicare payment rules on January 1 that were to have been changed due to provisions included in both the House and Senate versions of the 2005 Deficit Reduction Act (DRA). However, those changes are on hold until the House addresses some minor technical differences, which their Senate counterparts made in the bill after the House passed it. As soon as final House action occurs, CMS says that it will be ready to make all appropriate payment changes to comply with the law in the least burdensome manner possible. In the meantime, some of the Medicare rules that are effective for now, but that should change soon are: As required under current law, claims for physicians services on or after January 1 will be paid with the -4.4% reduction from 2005 levels. The DRA would keep physician payment rates from being reduced, and would provide significant savings to offset the increase and limit any impact on beneficiary costs. Hold harmless payments for outpatient services of small rural hospitals will expire under current law on December 31. The DRA would prevent payment reductions for about 230 small rural hospitals. The 5% add-on payment for home health services to rural beneficiaries expired on April 1, The DRA would re-establish these payments effective January 1 to support access to home health services in rural areas. Caps on payments for outpatient therapy services are scheduled to go into effect January 1, without the exceptions process outlined in the conference report for the DRA. Current law calls for two separate caps: $1,740 per beneficiary per year for physical therapy and speech therapy, and the same amount for occupational therapy. The DRA provides an exception process under which additional services could be approved when they are medically justified. Home health agencies will receive payments reflecting a 2.8% increase on January 1, rather than the no increase as recommended by MedPAC and specified in the budget bill.

4 AHA Notebook 4 January 10, 2006 Last summer, CMS temporarily suspended enrollment of new specialty hospitals while the agency reviewed its procedures for enrollment. At present, CMS plans to continue the suspension until February 15, 2006, after this review is completed. When signed, the DRA will continue this suspension for up to six months, pending development of a report to Congress containing a strategic plan for addressing specialty hospitals. See for a full list of Medicare payment rule changes being delayed. Hemophilia Clotting Factor Code Changes The Centers for Medicare & Medicaid Services (CMS) on December 31 notified its Medicare Fiscal Intermediaries (FI) of a change in codes for hemophilia clotting factors. Under the change, two old Q codes (Q0187-Factor VIIA, antihemophiliac factor, recombinant, per 1 microgram, and Q2022- VonWillebrand factor complex, human, IU) are replaced with new J codes (J7189 and J7188 respectively). The new codes were effective January 1, 2006; however, in order to pay claims submitted with these new J codes, there need to be some changes in the Fiscal Intermediary Shared System (FISS) used for claims processing. Unfortunately, the earliest the FISS changes can be made is March 6, Until then, CMS is asking providers to omit these new J codes from inpatient hospital claims. Once the system has been appropriately updated, providers may submit new claims that include the new J codes. At that time, FIs will be able to process claims for the codes and make payment. According to CMS, hospitals should not bill the two new hemophilia clotting factor J codes on their inpatient claims for now. By doing this, the hospitals will be able to receive payment for the relevant DRGs and HIPPS codes for the inpatient stay. After the system has been updated to accept and calculate payment on the J codes, Medicare Services will notify providers to resubmit their inpatient claims with discharge dates on and after January 1, Pinnacle Business Solutions, Inc., Arkansas Part A contractor, posted information about the change on its Web site last week and the Arkansas Hospital Association also distributed the information via a January 6 Hotline to hospital CEOs. If you have questions, please contact Sidney Hayes, M.D. at SPHAYES@pinnaclebsi.com. Mental Health Parity Act Extension The House and Senate last week approved a one-year extension of the Mental Health Parity Act of 1996, which has been extended each year since its original expiration in While this congressional action maintains the protections afforded by the bill as passed in 1996, it falls short of broader parity legislation called for by the American Hospital Association (AHA) and some 250 other health organizations. In an October 2005 letter prompted by Hurricane Katrina, these groups warned Senate and House leadership that loopholes in the 1996 statute, which requires group health plans to fund mental health benefits at the same level as medical and surgical benefits, allow for higher co-payments, deductibles and co-insurance payments for mental health services. The groups said a mere extension of the law is no remedy and would further perpetuate the discrimination faced by those with mental health needs. The AHA has long advocated parity for hospital days, outpatient visits, co-pays, deductibles and maximum out-of-pocket costs for in-network services.

5 AHA Notebook 5 January 10, 2006 Deadline For Section 1011 Payment Requests Hospitals and other healthcare providers have until January 11 to submit their first quarterly Section 1011 payment requests (for service period May 10-June 30) to TrailBlazer Health Enterprises, the Centers for Medicare & Medicaid Services contractor for the program. Section 1011 of the Medicare Modernization Act of 2003 allocated $250 million in Medicare reimbursements annually through fiscal year 2008 to help reimburse hospitals for the cost of providing uncompensated emergency care to undocumented immigrants. The application deadline for providers seeking first quarter payments under Section 1011 was November 28, Any new applications will be processed for the next quarter. P4P Should Bolster Effective Care Pay-for-performance, also called P4P, has the potential to increase the use and quality of effective care but is unlikely to help bring down the rising costs of healthcare, according to a new study sponsored by the Commonwealth Fund. Effective care is therapy that is viewed as medically necessary based on clinical-outcome evidence, for example the use of betablockers after a heart attack. John E. Wennberg of the Dartmouth Medical School, who authored the study, said that effective care is underused and influences only a relatively small proportion of the healthcare dollar. As a result, he said, it won t influence healthcare costs to the same extent as preference-sensitive care, which involves significant tradeoffs based on a patient s values, and supply-sensitive care, in which the supply of resources dictates the frequency of their use. Wennberg said preference-sensitive care is misused and supply-sensitive care is overused, but he predicted pay-for-performance strategies, along with efforts to reward efficient providers and pay for chronic-illness-management infrastructure, could promote reform. EHR Certification Pilot Test The Certification Commission for Healthcare Information Technology has selected six vendors to participate in a pilot test of its certification process for electronic health record products for physician offices. The organization expects to complete the pilot by the end of next month. Founded in 2004 with support from the American Health Information Management Association, Healthcare Information and Management Systems Society, and National Alliance for Health Information Technology, the commission seeks to speed the adoption of interoperable health information technology by creating a mechanism for certifying health IT products. HHS Funding Measure Signed President Bush on Friday signed H.R. 3010, providing $142.5 billion in discretionary funding for the Departments of Labor, Education, Health and Human Services and related agencies for fiscal year However, that excludes a 1% across-the-board cut in discretionary funding approved as part of the Department of Defense appropriations bill. Without the 1% cut, HHS appropriations include $500 million for hospital emergency preparedness, $15 million less than in FY05; $ million for nursing workforce development programs, $4.47 million less; $ million for rural health programs, a $16.98 million increase; and $107.4 million for health information technology. The last figure includes $61.7 million for HHS' Office of the Coordinator for Health Information Technology, a $57.4 million increase, and $50 million in new health IT funding for HHS' Agency for Healthcare Research and Quality.

6 AHA Notebook 6 January 10, Telehealth Payment Amount Section 1834(m) of the Social Security Act established the amount Medicare paid as the telehealth originating site facility fee for services provided from October 1, 2001, through December 31, The amount was set at $20. For such services provided on or after January 1 of each subsequent calendar year, the telehealth originating site facility fee was increased as of the first day of the year by the percentage increase in the Medicare Economic Index (MEI). The 2006 MEI increase is 2.8%. Thus, for calendar year 2006, the payment amount for HCPCS code Q3014 (telehealth originating site facility fee) is 80% of the lesser of the actual charge or $22.47, which is 102.8% of the 2005 fee. The beneficiary is responsible for any unmet deductible amount or co-insurance. Find more information about the telehealth originating site facility fee payment amount by going to on the CMS Web site. Ambulance Inflation Factor Medicare s Ambulance Inflation Factor (AIF) for calendar year (CY) 2006, has been released to contractors. Prior to January 1, 2006, during the transition period, the AIF was applied to both the fee schedule portion of the blended payment amount (both national and regional) and to the reasonable cost or charge portion of the blended payment amount separately, respectively, for each ambulance provider and supplier. As of January 1, 2006, the total payment amount for air ambulance providers and suppliers will be based on 100% of the national ambulance fee schedule, while the total payment amount for ground ambulance providers and suppliers will be based on either 100% of the national ambulance fee schedule or 60% of the national ambulance fee schedule and 40% of the regional ambulance fee schedule. Additionally, the AIF for CY 2006 has been set at 2.5%. The AHA Calendar January CPT 2006 Coding Update Workshop, DeGray Lake Resort, Bismarck 12 AHAA (Auxiliary) Board of Directors, AHA Headquarters, Little Rock 13 AHA Board of Directors, AHA Headquarters, Little Rock 13 CPT 2006 Coding Update Workshop, Holiday Inn, Jonesboro 25 Day With the Lawyers Workshop, Holiday Inn Select, Little Rock 26 Audio Conference: How to Succeed with Your 2006 Joint Commission Survey: Adapting to an Unannounced Survey - Part I (A Three-Part Audio Conference) APC & CPT/HCPCS Updates for your Outpatient Data Cycle, Holiday Inn Select, Little Rock Newsnotes About Arkansas Folks Jay Bunyard, chairman of the board of directors of DeQueen Regional Medical Center, has announced the sale of the hospital to JCE Healthcare, Inc. of DeQuincy, Louisiana. Amy Vines is administrator of the facility. Hospital expansion and upgrade plans for 2006 include the opening of a 10-bed rehabilitation unit, as well as replacing obsolete equipment with the latest technology, including 4-D ultrasound.

H1N1 Cases Confirmed in Arkansas

May 11, 2009 Volume 16, Number 17 H1N1 Cases Confirmed in Arkansas State Health Officer and Director of the Arkansas Department of Health (ADH) Dr. Paul Halverson issued a statement last Friday verifying