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Connection Newsletter - hospital visitation, budget watch

AzHHA updates on the latest healthcare legislation to be signed into law and a Supreme Court ruling on 340B. 

Legislative Update – hospital visitation signed, budget bill watch

This week, the hospital visitation bill supported by AzHHA was signed by the Governor (HB2633). This measure will require a change to hospital policy on visitation but does carve out behavioral health hospitals entirely. As previously reported, the new law will require a visitation policy that prioritizes in-person visitation, allows hospitals to require compliance with health and safety protocols, and allows physicians to deny visitation if it would not be in the best interest of the patient.

Last week, a draft of the budget spreadsheet was leaked to the press and others. You can view that document here. We haven’t seen any language for the budget reconciliation bills, or BRBs. However, based on the leaked spreadsheets, we anticipate the following:

  • Healthcare Workforce Bill (FY23, FY24, FY25)
    • $15 million for nurse education programs
    • $25 million for clinical rotation funding
    • $2 million for transition to practice program
    • $5 million for behavioral health technician training programs
  • Ongoing Spending
    • $10 million to expand AHCCCS coverage for postpartum women for 12 months
    • $10 million (plus $50 million federal match) for pregnancy provider rate increase
    • $2 million in FY23, $1 million ongoing for behavioral health student loan repayment program
  • One Time
    • $50 million for accelerated nursing programs ($6 million to Creighton, $44 million to other universities)
    • $500k for physician, PA, and NP preceptors

On Wednesday, the House introduced a broad expansion of empowerment scholarship accounts (ESAs or vouchers), tied to a measure to increase baseline funding for low-income districts. Some Capitol insiders think this signals that we are closer to an agreement on the budget. However, there are still several holdouts in the majority, and passing the budget may require Democratic votes. Those negotiations have not begun, as far as we know. Should an agreement not be reached in advance of the June 30 deadline, state government agencies will be forced to shut down.

Supreme Court rules in favor of hospitals on 340B

In a unanimous ruling this week, the U.S. Supreme Court opined that the Department of Health and Human Services does not have the discretion to change 340B reimbursement rates without gathering data on what hospitals pay for outpatient drugs. The opinion, authored by Justice Brett Kavanaugh, reverses a 2020 decision by the U.S. Court of Appeals for the District of Columbia Circuit.

AzHHA submits comments to CMS on proposed IPPS Medicare rule

AzHHA this week submitted comments on the Fiscal Year (FY) 2023 Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care and Long-Term Care Hospital Prospective Payment System Proposed Rule. AzHHA’s letter expressed concern for the woefully inadequate rate update of 3.2% in light of the unprecedented inflationary environment. The letter asks the Centers for Medicare and Medicaid Services (CMS) to implement, for FY 2023, a retrospective adjustment to account for the difference between the market basket adjustment that was implemented for FY 2022 and what the market basket is currently projected to be for FY 2022. The letter also asks CMS to eliminate the productivity cut for FY 2023. In addition to revising the low rate increase, the letter asks CMS to examine its outlier methodology more closely and consider making additional, temporary changes to help mitigate the substantial increases (a 39% increase) that are still occurring in the outlier threshold.

GE Healthcare update on iodinated contrast media

GE Healthcare reported Tuesday its Shanghai facility has been operating at 100% production capacity since Wednesday June 8, following the easing of local COVID restrictions. In May, hospitals nationwide reported shortages of GE Healthcare’s iohexol and iodixanol intraveneous contrast media products for computed tomography imaging. The shortage has been attributed to COVID-19 related lockdowns in Shanghai, China where the iodinated contrast media is manufactured.

Monkeypox Outbreak— Updated Case-finding Guidance

The U.S. Centers for Disease Control and Prevention (CDC) issued an update Tuesday to detail clinical presentations of monkeypox seen so far in the United States. The agency also provided updated and expanded case definitions intended to encourage testing for monkeypox among persons presenting for care with relevant history, signs and symptoms.

The CDC says since May 2022, monkeypox cases, which have historically been rare in the United States, have been identified in 18 states and territories among both persons returning from international travel and their close contacts domestically. Globally, more than 1,600 cases have been reported from more than 30 countries; the case count continues to rise daily. In the United States, evidence of person-to-person disease transmission in multiple states and reports of clinical cases with some uncharacteristic features have raised concern that some cases are not being recognized and tested.  

CMS fines hospitals under price transparency rule

CMS last week imposed its first penalties under its hospital price transparency rule. Beginning January 1, 2021, hospitals were required to post a cost estimate for 300 “shoppable” services or begin facing penalties that range from $300 to $5,500 per day, varying by the size of the hospital.    

Dragonfly OpStar Imaging Catheter Recall

The Food and Drug Administration (FDA) issued a Class I recall May 26 of the Dragonfly OpStar Imaging Catheter for potential loose catheter marker band that may cause patient harm.

A Class I recall is the FDA’s most serious type of recall. Use of these devices may cause serious injuries or death.

Recalled Product:

Product Name: Dragonfly OpStar Imaging Catheter

Product Lot Numbers: See recall database entry

Devices Recalled in the U.S.: 4,800

Date Initiated by Firm: April 11, 2022

Upcoming Events

June 21- Introduction to POLST

Interested in learning how to use the Arizona POLST form with your patients? The one-hour Introduction to POLST workshop equips healthcare professionals with knowledge and resources to begin using POLST, Physician Orders for Life-Sustaining Treatment, in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. Register here.

June 30—Wage Index Review Webinar

AzHHA is presenting an opportunity to work with FORVIS (formerly BKD) to have them review whether hospitals are accurately capturing wage index payments. Since wage index accounts for approximately 60-70% of total Medicare reimbursements for general acute care hospitals, ensuring their accuracy can have a large impact on Medicare reimbursement. AHCCCS will be hosting a webinar on June 30 which will provide additional details. Please contact Amy Upston, [email protected] for more details. 

October 19-21 - Save the Date: AzHHA Annual Leadership Conference

Mark your calendars for the 2022 Annual Leadership Conference October 19-21, 2022. After two years of putting the conference on pause to focus on the pandemic response, we will meet in the majestic Lowes Ventana Canyon in Tucson. The AzHHA Annual Leadership Conference brings together hundreds of healthcare CEOs, leaders, legislators and community partners from across the state for two and a half days of education, recognition and networking. Registration will become available in the coming months.

Sponsorship opportunities are now available. Download the sponsorship prospectus, here. Questions about sponsorship may be sent to Laura Dickscheid at [email protected].

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