Legislature in recess until next month, good news for AHCCCS prior to adjournment
Legislative Update—AHCCCS continued
We’re now well past 100 days of legislative session, but the Chambers did just one day of work this week, and then promptly recessed until Monday, June 12. There is a chance the Speaker and President could call the body back sooner if urgent business required it, but if not, we’re officially on another break until mid-June. When the Chambers convened on Monday, they passed a measure to continue the existence of the Arizona Health Care Cost Containment System (AHCCCS) through calendar year 2029 (SB1075), an important procedural action the healthcare community has been anxiously awaiting all session. The Legislature also took final votes on many of the remaining bills still in process, but most of them were hyper-partisan and can expect to meet with Governor Hobbs’ well-used veto stamp in the coming days. Sine die is no closer as far as we can tell, and the rumor mill abounds suggesting that the Legislature will remain perpetually in session, something that has never happened before.
AHCCCS sting terminates fraudulent providers
On Tuesday, Governor Katie Hobbs announced the suspension of Medicaid payments to more than 100 behavioral health providers based on allegations of fraud. Read more about the announcement on the Arizona Health Care Cost Containment System’s (AHCCCS) website. Providers should continue to arrange services as usual. A dedicated member hotline at 2-1-1 (press 7) has been established for members who have been impacted by the closure of a sober living home or residential facility. Visit www.211Arizona.org/MMIP.
The challenges of getting paid by commercial providers
While commercial payors typically pay providers at a higher rate than Medicare, a recently released report by Crowe demonstrates the increased efforts providers must engage in to simply be paid. Using its Revenue Cycle Analytics net revenue software platform, Crowe analyzed denials and accounts receivable to show differences in payment by traditional Medicare and commercial providers (including all managed care providers). Some key points include:
- During the first three months of 2023, almost a third of commercial claims were not paid within the first 90 days for both inpatient and outpatient claims, compared to 11-12% for traditional Medicare.
- Initial denials for commercial payors were 15.1% in the first quarter of 2023, compared to only 3.9% for traditional Medicare.
- Medical necessity inpatient claim denials by commercial providers increased to 3.2% in the first quarter of 2023, up from 2.4% just two years earlier. In comparison, traditional Medicare denials stayed flat at 0.2%.
- Providers lose 8 cents on every dollar due to a combination of final denials, takebacks and bad debt.
AzHHA Members - Don’t miss out on revenue recovery opportunities through MCAG
As your advocate, AzHHA has endorsed Managed Care Advisory Group (MCAG) with filing class action settlements on behalf of its membership. MCAG’s Settlement Recovery Service delivers the most on class action claims with the least amount of effort. Once a claim is filed on your behalf, settlements are typically paid out within 12 to 18 months. Depending on the number of settlements that your hospital participates in, engaging with MCAG can result in two to three settlements each year. There are a number of upcoming settlements from which you can still benefit. The next filing deadline is June 13. Join seven other AzHHA members in recovering revenue for your respective hospital. Click here to visit MCAG’s website for AzHHA members.
AzHHA is hiring – Transition to Practice Program Director
We are pleased to announce that we have a contract with AHCCCS to administer a state-wide Transition to Practice program for new graduate RNs. We will be recruiting facilities that employ new graduate nurses to participate in our statewide program. We will engage a vendor for evidence-based content and will provide a year-long program for 100 people per year. We will also deliberately incorporate emergency preparedness in the curriculum and experiential training.
Since the pandemic, Arizona has been experiencing a severe nursing shortage. While it is important to increase the number of new nurses in the pipeline, it is also important to retain new nurses in their roles. New graduate nurse turnover was high before the pandemic and only increased throughout the pandemic. A formal New Graduate Registered Nurse Transition to Practice Program provides another level of support for new nurses and has been shown to increase retention.
As part of the program, we are hiring a new position: Transition to Practice Program Director. View the job description and apply here: https://lnkd.in/gYKT-2gy.
Sponsorship opportunities open for the Arizona Hospital and Healthcare Foundation’s 2023 Arizona Hospital Leadership Conference
Sponsorship opportunities are now available for the 2023 Arizona Hospital Leadership Conference, October 25-27 at the beautiful Loews Ventana Canyon Resort in Tucson. View our sponsorship prospectus to learn more about our bundled options or stand-alone sponsorships. The number of sponsors is limited to maintain the personal nature of this experience while also maximizing opportunities for sponsors to have face-time engagement with attendees.
Mental Health in Rural Communities toolkit
The Rural Community Health Toolkit compiles evidence-based and promising models and resources to support organizations implementing mental health programs in rural communities across the U.S., with a primary focus on adult mental health. Modules in the toolkit contain resources and information focused on developing, implementing, evaluating, and sustaining rural mental health programs.
New resource for maternal health care
We celebrate Maternal Mental Health Month in May by applauding AHCCCS for funding a new, free service for medical providers who are treating pregnant and postpartum patients with mental health and substance use disorders. The University of Arizona College of Medicine – Tucson’s Arizona Perinatal Psychiatry Access Line (APAL) launches on June 1 and gives access to perinatal psychiatrists in real time, who will answer providers’ questions and review treatment options by phone at 888-290-1336. Hours are Mon-Fri, 12:30 p.m.-4:30 p.m. Information and resources are available at APAL.arizona.edu.
UPCOMING EVENTS
May 23 - The NLC: What Nurse Employers Need to Know
The Nurse Licensure Compact (NLC) is offering a free educational webinar for nurse employers on Tuesday, May 23, 2023, from 2-3 p.m. Central Time. It will provide a general overview of the NLC and how it works, explain common questions nurse employers often have, debunk myths and misconceptions, provide a legislative update, and explain Nursys.com and Nursys e-Notify.
May 23 - WEBINAR for Revenue Cycle Managers: Standardizing Denial Metrics to Improve Revenue Cycle Performance
Insurance claim denials cost hospitals more than $262 billion annually, translating to an average of $5 million per provider. Currently, 65% of denied claims are not refiled and 90% are preventable. Join us as Pat Murphy and Tiffany Martin from TruBridge, AzHHA’s endorsed vendor and affiliated partner in the revenue cycle space, outline the Healthcare Financial Management Association’s (HFMA’s) MAP Keys for denial management and share why you should be tracking them. In this session, they’ll also cover how to implement a claims integrity team within your organization. Join us on Tuesday, May 23 from 11 a.m. to noon. Register here and a Zoom link will be sent to you one day prior to the webinar.
June 1 - OPEN DISCUSSION: Securing Temporary Staff during a Hospital Surge
As part of the Arizona Health Improvement Plan (AzHIP) pandemic recovery and resiliency efforts, AzHHA and the Arizona Department of Health Services (ADHS) invite you to share your feedback on how we can collectively improve the staffing system to accommodate a volunteer or staff sharing model. Some of the topics to be addressed include:
- General barriers to utilizing volunteers and staff from other hospitals/health systems or states
- Barriers to rapid onboarding of temporary staff
- Legal or procedural obstacles that should be considered by the state or regulatory boards
- Ideas/suggestions for an ideal platform to share staff
Please join the conversation on Thursday, June 1 from 3 to 4 p.m. Register to receive the Zoom link here. The link will be sent the day prior to the event, so please hold the time on your calendar.
June 5-6 – American Hospital Association Advocacy Event in Washington, D.C.
Hospital and health system leaders can register for a June 6 American Hospital Association (AHA) Advocacy Day event in Washington, D.C. The AHA team will provide a briefing on the current congressional landscape and share key messages that hospital and health system leaders can deliver to their representatives and senators on Capitol Hill. This event is for AHA members only. Please click here for details about how to register for the June 6 briefing, as well as a networking event on June 5.
June 8 - FREE WEBINAR: Meta Pixel and Other Online Tracking Technologies—Investigation and Legal Response
ATTN: Mar/Comm, IT, Legal and Compliance – following a recent news investigation into healthcare organizations’ use of online tracking technologies for marketing purposes (such as Meta Pixel), the Office for Civil Rights and the Federal Trade Commission have initiated investigations and class-action lawsuits have been filed across the country. This webinar will explore the legal issues involved in the use of online tracking technologies and discuss investigation and response. Speakers include:
- Kristen Rosati, an attorney at Coppersmith Brockelman in Phoenix. She is considered one of the nation’s leading “Big Data” and HIPAA compliance attorneys and is a Past President and a Fellow of the American Health Law Association.
- Nate Kunz, an attorney at Coppersmith with substantial experience in data-related class action and other commercial litigation.
- Andrew Shaxted, a Managing Director at FTI Consulting. He is an interdisciplinary technologist and lawyer specializing in privacy engineering, data and analytics, ad tech, digital forensics and privacy governance.
Join us June 8 from 12-1:30 p.m., free of charge to AzHHA members. To receive the Zoom link on the day prior to the webinar, register here.
May & June – Critical Incident Stress Management Peer Team Training for Crisis Intervention
As crises in the workplace and community disasters are becoming more frequent, the need for effective psychological crisis response capabilities becomes obvious. As a result, AzCHER will be offering Group and Individual Critical Incident Stress Management (CISM) Peer Team Training for Crisis Intervention in May and June, in the Tucson area. CISM represents a powerful, yet cost-effective approach to deal with the resultant psychological, emotional and spiritual effects from a crisis. This training will help your facility create and maintain a CISM Peer Team for both Individual and Group debriefing. Lunch will not be provided, so please plan accordingly.
Abrams Public Health Center: 3950 S. Country Club Rd, Tucson, Arizona, 85714
- May 30-31, 7:30 a.m. - 5 p.m. - capacity for 25 people
- June 13-14, 7:30 a.m. - 5 p.m. - capacity for 25 people
To register, contact Cheryl Hewlett at [email protected].
IN THE NEWS
Advancing Health Equity Through The CMS Innovation Center: First Year Progress And What’s To Come (HealthAffairs.org)
Arizona Senate candidates keep distance from Biden on Title 42 (The Hill)
How we license facilities that provide substance abuse recovery resources (ADHS Blog)