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Connection newsletter 1-25-24

Check out this week's legislative update, details on the CMS final rule to streamline prior authorizations, and a summary of an Arizona Republic article that featured AzHHA's priority bills.

 

 

   
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Connection Newsletter

By AzHHA Communications ● Jan. 25, 2024

Smart Brevity® count: 4.5 mins...1180 words

In this issue, you’ll find:

  • This week’s legislative update.
  • Details on the CMS final rule to streamline prior authorizations.
  • A summary of an Arizona Republic article that featured AzHHA’s priority bills.
 

Legislative update – week 3

Hospital plus being pulled down by people. People are in the shadow of the plus.

We are just over 17 days of session, and as of Wednesday morning, sitting at 999 bills that have been filed.

  • The House Health Committee met for the first time on Monday and discussed four bills. We anticipate the committee’s agendas to grow significantly over the coming weeks given the backlog of bills waiting to be heard in committee.
  • The Senate Health Committee also met on Tuesday with only five bills on the agenda. One of which is a continuation from last year looking to include comprehensive dental care for AHCCCS patients, a bill that AzHHA supports.

Be sure to join us on Fridays for our member-only legislative calls where we dive into more of the theatrics taking place.

 

CMS finalizes rule to streamline prior authorizations

A red cross in a chair in a cubicle

What’s new: On Wednesday, Jan. 17, CMS finalized their rule to streamline prior authorizations. Most provisions take effect in 2026.

Why it matters: Key provisions of the rule include:

  • Beginning in 2026, Medicare Advantage, Medicaid Fee-for-Service, Medicaid managed care and federal market place plans must respond to prior authorization requests within 72 hours if they are urgent or seven calendar days if they are non-urgent.
  • If prior authorizations are denied, payers must provide specific reasons for denying the authorizations.
  • Payers will need to publicly report several prior authorization metrics.
  • Payers will need to implement a standardized application programming interface (API) by Jan. 1, 2027.

Few changes were made from the proposed rule which AzHHA supported.

 

AzHHA’s priority bills featured in Arizona Republic article

Illustration of people entering a medical building

What’s new: An article in the Arizona Republic from Saturday, Jan. 20 titled “‘I’ve never seen it this busy’: Here’s why Arizona emergency departments are jammed” illustrates issues such as winter visitors, overburdened primary care doctors and lack of insurance accountability.

Why it matters: This article highlights the two priority bills for AzHHA, HB2035 (health plan accountability) and HB2290 (interfacility transportation), and how those bills could help reduce emergency department volumes.

“I really believe that the only way to solve this is through policy change. If you are an independent physician and you are practicing in a market where payers are unchecked, you can’t get paid for the work you do and you leave. Payer accountability is a really important change we can make.”

Mimi Coomler, chief executive officer, Tucson Medical Center

Go deeper: Read the full article here (subscription required).

 

AzCHER unveils 2023-24 CHVA/RGA Summary Report

📢The Arizona Coalition for Healthcare Emergency Response (AzCHER) unveils the much-anticipated Community Hazard Vulnerability Assessment/Resource Gap Analysis (CHVA/RGA) Summary Report for the year 2023-24.

  • This comprehensive report, meticulously compiled by AzCHER, is now available on AzCHER’s website.

💡 Why it matters: In the pursuit of a safer and more resilient community, knowledge is power.

  • This report equips us with the information needed to strengthen our healthcare emergency response capabilities, ensuring the well-being of everyone in Arizona.
  • Use this report to identify your own hazards and resource gaps, a federal and state health licensing requirement.

🔍 What's inside?

  • Explore the latest insights into our healthcare community's hazard vulnerabilities and resource gaps.
  • The report delves into critical aspects, providing a thorough analysis to enhance our preparedness and response strategies.

📊 Key highlights:

  • Hazard Vulnerability Assessment: Uncover the potential risks and vulnerabilities our healthcare community faces. See an overview for each region.
  • Resource Gap Analysis: Gain valuable insights into the gaps that exist in our healthcare resources for effective emergency response. See a snapshot of resources for hospitals, long-term care/skilled nursing, EMS/Fire, public health and more.
 

AzHHA welcomes new member - Casa Grande Academy

AzHHA is excited to announce the association’s newest healthcare member, Casa Grande Academy.

Get to know our new member:

  • Casa Grande Academy is a 32-bed behavioral health residential treatment facility in Pinal County.
  • Serving moderate to high-risk youth aged 12 to 18, the facility maintains a track for mood, trauma and conduct-related disorders (Seeking Self Program) and a separate track for risky or problematic sexualized behaviors (Pathways Program).
  • Their mission is to provide healing through respect, integrity and hope for their clients, their families and each other.

Welcome, Casa Grande Academy!

 

Nominations open for the 2024 EMS & Trauma Awards

🆕The Arizona Department of Health Services Bureau of EMS & Trauma System is hosting the second annual Emergency Medical Care Technician (EMCT) of the Year Award and the first annual Trauma Awards.

Why it matters: Awards for the EMCT of the Year Award will be presented per region. Eight individuals who have demonstrated dedication, leadership and excellence within their role in the Arizona trauma system will also be recognized.

👉Nominations are due Friday, March 15.

 

 

Member spotlight: Wickenburg Community Hospital raising awareness of payor issues

Several members of the Wickenburg Community Hospital (WCH) leadership team including Jackie Lundblad, president and CEO of WCH and AzHHA board member, were featured in an article in the Wickenburg Sun titled “WCH looks to strengthen payor relationships.”

  • The article discusses issues with getting payors to pay outstanding claims, especially in rural areas.
  • It also addresses some of the specific challenges that WCH is facing as it relates to payors.

Go deeper: Read the article here.

👍Thank you for helping to raise awareness in your community about some of the issues AzHHA is looking to address with the health plan accountability bill, HB2035.

 

UPCOMING EVENTS

Tuesday, Jan. 30 - Crisis Standards of Care tabletop exercise
AzCHER will conduct a virtual tabletop exercise that will address Crisis Standards of Care in Arizona. Registration closes on Monday, Jan. 29. Learn more and register.

Tuesday, Feb. 6 - Arizona Rural and Public Health Policy Forum 2024
Each year, this forum focuses on issues of the day that are affecting the health of rural Arizonans. The event will be held at the Virginia G. Piper Auditorium located at 600 E. Van Buren Street in Phoenix. Register now.

Friday, Feb. 16 - 2024 Winter State of the State
Join Arizona healthcare professionals at this conference to learn about the latest news on Arizona managed care from a panel of experts. Enjoy breakfast and networking before a full morning conference featuring the latest news, data and trends relevant to our competitive and evolving healthcare landscape. AzHHA members can receive $15 off admission with coupon code “azhha2024.” Learn more and register.

Wednesday, Feb. 21 - Introduction to POLST 
Join physician orders for life-sustaining treatment paradigm (POLST) for their one-hour virtual workshops equipping healthcare professionals with knowledge and resources to begin using POLST in Arizona. Register here.

 

IN THE NEWS

 

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