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Connection newsletter 2-16-23

Read about healthcare updates at the Capitol, AHCCCS activities and Arizona’s OSHA authority

Legislative Update – week six

AzHHA’s top priority legislation (HB2290) received unanimous support in the House Health Committee on Monday evening. Thank you to members from Cobre Valley Regional Medical Center and Summit Healthcare for testifying before the Committee. The next step is to work through some recommended amendment language to add to the bill on the House floor. Stay tuned for additional opportunities to engage in support of this health plan accountability bill, including communicating with your legislators about your experience with health plans.

The Senate also convened a new committee to review Governor Hobbs’ agency director nominees. The first hearing was held last Thursday when Dr. Theresa Cullen, nominee to lead the Arizona Department of Health Services (ADHS), was considered. After a lengthy hearing and intense scrutiny over COVID-19 policies, the committee voted not to recommend her confirmation. The Senate proceeded to vote against Dr. Cullen’s confirmation, though Governor Hobbs also retracted the nomination the same day. The Governor’s office must now recruit another candidate for the role of ADHS Director. The nominee for Director of Arizona Health Care Cost Containment System (AHCCCS) has not been considered by the Senate Committee yet, but that is expected to proceed in the coming weeks.

The House overcame the hurdle and passed a ‘continuation’ budget on Monday evening. The Governor’s office has already indicated it doesn’t support the continuation budget and plans to veto it. The question will become if Governor Hobbs chooses to veto the budget in whole or in part, setting up the next several months of negotiations with the legislature over funding the state government. The House Health committee will hold a second meeting this week, convening in the afternoon on Thursday, Feb. 16, to consider additional bills before the Friday legislative deadline to get bills through committee in their chamber of origin.

AHCCCS’ proposed Differential Adjusted Payments for 2024

AHCCCS posted its proposed DAP metrics last week for contract year ending 2024 (Oct. 1, 2023 – Sept. 30, 2024). The proposed metrics for hospitals will continue to tie the majority of funding to the health information exchange (HIE) milestones, with a Scope of Work due April 1. Additional metrics include:

  • Initiate use of the Arizona Health Directives Registry (Scope of Work is due April 1),
  • Continuation of the Social Determinants of Health Closed Loop Referral Platform (Scope of Work is due April 1),
  • Behavioral health hospitals that meet the Inpatient Psychiatric Facility Quality Reporting Program performance measure,
  • Long term acute care hospitals that meet or fall below the national average for the pressure ulcers performance measure and
  • Rehabilitation hospitals that meet or fall below the national average for the pressure ulcers performance measure.

Comments to the proposed rule are due March 5, 2023. Hospitals have a number of deadlines on April 1, 2023. Comments or questions may be emailed to AzHHA’s Director of Financial Policy and Reimbursement, Amy Upston

AzHHA submits comments to CMS on proposed rule on Medicare Advantage Rule

AzHHA submitted comments this week to the Centers for Medicare and Medicaid Services (CMS) on its proposed policy and technical changes to Medicare Advantage. In the letter, AzHHA voiced strong support for the proposed changes intended to strengthen consumer protections and oversight of Medicare Advantage Organizations (MAOs) which includes CMS’ proposal to limit MAOs from adopting more restrictive rules than Traditional Medicare. AzHHA mentioned a number of areas in which CMS could provide additional clarification such as explicitly stating that MAOs must follow the two-midnight rule and clearly stating that MAOs cannot adopt policies which restrict the site(s) where a covered services can be delivered when there is no basis for that restriction in Traditional Medicare. AzHHA applauded CMS for its proposals to expand access to behavioral health services and strengthen MAO provider networks, but made an additional recommendation that CMS add a requirement that rehabilitation hospitals and long-term acute care hospitals be explicitly added to Medicare Advantage network adequacy requirements. Finally, AzHHA recommends Health and Human Services should not deviate from this current practice and impose an unrealistically strict 60-day deadline on hospitals and health systems to return overpayments.

CMS updates antibiotic use and resistance data reporting

In a recent Final Rule, the Centers for Medicare & Medicaid Services (CMS) will now require reporting of antibiotic use and resistance data to the National Healthcare Safety Network (NHSN) to satisfy the Public Health and Clinical Data Exchange Objective of the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals (CAHs). 

In Arizona, large health systems are already reporting this data to NHSN, as are numerous stand-alone and critical access hospitals. Information on the Antimicrobial Use and Resistance module in NHSN is located here. Hospitals are encouraged to review the Federal Register for additional details. 

OSHA to withdraw federal pursuit over state authority

The U.S. Department of Labor announced this week that the Occupational Safety and Health Administration (OSHA) is withdrawing its proposal to revoke the state’s authority to enforce workplace safety programs under a State Plan. The department’s announcement states that Arizona has made progress toward addressing the agency's concerns. AzHHA last year submitted comments urging the department and OSHA not to revoke Arizona’s State Plan status.

Arizona is one of 28 states and territories who are authorized to enforce their own workplace safety programs as long as they are at least equivalent to the Department of Labor’s standards.

No Surprises Act dispute resolution struck down

A Texas judge last week held that the federal government’s revised independent dispute resolution process for determining payment for out-of-network services under the No Surprises Act skews the arbitration results in commercial insurers’ favor in violation of the compromise Congress reached in the Act. “The Court concludes that the challenged portions of the Final Rule are unlawful and must be set aside under the Administrative Procedure Act (APA),” wrote United States District Court Judge Jeremy Kernodle ruling in favor of the Texas Medical Association in a case brought against the departments of Health and Human Services, Labor, and the Treasury. As a result of this decision, the regulations are vacated nationwide, and, as Judge Kernodle wrote, “arbitrators will decide cases under the statute as written without having their hands tied by the Departments.”

SAMHSA removes X-waiver requirement

In case you missed it: the Consolidated Appropriations Act of 2023, signed at the end of 2022, will eliminate the DATA-Waiver, or X-Waiver Program. This means a DATA-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder according to the U.S. Department of Justice, Drug Enforcement Administration. Visit the Substance Abuse and Mental Health Services Administration website for more information.

Member spotlight: KRMC cancer program earns national accreditation from the Commission on Cancer of the American College of Surgeons

Kingman Regional Medical Center on Tuesday announced the Commission on Cancer (CoC), a quality program of the American College of Surgeons, granted three-year accreditation to its cancer program. In a news release, KRMC explains a cancer program must meet 34 CoC quality care standards, be evaluated every three years through a survey process, and maintain levels of excellence in the delivery of comprehensive patient-centered care in order to earn voluntary CoC accreditation. Congratulations to KRMC for achieving this milestone!

AzCHER emergency preparedness

AzHHA’s Arizona Coalition for Healthcare Emergency Response (AzCHER) recently participated in multi-agency emergency preparedness efforts representing hospitals during the state’s premier sporting events including the WM Phoenix Open and Super Bowl LVII. Working out of the multiagency coordination center (MAC) the AzCHER team served as a key resource for hospitals in the event of any disasters. Our appreciation goes out to partnering agencies including first responders and VIP visitors who helped support our efforts to keep Arizona hospitals safely operating during these high-profile events.



HR Professionals: Join us for a Webinar on Background Screening Challenges in 2023

As hospitals and healthcare organizations face increasing challenges in meeting workforce demands, AzHHA is working with our endorsed vendor and affiliated partner, Universal Background Screening, to bring compliance updates and useful tips to members. Join us on March 9, 2023, at 11 a.m. for a review of recent consumer reporting industry changes and regulations regarding employment background screening and drug testing.  The presentation will target healthcare facilities and will cover the following topics:

  • Best practices for screening  
  • Increase in screening litigation and how to avoid the pitfalls
  • Increase in license fraud / Primary Source verification importance
  • Ban the Box, Fair Chance regulations and expungement / redaction of information at courts
  • Changes in THC / marijuana drug testing laws

To receive an invitation to this members-only meeting, email our Vice President of Member Services, Laura Dickscheid.


Feb. 22 - Hospital Assessments and HEALTHII payments 101 for AzHHA members

Feb. 23 (in person) and March 2 (virtual) - AzCHER Radiation Surge Annex Training and Tabletop Exercise

March 14 – Introduction to POLST workshops



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