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Connection Newsletter - “Skinny” budget does not obtain enough support to pass committee

The 2022 legislative has officially surpassed the 100-day mark with no resolution on the state budget in sight.

Legislative update

We have officially surpassed the 100-day mark for the 2022 legislative session. Beginning next week, each chamber will require a majority vote to continue working for the year. The primary election is inching closer, and members who are running for re-election or alternate offices cannot campaign or fundraise while the legislature remains in session. Several bills AzHHA has been tracking made their way to Governor Doug Ducey’s desk this week. SB1311, the healthcare worker assault protection bill that has been several years in the making, was finally approved. Additionally, two bills restricting vaccination and mask policies were also approved on party lines. HB2498 will prohibit the state or any political subdivision from requiring COVID-19 vaccinations, but it does carve out state-owned or operated healthcare institutions, and HB2616 prohibits government or school mask mandates from applying to minors without the express, written consent of a parent or guardian. Governor Ducey is expected to sign all three bills.

On the budget front, the House suspended its rules this week to allow for the introduction of a “skinny” budget. The so-called “skinny” budget is, in fact, a continuation budget, which sets spending at essentially the same level as fiscal year (FY) 2022. It eliminates some one-time spending initiatives from this year and provides a few very modest increases to select agencies to comply with other legislation. Recent Joint Legislative Budget Committee reports indicate the state has approximately a $5 billion surplus this year, but this proposal does not spend any of that money. Governor Ducey’s office has signaled they do not support this proposed approach, and several Republican Senators have also publicly stated they will not support a “skinny” budget. The House Appropriations Committee met Wednesday afternoon to begin their consideration of this budget proposal, but the bills failed in Committee. Therefore, the “skinny” budget will not move forward. We will continue to monitor the budget approval process and provide our members with updates as we know them.

CMS releases IPPS proposed rule for FY 2023

The Centers for Medicare & Medicaid Services (CMS) issued its hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS proposed rule on April 18 for fiscal year 2023. The rule proposes a 3.2% rate increase for inpatient PPS payments in FY 2023. However, when accounting for proposed changes to disproportionate share hospital payments, outlier payments, the Medicare-dependent hospital and low-volume adjustment programs and other policies, CMS estimates that inpatient PPS hospitals would see a net decrease of 0.3% from FY 2022 to FY 2023. In addition, the proposed rule would increase net LTCH payments by $25 million in FY 2023, relative to prior levels. While the proposed rule contains no major changes to the LTCH payment system, the proposed high-cost outlier offset of 1.7 percentage points is significant.

AzHHA members will receive a more detailed overview of the proposed rule in the coming weeks, including estimates of facility-specific impacts.

Cybersecurity authorities warn of possible cybersecurity threats as increased malicious activity increases

The cybersecurity authorities of the United States, Australia, Canada, New Zealand and the United Kingdom released a joint Cybersecurity Advisory (CSA) to warn organizations that Russia’s invasion of Ukraine could expose organizations both within and beyond the region to increased malicious cyber activity. Specifically, they recommend organizations patch all systems, enforce multifactor authentication, secure and monitor Remote Desktop Protocol and other risky services, and provide end-user awareness and training.

Federal Independent Dispute Resolution portal is live

The federal Independent Dispute Resolution (IDR) portal is now open for providers, facilities, plans and issuers to initiate the dispute resolution process to adjudicate disputes related to certain out-of-network medical bills. The federal IDR process must be initiated within four business days after the end of the 30-business-day open negotiation period concludes. To start a dispute, an initiating party will need:

  • Information to identify the qualified IDR items or services;  
  • Dates and location of items or services;
  • Type of items or services such as emergency services and post-stabilization services; 
  • Codes for corresponding service and place-of-service;  
  • Attestation that items or services are within the scope of the Federal IDR process and
  • The initiating party’s preferred certified IDR entity. A list of certified entities can be found here

Procedures codes for second Moderna booster vaccine

Current Procedural Terminology codes for reporting a second Moderna COVID-19 vaccine booster dose on medical claims are now available. Visit the CMS website for more information.

Virtual summit for healthcare providers - Conversations on encouraging COVID-19 vaccinations

Join the Department of Health and Human Services tomorrow, April 22, in a virtual summit for the medical community geared towards how providers and the healthcare community can encourage COVID-19 vaccination among children, pregnant people and young adults. Join the live streamed event here at 9 a.m. Arizona time.

HRSA releases ‘Phase 4’ PRF payments

Another $1.75 billion in Provider Relief Fund “Phase 4” payments were released April 13 to providers who experienced revenue losses and expenses related to COVID-19. Payments were based on changes in operating revenues and expenses from July 1, 2020, to March 31, 2021.

Human resource leaders – Attend ASHHRA22 this April 24-27 free

Human resource leaders, you are invited to attend the American Society for Health Care Human Resources Administration’s conference and tradeshow this April 24-27 in Phoenix. Join healthcare human resource peers for critical connections, innovative solutions and transformative experiences. AzHHA members receive complimentary registration. Please email [email protected] to request the discount code. Learn more and register, here.


Upcoming Events

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. To register for a workshop, click on a date below.

May 7 - Communication in Serious Illness Workshop

The objectives for this 2.5-hour didactic session are to review the need for a systematic approach to having more, better and earlier conversations about patient values and priorities in serious illness, defining a population with serious illness for whom improved communication holds many benefits, applying a structured communication tool to facilitate communication with patients with serious illness, and reviewing the value of summarizing, follow up and documentation. Learn more and register here.

June 14 – Annual Arizona Rural Health Conference

For the past 47 years, the Arizona Center for Rural Health has hosted the Annual Arizona Rural Health Conference in collaboration with the Arizona Rural Health Association, making it one of the longest continually running rural health conferences in the United States. The Arizona Rural Health Conference provides an environment for networking and dissemination of pertinent information among professionals and community members from rural Arizona and the Southwest. Register here.

In the News

Hospitals are also struggling to fill jobs across Arizona

Justice Department to appeal order voiding travel mask mandate
Associated Press

US Department of Labor announces proposal to reconsider, revoke final approval of Arizona's State OSHA Plan after pattern of failures
United States Department of Labor