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Surprise billing: Litigation update and new FAQs

Healthcare groups urge the U.S. District Court for the District of Columbia to strike down provisions of the No Surprises Act.

Legislative update

Action at the Capitol was even more limited this week. The House gaveled in Monday and Tuesday, considered fewer than a dozen bills and adjourned action until Monday, April 18. The Senate convened through Wednesday and also had extremely short calendars resulting in adjourning until Monday. The lack of action is typical for this time of year, but it is worth noting that next week will mark the infamous 100th day. Following the 100th day, House and Senate leadership can extend for an additional seven days, and after that, they will require a majority vote in each of their chambers to continue working. We’re in for a slow, long next few weeks.

Air ambulance rules finalized

The Arizona Department of Health Services’ (ADHS) Notice of Final Rulemaking for EMS Air Ambulance Rules was approved by Governor Doug Ducey’s Regulatory Review Council and filed with the Office of the Secretary of State. The new rules will be effective June 5, 2022. 

The final rules include an AzHHA-supported provision that requires air ambulance providers to work with hospitals and other stakeholders on plans for terminating operations. Air ambulance providers have previously been permitted to close base operations without prior warning to the community, creating safety concerns for impacted hospitals and patients. AzHHA appreciates the Department’s inclusion of this new provision, which is particularly important for patients in rural Arizona.

Surprise billing: Litigation update and new FAQs

The American Hospital Association (AHA) and American Medical Association (AMA) urged the U.S. District Court for the District of Columbia to act quickly to strike down certain provisions of the regulations implementing the No Surprises Act that favor insurers at the expense of providers and ultimately could reduce access to care. Specifically, the provisions being challenged by AHA and AMA relate to the arbitration process for determining fair payment for services by out-of-network providers. The challenge will not prevent the No Surprises Act’s core patient protections from moving forward or increase out-of-pocket costs to patients. In February, a federal judge in Texas struck down certain parts of the rule related to these arbitration provisions, finding that they conflict with the No Surprises Act. AHA and AMA are requesting that the D.C. Circuit Court render a decision as soon as possible, as the regulation’s arbitration provisions went into effect on January 1, 2022.  

Also related to the No Surprises Act, the Centers for Medicare & Medicaid Services (CMS) released a new FAQ for health care providers on the law’s requirements and the independent dispute resolution process, as well as a new FAQ on providing good faith estimates to uninsured and self-pay patients. CMS plans to launch an online Independent Dispute Resolution portal in the coming days.

National COVID-19 public health emergency once again renewed

Xavier Becerra, Health and Human Services Secretary renewed the COVID-19 public health emergency April 12 for an additional 90 days. The first U.S. public health emergency declaration for COVID-19 was signed in January 2020 and has since then been renewed every 90 days. Renewal of the COVID-19 public health emergency means expanded telehealth services, state support and Medicaid coverage protections will continue at least through July. The renewal is effective April 16.

Shelf-life for Janssen COVID-19 vaccine is extended

The U.S. Food & Drug Administration granted shelf-life extension on April 7 for the Janssen COVID-19 vaccine. When stored at 2-8°C the vaccine’s shelf-life is extended from nine to 11 months. The Janssen COVID-19 vaccine was initially issued emergency use authorization on February 27, 2021.

Some providers may be eligible for late reporting on provider relief payment use

Healthcare providers who missed the deadline to report provider relief fund use for period 1 may request an extension if the deadline was missed due to certain extenuating circumstances. Providers whose request is approved by the Health Resources and Services Administration must submit the completed report within 10 days.

Black Maternal Health Week

This Black Maternal Health Week, April 11-17 is a dedicated time to amplify the voice of Black Moms. The work in improving maternal health does not end in a week, it is an ongoing effort. Join AzHHA in its first Arizona AIM Collaborative conference May 26 where we will be hosting a virtual screening of Toxic: A Black Woman’s Story,” a film that helps explore the many underlying factors, such as toxic stress, racial inequities, unconscious bias and microaggressions, impacting the health of Black women and their birth outcomes. Following the screening, conference attendees will engage in a breakout session facilitated by Arizona, maternal health experts to unfold the issues critical to improving maternal health equity. To register for the conference, click here.

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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.

May 26 - 2022 Arizona AIM Collaborative Conference

Reserve your seat for the 2022 AIM Collaborative virtual conference held May 26. This year’s conference theme, A Push for Change, will focus on the Alliance for Innovation on Maternal Health (AIM)’s maternal hypertension bundle. Attendees will learn about the newest evidence and strategies for timely treatment of hypertensive disorders of pregnancy and integration of health equity into patient care. Register for the free, virtual conference here by May 18.

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.

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