Your 2009 Hill Day Participants meeting with Dean Heller
Participants:
Mary Lawrence, Reno
Cathy Ulibarri, Reno
Merri Faretto, Reno
Mary Harris, Reno
Carrie Ayala, Las Vegas
Tamra Wood, Boulder City
Meeting with Dina Titus
and with Carolyn Gluck, Harry Reid's Assistant
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Legislative Issues
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CMS Publishes Final Rule for Skilled Nursing Facilities PPS FY 2008
On August 3, CMS published the final rule outlining updates to the payment rates used under the prospective payment system for skilled nursing facilities for fiscal year 2008 (72 FR 43412). The final rule becomes effective on October 1.
HHS Seeks Comment on AHIC
The American Health Information Community (AHIC) was created in 2005 to serve as an advisory group to the Department of Health and Human Services on issues related to the development of a nationwide health information network. AHIC is now seeking comment on a white paper that discusses a proposed successor. The department is seeking feedback in five areas:

1. purpose and scope of the successor group
2. membership
3. governing body and decision-making processes
4. protections, incorporation, management and staffing, and
5. participation value for stakeholders

Public comments may be submitted through September 10.

A copy of the white paper is available at

http://www.hhs.gov/healthit/community/background/AHICsuccessor.html
CMS Publishes Final Rule on
The Center for Medicare & Medicaid Services (CMS) issued a final rule for inpatient hospital services in fiscal 2008 that would increase total Medicare reimbursement by an estimated 3.5 percent and include new severity-adjusted DRGs to more accurately account for patient severity. The 745 new Medicare Severity DRGs (MS-DRGs) will replace the current 538 DRGs. Medicare payment is expected to increase for hospitals serving more severely ill patients and decrease for those serving patients who are less ill. The MS-DRGs will be phased in over two years beginning October 1.
House Passes One-Year Delay of Medicare Severity DRGs
An amendment to the inpatient prospective payment system proposed rule to delay the implementation of Medicare severity-adjusted DRGs for one year for fiscal year 2008 overwhelmingly passed the House 412-12 during consideration of HR 3043, appropriations legislation for the Departments of Labor, Health and Human Services, Education and related agencies. The amendment, offered by Representatives John Lewis (D-GA), Jerry Weller (R-IL), and Peter Welch (D-VT), would also stop the implementation of the 2.4 percent behavioral offset. For the provisions of this amendment to take effect, they will have to be included in the final package sent to President Bush. The full Senate has not yet considered its Labor, HHS, and Education (S. 1710) legislation and is not expected to do so until after the August recess. S. 1710 currently does not contain language consistent with the Lewis/Weller/Welch amendment. The House passed HR 3043 on July 19, 276-140. To learn more about the bill, go to http://thomas.loc.gov/.
Senators Stabenow and Snowe Introduce Health IT Bill
Senators Debbie Stabenow (D-MI) and Olympia Snowe (R-ME) have introduced the Health Information Technology Act of 2007 (S. 1408). Referred to the Senate Finance Committee, the bill intends to “improve quality in health care by providing incentives for adoption of modern information technology.” The bill would establish an informatics systems grant program to offset costs of implementing health IT incurred by hospitals, critical access hospitals, skilled nursing facilities, federally qualified health centers, physicians, and community mental health centers. The legislation also sets up a Medicare payment incentive program for health information technology. One of the requirements of the program calls for establishing new codes, modifying existing codes, and adjusting evaluation and management modifiers to those codes that take into account health IT services with patient-specific applications. The bill also calls for the development of interoperability standards by the Secretary of Health and Human Services. For additional information on this legislation, visit the Action Center of the Advocacy Assistant at
https://secure.ahima.org/DC/Login.asp
CMS Issues Instructions for POA Reporting
The Centers for Medicare and Medicaid Services (CMS) issued instructions on reporting the present on admission (POA) indicator, which is to be reported for every diagnosis on a Medicare inpatient acute care hospital claim beginning with discharges on October 1, 2007. Although hospitals must report the POA code on the claim, the information will not be used by claims processing systems until January 1, 2008. Direct data entry (DDE) screens cannot be updated to include a space for entering POA information until January 1, so hospitals submitting claims via DDE will not be able to submit the POA indicator until January 1, 2008. Beginning with claims submitted on January 1, 2008, if hospitals do not report a valid POA code for each diagnosis on the claim, the claim will continue to process. However, hospitals will be provided with a remark code on their remittance advice advising them they did not correctly submit the POA code on the claim. Beginning April 1, 2008, if hospitals do not report a valid POA code for each diagnosis on the claim, the claim will be returned to the hospital.

CMS is adopting the reporting requirements and guidelines described in the UB-04 Data Specifications Manual and the ICD-9-CM Official Guidelines for Coding and Reporting, with the exception that a reporting option of “1” will be used for “unreported/not used.” To read the transmittal, go to

http://www.cms.hhs.gov/transmittals/downloads/R1240CP.pdf

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