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November 18, 2010 News Headlines

Governor to Call Legislature Into Extraordinary Session November 29

Governor David Paterson announced that he will call an extraordinary session of the State Legislature for Monday, November 29. In making the announcement, the Governor did not provide an official agenda for the session. “There is still unfinished business that must be addressed before the end of the calendar year, which is why I am calling for an extraordinary session of the Legislature,” Governor Paterson said.

The Governor previously indicated that potential items for a special session could include an appropriations bill to authorize the distribution of federal education money, a revised version of the education budget bill, legislation to reorganize the New York City Off-Track Betting Corporation, nominations to be considered by the Senate, and legislation to address the current year budget deficit.

HANYS will keep members informed about developments related to this special session.

Contact: Nicholas Henley

Congress Returns for Lame Duck Session; Effort to Address Physician Fix, Budget, and Tax Cuts Underway

The 111th Congress returned to Washington, D.C. this week for a lame duck session to address “must-do” issues, including thwarting a significant reduction in Medicare physician fees and continuing funding of the federal government. Congress may also extend some or all of the Bush-era tax cuts due to expire at the end of the year, and will consider continuing the extension of unemployment benefits past their scheduled expiration.

HANYS joined many provider groups in pressing Congress for swift passage of federal spending legislation that funds health programs and medical research. Congress could extend the current continuing resolution, set to expire December 3, to fund all federal operations in federal fiscal year (FFY) 2011 at FFY 2010 levels, or pass an omnibus appropriations bill.

Physicians will experience a 23% cut in Medicare payments at the end of this month under current law, with the reduction deepening to 30% on January 1, 2011. The U.S. Senate tonight is giving consideration to a bill that would provide a one-month reprieve from the reduction, paid for by advancing by one month the implementation of a Centers for Medicare and Medicaid Services regulation that would reduce Medicare reimbursement under the physician fee schedule for second and subsequent outpatient therapy services furnished for the same beneficiary on the same day for outpatient therapy.

The White House and other lawmakers are backing a 13-month fix at a cost of $20 billion. In either case, HANYS and the American Hospital Association (AHA) are actively advocating that no cuts to hospitals and health systems be considered as a potential offset.

HANYS and AHA are looking to include top legislative priorities to any moving legislation, including:

  • relief from the Medicare Inpatient Prospective Payment System coding offset;
  • extending expiring health provisions such as Section 508 wage index adjustment;
  • relief from Critical Access Hospital provider tax issues; and
  • ensuring equity in incentive payouts under the Electronic Health Record Incentive Program for multi-campus hospitals that share a Medicare provider number.

Congress will recess next week and return the week of November 29. Contact: Susan Van Meter

CMS and ONC Release Increased Certification Requirements for EHR Meaningful Use

The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released guidance requiring hospitals eligible for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program to put in place systems that have been certified against all 24 “meaningful use” objectives, not just the 19 required to be in place to demonstrate meaningful use. Providers must be “meaningful users” of EHRs to receive incentive payments under the program.

The new approach represents a departure from the final rule CMS issued in July, which allowed hospitals to use their discretion to select five of ten meaningful use objectives in addition to 14 mandatory, or core, objectives.

By requiring certification for all objectives, hospitals are denied the flexibility built into the final rule to decide how best to achieve meaningful use of EHRs. Further, to meet the certification requirements, hospitals will need to purchase and implement additional technology.

HANYS and the American Hospital Association believe this interpretation of the rule may delay hospitals’ implementation efforts and are working to preserve the flexibility afforded by the final rule. Additional information regarding ONC’s interpretation of the final rule is available in an AHA Special Bulletin. Contact: Susan Van Meter

CMS Administrator Berwick Appears Before Committee; Recognizes New York Hospital

The Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick testified before the Senate Finance Committee yesterday in his first appearance on Capitol Hill since his July 2010 appointment. He said his top priorities are ensuring the longevity and viability of the Medicare trust fund, moving swiftly toward integrated care, reducing chronic disease, eliminating waste, and improving patient safety.

Dr. Berwick said improving patient outcomes and reducing health care-acquired conditions are critical to improving quality of care. He recognized Claxton-Hepburn Medical Center in Ogdensburg, New York, which has all but eliminated adverse events as a result of its quality improvement efforts.

In his testimony, Dr. Berwick highlighted the Center for Medicare and Medicaid Innovation (CMMI), established by the Affordable Care Act (ACA) to spend $10 billion over the next ten years to fund innovative delivery models designed to improve the quality of patient care, improve public health, and reduce costs. HANYS sent its members detailed information on HANYS’ ongoing work with CMMI to ensure that New York hospitals and health systems across the state are afforded the opportunity to take advantage of funding available through CMMI to begin innovative programs.

Dr. Berwick refers to CMMI as the “jewel in the crown of health care reform.” Yesterday, he credited CMMI for creating significant flexibility to adopt, according to the needs of individual communities, the delivery system reform enacted by ACA—including bundled payments, Accountable Care Organizations (ACOs), and Medicaid’s medical home model. CMS expects to issue a proposed rule on ACOs later this year.

In his remarks today, Dr. Berwick announced that CMS will increase support to states as they try to provide better care and reduce costs for the nine million Americans who are eligible for both Medicare and Medicaid; they account for 40% of Medicaid costs. In December, CMMI will award 15 states up to $1 million each to fund programs that fully integrate care for dual-eligibles. Contact: Susan Van Meter

UHF Receives a $2.8 Million from Bristol Myers to Improve Diabetes Outcomes for Seniors

United Hospital Fund (UHF) will receive $2,845,967 from the BristolMyers Squibb Foundation as part of the Foundation’s, Together on Diabetes: Communities Uniting to Meet America's Diabetes Challenge initiative. The three-year grant will enable UHF to develop and test a diabetes control strategy targeting seniors in two New York City communities.

UHF will work closely with the New York City Department for the Aging and the New York City Department of Health and Mental Hygiene. Initially, UHF will focus on one New York City community, to be chosen for its high prevalence of seniors with diabetes, other service and demographic considerations, and the interest of a broad range of community organizations and health providers in forging a working partnership. A second community will be selected in the program’s second year. UHF will build on its experience in addressing diabetes using evidence-based practices to improve the health status of older adults in naturally occurring retirement communities. The initiative will include multiple components, including fielding a community activation campaign, adapting or building a community registry, fostering effective linkages between health care providers and other community resources as well as with seniors themselves, and customizing diabetes control intervention activities to the needs of the seniors and their community. Contact: Nancy Landor