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State and Federal Review Delaware Healthcare Association Delaware Organization Of Nurse Executives Nov. 10, 2011.

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Presentation on theme: "State and Federal Review Delaware Healthcare Association Delaware Organization Of Nurse Executives Nov. 10, 2011."— Presentation transcript:

1 State and Federal Review Delaware Healthcare Association Delaware Organization Of Nurse Executives Nov. 10, 2011

2 Delaware Legislation

3 Overview Revenues – January of 2011 = DOWN Revenues - June of 2011 = UP $350 Unexpected Money in Four Months Escheat Personal Income Tax Corporate Income Tax Bank Taxes Because of January DOWN: Governor Proposed Cutting Medicaid by $5 Million

4 Highlights Good: Proposed Medicaid Reduction of $5 million Turned Back DHIN Receives $2,996,900 Impediments to Blue Shield / Highmark Affiliation Removed Placed a DHA Appointee on Advisory Board to the Office of Public Guardian Bad: Reimbursements By Medicaid and Private Health Insurers for School Based Wellness Centers

5 Bradley Bills Continue Bradley Bills Continue Bradley Bills Continue Bradley Bills Continue Bradley Bills Continue

6 Professional licensure laws are amended to further define and clarify a health care license holder’s duty to report unprofessional conduct, child abuse and neglect; and providing for license revocation for felony sexual offenses.

7 SB 31 - Dentistry and Dental Hygiene SB 32 – Psychologists SB 33 - Physician Assistant SB 59 & HB 45 - Nursing HB 67 - Mental Health and Chemical Dependency Professionals HB 68 - Clinical Social Workers HB Physicians and Health Care Facilities

8 Other Legislation…. SB 13 – Needle Exchange Program Continuation SB 17 – Medical Marijuana Act SB 19 – Registered Lobbyists. Would prohibit lobbyists from serving on public bodies; commissions, task forces (Did not Pass) SB 45 – (Abortion Clinics). Licensure, monitoring and oversight HB 47 – DHSS Authority to Investigate and Inspect (Abortion Clinics) SB 90 – Accreditation for Medical Facilities Performing Invasive Procedures. (Abortion Clinics)

9 Other Legislation… HB 165 – Duty to Report Physician Privileges – Only adverse events HJR 7 – Study Group Child Mental Health Needs Downstate SB 137 – Health Insurance Charges for Different Classifications of Prescription Drugs – Health Care Commission to study the issue of specialty tier prescription drugs HB 95 – Motorcycle Helmets – Eliminates the requirement that those over age 19 must have a helmet on their bike HB 155 – Nursing Licensure – allows renewals up to 60 days past renewal period

10 Other Legislation SB 84 – Cardiovascular Disease and Stroke Prevention Program Established SB 108 – Prohibition on “Over-the-Line” Worker’s Compensation Facilities HB 3 – Limit on Trans Fatty Acids in School Meals

11 Worker’s Compensation Law Passed 2007  Difficult to Implement for Hospitals  HCAP Draft Solution  80% of Charge Reimbursement (Except Drugs/Supplies) Adjusted Annually…..  Blended Rate for All Hospitals  Compared to Medical CPI  Drugs and Supplies – Consistent Mark-up Methodology

12 Health Resources Board Health South Application Process Reverberates Governor, Members of General Assembly have Questioned Certificate of Public Review Process Is it Anti-Competitive and Drive Up Costs? Should Economic Development Be a Factor? HRB Places on Sun-Set Review

13 And Then There Is Medicaid…. Governor’s Plan -- $ 5 Million Cut by ($12 Million w/Fed $)  No Reimbursement for more than 3 Non-Urgent ED Visits  Non-Urgent ED Visits Reimbursed at 25% of Urgent Rate  Caps on Reimbursement for Outpatient  Caps on Reimbursement for Rehab

14 Medicaid…. Governor’s Plan -- $ 5 Million Cut by ($12 Million w/Fed $) Problems  Codes Not Properly Assigned  Urgency Determined on Diagnosis Not Presentation  Counter to Public Health Message to “Call 911 if Emergency”  We Don’t Have A Choice - EMTALA

15 Medicaid…. Governor’s Plan -- $ 5 Million Cut by ($12 Million w/Fed $)  Joint Finance Committee Turned Away Cut  We Advocated for a Task Force (Section 156 Task Force) to Work On Medicaid Savings  Senator Harris McDowell Legislated to Use Medical Care Advisory Committee to Explore “Health Care Savings and Reform”

16 Medicaid…. Governor’s Plan -- $ 5 Million Cut by ($12 Million w/Fed $) Section 156 Task Force  A Health Provider Presence  Report Due by December 1 st  Goal of $5 Million State Budget Savings  Looking at Alternatives  Christian’s “High Flyer” Pilot Expansion

17 Future of Nursing DHA – DNA Joined Campaign For Action Coalition  DHA Supports Nurse Advancement Opportunities  DHA Supports Practicum Opportunities  DHA Supports Nurses Being Included In Reform Discussions (Of Course Hospitals Haven’t Been Included In Reform Discussions, Either!)


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