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Kentucky Chapter HFMA Winter Institute Stephen P. Miller Kentucky Hospital Association January 24, 2013
FEDERAL ISSUES Fiscal Cliff Fix American Taxpayer Relief Act (ATRA) Permanently extends middle class tax cuts Postpones sequester for two months One year “doc fix” - $30 billion
FEDERAL ISSUES (cont’d) Doc Fix – Hospitals Cover the Cost $10.5B downward adjustment in annual update $4.2B additional Medicaid DSH reductions $4.9B end stage renal payments $2.0B reduce risk-adjusted payment for Medicare Advantage
FEDERAL ISSUES (cont’d) These cuts are “in addition” to: Cuts contained in ACA $11B Medicare cuts in sequestration $5.8B From Hospital 2% Reduction Ky. Approx. $100M Includes CAHs
FEDERAL ISSUES (cont’d) New Fiscal Cliff Sequestration – Hospital Payments April 1 Debt Ceiling – Possible Three-month Delay Continuing Resolution or Budget
FEDERAL ISSUES (cont’d) Reimbursement areas that survived ATRA E&M Codes CAHs Bad Debts GME Likely targets for future “savings”
FEDERAL ISSUES (cont’d) Wage Index HHA Secretary proposed changes in April 2012 Report – Required by ACA CMS, Congress and MedPAC want to change methodology – No Agreement
FEDERAL ISSUES (cont’d) Wage Index (cont’d) Massachusetts “windfall” has increased scrutiny Cape Cod Hospital Reclass from CAH to PPS Impact on Rural Floor+$200M to MA - $13M for KY
STATE ISSUES MCOs and MCOs 2013 Legislative Session - Legislators must hear from YOU about YOUR hospital problems – Personal - Hospital Employees and Trustees - Nitty Gritty Examples
STATE ISSUES (cont’d) Issues – ER Assessment Fee Network Adequacy after Terminations Claims Denials Prompt Pay Substantial Increase in A/R Payments to PCC – Not hearing from hospitals
STATE ISSUES (cont’d) Survey sent to every CEO and CFO Account Receivables Medicaid Admissions, Denials and Re-admits Change in PCC Payments
STATE ISSUES (cont’d) Need data to counter Cabinet’s position that increase in A/R is due to hospitals not filing “clean claims” Survey will continue quarterly
STATE ISSUES (cont’d) Other Issues Medicaid Expansion45% Increase Exchanges Medicaid DSH – 50% less funding Revamp State Methodology
W. Thomas Deweese, FACHE Regional Executive American Hospital Association Center for Rural Health Annual Summer Meeting August 7- 9, 2013.
June 5, 2013 MS Healthcare Executives Summer Meeting Sustaining a Financially Vibrant Healthcare Organization.
Health Care Reform Update – The 28% Factor W. Stephen Love President and Chief Executive Officer Dallas-Fort Worth Hospital Council November 14, 2013.
HFMA February 18, Today’s Update What’s Happening in Western Pennsylvania -Highlights from Hospital Council’s Flash Survey State Budget Update Healthy.
Presented by: Ted Shaw THA president/CEO 2015 – A Conservative Year September 23, 2014 Texas Association for Healthcare Financial Administrators Fort Worth,
State of the Union: Medicare AEI on the Hill January 25, 2012 Joseph R. Antos, Ph.D. Wilson H. Taylor Scholar in Health Care and Retirement Policy and.
Health Care Policy: What You Should Know American Nephrology Nurses Association (ANNA) Long Island Chapter, Fall Conference November 13, 2013 Carle Place,
Rural Health Advocacy Missouri Rural Health Conference November 18, 2015 Tim Wolters, Director of Reimbursement Citizens Memorial Hospital, Bolivar Lake.
Mike Lane Director, Health Care Finance Policy The Hospital & Healthsystem Association of Pennsylvania State & Federal Legislative Update Keystone AAHAM.
The Politics of Health Care: State and Federal Policy Priorities for Advocate Health Care Meghan Clune Woltman, Vice President, Government and Community.
Understanding Charity Care/Bad Debt for Hospitals in South Dakota Dave Hewett, President/CEO South Dakota Association of Healthcare Organizations Medicaid.
Idaho Hospital Association 2013 Economic Outlook & Revenue Assessment Committee 1.
Can America Govern Itself? Deficits, Debt, and Delay Ron Haskins Senior Fellow, The Brookings Institution Senior Consultant, The Annie E. Casey Foundation.
Camila Knowles Friday, May 3, 2013 Washington Update Georgia Academy of Healthcare Attorneys.
FY 2008 Medicaid Budget Update Medicaid Advisory Committee Meeting April 26, 2007.
AHA Advocacy Agenda Allied Hospital Associations’ Accounting & Financial Specialists (A 2 HA) 2013 Spring Meeting March 18, 2013.
Challenges Ahead for the ACA Mary Agnes Carey Senior Correspondent Kaiser Health News “From the White House to Community Clinics: What’s Next for Healthcare.
6/15/ Hospital Rate Setting Methods for State Fiscal Year 2011 June 15, 2010 Department of Health Services Division of Health Care Access and Accountability.
Lisa Kilawee 2016 NRHA President National Rural Health Association Rural Health Care and NRHA.
The Fiscal Cliff and Beyond Joel Packer, Principal, The Raben Group; and Executive Director, Committee for Education Funding.
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