CEO Update 202
Please Submit Your Updated Member Information Today, Friday Sept. 27!
NABH is developing its online-only 2024 Membership Directory, an essential member benefit that helps the association in its advocacy efforts.
Last month NABH e-mailed system members a link to the association’s membership-update tool. To help ensure we have the most accurate information on our members, please use that link to our membership-update tool and verify your system’s information.
The answers to these questions will help us provide a more accurate description of our diverse membership to policymakers, regulators, partner organizations, and the media. Please be sure to enter information for all of your system’s facilities so that we have a better picture of our membership.
We extended the deadline for members to submit changes to today, Friday, Sept. 27. If you need assistance, please contact Maria Merlie maria@nabh.org or 202-393-6700, ext. 104.
As always, thank you for your time and for all you do to advance NABH’s Mission and Vision!
FDA Approves First New Schizophrenia Drug in Decades
The U.S. Food and Drug Administration (FDA) on Thursday approved Cobenfy (xanomeline and trospium chloride) capsules for oral use to treat schizophrenia in adults. According to the FDA, it is the first antipsychotic drug approved to treat schizophrenia that targets cholinergic receptors as opposed to dopamine receptors that has long been the standard of care.
“Schizophrenia is a leading cause of disability worldwide. It is a severe, chronic mental illness that is often damaging to a person’s quality of life,” Tiffany Farchione, M.D., director of the Division of Psychiatry, Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research, said in the agency’s announcement. “This drug takes the first new approach to schizophrenia treatment in decades. This approval offers a new alternative to the antipsychotic medications people with schizophrenia have previously been prescribed.”
House and Senate Clear Short-term Spending Bill, Delaying Funding Fights to December
The House and Senate on Wednesday night approved a bill to avert a government shutdown, pushing numerous tough spending fights past the November elections to the end of the year.
The legislation leaves federal agencies with static budgets through Dec. 20 and will now move to the White House for President Biden’s signature before the Sept. 30 shutdown deadline.
The three-month stopgap legislation sets the stage for another shutdown showdown in December, during the congressional “lame-duck” period, when lawmakers will have to piece together a spending bill to keep the government funded past the new deadline.
House Speaker Mike Johnson (R-La.) has vowed that the House will not approve a sprawling omnibus bill to avert a December shutdown, although he acknowledged that will be a difficult goal to achieve as the House has passed only five of 12 spending bills, while the Senate Appropriations Committee reached bipartisan agreements on 11 of the 12 appropriations bills—none of which made it to the Senate floor.
The two chambers are currently nearly $90 billion apart on overall discretionary spending, and that was before the Biden administration identified a $12 billion veterans’ healthcare shortfall. The success of a year-end spending bill and any additional year-end legislative priorities will also hinge on the November elections and which party wins control of the House, Senate, and White House.
Update: FY 2025 IPF PPS Rule’s Provision on All-Inclusive Reporting
After the Centers for Medicare & Medicaid Services (CMS) released its FY 2025 IPF PPS final rule, NABH has communicated with CMS staff to discuss the rule’s provisions related to all-inclusive reporting on cost reports.
Under the rule, inpatient psychiatric hospitals that are not tribally or federally owned must bridge from all-inclusive reporting to include ancillary charges – especially laboratory and pharmacy charges – on cost reports, including for claims from private payers. This shift is to be implemented by the cost reporting period beginning on or after Oct. 1, 2024.
As the final rule lacked full details on the agency’s expectations and protocols for how providers and their Medicare administrative contractors (MAC) should implement this change, NABH has recommended to CMS a bridging methodology that recognizes that every all-inclusive hospital will not be in full compliance with this shift for their entire next cost-reporting period. CMS understands this reality and this week the agency reported it has several forms of guidance in process, including instructions for both providers and MACs.
NABH is waiting for CMS’ final position on the matter; however, it appears the agency will grant some flexibility to hospitals facing challenges implementing a new charges reporting system. NABH will keep members posted as soon as we learn more about such flexibilities.
Sens. Wyden and Warner Introduce Bill to Enforce Minimum Healthcare Cybersecurity Standards
Senate Finance Committee Chairman Ron Wyden (D-Ore.) and Senate Intelligence Committee Chairman Mark Warner (D-Va.) on Thursday unveiled legislation that would require HHS to enforce minimum cybersecurity standards in the healthcare sector.
According to the bill’s sponsors, the legislation is in response to a surge in cybersecurity attacks that threatened patients’ privacy and lives as well as healthcare providers’ bottom lines. In 2023, 725 data breaches that affected more than 120 million Americans were reported. HHS has not conducted a cybersecurity audit since 2017 and has not issued updated regulations under the HIPAA Security Rule since 2013.
If adopted, the legislation would modify HIPAA requirements by mandating HHS adopt minimum cybersecurity standards for HIPAA-covered entities such as providers, insurers, and their business associates within two years. HHS would also be required to update those standards every two years. Meanwhile, covered entities and business associates would have to conduct a security risk analysis, craft plans to resolve cyber incidents, and conduct stress tests.
The legislation would create fines for violators, rising from $500 for violators with no “knowledge” and up to $250,000 for violators with “willful neglect” that don’t make corrections. HHS may consider an entity’s size, history of compliance, and “good faith efforts to comply” with the requirements.
It would also offer $800 million for two years for 2,000 rural and urban safety net hospitals to prepare, as well as $500 million to encourage hospitals to adopt enhanced practices. The bill would also cement HHS’ authority to provide accelerated and advanced Medicare payments in the event of a cyberattack, such as the one that happened in the wake of the Change Healthcare cyberattack.
The outcome of the legislation is unknown at this point. Sens. Wyden and Warner would like to get the legislation into an end-of-year legislative package; however, Republican members have not expressed support for the legislation and the bill’s unknown cost could potentially be a barrier.
Click here for a one-page summary of the bill; here for a section-by-section summary; and here for the full legislative text.
Please Tell Us More About Your AI Use!
NABH continues to explore how our members use Artificial Intelligence (AI). Our AI survey earlier this year identified Care Quality, Business Operations, and Workforce Solutions as our members’ priority areas.
As follow-up to our first survey, we ask you to complete this brief follow-up survey to help us delve deeper into members’ AI practices, which will help refine our advocacy efforts on this important issue.
Please complete our survey by Monday, Oct. 7.
Register for Our November Webinar on Using Publicly Available Data in Health Plan Negotiations
Please join NABH for a webinar on Thursday, Nov. 14, 2024 to learn about using hospital data effectively in your negotiations with health plans.
The webinar will feature Erica K. Fox, M.B.A., vice president of business development and managed care contracting at Perimeter Healthcare. A member of NABH’s Managed Care Committee, Fox will review the use of publicly available data from hospitals, such as payer-specific negotiated rates and standard charges for all payers and plans, to negotiate contracts with health plans.
Fox has more than 25 years of senior leadership experience in the behavioral health sector. Prior to her current role, she served as the business development director at Peachford Hospital, a Universal Health Services facility. Fox earned her undergraduate degree from Michigan State University, where she received a dual degree in Communications and Spanish. She later earned a master’s degree in healthcare administration from Loyola University Chicago.
Register here for this hourlong webinar that will begin at 1 p.m. on Nov. 14.
Please Submit Data to NABH’s Denial-of-Care Portal
We urge all NABH members to join those already submitting data to our Denial-of-Care Portal.
We are beginning to use aggregated portal data to illustrate and compare prior authorization practices for commercial, Medicare Advantage, and Medicaid managed care denials.
Policymakers have expressed particular interest in our aggregate estimate on days of uncompensated charity care, as well as the length of delayed health plan responses to prior-authorization requests.
To support this advocacy push, we strongly encourage all NABH members to submit data to the portal. Please contact NABH Associate Manager for Congressional Affair Emily Wilkins with questions about the data metrics that we are collecting and/or the data-submission process.
Fact of the Week
National surveys from the Centers for Disease Control and Prevention show an unprecedented decline in drug deaths of roughly 10.6%. Nabarun Dasgupta, Ph.D., M.P.H., a researcher at the University of North Carolina and an expert on street drugs, said he expects the data will show an even larger decline in drug deaths when federal surveys are updated to reflect improvements being seen at the state level, especially in the eastern United States. “In the states that have the most rapid data collection systems, we’re seeing declines of twenty percent, thirty percent,” Dasgupta told NPR.
For questions or comments about this CEO Update, please contact Jessica Zigmond.