President’s ReportWashington UpdateNurse Licensure Compact UpdatePhysician RecruitmentNDHA Convention Hotel RoomsNDHA Education UpdateCMS Finalizes 2018 Payment & Policy Updates for Medicare Hospital AdmissionsState Cardiac and Stroke ConferenceNDHA Convention SponsorsND Behavior Locator

Click on link to view attachments:https://www.ndha.org/resources/publications/

CMS Press ReleaseState Cardiac & Stroke Conference

Phone: 701-224-9732Fax: 701-224-9529Web Site: www.ndha.org

Jerry Jurena, PresidentTim Blasl, Vice PresidentCallen Cermak, Finance ManagerLori Schmautz, Executive AssistantPam Cook, Education DirectorMelissa Hauer, General Counsel

A portion of this publication is supported by The Center for Rural Health’s Medicare Rural Hospital Flexibility Program. Visit their site at http://rural-health.und.edu/projects/flex/.

The Informer

In This Edition:

Attachments:

NDHA Contacts

August 3, 2017

President’s Report ~ Jerry Jurena

Interim Committees: Many of the Interim Committees have had their first meet-ing. The following interim committees met this week: Health Services Committe, chaired by Senator Judy Lee, Human Services Committee, chaired by Representative Kathy Hogan, and the Health Care Reform Review Committee, chaired by Representa-tive George Kaiser.

The list of Interim Committees we are following/tracking are:

1. Administrative Rules 2. Health Care Reform Review 3. Health Services Committee 4. Higher Education 5. Human Services 6. Government Administration 7. Government Finance 8. Incarceration Issues 9. Information Technology 10. Judiciary 11. Justice Reinvestment Committee 12. Legislative Revenue Advisory Committee 13. Taxation 14. Tribal Taxation

Health Care Reform: Hopefully you have all been reading updates from John Flink and AHA on the rollercoaster of events regarding the repeal and replace or just plain repeal of the ACA. Right now the Senate is taking a step back and reassessing their next move. The discussion on ACA is not over and I am sure we will hear something again this fall from the Senate. Stay tuned.

AHA Summit Conference: Last week AHA hosted its Leadership Conference with over 1600 people in attendance. The first two days were devoted to Quality. AHA’s HRET put on a great conference with plenty of education and sharing focusing on the HIIN criteria. I heard from many people saying the two days devoted to quality were the best sessions they had been to on quality. The last three days were a mix of state of the art health care education and almost hourly updates from Rick Pollack and Tom Nickels regarding the discussions and the vote in D.C. on the Senate bill to repeal ACA.

AHA did a great job, the education was timely and there was plenty of time each day for networking.

Tuesday September 26, 2017Bismarck Event CenterBismarck, North Dakota

More details to follow

Governor Doug Burgum and

First Lady Kathryn Helgaas Burguminvite you to

reinventedrecovery

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After a tumultuous seven-week debate over the future of the Affordable Care Act, the Senate yesterday quietly adjourned for its August recess. The Senate’s rejection last week of three proposals to repeal and partially replace the 2010 health law has ended the health care debate for now, and Senate GOP leaders have made clear – despite protests from the White House – that they want to move on to other issues, especially tax reform.

But plenty of health care activity still awaits lawmakers when they return after Labor Day. The Senate Health Education Labor and Pensions Committee has announced hearings in early September on proposals to stabilize the individual insurance market. They want to produce a bill by mid-September, about the time insurers must commit to offering plans in the 2018 insurance exchange.

Meanwhile, two Republican Senators – Lindsay Graham (SC) and Bill Cassidy (LA) – are trying to build momentum for a scheme that would pool the federal money spent for Medicaid expansion, premium subsidies and subsidies for low-income people under the ACA and distribute it as block grants to states to use for health care.

And the Senate Finance Committee reportedly plans hearings on funding for the Children’s Health Insurance Program (CHIP), which is due to expire sometime during the fall.

In the House, a bipartisan group of 40 House members this week released a plan that includes proposals for market stabi-lization, but no hearings are planned to discuss this or other proposals.

The most important of the market stabilization proposals under discussion is full funding for the cost-sharing reductions (CSR) that help offset low-income ACA enrollees’ co-payments and deductibles. The Trump administration has been making these payments on a month-by-month basis and threatened to stop doing so after the Senate’s failure to pass repeal and re-place legislation. Insurers have said failure to continue making these payments would force dramatic premium increases and cause some insurers to leave the individual market.

Lawmakers are also considering establishing a reinsurance mechanism to help offset insurers’ bills for high-cost medical treatment and allowing individuals in counties in which no insurer is offering a plan on the exchange to purchase coverage through the Washington, D.C. exchange.

The outlook for these proposals is uncertain. The congressional agenda is jam-packed in September with action needed on a 2018 budget, 2018 government funding levels, an increase in the borrowing limit and funding for CHIP. All of this will probably crowd out significant action on new repeal and replace proposals, but that doesn’t mean the issue will disappear.Finally, a couple of regulatory notes…the final inpatient PPS rule, released this week, would make review of CAH length-of-stay issues a low-audit priority. While this does not solve the underlying statutory conflict between the CAH conditions of participation – an average annual LOS of 96 hours – and the conditions of payment – 96 hours LOS for every episode of care – it does provide immediate relief for CAHs.

Also, the proposed outpatient PPS rule would make three very significant changes for hospitals:

• CMS proposes to pay for drugs available through the 340B program at the average sales price (ASP) minus 22.5 percent, rather than the current rate of ASP plus 6 percent. • CMS proposes significant reductions to the site neutral payment rates in the physician fee schedule. • CMS proposes to extend the moratorium on enforcement of the outpatient therapeutic services supervision rule to CY 2018 and 2019. CAHs and small rural hospitals (100 beds) would be affected.

AHA special bulletins provide additional details on both of these rules.

Enjoy the rest of August…

Washington Update ~ John Flink

The enhanced Nurse Licensure Compact (NLC) has officially been enacted in 26 states and will be implemented in January 2018. The new compact will include a few new states not part of the original, including WY, GA, OK, and FL. However, CO, RI, WI, and NM have not yet passed and these states were in the original. See link below for press release,

http://mailchi.mp/ncsbn/enhanced-nurse-licensure-compact-enlc-enactment-a-modern-nurse-licensure-solution-for-the-21st-century?e=daea2e51c5

Nurse Licensure Compact Update

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Physician Recruitment ~ Kevin MaleeAAFP National Resident & Medical Students Meeting in Kansas City, MO

Last week the American Academy of Family Practice National Resident & Medical Student Meeting held their Annual event in Kansas City, MO. Over 2500 Family Medicine residents, medical students, faculty & Program Directors attended the event. This annual event gathers Family Practice program residents and interested medical students from throughout the USA to provide educational, and leadership opportunities in their specialty. As well, residents have an opportunity to network among their peers and pursue many practice opportunities in the exhibit hall. These connections and networking opportunities are invalu-able to the residents as they ready themselves to begin their careers.

I visited with residents who will be looking for practice opportunities in the future. I also visited with several faculty and Program Directors in the Midwest. Every Family Medicine Training Program in the country is represented at this annual meet-ing. These kinds of events are paramount in providing information to future practicing physicians and attracting them to North Dakota, where our life style and quality of life issues are abundant.

If I can assist you in your physician recruitment efforts, please contact me at northdakotarec@comcast.net or 701-320-2109.

NDHA Convention Hotel Rooms NDHA’s Annual Convention is scheduled for October 3-5, 2017 at the Hilton Garden Inn in Fargo. NDHA has negotiated some room rates at surrounding hotels as well as the Hilton Garden Inn where the convention is being held. If you will be attending HSI Solution’s Update Conference as well (October 2-3), these are the same rates and room blocks under NDHA.

Hotel Phone Room Rate Room Block Release DateHilton Garden Inn 701-499-6001 $144 + tax per night September 11, 2017

Expressway Suites 877-239-4303 $65.95 + tax per night Available up until week of convention(Next door to Hilton)

Delta Hotels Fargo 701-277-9000 $92 + tax per night September 10, 2017(Formerly Ramada Plaza Suites)

Below is a listing of webinars that may be of interest to you. Registration fees for webinars are $175/NDHA member, and $300/non-member. This fee is “per facility” and you can have as many staff sit in on one connection as you’d like. If a webinar is co-sponsored by either ND HFMA or ND HRMS, individuals who are members of those groups can register at the member rate. Their logo will appear on the flyer if it is co-sponsored by either group. All times listed below are central time.

Follow this link to register! https://www.ndha.org/education/education-events/

NDHA Education Update

August 2017CMS, Joint Commission, DNV & Other Standards on Informed ConsentDate: 08/08/2017 From 9:30 AM - 10:30 AM

The Changing Landscape of Pharmacy Technician Training & Certification Requirements – Are You Ready?Date: 08/17/2017 From: 11:00 AM to 12:00 PM

Email Fail - Strategies for Reducing Risks from Electronic Communication in Litigation & Gov’t InvestigationsDate: 08/29/2017 From 9:30 AM - 10:30 AM

Conducting Emotionally Difficult ConversationsDate: 08/31/2017 From 9:30 AM - 10:30 AM

The final rule supports transparency, flexibility, program simplification and innovation in the Medicare program. Read the CMS Press Release in this week’s attachments.

CMS Finalizes 2018 Payment and Policy Updates for Medicare Hospital Admissions

NDHA Convention SponsorsNDHA would like to recognize and thank the following sponsors of the 2017 NDHA Annual Convention & Trade Show:

Diamond Level Gold Level Bronze LevelBronze Level

Bronze Level

Bronze Level Bronze LevelBronze Level

Lunch SponsorBronze Level

Attached you will find the 2017 State Stroke and Cardiac System brochure. The event is free this year, but attendees must register at https://www.surveymonkey.com/r/2HHXN6N before September 17, 2017. There is a block of rooms that attendees can reserve at the conference rate. The room block name is ND Dept of Health and rooms will be held until 8/24/2017. If you have any questions, please contact Shila Thorson at 701-328-4569 or smthorson@nd.gov.

State Cardiac and Stroke Conference

Bronze Level

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North Dakota Behavior Health Locator The purpose of the Behavioral Health Locator is to assist practitioners in making appropriate referrals for behavioral health services. Secondarily the locator will be used to identify service and workforce shortages in various geographic areas.

www.locator.fyi Based on preliminary research there are more than 3000 licensed behavioral health professionals working in the state and an untold number of behavioral health provider organizations. The Locator encompasses all behavioral health professions including counselors, addiction professionals, social workers, psychologists and psychiatrists. This list is not meant to be exclu-sive, any provider/practitioner providing a mental health or substance abuse service can be included.

If a licensed practitioner is not in private practice the provider agency must enter its information first and then invite its practitioners to be listed. A provider agency can enter its information in less than 10 minutes and a practitioner in only a few minutes. In most cases, agencies are cutting and pasting information from existing documents with minor editing.

Additional information about the locator:

• Funded by Heartview along with start-up support for programming from several federally funded projects operated by Heartview. • The first project to include both public and private providers and practitioners. • Contains information essential to making referrals for behavioral health services. • An automated system where providers and practitioners enter and update their information electronically with a secure password and username. • Free to anyone with access to the Internet. • Printable and searchable by provider and practitioner, service or specialty, and geographic area. • A starting point for researching behavioral health service shortages and needs on a statewide or other geographic area {county, region, reservation}