Federal Update

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Federal Update June 2005
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Update

• Front Burner Legislative
• Policy IssuesIPPS Rehab
• Other Issues on your mind

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ISSUE MANAGEMENT

• Antitrust and Business Practices
• Retrospective reviews
• Insurance industry consolidation
• Group purchasing organizations
• BCC
• Billing
• Collections
• Charges
• Executive compensation
• Class action litigation
• Public Relations
• Membership education and tools
• Beyond current charges
• Studies
• Coverage
• HCCU
• CTUW III
• Association health plans
• Comprehensive approach (UHPP)

• Fraud and Abuse
• OIG pricing regulations
• Health Care Liability Reform
• Federal MICRA legislation
• Alternatives
• State action center
• Information Technology
• Interoperability standards
• MD integration
• Treatment of regional information networks
• Federal funding
• Mental health
• Medicare psychiatric PPS
• Coverage parity
• Payment
• Federal budget
• Budget resolution
• Reconciliation Medicaid modernization
• MD payment

• Quality and Patient Safety
• Patient safety legislation
• FCC medical telemetry
• 8th Scope of Work
• JCAHO legislation
• COP revisions
• Leadership Agenda
• Improvement Use of Evidenced-Based
  Medicine Practices Best Practices Clearinghouse
• Accountability Hospital Quality Alliance
  Governance Dashboard
• Coordination Organizational redesign/
  clinical micro-systems Chronic care
  coordination
• Racial and Ethnic Priorities
• Health Gap/Equality Legislation
• Data collection
• Membership tools/leadership forum
• Regulatory Relief
• HIPAA
• Model practices
• EMTALA
• ICD-10 approval

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Immediate Priorities

• Payment
• Medicaid
• Medicare
• Public accountability
• Quality and patient safety
• BCC
• Billing
• Charges
• Collections
• Executive compensation
• Tax-exempt status
• Liability reform
• Limited service providers
• Coverage

• Organizing Themes
• Protecting the safety net
• Increasing affordability and improving care
• Expanding coverage

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Budget Conference
Outcome

• Medicaid
• 10 billion over five years
• No cuts in first year
• Commission (presidential appointment)
• Short-term vs. long-term (15 voting 15
  non-voting 8 MOCs Ds may not play)
• Medicare
• 1 billion over five years from House Ways and
  Means Committee
• Deadline September 16

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Payment
Challenges

• Medicare exposure
• Medicaidholding hospitals harmless
• Rx reimbursement (5-6 billion)
• Physician payment

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State Association Steering Committee on Medicaid
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Coalition to Protect America's Health Care
COMMUNICATING ABOUT MEDICAID
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Limited Service Hospitals
Challenges

• Competition Argument
• House Leadershipother R (Barton/Coburn)
  Opposition
• Terry Cloth Robe Factor
• (Patients like LSHs)
• Payment refinements

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Special Coverage Project Project

• Advisory Group
• American Hospital Association
• Association of Health Insurance Plans
• U.S. Chamber of Commerce
• Families USA
• Federation of American Hospitals
• Heritage Foundation
• Health Leadership Council
• Service Employees International Union
• A Practical Plan for Expanding Health Care
  Coverage
• As Many People As PossibleAs QuicklyAs Possible

AARP AAFP AFL-CIO AMA ANA APHA BCBSACHA HR
Association Johnson Johnson Kaiser NGA NCSL Pfiz
er Project Hope
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