IHA Daily Briefing: Nov. 22

Friday, November 22, 2019
IHA Issues Price Transparency Memo
Recommended Action for 340B Hospitals
Another Vaping-Related Death in Illinois
Cook County Board Approves Budget
Briefly Noted

IHA Issues Price Transparency Memo
Yesterday, IHA made available to its member hospital CEOs, CFOs, and other finance staff, a summary of the Centers for Medicare & Medicaid Services’ (CMS') final hospital price transparency rule. All hospitals operating in the U.S. are required to make standard charges (newly defined by the agency to include negotiated rates) publicly available for all items, services and service packages provided to patients. Hospitals must also make standard charges for 300 shoppable services publicly available in a consumer-friendly format. Hospitals that are discovered to be out of compliance with these requirements are subject to a civil monetary penalty of up to $300 per day.

AHA will take legal action in an attempt to prevent CMS from implementing these requirements, which are effective Jan. 1, 2021.


Recommended Action for 340B Hospitals
On Nov. 21, IHA provided 340B drug pricing program member hospitals and health systems with guidance regarding ongoing Medicare reimbursement cuts for 340B-acquired drugs and the American Hospital Association’s (AHA) lawsuit challenging this payment policy. AHA advises 340B providers to preserve their right to an administrative appeal by notifying their Medicare Administrative Contractor (MAC) of their intent to appeal each current and future claim involving 340B drugs reimbursed at any level below the statutorily prescribed rate from Jan. 1, 2018 through final adjudication and 340B payment litigation.

Along with the memo, IHA provided a template letter for hospitals and health systems to send to their MAC. Participating member hospitals are advised to send this letter to the MAC’s Audit and Reimbursement department, and the MAC’s Appeals department.


Another Vaping-Related Death in Illinois
The Illinois Dept. of Public Health (IDPH) announced yesterday that a fifth Illinois resident has died due to lung injury associated with the use of e-cigarette or vaping products (EVALI). IDPH says a total of 187 people in Illinois, ranging in age from 13 to 75 years old, with a median age of 22, have experienced lung injuries after using e-cigarettes or vaping.  Another 40 possible cases in Illinois are under investigation. Statewide, 32 counties have reported cases. As of Nov. 20, there were 2,290 EVALI cases nationally with 47 confirmed deaths.  

"Although this resident who recently died had been hospitalized for several weeks, we continue to see new cases reported with recent onset of lung injury," said IDPH Director Dr. Ngozi Ezike.  "I cannot stress enough the severity of these illnesses and the need for people not to use e-cigarette or vaping products that contain THC while this investigation is ongoing, especially those obtained through illicit or unregulated sources."

On Tuesday, the Centers for Disease Control and Prevention (CDC) released updated guidance for healthcare providers to help diagnose and treat patients with EVALI. This updated guidance, published in its Morbidity and Mortality Weekly Report, comes as the 2019-2020 influenza season approaches, when many patients may show up in outpatient clinics or hospitals with symptoms of respiratory illness. This new guidance is an update to the clinical guidance CDC previously released in October 2019.

A variety of e-cigarette and vaping education resources are available on the Illinois Poison Center (IPC) website. A Cannabis: Vaping 101 blog by IPC Medical Director Mike Wahl, M.D., dives into the various ways cannabis can be used and potential health issues related to its consumption.


Cook County Board Approves Budget
The Cook County Board of Commissioners approved a balanced $6.2 billion fiscal year 2020 budget yesterday aimed at advancing Cook County Board President Toni Preckwinkle’s work on criminal justice reform, public health, infrastructure and economic development without the need to increase existing taxes. The budget approval follows a month of departmental hearings, commissioner questions and public meetings.

“Approving a balanced and equitable budget is one of our most important duties,” President Preckwinkle said. “This budget is building on our continuing dedication to providing essential services while being fiscally responsible all without the need to increase existing taxes.”

The $6.2 billion budget is said to further the Cook County Policy Roadmap: A Five-Year Strategic Plan unveiled last year. Under the Roadmap, Cook County is promoting fiscal responsibility; advancing reforms in the criminal justice arena; ensuring residents have access to quality healthcare; protecting the environment; connecting people through transit and public infrastructure; and serving as a regional leader in growing the economy.

Complete details on the Cook County budget is available here.


Briefly Noted
President Trump averted a government shutdown last night by signing H.R 3055, a continuing resolution passed by Congress, to fund the government through Dec. 20. The measure also includes short-term extensions of important healthcare programs including a delay in cuts to the Medicare Disproportionate Share Hospital program.