Smart Brevity^® count: 6.5 mins...1731 words

In this issue, read about:

• A hiatus at the Arizona Capitol.
• AzHHA comments on the 340B program.
• AzHHA Quality Awards.

This week, as we reach day 88 of the legislative session, there hasn't been much activity from either the Senate or the House, amid speculation that a recess might be forthcoming.

• Meanwhile, the Governor has been busy, signing a significant number of bills into law, bringing the total to 80.
• Additionally, the Governor has vetoed 18 bills as of Wednesday afternoon.
• Among the legislation that has been enacted, some of the bills may be recognizable to you.

HB2093 emergency services; prudent layperson; definition

• Adds language to the definition of emergency services that allows a prudent layperson with standard medical knowledge to attest to the medical condition and symptoms of a person suffering from a medical condition warranting emergency intervention.

HB2113 medical assistants; scope of practice

• Expands scope of practice for medical assistants to allow them to relay documented information to the patient. It also allows the medical assistant to process and communicate medication or procedure prior authorization as documented and ordered by the provider.

What's next: The progress of HB2035, a bill focused on health insurance accountability, is on hold as it awaits inclusion on the Senate Rules Committee's agenda.

• This delay was expected, given the initial financial assessment, suggesting the bill could incur costs up to $2.9 million.
• The latest updates indicate that this financial estimate is being reviewed again.
• The goal is to potentially lower the projected cost and more accurately determine the necessity for any full-time employees (FTEs) as mentioned in the original assessment.

Lastly: The revolving door of House Democrats continues to move as the Maricopa County Board of Supervisors (BOS) appointed Deborah Nardozzi to fill the seat in LD8 vacated by Jevin Hodge. Hodge was previously appointed by the BOS to replace Athena Salman earlier this year, but then he resigned last month.

The Centers for Medicare & Medicaid Services (CMS) issued proposed rules last week for the inpatient rehabilitation facility (IRF) prospective payment system (PPS) and inpatient psychiatric facility (IPF) PPS for fiscal year (FY) 2025.

The proposed IRF PPS rule would increase payments by 2.8% relative to FY 2024, which includes a market basket update of 3.2% less a productivity factor cut of 0.4%.

• Payments would be further reduced by a proposed update to outlier payments.
• While CMS does not propose to adopt, modify or remove any quality measurements, hospitals would be required to report social determinants of health items on housing stability, food security and utilities.

The proposed IPF PPS rule would increase payments by 2.6% relative to FY 2024. CMS also proposes adopting a new quality measure on all-cause emergency department visits following discharge and to submit quarterly quality data as opposed to annual data.

What’s next: AzHHA members should be on the lookout for a more detailed analysis of the proposed rule in the coming days, including facility-specific estimated impacts.

• Hospitals may report feedback on the proposed rules to AzHHA’s Director of Financial Policy and Reimbursement Amy Upston.
• CMS is accepting comments on the rules until Tuesday, May 28, 2024.

On Thursday, March 28, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for fiscal year 2025 for the skilled nursing facility (SNF) prospective payment system, which would increase aggregate Medicare spending by 4.1% or $1.3 billion compared with FY 2024.

CMS proposes to revise regulations regarding its nursing home enforcement authority to allow the agency to impose additional financial penalties on facilities where health and safety deficiencies are identified.

While CMS does not propose to adopt or remove any quality measures from the SNF Quality Reporting Program (QRP), the agency proposes to adopt and modify certain patient assessment items related to health-related social needs; SNFs would be required to collect and report specific data elements related to living situation, food and utilities beginning with the FY 2027 SNF QRP. CMS also proposes to adopt a data validation process for the SNF QRP beginning the same year.

What's next: CMS proposes a number of operational updates to the SNF Value-based Purchasing program, including policies regarding measure removal and review and corrections. The agency also proposes an update to the case mix methodology used to calculate the total nurse staffing measure.

• CMS will accept public comments on the proposed rule through Tuesday, May 28, 2024.

What’s new: On Monday, April 1, 2024, AzHHA submitted a comment letter to the “Gang of Six” Senators in response to a Request for Information on Supporting Underserved and Strengthening Transparency, Accountability and Integrity Now and for the Future of (SUSTAIN) 340B Act and the critical importance of the 340B Drug Pricing Program.

What they're saying: AzHHA reiterated the critical importance of the program. By allowing certain hospitals to achieve savings through purchasing certain outpatient drugs at a discount, it enables them to provide a range of programs and services that benefit their patients. Some key highlights include:

• Supporting efforts to recognize contract pharmacies as an integral part of the 340B program and prohibit drug companies from restricting access to 340B drugs through contract pharmacies;
• Specifying that AzHHA believes that existing HRSA guidance is sufficient in defining a 340B patient and does not see the need to legislate this issue;
• Stating that there is no factual or policy justification to create additional restrictions on the use of child sites. Those restrictions would reduce access to care and diminish the value of the 340B program to patients; and
• Expressing support of the draft bill’s efforts to prohibit PBMs and insurers from engaging in discriminatory pricing and patient steering tactics.

Health disparities: Rural areas in Arizona face unique healthcare challenges, including limited access to services and higher rates of chronic conditions.

Importance of health equity: Ensuring all Arizonans, regardless of their zip code, have access to quality healthcare.

Focused strategies: Through our Health Equity Organizational Assessment Collaborative, hospitals and rural health clinics are tailoring health initiatives to meet the specific needs of their communities.

Community engagement: Involving local leaders and residents in healthcare planning and decision-making.

• Actionable takeaway: Prioritizing health equity in rural Arizona can lead to more inclusive and effective healthcare solutions.
• Check out the health equity map we created in collaboration with the Arizona Department of Health Services here.
• If your hospital is an AzHHA member and has created a program or other community partnership to improve healthcare in your area, consider applying for our 2024 Quality Awards!

Applications for the 2024 AzHHA Quality Awards are now open!

Why it matters: These awards celebrate and recognize Arizona’s leaders committed to advancing healthcare with exceptional quality performance, community engagement and a culture of continuous improvement.

• NEW this year: Awards will be presented for Maternal Health Innovation.
• The outstanding achievements will be honored at the AzHHA Quality Awards Luncheon on Wednesday, Oct. 16, 2024 during the 2024 Arizona Hospital Leadership Conference.

The big picture: Applicants must be able to highlight a recent project, within the last 12 months, in:

• 🏥Patient Safety and Quality
• 📢Community Engagement
• 🤰Maternal Health Innovation

Ready to apply? Read the application instructions and complete the Applicant Information form to get started.

The deadline for submissions is 5 p.m. on Friday, May 31, 2024.

AzHHA’s affiliated partner and endorsed vendor, careLearning, offers a dynamic learning management system with affordable pricing specific to healthcare facilities.

• An informational webinar at 11 a.m. on Wednesday, April 17, 2024 will help your hospital or healthcare facility organize and manage your education program.
• Attendees will learn how to maximize course offerings in a cost- and resource-effective manner.
• This webinar is targeted at staff educators, human resources, nursing executives or managers, and compliance officers.
• To participate in this webinar, register here, after which you will receive an email with the Zoom link.Questions can be directed to [email protected].

The deadline for the second Arizona Transition to Practice Program for New Graduate Registered Nurses cohort beginning in June 2024 is fast approaching!

What's next: · Applications are due Friday, April 12, 2024.

• Already applied? The Arizona Transition to Practice Program team will contact you soon.

Why it matters: With this program, we aspire to create an environment where our nurses can transition seamlessly from academia to practice, gaining confidence and competence they need to provide the best possible quality care to our communities.

The big picture:

• Any Arizona healthcare facility licensed by the Arizona Department of Health Services that hires new graduate registered nurses can apply.
• Priority will be given to critical access hospitals or hospitals located in counties with a population of less than 500,000 people.
• Hospitals with existing 12-month Transition to Practice programs are not eligible.

Questions? Email [email protected].