The U.S. Senate Bill and MNA Actions Spell Harm for Mass.

Mass. Stands to Lose Billions and Increase Uninsured Under BCRA

As Monday Report went to press, the U.S. Senate Republican leadership was reported to be putting its rewrite of its healthcare reform bill back on the fast track after the original version was derailed earlier this week due to opposition from both conservative and moderate members of the GOP.

Senate Majority Leader Mitch McConnell planned to get a rewrite to the Congressional Budget Office quickly so that CBO could “re-score” the bill to determine how the legislation would affect federal spending and insurance coverage levels in the future.

Earlier in the week, the rapid progress on the Senate bill hit a roadblock when some Republicans insisted that the scheduled vote be delayed until after the July 4 break. All Democrats oppose the GOP’s “Better Care Reconciliation Act” (BCRA).  President Trump held a meeting with Republican senators at the White House on Tuesday at which the Senate bill was debated.

MHA opposes the BCRA as it would result in the loss of federal funding to the state, increase the number of uninsured in Massachusetts, and ultimately result in higher healthcare costs due to the necessary rollback of existing state reform efforts that rely on state-federal partnerships.

Massachusetts’ Democratic  Senators Elizabeth Warren and Edward Markey have been staunch opponents of the GOP’s healthcare bill.  Markey has been especially vocal in detailing how the Senate bill’s cuts to Medicaid will have a direct effect on the national fight against the opioid epidemic.

“All the bipartisan progress we have made on combatting this crisis will be thrown out the window if Senate Republicans repeal and replace the Affordable Care Act with their cruel and inhumane and immoral legislation,” Markey said on Tuesday.  
Massachusetts Republican Governor Charlie Baker laid out his administration’s concerns with the BCRA in a letter he sent Monday to the state’s Congressional delegation.

Baker wrote that the Senate legislation would cut $600 million in health safety net funding to Massachusetts starting in 2020; eliminate federal funding for the state’s Medicaid’s expansion population; impose a “massive transfer of risk” to states through the bill’s Medicaid per capita plan; and, “with no justification, the Senate proposal shifts billions of dollars of federal matching funds from higher wage states to lower wage states, dramatically expanding the current spread between them, and creating an enormous budget shortfall for higher wage states like Massachusetts, and an enormous windfall for lower wage states.”

The Baker Administration estimates BCRA will result in the loss of coverage for 264,000 Massachusetts residents and the loss of $8.2 billion by 2025.

MNA Lays Bare Its Strategy: First Do Harm

The Massachusetts healthcare community – which has seen its share of spirited but civil debates – was taken aback last week when it was revealed that the Massachusetts Nurses Association (MNA) had sent out an e-mail directive to its members at Tufts Medical Center asking them to strike at a time that is “most harmful to the hospital.” The MNA and Tufts Medical Center have been embroiled in a contract dispute.

That the MNA would try to financially destabilize a hospital from which it is trying to extract more money as part of its negotiations was seen by many as irresponsible.  That the union’s leadership was putting itself before the hospital’s patients that could be harmed by a strike timed to be “most harmful” to TMC was unreasonable.

Boston Globe columnist Joan Vennochi wrote of the MNA’s e-mail missives and threatening Facebook postings, “That’s bitter union medicine, applied not to a factory making parts but to a hospital treating people,” adding, “Interrupting patient care is a risk that everyone, including the union, should work hard to avoid — stat.”

MHA, asked for comment on the MNA’s actions, said, “The MNA union leadership continues to take a hostile approach to interactions with the hospitals that employ its nurses. This is unfortunate, unnecessary and wrong. It not only harms hospitals, but has the potential to disrupt care.”

Stage 3 Meaningful Use Registration with Specialized Registry

The CDC’s National Center for Health Statistics conducts national healthcare surveys, which include the National Hospital Care Survey (NHCS), National Hospital Ambulatory Medical Care Survey (NHAMCS), and the National Ambulatory Medical Care Survey (NAMCS). These nationally representative surveys provide data and information that Congress, researchers, and others use to shape healthcare policy.

The National Center for Health Statistics is accepting registration from eligible clinicians, professionals, and hospitals or critical access hospitals indicating their intent to submit data to the National Health Care Surveys as part of the Merit-Based Incentive Payment System (MIPS) and the Medicare and Medicaid EHR Incentive Programs (Meaningful Use). Parties may attest to Objective 8 - Public Health and Clinical Data Registry Reporting, Measure 4 for MU Stage 3. 

Please visit this CDC Meaningful Use site and consider registering for the National Health Care Surveys.  Affected entities can register their intent to submit data by e-mailing NCHSMUInfo@cdc.gov. Use that e-mail to submit questions about the initiative as well.

BORN Goes Green, Will Stop Mailing Renewal Notices

The Board of Registration in Nursing (BORN) will no longer be sending Registered Nurses and Licensed Practical Nurse written notices through the U.S. Postal Service that their licenses are up for renewal. BORN will use e-mail to send updates to nurses who maintain a current e-mail address in the board’s database. 

Also, APRNs (nurse practitioners, nurse anesthetists, nurse midwives, psychiatric clinical nurse specialists, and clinical nurse specialists) are required to have current certification from a BORN-approved certifying organization. When renewing an RN license, APRNs will renew their BORN authorization to practice as an APRN at the same time.

RN license and APRN authorization renewals occur on the RN’s birthday in even numbered years. LPN license renewals occur on the LPN’s birthday in odd numbered years. Licenses revert to an “Expired” status automatically should the licensee fail to renew by 11:59 p.m. on the license expiration date. Practice with an expired license is illegal and may result in fines of up to $2,500 and/or six months of imprisonment.

Elder Protective Services Centralizes its Services

Beginning the morning of Friday, June 30, the Executive Office of Elder Affairs will centralize the Elder Protective Services abuse report intake system (elder abuse hotline) to a single phone number, connecting the caller to a call center with specially trained intake workers in Massachusetts.

The elder abuse hotline number will remain the same (1-800-922-2275). While the initial intake will be centralized, all reports will continue to be referred to local Protective Services Agencies for screening and, if indicated, investigation and service planning.

The people most affected by this change will be mandated reporters, which include: physicians, physician assistants, nurses, medical interns, social workers, case managers, and health aides, among many others.

Happy Fourth of July

Have a healthy and enjoyable extended holiday weekend. Speaking of good health, here’s what George Washington wrote to an old military friend, Richard Varick, in 1785 before Washington became president: “Disorders oftentimes, are easier prevented than cured, and while you are in the way to re-establish your health, (on which I congratulate you) it is better to use preventatives, than alternatives &c. &c. with which the Apothecaries Shops are replete.” And in retirement, in a letter to his farm manager, the ex-president wrote that health was "amongst (if not the most) precious gift of Heaven," and noted that without it "we are but little capable of business, or enjoyment.”  MHA will be closed July 3 and 4.

Project Management for Healthcare

Friday, September 15; 8:30 a.m. – 3 p.m. MHA Conference Center, Burlington, Mass.

The fundamental purpose of project management is to be one step ahead of potential risk that could show itself during your project planning and execution. The trick is to plan, organize, and control as many of the steps as possible to mitigate unnecessary consequences. This MHA seminar is designed to do just that – it will provide you with strategies that you can use right now, wherever you are in your project timeline. Whether it’s starting with the project plan or building the right team for the task, key strategies on time management, effective communication, and maintaining motivation will be presented. A “how to” related to workflow diagrams will be a significant takeaway of this one-day program.  Click here for more details.

John LoDico, Editor