Archived Weekly News Items

IHA Weekly News - Sept. 28, ​2022​ ​​ ​​ ​​

​​​ CDC Updates COVID-19 Infection Control Guidance for Health Care Settings

Last Friday, the Centers for Disease Control and Prevention updated its COVID-19 infection control guidance for U.S. health care settings based on current information. The guidance updates the circumstances when source control (respirator and face mask use) and universal personal protective equipment are recommended, and no longer uses vaccination status to inform source control, screening testing, or post-exposure recommendations. It also updates recommendations for testing frequency, and clarifies that facilities may use their discretion regarding screening testing for asymptomatic health care personnel, among other changes. To allow for earlier intervention to prevent a strain on the health care system, the guidance recommends health care facilities use data on COVID-19 community transmission rather than COVID-19 community levels to guide certain practices. 

AHA has released a special bulletin​​ describing key changes in the guidance. While the latest CDC guidance provides some flexibility on how hospitals manage their COVID response, hospitals should evaluate the potential impact for all areas of the facility and other infectious diseases within the community. 

IHA will be convening our Council on Quality & Patient Safety to explore best practices for infection control given this new guidance. Comments and Questions can be referred to Karin Kennedy (kkennedy@ihaconnect.org), IHA VP of Quality & Patient Safety or Andy VanZee (avanzee@ihaconnect.org), IHA VP of Regulatory & Hospital Operations.


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​​Donors Needed at The Susan G. Komen Tissue Bank

The Susan G. Komen Tissue Bank at the IU Simon Cancer Center was created in response to a need by scientists carrying out breast cancer research: understanding wh at is abnormal in
breast cancer is slowed down by our lack of knowledge about wh at is normal. By collecting tissue from women with and without breast cancer, or with a variety of benign breast conditions, scientists will be able to determine differences which ultimately could lead to a better understanding of the breast cancer process.

Tissue Donation Information:
Date and Time: Saturday, Nov. 12,  8  a.m. - 2 p.m.
Location: IU Health Simon Cancer Center, 2nd floor Women's Clinic,
1030 W Michigan St, Indianapolis, IN 46202


Learn More: https://www.komentissuebank.iu.edu/donate-tissue/about-tissue-donation.php

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IHA Weekly News - Sept. 21​, ​2022

Patient Safety Summit

Thank you to all those who attended yesterday’s IHA Patient Safety Summit!

President Brian Tabor spoke to attendees and expressed gratitude for their tireless efforts to keep patients out of harm’s way. Other topics for the day included innovation, high reliability leadership, and reducing the threat of violence to staff and patients.

The Summit also hosted an insightful member panel highlighting crucial pivots that were made to ensure patient safety during their facilities’ recent cyberattacks. A special thank you to Hendricks Regional Health, Johnson Memorial Health, and Norton King's Daughters' Health for sharing your experiences. 

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​​​​​​​​​​​​​​​​​​​​​​​​​​IHA Weekly News - Sept. 14​, ​2022

​​IDOH: Updated Terminated Pregnancy Report Submission Guidance

On Sept. 9, the Indiana Department of Health issued updated guidance regarding Terminated Pregnancy Reports (TPR)​. The updated guidance provides an overview of when and where TPRs must be filed.  It also states:  

"Treatment of a missed miscarriage, septic abortion, inevitable miscarriage, ectopic pregnancy, molar pregnancy, or any pregnancy where the fetus has died in utero continue to not be required to be submitted as a terminated pregnancy report."

We encourage you to review the guidance with your team and legal counsel as you update any policies and procedures ahead of the effective date of Senate Enrolled Act (SEA) 1 on Sept. 15. To date, no action has been taken by either the Monroe County Circuit Court or the Marion County Superior Court on the lawsuits filed challenging SEA 1. As such, hospitals and ambulatory outpatient surgical centers should continue to work towards ensuring compliance with SEA 1 starting Sept. 15. 

While IHA cannot provide legal advice, please do not hesitate to contact a member of our team with any questions.


IHA Weekly News - Sept. 7, ​2022

​​​V​​ersiti Blood Center of Indiana Needs Donors
Versiti would like to remind Hoosiers of the need in our community to donate blood, especially around holiday weekends.
Consider donating today. More information can be found on Versiti's website: https://www.versiti.org/home ​​ 


​​​​​​​​​​​​​​​​​IHA Weekly News - Aug. 31, ​2022

BBW 2022: 10 Years, A New Foundation
This year marks the 10th anniversary of Black Breastfeeding Week. Join in celebrating the countless stories and families - past, present & future. The new foundation of lactation support is built on racial equity, cultural empowerment, and community engagement and is powered by our collective resilience.

Please share and help spread the word. Visit blackbreastfeedingweek.org​ for more information.


​​SEA 1 Q&A and Abortion Certification Form 

In addition to the Senate Enrolled Act (“SEA") 1 memorandum distributed on Aug. 10 detailing Indiana's updated abortion framework, IHA has compiled a SEA 1 Q&A document, as well as a sample Abortion Certification Form ​

Please note, these documents do not constitute legal advice.  If you have any questions, please contact IHA's Deputy General Counsel, Laura Brown, at Lbrown@ihaconnect.org

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​Submit a Hardship Exception Application by Sept. 1

On May 1, the Centers for Medicare & Medicaid Services (CMS) opened the Hardship Exception Application period for eligible hospitals and critical access hospitals (CAHs) that participated in the Medicare Promoting Interoperability Program in Calendar Year (CY) 2021. The Hardship Exception Application period closes Sept. 1, 2022.

About Hardship Exception

CMS mandates that downward payment adjustments be applied to eligible hospitals and CAHs that were not meaningful users of certified electronic health record technology (CEHRT) and scored below the 50-point minimum requirement and failed to report two self-selected calendar quarters of electronic clinical quality measures (eCQMs) data on four self-selected eCQMs. Participants may be exempt from Medicare penalties and avoid a downward payment adjustment if they can show that compliance with the requirement for being a meaningful CEHRT user would result in a significant hardship.

To be considered for an exemption, participants must complete a hardship exception application and provide proof of hardship (e.g., natural disaster, lack of internet access, etc.). If approved, the hardship exception is valid for only one payment adjustment year. Eligible hospitals and CAHs would need to submit a new application for subsequent years and no eligible hospital or CAH can be granted more than five exceptions.

Hardship Exception Application Details

  • The deadline for eligible hospitals and CAHs to submit a hardship exception application for the CY 2021 reporting period is this Thursday, Sept. 1, 2022.
  • More information on the Medicare Hardship Exception Application can be found here (PDF).
  • Previously registered users should already have account access, and new users can sign up by visiting QualityNet and selecting “Register" to create a new account.
  • If an electronic submission is not possible, you may verbally submit your application over the phone by calling the Center for Clinical Standards and Quality (CCSQ) Service Center at (866) 288-8912.

For more information, visit the Promoting Interoperability Program website or contact Matt Browning, IHA Vice President Data Services & Member Solutions.​


IHA Weekly News - Aug. 24, ​2022 

​​IHEN Annual Awards Program​​​​​
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Indiana Healthcare Executives Network (IHEN, the local chapter of the American College of Healthcare Executives) will host their Annual Awards program, Inclusive Leadership: Leveraging Diversity as a Strength, with Stephan Davis, DNP, MHSA, FACHE, FNAP on Sept. 15 at the Golf Club of Indianapolis. The format of the evening includes 3 Face to Face education credits, networking, an awards presentation, and a plated dinner.

Additional information and attendee registation: http://ow.ly/78vz50KmSiJ


​​​Quality Measures Table Includes Changes Finalized and Proposed in CMS PPS Rules

​The Centers for Medicare & Medicaid Services (CMS) issued final rules in August that affect acute care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, long-term care hospitals, and PPS-exempt cancer hospitals. They also issued proposed rules that affect outpatient services in acute care hospitals, ambulatory surgery centers and ESRD facilities. IHA has updated the quality measures table to reflect the changes to quality measurement reporting requirements announced in the rules. 

For questions regarding the quality measures table, please contact Elaine Pittman at epittman@IHAconnect.org or 317-423-7735.


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​​​IHA Weekly News - Aug. 17, ​2022

​​Updated Out-of-State Telehealth Certification Forms

The Indiana Professional Licensing Agency (IPLA) has updated its Out-of-State Telehealth Certification Forms for practitioners, employers, and contractors as a result of Senate Enrolled Act (SEA) 284 from the 2022 legislative session. The updated form for practitioners can be found here, and the updated form for employers and contractors can be found here. The updated forms are also available on the Indiana Archives and Records Administration's State Forms Catalog webpage, and IPLA intends to add the updated forms to IPLA's telehealth webpage as well.

As a result of SEA 284, several additional practitioners are now included on the forms, including behavior analysts; students who are pursuing a course of study in or who are a graduate from a health care profession that is permitted to practice telehealth in Indiana; qualified behavioral health professionals within a community mental health center; and more. If you have any questions, please contact IHA's Deputy General Counsel, Laura Brown, at Lbrown@ihaconnect.org


​​ ​​2022 Perinatal Substance Use Virtual Conference 

The Indiana Perinatal Quality Improvement Collaborative and IHA will be presenting the 2022 Perinatal Substance Use Virtual Conference on Aug. 31 from  10 a.m. – 1 p.m. EST. View the flyer​.


Speakers: 

Implementation of a Standardized Clinical Definition of Opioid Withdrawal in the Neonate
Dr. Shahla M Jilani
Office of the Assistant Secretary for Health
US Department of Health and Human Services

Mandated Reporting of Perinatal Substance Use: the Root of Inequity
Dr. Caitlin Bernard
Assistant Professor of Clinical Obstetrics & Gynecology
Indiana University School of Medicine

Dr. Brownsyne Tucker Edmonds
Vice President and Chief Health Equity Officer at Indiana University Health
Associate Professor of Obstetrics & Gynecology and Pediatrics at
 Indiana University School of Medicine​


Engaging Community Stakeholders into Family Care Plans
Kathy Detweiler, MHL, BSN, RN
Director, Perinatal Center and Nurse Navigation Women's & Children's Services
Parkview Regional Medical Center


IHA Weekly News - Aug. 10, ​2022​ ​​

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Indiana's Updated Abortion Framework​​​​

Late in the evening of August 5, 2022, Governor Holcomb signed Senate Enrolled Act (“SEA") 1 into law, which updates Indiana's abortion framework in light of the U.S. Supreme Court's Dobbs v. Jackson Women's Health Organization opinion. The provisions of SEA 1 are effective Sept. 15, 2022. Highlights of the new law can be found here.


​​Final Report Released: Governor's Public Health Commission

The Governor's Public Health Commission report​ is now available and includes recommendations for improvements in six workstreams: funding; workforce; governance and infrastructure; data and analytics; emergency preparedness; and childhood and adolescent health. Those recommendations will form the basis of proposed legislation for the 2023 legislative session.

Indiana Hospital Association applauds the Governor’s public health commission recommendations in a statement​ from IHA President Brian Tabor:

"Indiana’s hospitals are truly grateful for Governor Holcomb’s leadership and commitment to improving Hoosiers’ health. The Commission’s in-depth review of Indiana’s public health system provides an opportunity to address a decades-old problem—we can no longer tolerate being 45th in the nation in terms of per capita funding. IHA looks forward to partnering with policymakers to reinvigorate our health care workforce and create a healthier Indiana."​


​​ ​​​Aug. 25 Webinar: Preparing for the End of the Public Health Emergency

The COVID-19 Public Health Emergency (PHE) has been in effect for so long now that our “new” processes have become our standards. Which leaves many wondering, what happens after the PHE expires?

Join IHA and H4 Technology for a virtual presentation with guidance on:

  • How to take inventory of your office’s current PHE guidelines
  • Reviewing changing regulations against current practice policies and procedures
  • Parity training guidance for staff hired before, during, and after the PHE expires
  • New telehealth guidelines that may change once the PHE is expired
Get prepared in advance by attending this webinar on Aug. 25 at noon CT / 1 p.m. ET, free to all IHA members. Register here.

Please contact Sharon Shover with questions.

Content conveyed at, or in conjunction with, this event does not constitute the opinion or views of IHA.


IHA Weekly News - Aug. 3, ​2022​ ​​

​​Individual Facility COVID-19 Waivers

While the Indiana Department of Health's (IDOH) COVID-19 Regulatory Blanket Waivers expired on July 1, hospitals and ambulatory surgical centers may now request individual waivers to continue temporary changes to physical plant requirements, such as temporary negative pressure isolation rooms. More information regarding individual waiver requests can be found here, and any requests should be submitted to Jennifer Hembree at Jhembree@isdh.in.gov.

If a hospital or ambulatory surgical center intends to make a physical plant change permanent, the facility must submit a plan review application, and the plans must be received by IDOH Health Care Engineering within 60 days of the application being submitted. Facilities do not need to submit a request for a temporary waiver if the plan review application has been submitted and may continue to operate until the plan review process is finalized. 

Please note, while IDOH's COVID-19 Regulatory Blanket Waivers have expired, unless IDOH issues an individual waiver, the federal Centers for Medicare and Medicaid Services' (CMS) 1135 Waiver is still currently in effect as a result of the federal public health emergency. CMS's 1135 Waiver can be found in full here.  


​​IPLA to Implement Licensure by Reciprocity in Tranches

As a result of Senate Enrolled Act 5, an IHA priority bill enacted during the 2022 legislative session, which creates reciprocity for health care professionals licensed in other states, the Indiana Professional Licensing Agency (IPLA) recently announced the agency will implement licensure by reciprocity in tranches through the end of the year. 

Licensure by reciprocity is now available to applicants for medical (physicians and osteopathic physicians) licenses and physician assistant licenses.  IPLA expects to implement licensure by reciprocity for pharmacists, physical therapists, occupational therapists, and other health care professionals by Oct, 17, 2022, and for nurses dentists, and other health care professionals by Dec. 12, 2022.

The application instructions for physicians and physician assistants applying for licensure by reciprocity are now available on the Medical Licensing Board's webpage, as follows: 

Licensure by Reciprocity: The Medical Licensing Board shall issue a license to an applicant if the applicant satisfies the following conditions:

  • Holds a current license from another state or jurisdiction; and
    • that state's or jurisdiction's requirements for a license are substantially equivalent to or exceed the requirements for a license of the Board; or
    • when the person was licensed or certified by another state:
      • there were minimum education requirements in the other state or jurisdiction;
      • if there were applicable work experience and clinical supervision requirements in effect, the person met those requirements to be licensed in that state; and
      • if required by the other state or jurisdiction, the person previously passed an examination required for the license or certification.
  • Has not committed any act in any state or jurisdiction that would have constituted grounds for refusal, suspension, or revocation of a license, certificate, registration, or permit to practice that occupation in Indiana at the time the act was committed.
  • Does not have a complaint or an investigation pending before the regulating agency in another state or jurisdiction that relates to unprofessional conduct.
  • Is in good standing and has not been disciplined by the agency that has authority to issue the license or certification.
  • If a law regulating the applicant's occupation requires the board to administer an examination on the relevant laws of Indiana, the Board may require the applicant to take and pass an examination specific to the laws of Indiana.
  • Pays any fees required by the Board for which the applicant is seeking licensure. 

Provisional Licenses: An applicant for a license by reciprocity is entitled to a provisional license, if all the following conditions are met:

  • The individual signs an attestation, under the penalties for perjury, the following:
    • The individual is in good standing in all states and jurisdictions in which the individual holds a license or certificate for the occupation applied for.
    • The individual has not had a license revoked and has not voluntarily surrendered a license in another state or jurisdiction while under investigation for unprofessional conduct.
    • The individual has not had discipline imposed by the regulating agency for the occupation in another state or jurisdiction.
    • The individual does not have a complaint or an investigation pending before the regulating agency in another state or jurisdiction that relates to unprofessional conduct.
  • The individual does not have a disqualifying criminal history.
  • The individual submits verification that the individual is currently licensed or certified in at least one (1) other state or jurisdiction in the occupation applied for.
  • The individual has submitted an application for a license or certificate under this chapter with the board and has paid any application fee. 

The provisional license shall be issued not more than 30 days after the requirements for a provisional license are met and is valid until the earlier of the following:

  • Three hundred sixty-five (365) days after it is issued.
  • The date on which the board approves and issues the individual a full license for the occupation.
  • The date on which the board denies the individual's application for a full license for the occupation. 

IHA is still working with IPLA to understand if the provisional license number and full license number can be issued to match and will keep members updated. If you have any questions, please contact IHA's Vice President of Regulatory & Operations, Andy VanZee, at avanzee@ihaconnect.org or IHA's Deputy General Counsel, Laura Brown, at lbrown@ihaconnect.org.

​​Terminated Pregnancy Report Submission Guidance 

With the recent launch of the fetal death and terminated pregnancy modules of the state's new Database for Registering Indiana's Vital Events, the Indiana Department of Health (IDOH) would like to remind providers of the statutory requirements for reporting terminated pregnancies. ​Providers are encouraged to review IDOH's Terminated Pregnancy Report Submission Guidance here

​​IDOH Guidance for Implementation of Newly Enforceable Informed Consent Requirements 

On Aug. 1, the Indiana Department of Health (IDOH) updated its guidance regarding newly enforceable informed consent requirements for patients seeking abortions. The updated guidance can be found here​ and is a result of the Seventh Circuit U.S. Court of Appeals lifting an injunction that had previously stayed the enforcement of an additional provision of Indiana's informed consent disclosure laws. 

Effective immediately, as a part of the informed consent process, providers are required to disclose that Indiana does not permit an abortion based on race, color, national origin, ancestry, sex, or diagnosis or potential diagnosis of Down syndrome or any other disability. Additional informed consent requirements are outlined in the guidance document. 

IDOH is in the process of updating all appropriate state forms and documents, but until those updates are completed, providers should continue to document informed consent and disclosure in the patient's medical record to verify compliance with state laws.

 IHA Weekly News - July 27, ​2022

​​IDOH Monkeypox Update


The Indiana Department of Health (IDOH) is tracking a global outbreak of monkeypox, a rare disease caused by infection with the monkeypox virus. As a key component of the outbreak response, IDOH has created a website to provide comprehensive information about monkeypox to the public and clinicians. Please visit monkeypox.health.in.gov​  for the most recent updates. 
 
The website includes frequently asked questions as well as information and guidance on testing, vaccine, treatment and more. In addition, a clinical guide to monkeypox in Indiana and a quick reference for ordering the JYNNEOS vaccine are attached and can also be found on the website. ​Please continue to check the website for new information.


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​​CDC COCA Call: Monkeypox Outbreak: Updates on the Epidemiology, Testing, Treatment, and Vaccination 

The Clinician Outreach and Communication Activity (COCA) had a call on July 26 that provided updates on the epidemiology of the monkeypox outbreak, commercial testing capability, how to obtain and use TPOXX (Tecovirimat) to treat monkeypox, and vaccine strategy.


 IHA Weekly News - July 20, ​2022

​​HHS Renews Federal PHE – Emergency Practitioner Temporary Licenses & 1135 Waiver Also Extended 

On July 15, the U.S. Department of Health and Human Services renewed the federal public health emergency for another 90 day period, through Oct. 13.  

Health care practitioners who hold an emergency practitioner temporary license in Indiana under Indiana Code § 25-1-5.7 may continue to practice under their temporary license for the duration of the extension, and the Indiana Professional Licensing Agency's system will now reflect an expiration date of Oct. 13 for these temporary licenses. However, we continue to encourage those practicing under an emergency practitioner temporary license to begin moving toward full licensure.  

Further, the COVID-19 Emergency Declaration Blanket Waivers for health care providers under the Centers for Medicare & Medicaid Service's current 1135 Waiver are also extended for the duration of the extension. If any portions of the 1135 Waiver are repealed prior to Oct. 13, IHA will keep you updated. 

If you have any questions, please contact IHA's Vice President of Regulatory & Operations, Andy VanZee, at avanzee@ihaconnect.org or IHA's Deputy General Counsel, Laura Brown, at lbrown@ihaconnect.org

​​​​IDOH Guidance for Implementation of Newly Enforceable Informed Consent Requirements

On July 19, the Indiana Department of Health (IDOH) issued guidance for the implementation of newly enforceable informed consent requirements for patients seeking abortions. The guidance can be found here ​and is a result of the Seventh Circuit U.S. Court of Appeals lifting an injunction that had previously stayed the enforcement of certain informed consent disclosure laws. 

Effective immediately, providers are required to disclose additional information to patients seeking an abortion as part of the informed consent process, as outlined in the guidance, and disseminate the Perinatal Hospice Brochure for patients diagnosed with a lethal fetal anomaly.  The Perinatal Hospice Brochure can be found here​​.

IDOH is in the process of updating all appropriate state forms and documents, but until those updates are completed, providers should continue to document informed consent and disclosure in the patient’s medical record to verify compliance with state laws.

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IHA Weekly News - July 13, ​2022​

CMS Issues Guidance Reinforcing EMTALA Obligations 

On July 11, CMS issued QSO 22-22 reinforcing EMTALA obligations specific to patients who are pregnant or are experiencing pregnancy loss.  Highlights of the QSO can be found below, and we encourage members to review the memorandum in its entirety.  

  • EMTALA:  The EMTALA statute requires that all patients receive an appropriate medical screening examination, stabilizing treatment, and transfer to another hospital, if necessary, that has the capabilities to provide stabilizing treatment.
  • Emergency Medical Conditions:  The QSO states an emergency medical condition includes medical conditions with acute symptoms of sufficient severity that, in the absence of immediate medical attention, could place the health of a person (including pregnant patients) in serious jeopardy, or result in a serious impairment or dysfunction of bodily functions or any bodily organ.  The QSO states emergency medical conditions involving pregnant patients may include, but are not limited to ectopic pregnancy, complications of pregnancy loss, or emergent hypertensive disorders, such as preeclampsia with severe features.
  • Stabilizing Treatment:  The EMTALA statute requires that stabilizing treatment prevent material deterioration.  The QSO states that if qualified medical personnel determine that the patient's condition, such as an ectopic pregnancy, requires stabilizing treatment to prevent serious jeopardy to the patient's health (including a serious impairment or dysfunction of bodily functions or any bodily organ or a threat to life), the qualified medical personnel is required by EMTALA to provide the treatment.
  • Transfers:  The QSO clarifies that a hospital cannot cite State law or practice as the basis for transfer.  Hospitals that are not capable of handling high-risk deliveries or infants often have written transfer agreements with facilities capable of handling high-risk cases, but the hospital must first meet the screening, treatment, and transfer requirements of EMTALA.
  • Hospital's Obligation:  Finally, the QSO notes that a hospital's EMTALA obligation ends when a physician or qualified medical person has made a decision that no emergency medical condition exists (even though the underlying medical condition may persist); that an emergency medical condition exists and the individual is appropriately transferred to another facility; or that an emergency medical condition exists and the individual is stabilized or admitted to the hospital for further stabilizing treatment.  The QSO states that any State that has a more restrictive definition of emergency medical condition or that has a definition that directly conflicts with any definition above is preempted by the EMTALA statute. 

If you have any questions, please contact IHA's Vice President of Regulatory & Operations, Andy VanZee, at avanzee@ihaconnect.org or IHA's Deputy General Counsel, Laura Brown, at lbrown@ihaconnect.org

Order Issued Lifting Dismemberment Injunction 

On July 7, the U.S. District Court for the Southern District of Indiana issued an Order lifting the preliminary injunction that was placed on various provisions of House Enrolled Act (HEA) 1211, enacted during the 2019 legislative session, including Ind. Code §§ 16-18-2-96.4, 16-34-2-1(c), 16-34-2-7(a), 16-34-2-9, and 16-34-2-10. 

Specifically, the provisions prohibit an individual from knowingly or intentionally performing a dismemberment abortion unless reasonable medical judgment dictates that performing the dismemberment abortion is necessary to prevent any serious health risk to the mother or to save the mother's life.  The term “dismemberment abortion" is defined under Ind. Code § 16-18-2-96.4, which can be found here. 

The preliminary injunction was originally issued on June 28, 2019 and is lifted immediately, thereby allowing the above provisions of HEA 1211 to go into effect.  If you have any questions, please contact IHA's Deputy General Counsel, Laura Brown, at Lbrown@ihaconnect.org

CMS Issues Infection Prevention and Control & Antibiotic Stewardship Program Guidance 

On July 6, CMS issued QSO 22-20 providing guidance on the “Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction" Final Rule, which included revisions for the hospital Condition of Participation at 42 CFR §482.42 regarding infection prevention and control and antibiotic stewardship programs. 

The QSO clarifies:

  • The final rule allows for flexibility and does not require hospitals to adhere to a specific set of regulatory guidelines or best practices in implementing the programs; and
  • The final rule does not dictate whether the programs must be together or separate; the final rule allows hospitals to have unified and integrated infection prevention and control and antibiotic stewardship programs, or separate programs, accordingly to the hospital's design. 

​​ Downcoding Policies Webinar: Aug. 18

Join IHA for a virtual presentation with Lash & Goldberg LLP. Alan Lash and Jason Coe will discuss strategies for addressing emergency department downcoding policies.

Date:  Aug. 18, 202
2
Time:  2 – 3 p.m. ET

Register TodayContact Laura Brown with any questions.

Content conveyed at, or in conjunction with, this event does not constitute the opinion or views of IHA. 

Save The Date: Perinatal Substance Use Virtual Conference

The Indiana Perinatal Quality Improvement Collaborative and IHA will be presenting the 2022 Perinatal Substance Use Virtual Conference on Aug. 31 from 10:00 am – 1:00 pm EST.  

Speakers: 
  • Dr. Shahla M Jilani - Office of the Assistant Secretary for Health, US Department of Health and Human Services
  • Dr. Caitlin Bernard - Assistant Professor of Clinical Obstetrics & Gynecology, Indiana University School of Medicine
  • Kathy Detweiler - Parkview Regional Medical Center, Community Engagement in Family Care Plans​
Stay tuned for more information.


Leadership in Times of Crisis: July 20 Webinar

The Massachusetts Health and Hospital Association is offering a free webinar with Dr. Thom Mayer on July 20. Learn how to lead through crisis with Dr. Mayer's inspiring yet highly pragmatic message. 


Content conveyed at, or in conjunction with, this event does not constitute the opinion or views of IHA. 


IHA Weekly News - July 6, ​2022​ 

Cybersecurity Advisory: Ransomware Threat

The FBI, Cybersecurity and Infrastructure Security Agency, Department of the Treasury, and Financial Crimes Enforcement Network is urging organizations to take action to protect their networks from MedusaLocker ransomware, which uses vulnerabilities in the Remote Desktop Protocol to access victims’ networks and encrypt their data.

AHA’s National Advisor for Cybersecurity and Risk, John Riggi, stated, “It is strongly recommended that organizations continue to emphasize phishing email education for staff, exercise cyber incident response plans, and ensure the segregation and security of network and data backups, among the many helpful risk mitigation recommendations contained in the advisory.”



Indiana Lowers Thresholds for Blood Lead Levels in Children 

On July 1, the Indiana Department of Health (IDOH) adopt​ed an emergency rule that lowers the level at which it determines a child has elevated blood lead levels to 3.5 micrograms per deciliter, in alignment with the values set by the Centers for Disease Control and Prevention.  IDOH is then expected to proceed with adopting final rules to make the emergency rules permanent as a part of continued statewide efforts to increase lead testing and reduce the risk of lead exposure. 

Families of children who have a blood lead level between 3.5 and 4.9 micrograms per deciliter will receive education about lead risks and be advised to test siblings in the same household.  Children with a confirmed level of 5 or above will be enrolled in case management, in which families are offered a home visit by trained case support personnel and a home risk assessment by a licensed assessor. 

As a reminder, effective January 1, 2023, IDOH will also be requiring healthcare providers to offer universal screening for lead for all children under the age of 6 per House Enrolled Act (HEA) 1313, enacted during the 2022 legislative session.  IHA will keep you updated as further guidance related to HEA 1313 is developed this year. ​

IHA Weekly News - June 29, ​2022​ 

​​​ IN Missing Children's Clearinghouse Newsletter

The quarterly Missing Children & Endangered Adults directory has been published. This issue highlights the risks associated with children on the autism spectrum and ways to be prepared.​​ 

Children on the autism spectrum may exhibit behavioral character-istics that threaten their safety such as:  

  • Attractions to bodies of water, roadways/highways, trains, fire trucks, or traffic signals
  • Being non-speaking/non- verbal or unable to respond to searchers when their name is called
  • Experiencing sensory/stimuli overload and bolting from their environment
  • Heightened risk for exploitation because of their disability

View the full newsletter​.​

IHA Weekly News - June 22, ​2022​ 

Update on 988 in Indiana​

On July 16, 2022, 988 will go live as a new national three-digit dialing code for reaching the National Suicide Prevention Lifeline. The current long-form phone number of 800-273-TALK will also continue to be an option.  

988 is more than just an easy-to-remember number—it will offer a direct connection to compassionate, accessible care and support for anyone experiencing mental health-related distress – whether that is thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. People can also dial 9-8-8 if they are worried about a loved one who may need crisis support.

911 isn’t going away, this is just another option specifically for anyone experiencing mental health related distress. Call 9-1-1 for police, fire and medical emergencies. Call 988 for thoughts of suicide, mental health or substance use crises, or any other kind of emotional distress. If you are not sure, call 9-1-1.

Indiana is using the arrival of 988 to invest in a broader crisis response system to help all Hoosiers. This will ultimately include more than just someone to contact at a 988 center, but also someone to respond and a safe place to go for help, if needed. View the full article here​.


Monkeypox Case Counts
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The Centers for Disease Control and Prevention (CDC) is tracking numerous cases of monkeypox that have been reported in countries where monkeypox is not endemic. As of June 17, 2022, there have been 113 confirmed cases of orthopox/monkeypox virus identified across the United States. Two probable cases of monkeypox have been identified in Indiana.

The Indiana Department of Health is updating testing authorization protocol, specimen collection and submission guidance, epidemiological criteria, treatment, and recommendations for post-exposure prophylaxis. 

At 12:00 on Friday, June 24, a webinar will be hosted by our Chief Medical Officer, Dr. Lindsay Weaver to discuss Monkeypox and COVID-19 vaccinations.  



​​Hall Render Webinar: June 23

​Join Hall Render attorneys Lori Wink and Joe Wolfe, along with Advisory Services advisor Delena Howard, for this webinar. Their team will provide their perspectives on staffing opportunities, compliance, billing and physician compensation issues and trends in care models where services or a portion of the services are performed by nonphysician practitioners (“NPPs”). The use of NPPs has gained renewed attention and importance since CMS implemented new requirements for split/shared billing in the 2022 Medicare Physician Fee Schedule (“MPFS”). Under the new MPFS, split/shared visits are billed under the physician or NPP who provided the “substantive portion” of the services. 

Topics will include opportunities and guardrails on the use of NPPs in care delivery models, the new 2022 MPFS guidance on split/shared billing, common physician compensation models for NPP supervision and potential impacts on how compensation is calculated under productivity-based compensation models. Our panelists will also discuss what practical steps health care providers can take now to mitigate risk. Register here.

Content conveyed at, or in conjunction with, this event does not constitute the opinion or views of IHA.


​​​​​IHA Weekly News - June 15, ​2022​ 

​​ ​Versiti Issues Emergency Plea for Blood Donors, O Negative Supply Dangerously Low​

Versiti Blood Center of Indiana has issued an emergency appeal for blood donations, pleading with Hoosiers to donate. Versiti has seen a drastic drop in scheduled appointments and the blood center anticipates the available inventory of blood to be at less than a one-day supply within the coming days. Versiti strives for at least a three-day supply of blood, so it can be ready to serve all patients, even during unexpected events.

While all blood types are needed, Type O Negative blood, used to treat trauma patients in emergencies, is the most at risk. Only about 7% of donors have Type O Negative blood, making it extremely important for those individuals to donate.

Versiti is urgently seeking donors for more than 2,500 open appointments available at community blood drives and donation centers throughout the state.

Platelet donors are also desperately needed. Platelets are a component of blood that promotes clotting and are a special type of blood donation. Platelet donations have a shelf life of less than one week, which means that donations will be used by a patient in a local hospital on average within five days. Platelets are incredibly important in a wide range of treatments for patients of all kinds, including premature babies, warriors fighting cancer, trauma victims, and those receiving organ or bone marrow transplants. Donors of all blood types are encouraged to donate platelets.

For those who do not know their specific blood type, the best way to find out is by signing up to donate blood. Donors can schedule an appointment to donate blood by calling 1-317-916-5150 or visit Versiti online at www.versiti.org/indianaVersiti has extended hours at its donor center locations through June 21, 2022, to provide more flexibility for donors. Appointments are preferred, but walk-ins are welcome.

Donor center locations:
  • INDIANAPOLIS: 3450 N. Meridian St.
  • FISHERS: 11005 Allisonville Road
  • CARMEL: 726 Adams St., Suite 150
  • GREENWOOD: 8739 U.S. 31 South
  • TERRE HAUTE: 2021 S. Third St.
  • LAFAYETTE: 2200 Elmwood Ave., Suite D-16


​​PLA Updates Primary Source Documentation Requirements  

The Indiana Professional Licensing Agency (PLA) recently changed its requirements regarding primary source documentation for the licensing of health care practitioners.  An individual applying for a health care license may now upload an original school transcript or a copy of the original transcript. 

If an original transcript is not available, the applicant must submit a copy of the original transcript, which must include the degree conferred and the date the degree was conferred, and a statement explaining why the original transcript is not available.

If an individual attended multiple schools, a transcript from each is required.  If the transcript is in a language other than English, it must be accompanied by a certified translation.

Updated application instructions are now on the PLA’s website, and individuals are encouraged to utilize the PLA’s online portal for submitting applications.


​​​CMS Issues Guidance on Surveying for Staff Vaccinations 

On June 14, the federal Centers for Medicare and Medicaid Services (CMS) issued QSO 22-17 regarding state surveys for compliance with CMS's Interim Final Rule requiring COVID-19 vaccination for health care staff. 

QSO 22-17 provides that state survey agencies will now only be expected to perform compliance reviews of the staff vaccination requirement during initial and recertification surveys, and in response to specific complaint allegations that allege non-compliance with the staff vaccination requirement.  State survey agencies are no longer expected to perform these reviews on every survey. 

To date, 12,000 providers and suppliers have been surveyed for compliance, and 95% have been found to be in substantial compliance.  The QSO provides that this reduction in survey frequency is in keeping with the normal process for oversight of any Medicare requirement and is supported by the high rates of compliance in initial surveys.​

IHA Weekly News - June ​8, ​2022​ 

IHA, IONL Lend Support for Bucshon Bill to Protect Health Care Employees

Indiana Congressman Rep. Larry Bucshon and Pennsylvania Congresswoman Madeleine Dean yesterday introduced the Safety From Violence for Healthcare Employees (SAVE) Act, which would provide legal penalties for individuals who knowingly and intentionally assault or intimidate a hospital employee. IHA and IONL lent support for the bill. 

“IHA and IONL mourn the loss of a growing number of victims of violence in medical facilities across our country, and we thank Rep. Bucshon and Rep. Dean for bringing this important legislation forward. We will continue to collaborate with our elected leaders and community partners on initiatives to improve safety in our hospitals to protect health care workers," Brian Tabor, president of the Indiana Hospital Association (IHA) and Mary Browning, CEO of the Indiana Organization for Nursing Leadership (IONL) said.

Last week, Tabor issued a media statement in response to shootings at medical facilities in Oklahoma and Ohio. You can read his comments here​.


​​IDOH COVID-19 Waivers Ending on July 1

​As a reminder, on March 16, IDOH announced that the current Temporary Blanket Waivers for COVID-19 for hospitals and ambulatory surgical centers will expire on July 1, 2022.  If a hospital has not been granted a facility-specific waiver, the flexibilities offered through the state's Temporary Blanket Waivers for COVID-19 may not be used after July 1. For your convenience, a chart outlining the state's Temporary Blanket Waivers for COVID-19 can be found here. 

With regard to the federal waivers, CMS has not announced any changes to the curre​nt 1135 waivers for hospitals and critical access hospitals at this time, which remain in effect as a result of the ongoing federal public health emergency.

​​Indian​a OSHA Announces Enforcement of Healthcare ETS Recordkeeping Provisions 

On May 25, the Indiana Occupational Safety & Health Administration (OSHA) announced that beginning Aug. 14, 2022, Indiana OSHA will enforce the recordkeeping provisions still in effect as a result of the federal OSHA’s Healthcare Emergency Temporary Standard (ETS).  The entirety of Indiana OSHA’s announcement can be found here.

As a reminder, on Dec. 27, 2021, the federal OSHA announced that the Healthcare ETS that was originally published on June 21, 2021, would expire until superseded by a permanent standard, except for the COVID-19 log and reporting provisions at 29 CFR 1910.502(q)(2)(ii), (q)(3)(ii)-(iv), and (r), which remain in effect.  While the federal OSHA is considering adopting a final Healthcare ETS, the timeline for a final standard and whether a final standard will ultimately be adopted are unknown at this time.  Both AHA and IHA submitted comments to ensure that if a final standard is adopted, it does not create conflicting requirements across federal regulatory agencies.

If you have any questions regarding Indiana OSHA’s enforcement of the recordkeeping provisions beginning Aug. 14, please contact IHA’s Vice President of Regulatory & Operations, Andy VanZee, at avanzee@ihaconnect.org or IHA’s Deputy General Counsel, Laura Brown, at lbrown@ihaconnect.org


​​Medicaid COVID-19 Coverage Following the Federal PHE

On May 25, the Indiana Family & Social Services Administration (FSSA) announced that in compliance with the federal American Rescue Plan Act of 2021, Indiana Medicaid will provide the following, with no cost sharing to Medicaid beneficiaries, starting at the end of the federal public health emergency (PHE) through the end of the last day of the first calendar quarter that begins one year after the last day of the federal PHE:

  • COVID-19 vaccines and their administration;
  • COVID-19 vaccine counseling under the Early and Periodic Screening, Diagnostic, and Treatment benefit for individuals 21 years of age and under;
  • COVID-19 testing; and 
  • COVID-related treatments. 
The entirety of FSSA’s announcement can be found here


​​CMS Issues Revised QSO 20-41 on Emergency Preparedness Exercises

On May 26, the Centers for Medicare and Medicaid Services (CMS) issued revised QSO 20-41​, which originally provided guidance on exemptions for emergency preparedness exercises based on a facility’s activation of its emergency plan.  The updated QSO makes it clear that the guidance also applies to outpatient providers that have activated or reactivated their emergency plan, in addition to inpatient providers.  The updated QSO also clarifies when providers must conduct their next emergency preparedness exercise, based on when their emergency plan was last activated or reactivated.  


The exemptions apply only for the next-full scale exercises, not exercises of choice.  Additionally, while facilities may be continuing to operate under an activated emergency plan, CMS encourages facilities to consider conducting their individual facility-based exercises, if possible.


​​Quality Measures Table Includes Changes Proposed in CMS PPS Rules

The Centers for Medicare & Medicaid Services (CMS) issued proposed rules in April that affect acute care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, long-term care hospitals, and PPS-exempt cancer hospitals. IHA has updated the quality measures table​ to reflect the proposed changes to quality measurement requirements announced in the rules. 

For questions regarding the quality measures table, please contact Elaine Pittman at epittman@IHAconnect.org or 317-423-7735.


IHA Weekly News - May 25, ​2022​ 

​​ Medical Ex​emption Guidance for CMS Interim Final Rule 

The Joint Commission recently received guidance from the Centers for Medicare & Medicaid Services (CMS) that organizations that accepted medical exemption documentation for an eligible individual prior to the CMS Interim Final Rule being published are required to retrospectively obtain any of the required missing documentation.  More information can be found on the Joint Commission’s website here, and examples of required documentation include:

  • Documentation signed and dated by a licensed practitioner;
  • Information specifying which of the vaccines are clinically contraindicated;
  • The recognized clinical reasons for the contraindication; and
  • A statement recommending the staff member be exempt.
If you have any questions, please contact IHA’s Deputy General Counsel Laura Brown at Lbrown@ihaconnect.org. 

​​Monkeypox Virus Infection in the United States and Other Non-endemic Countries

The Indiana Department of Health has distributed the attached CDC Health Advisory for monkeypox. Please see key highlights below and read the full advisory here​.


  • The Massachusetts Department of Public Health and CDC are investigating a confirmed case of monkeypox in an adult male Massachusetts resident with history of travel to Canada.
  • CDC is also tracking multiple confirmed and suspected clusters of monkeypox reported in early- to mid-May in several non-endemic countries, including in Europe and North America. Providers are encouraged to visit CDC's website for updates on affected countries.
  • Monkeypox should be considered as a possible diagnosis for patients presenting with clinically compatible illness​, especially those with a recent travel history to a country where monkeypox has been reported. 
  • A high index of suspicion for monkeypox is warranted when evaluating people with the characteristic rash, particularly for the following groups: 
    • ​Men who report sexual contact with other men and who present with lesions in the genital/perianal area.
    • People reporting a significant travel history in the month before illness onset.
    • People reporting contact with people who have a similar rash or have received a diagnosis of suspected or confirmed monkeypox
  • If you suspect monkeypox in a patient:
    • Immediately contact the Indiana Department of Health at 317-233-1325. After business hours, follow the prompts in the automated menu to be connected with the epidemiologist on call.
    • If the Indiana Department of Health cannot be reached, CDC can be contacted through the CDC Emergency Operations Center (770-488-7100).
    • All diagnostic specimens must be sent through the Indiana Department of Health. Specimens may not be sent directly to CDC without prior authorization.
Read the full CDC Health Advisory here​.


​​​2022 Indiana School Health Network Conference

The Indiana School Health Network is holding their annual conference June 20-21 at the Indianapolis Marriott East Hotel. This year’s theme of Celebrating School Health Successes is especially relevant as schools and communities continue to recover and succeed in the current COVID environment. Dynamic speakers, subject matter experts, exhibitors and networking opportunities will provide valuable information, resources, and inspiration to move initiatives forward. This is an opportunity to attend stimulating breakout sessions and connect with like-minded folks across the state​.

Because IHA is a sponsor/supporting organization, our members  may attend at no cost by using this link: www.eventbrite.com/e/243092695797/?discount=ISHN22GUEST​View the agenda and flyer.


IHA Weekly News - May 18, ​2022​ 

​​ Indiana Hospital Association Awards

The Indiana Hospital Association recognizes outstanding personal achievement in support of the humanitarian and management goals of Indiana health care institutions, and honors outstanding leadership and delivery of health care.

Various awards include the Distinguished Service Award, Award of Merit, Douglas J. Leonard Caregiver of the Year Award, Administrative Professional Excellence Award, and many more. 

If you know an individual who would be fitting for an award, please consider nominating them. Awards will be presented at this year's Annual Meeting in November. Submissions are due September 1. 


​​New Resources to Keep Hoosiers Covered after Federal Public Health Emergency Ends

The federal public health emergency will likely be extended through the fall of 2022 after a deadline came and went Monday without an announcement. HHS Secretary Xavier Becerra promised to give 60 days’ notice before the emergency expires, signaling the likely extension. The move would keep intact Medicaid coverage and a plethora of other policies enacted at the beginning of the pandemic — giving state officials, industry leaders and health care advocates more time to prepare for the public health emergency’s end. 

During the COVID-19 federal public health emergency, Indiana Medicaid members have been able to keep their coverage without interruption. However, when the federal public health emergency ends, Indiana Medicaid will begin to return to normal operations. IHA's Senior Vice President of Finance Terry Cole co-chairs the state’s Medicaid Advisory Committee with Indiana Medicaid Director Allison Taylor and has been working closely with the administration on this process to ensure a smooth transition. FSSA previewed a new website yesterday that is now live to assist people and offer health coverage options. IHA is encouraging hospital members to review these materials and use them in your communications with patients who are enrolled in Indiana Health Coverage Programs (IHCP) to help them stay covered.


​​May 19 Webinar: Navigating HIPAA’s Right of Access

Join Hall Render attorneys Stephane Fabus and Patricia Connelly to learn how to distinguish patient access requests from other requests for information, compare the requirements of the Information Blocking Rule versus HIPAA’s right of access, discuss the challenges with defining the designated record set and assess common scenarios that may give rise to liability. Register here.

Content conveyed at, or in conjunction with, this event does not constitute the opinion or views of IHA.

​​​June 9 Webinar: Stark Law Back to Basics

Join Hall Render attorneys Keith Dugger, Kerry Dutra, Alyssa James and Katherine Schwartz for a webinar on the basics of the Stark Law, including key definitions, exceptions, penalties for non-compliance, developments and trends, and compliance strategies for health care organizations. This presentation is Part 1 of their 2-part Stark Law and Anti-Kickback Statute Primer Series. Register here​.
Content conveyed at, or in conjunction with, this event does not constitute the opinion or views of IHA.


IHA Weekly News - May 11, ​2022​ 

​​National Nurses and Hospital Week

This week is National Nurses and Hospital week, and we are thrilled to celebrate them for all the hard work and love they pour into patients every day. We want to empower nurses and healthcare workers so they can best tailor clinical care for patients.

It's no secret COVID-19 was extremely tough on all our nurses and hospital staff. To mitigate and respond to the psychological toll of cries such as the pandemic, it is critical that health care organizations have systems in place that support institutional an individual resilience. Statewide, many Indiana hospitals are implementing resiliency strategies, such as Resilience and Emotional Support Teams (REST) program, to provide health care workers with facilitated debriefing sessions that increase individual resiliency and self-efficacy.

Along with caring for our hospital employees' mental health, it is also important they feel safe in the workplace. Hospitals and health care systems have long had robust protocols in place to detect and deter violence against their staff. Since the onset of the pandemic, violence against hospital employees has increased — and there is no sign it is receding. The hospital industry has urged the U.S. Attorney General to support legislation that would increase protections for health care workers from assault and intimidation. While we may never reduce violence in our hospitals to zero – because we are there to serve in the most challenging settings and circumstances – we can insist on zero tolerance for abusive behavior.  ​​

Join Your Peers in Supporting the Friends PAC

THANK YOU to the following hospitals who have met their Friends of Indiana Hospitals PAC goals for 2022: 
  • Adams Memorial Hospital ​
  • Baptist Health Floyd
  • Beacon Health System​
  • Clark Memorial Hospital 
  • Columbus Regional Hospital 
  • Deaconess Health​
  • Goshen Health
  • Greene County Memorial Hospital
  • Hancock Regional Hospital 
  • Harsha Behavioral Center
  • King’s Daughters’ Health
  • Lutheran Health Network
  • Northwest Health
  • OrthoIndy Hospital 
  • Perry County Memorial Hospital ​
  • Pulaski Memorial Hospital ​
  • River Bend Hospital
  • Rush Memorial Hospital
  • Schneck Medical Center​
  • Scott Memorial Hospital ​
  • St. Elizabeth Dearborn
  • Terre Haute Regional Hospital
  • Wellstone Regional Hospital

​​SUNRx 340B Webinar Series: 340B Regulatory Brief

Live Webcast Date/Time:  Tuesday, 6/14/22 - 2 PM ET

The regulatory environment for 340B pharmacy is in a constant state of change, requiring eligible entities to be nimble and disciplined in the management of their program. Navigating the current ecosystem of 340B pricing limitations created by Big Pharma requires an understanding of the current regulatory environment. This webinar will provide insights that will support decisions that position your entity to maintain a compliant and optimized 340B pharmacy program. 

In this session, we will share valuable insights for consideration in the management of your 340B pharmacy strategy. We will cover:

  • How did we get here?
  • Current regulatory environment
  • Implications moving forward


Content conveyed at, or in conjunction with, this event does not constitute the opinion or views of IHA.

​​DMHA RFI on Pediatric Health Network Mental Health Partnerships
 
On May 4, FSSA’s Division of Mental Health and Addiction (DMHA) released a Request for Information (RFI) regarding partnerships to place mental health professionals in existing pediatric health systems.  The RFI can be found here, and responses are due by June 3 at 3 PM ET.

As stated in the RFI, DMHA is interested in learning about existing, large pediatric providers interested in partnership with the State to integrate mental health professionals into their networks.  In order to maximize the impact of this partnership, the State is soliciting proposals from respondents who:

  • Have existing, pediatric provider networks serving children who reside in seven (7) or more counties in the State; and
  • Will commit to matching State investment on a one-to-one basis with cash (no in-kind matches will be permitted).
This RFI is an opportunity for DMHA to explore future grant making.

​​IHCP Bulletin

As a result of the Centers for Medicare & Medicaid Services (CMS) Update to COVID-19 Emergency Declaration Blanket Waivers for Specific Providers memorandum released on April 7, 2022, the Indiana Health Coverage Programs (IHCP) rescinds the provision of services in alternative settings granted by the CMS-approved 1135 waiver as a result of the coronavirus disease 2019 (COVID-19) public health emergency.

Effective for dates of service on or after June 6, 2022, the IHCP will reinstate the federal requirement that all facility providers must render services in a licensed facility to be fully reimbursed. This requirement includes the following facilities:

  • Nursing facilities (NFs)
  • Intermediate care facilities for individuals with intellectual disabilities (ICFs/IID)
  • Psychiatric residential treatment facilities (PRTFs)
  • Hospital NFs
View the full bulletin: BT202235.pdf

​​FDA Limits Use Of J&J COVID-19 Vaccine

The FDA has limited the authorized use for the Johnson & Johnson/Janssen COVID-19 vaccine to individuals who are ages 18 and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate, and to individuals ages 18 and older who elect to receive the Janssen COVID-19 vaccine because they otherwise would not receive a COVID-19 vaccine. This change in authorization is due to the risk of thrombosis with thrombocytopenia syndrome.

​​IHCP COVID-19 Response

In response to the national public health emergency due to the coronavirus 2019 (COVID-19), the Indiana Health Coverage Programs (IHCP) is offering financial relief to Indiana units of local government and independent ambulance operators. The purpose of these grants is to improve transportation services to members residing in their home and needing nonemergent care and services within their community that requires the use of an ambulance.

The IHCP is making available a one-time, federally funded grant opportunity to cover the cost to purchase bariatric ambulances at $180,000 per vehicle, and up to two vehicles per applicant, aimed at increasing nonemergency medical transportation (NEMT) services. 

To be eligible for an HCBS ambulance grant, providers must meet the following criteria as of the date of attestation submission:

  • Appropriately licensed to operate ambulances and be an actively enrolled IHCP provider as a transportation provider contracted with the state’s fee-for-service NEMT program, currently administered by Southeastrans, Inc.
  • Willing to pick up members at their own residence, such as house, condo or apartment. Separate funding is available to assist members in addressing structural accessibility issues that may reduce/limit the ability of the Emergency Medical Services (EMS) to enter the residence with the necessary equipment.
  • Able to submit a quarterly usage report and an annual impact report to the Office of Medicaid Policy and Planning (OMPP).
  • Agree to schedule and bill for services according to the state and NEMT broker policies.
  • Comply with the requirements of Code of Federal Regulations 2 CFR 200.313 – Equipment upon receipt of grant funds and cooperate with the appropriate state or federal agencies to verify ongoing compliance. 
View the full bulletin: BT202236.pdf

​​Drug Shortage Of Iohexol And Related Mitigation Strategies

Nationwide shortage of the GE contrast product Iohexol (Omnipaque) is causing some concerns. This shortage is expected to be resolved by the end of June. Facilities experiencing shortages are encouraged to explore use of contingency contrast agents that remain available on the market. As this is a global issue for GE, it is unlikely that other facilities would have sufficient supplies on hand. Facilities also can explore if the supplier has an identical product in different volumes than typically ordered. 

Below are potential conservation strategies to consider:

  • Evaluate the amount of on-hand inventory
  • Seek other means of securing contrast media including alternate wholesalers and distributors
  • Evaluate incoming CT and x-ray orders to determine if an alternate imaging modality can be utilized
  • Discuss protocol options with radiology leadership, radiology staff, and ordering physicians including Emergency Department physicians, cardiologists, and outpatient imaging providers to ensure protocols are evaluated for the appropriate use of contrast media
  • Where appropriate, consider adjusting scanning protocols to scan without contrast and injector protocols to reduce the amount of contrast dose
  • Communicate opportunities for conservation and awareness of wasted contrast media to CT, x-ray, interventional, and catheterization lab technologists
  • Develop a communication plan for referring physicians and all imaging departments; leverage appropriate use criteria for when to utilize contrast-based CT examinations

 ​​​
IHA Weekly News - May 4, ​2022 

​​Reminder: Certain Waivers for Nursing Facilities to End

 As a reminder, on Apr. 7, CMS issued QSO 22-15, announcing the end of certain waivers for skilled nursing facilities (SNF), inpatient hospices, intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), and end-stage renal disease (ESRD) facilities within 30 to 60 days from the publication of the QSO, as outlined below. QSO 22-15 did not impact the SNF waivers related to the three (3) day prior hospitalization stay and pre-admission screening (PASARR), and at this time, CMS has not announced any changes to the current 1135 waivers for hospitals and critical access hospitals. 

 On May 7, the following waivers will expire for SNFs: 

  • Resident Groups - 42 CFR §483.10(f)(5)
  • Physician Delegation of Tasks in SNFs - 42 CFR §483.30(e)(4)
  • Physician Visits - 42 CFR §483.30(c)
  • Quality Assurance and Performance Improvement - 42 CFR §483.75(b)–(d) and (e)(3)
  • Detailed Information Sharing for Discharge Planning - 42 CFR §483.21(c)(1)(viii)
  • Clinical Records - 42 CFR §483.10(g)(2)(ii)

On June 7, the following waivers will expire for various facilities: 

  • ​Physical Environment for SNFs - 42 CFR §483.90
  • Equipment Maintenance & Fire Safety Inspections for ESRD facilities - 42 CFR §494.60(b) and(d)
  • Facility and Medical Equipment Inspection, Testing & Maintenance (ITM) for Inpatient Hospice, ICF/IIDs and SNFs - 42 CFR §§418.110(c)(2)(iv), 483.470(j), and 483.90
  • Life Safety Code and Health Care Facilities Code ITM for Inpatient Hospice, ICF/IIDs and SNFs - 42 CFR §§ 418.110(d)(1)(i) and (e), 483.470(j)(1)(i) and (5)(v), and 483.90(a)(1)(i) and (b)
  • Outside Windows and Doors for Inpatient Hospice, ICF/IIDs and SFNs – 42 CFR §§418.110(d)(6), 483.470(e)(1)(i), and 483.90(a)(7)
  • Life Safety Code for Inpatient Hospice, ICF/IIDs, and SNFs - 42 CFR §§418.110(d), 483.470(j), and 483.90(a)
  • Paid Feeding Assistants for LTC facilities: 42 CFR §§483.60(h)(1)(i) and 483.160(a)
  • In-Service Training for LTC facilities – 42 CFR §483.95(g)(1)
  • Training and Certification of Nurse Aides for SNFs - 42 CFR §483.35(d)

​​ ​​CDC Health Alert Network​

The CDC HAN (health alert network) issued an alert describing an individual who tested positive for avian influenza A(H5) virus (H5 bird flu) in the US. Based on current CDC guidance for a confirmed case who is hospitalized, facilities should plan to follow standard contact and airborne precautions, which is a higher level than seasonal influenza. These precautions should be within the capabilities and scope of a traditional hospital setting. Currently, the risk of transmission from birds to humans is low. The potential risk of human-to-human transmission is extremely low. Local health departments (LHDs), hospitals, and local healthcare providers should continue to coordinate regarding the potential, although low, risk of having a patient with avian influenza within their jurisdiction.

If you have any questions, please contact the Indiana Department of Health, Epidemiology Resource Center at 317-233-1325.


IHA Weekly News - April 27, ​2022​
 

​​AHA Annual Meeting 2022

After not taking place in 2020 and 2021, the American Hospital Association (AHA) held their Annual Meeting this week in Washington, DC. Brian Tabor, Trent Fox, and Kristin Schwartz joined IHA members and hosted meetings with Indiana legislators at the Capitol​. As the first meeting since the COVID-19 pandemic, this year’s meeting was critical to reinvigorating relationships at the federal level. 

Thank you to Senator Young and Senator Braun for meeting with Indiana constituents to discuss issues facing the health care industry.

​​​May 13 Deadline: IHA Compensation Survey

The deadline for the compensation section of the 2022 Indiana Healthcare Compensation and Benefits Survey is May 13.

Time is running out to participate in the compensation portion of the 2022 Indiana Healthcare Compensation and Benefits Survey, presented by Indiana Hospital Association and Gallagher Surveys.  Please download the compensation survey template and upload to the portal by May 13. The survey is the premier source of compensation data for healthcare organizations across the state. Your organization's participation will grant you access to an indispensable planning tool while also helping build a resource used by your peers.

The reporting process is simple. 
  1. Download​ the compensation questionnaire and populate it with your organization's information. Complete instructions are included on the first tab of the worksheet.
  2. Upload your completed compensation spreadsheet to Gallagher’s secure server.

Important: If you are reporting for multiple hospitals/locations, you may include all of them on one compensation submission.

If you have questions, please contact Thomas Cummins at Gallagher Surveys (Thomas_Cummins@ajg.com). 

​​DMHA Request for Funding

The Division of Mental Health and Addiction has recently released RFF-2022-009 with the intent of increasing the number of low-barrier shelters for unhoused individuals in Indiana. You can find more information here: https://www.in.gov/fssa/dmha/funding-information/

 There will be an information Webinar on May 3rd, 2022 at 2pm EST for opportunity to learn more and ask questions. 

IHA Provides Tools to Promote Workforce Wellbeing

Promoting workforce wellbeing and resiliency has been a priority for IHA both before and during the pandemic and will continue to be a priority going forward.  Check out this Workforce Wellbeing video from Laurie Gerdt, Patient & Quality Safety Advisor here​.

​​Indiana Department of Health Advisory

The Indiana Department of Health (IDOH) is working with the Centers for Disease Control and Prevention (CDC) and health care providers who may have identified any individual cases or increase of acute hepatitis of unknown etiology in children in Indiana.  Based on a case timeline from other states, the IDOH is conducting a review of potential cases back to October 2021 via medical record search, and we will issue syndromic alerts moving forward. The IDOH wishes to coordinate with any clinicians who identify cases, and we will provide more details as this investigation continues across the United States and Europe.

Healthcare providers who suspect they have identified a case or increase in pediatric acute hepatitis of unknown etiology matching the description provided in the attached CDC HAN, are urged to notify the IDOH and provide the pertinent clinical details, including liver function testing, viral hepatitis testing, liver transplant status, adenovirus testing, and epidemiologic details of importance for the patient (such as travel status). Hospital laboratories may be asked to hold specimens for additional adenovirus testing, including whole blood specimens. Read the full CDC Health Advisory​.

For consultation or to report suspected cases to the IDOH Epidemiology Resource Center, please contact Nicole Stone, Senior Enteric Epidemiologist, at 317-234-2898 or nstone2@isdh.in.gov.
​​
​​Upcoming Gallagher Events for IHA Members

Gallagher is offering a couple May events for IHA members:

May 4, Town Hall: Inflation Frustration: Internal communication for high stress times

Persistent inflation, a volatile economy and high competition for talent are top challenges for organizations today. Employers are looking for ways to create loyalty while engaging and retaining talent. Gallagher's May 4 town hall, “ Inflation Frustration: Internal communication for high stress times," will outline trends, challenge assumptions and encourage strategic internal communication, all with the goal of helping employers maximize the impact of their messaging to support their workforce during these stressful times. This session is also pending approval for 1 hour of HRCI and SHRM accreditation. 

Register: https://event.on24.com/wcc/r/3727793/EF051125CEDC9395557E5E60E851E321?partnerref=AssociationIHA

May 18: The Women's Leadership Series

Join Gallagher's Virtual Women's Leadership Series event, Advocate For Your Time, on Wednesday, May 18. Given the blurred lines between work and home and the constant glamorization of busyness, it's no surprise that many working women feel overextended. Our panel will discuss strategies to counteract overwork culture and ways to get intentional about your time, both personally and professionally. 

Register: https://event.on24.com/wcc/r/3677216/7FBB746E34054389E58AB9238FBAC5CB?partnerref=AssociationIHA


​​​​​​​​​​​​​IHA Weekly News - April 13, ​2022​ 
​​
Black Maternal Health Week

This year marks the fifth-year anniversary of the Black Maternal Health Week campaign that takes place every year from April 11 - 17 and was officially recognized by the White House on April 13th, 2021. IHA recognizes that health disparities exist in th​e state of Indiana. We are committed and prioritize health equity by asking Indiana birthing hospitals to begin screening for social determinants of health in the maternal-infant health population through our Safety PIN C efforts.  

IHA is committed to reduce health disparities in the maternal-infant population so that all Hoosiers and infants receive an equal opportunity to achieve optimal health and well-being. 

IHA is partnering with the community and hospital members to implement an innovative health disparities framework. It is our goal to engage the community by transforming individual social determinants of health screening data into local population health data, where we will then target health disparities through analysis and visual presentation of maternal-infant data. This will allow Indiana birthing hospitals to better serve the patients in their communities and act on identified health disparities through local and statewide interventions. 

Please join us in commemorating the 5th anniversary of Black Maternal Health Week and take part in unforgettable activities & conversations aimed at shifting the state of Black Maternal Health in the U.S. Learn more: https://blackmamasmatter.org/bmhw/

​​Moving Forward: A New Focus On Patient Care Webinar Series

The Indiana Hospital Association, in partnership with 19 other state hospital associations, is pleased to bring an energizing, virtual engagement opportunity to our members. 

The series, led by national speakers from Huron Consulting (formerly Studer Group), looks to the future by moving forward from the COVID-19 pandemic and turning the focus to patient care. The  series is designed for all health care managers and supervisors, including those in the nursing and allied health professions, who would like to fine-tune their management skills.

Registration is limited to the first 250 people, so please secure your spot by registering today. Registration will automatically close when the registration limit has been reached. Sessions take place from 1 – 2 p.m. ET.  Register for this free series today: https://cvent.me/XD7KL1

May 3: Everyday Habits to Create a Culture of Innovation - Natalie Painchaud, Director of Learning, Innosight
June 14: Creating an Environment of Trust through Compassion - Karen Cook, RN, Coach & National Speaker, Huron
July 12: The Patient as a Consumer: How to Create Experiences  Patients Value - David Duncan, PhD, Managing Director, Innosight
August 16: Leading a Change-Ready, Inclusive Environment  - Kristie Tobias, Director, National Speaker & Author, Huron

Additional information, including ​full session descriptions and objectives, can be found here​.

​​CMS Issues Revised QSO 22-09 on Interim Final Rule 

On Apr. 5, CMS issued revised QSO 22-09​, which originally provided survey guidance on CMS’s Interim Final Rule (IFR) regarding COVID-19 vaccination of health care staff.  

The revised QSO clarifies and provides the following: 

  • ​Surveying for staff vaccination requirements is not required on Life Safety Code (LSC)-only complaints or LSC-only follow-up surveys.  
  • Surveyors may modify their staff vaccination compliance review if a provider was determined to be in substantial compliance with the requirement within the previous six (6) weeks.  

​CMS also issued a revised Attachment D, which accompanies the revised QSO 22-09 for hospitals.  The revised Attachment D clarifies and provides the following:

  • ​The term “temporarily delayed vaccination” now includes “known COVID-19 infection until recovery from the acute illness (if symptoms were present) and criteria to discontinue isolation have been met.”
  • With regard to the requirement that mitigation measures be taken for unvaccinated staff, Attachment D clarifies that the examples included are not all inclusive and only represent actions that can be implemented.
  • During the entrance conference to determine compliance with the CMS IFR, a hospital will be asked to provide its process for how the hospital ensures that its contracted staff are compliant with the vaccination requirement. 
  • During the record review, interview, and observations portion to determine compliance with the CMS IFR, there should be a minimum sample of six (6) direct care/patient engagement staff.  Of this sample, four (4) should include vaccinated staff/contractors, and two (2) unvaccinated staff/contractors (one (1) who is not fully vaccinated and one (1) with a medical exemption or temporary delay).  Two (2) of the direct care staff sampled should be contractors. 
    • ​​Surveyors should also choose a sample of at least of two (2) contracted staff (one (1) vaccinated and one (1) unvaccinated or exempt) who are not included in those direct care contracted staff outlined above.
  • Failure of contract staff to provide evidence of vaccination status reflects noncompliance and should be cited under the requirement to have policies and procedures for ensuring that all staff are fully vaccinated, except for those staff who have been granted exemptions or a temporary delay.
​​​​CMS Announces End of Certain Waivers for Nursing Facilities

On Apr. 7, CMS issued QSO 22-15, announcing the end of certain waivers for skilled nursing facilities (SNF), inpatient hospices, intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), and end-stage renal disease (ESRD) facilities in the next 30 to 60 days, as outlined below.  QSO 22-15 does not impact the SNF waivers related to the three (3) day prior hospitalization stay and pre-admission screening (PASARR), and at this time, CMS has not announced any changes to the current 1135 waivers for hospitals and critical access hospitals.  

Thirty (30) days from the publication of QSO 22-15, the following waivers will expire for SNFs:  

  • Resident Groups - 42 CFR §483.10(f)(5)
  • Physician Delegation of Tasks in SNFs - 42 CFR §483.30(e)(4)
  • Physician Visits - 42 CFR §483.30(c)
  • Quality Assurance and Performance Improvement - 42 CFR §483.75(b)–(d) and (e)(3)
  • Detailed Information Sharing for Discharge Planning - 42 CFR §483.21(c)(1)(viii)
  • Clinical Records - 42 CFR §483.10(g)(2)(ii)
Sixty (60) days from the publication of QSO 22-15, the following waivers will expire for various facilities:  

  • Physical Environment for SNFs - 42 CFR §483.90
  • Equipment Maintenance & Fire Safety Inspections for ESRD facilities - 42 CFR §494.60(b) and(d)
  • Facility and Medical Equipment Inspection, Testing & Maintenance (ITM) for Inpatient Hospice, ICF/IIDs and SNFs - 42 CFR §§418.110(c)(2)(iv), 483.470(j), and 483.90
  • Life Safety Code and Health Care Facilities Code ITM for Inpatient Hospice, ICF/IIDs and SNFs - 42 CFR §§ 418.110(d)(1)(i) and (e), 483.470(j)(1)(i) and (5)(v), and 483.90(a)(1)(i) and (b)
  • Outside Windows and Doors for Inpatient Hospice, ICF/IIDs and SFNs – 42 CFR §§418.110(d)(6), 483.470(e)(1)(i), and 483.90(a)(7)
  • Life Safety Code for Inpatient Hospice, ICF/IIDs, and SNFs - 42 CFR §§418.110(d), 483.470(j), and 483.90(a)
  • Paid Feeding Assistants for LTC facilities: 42 CFR §§483.60(h)(1)(i) and 483.160(a)
  • In-Service Training for LTC facilities – 42 CFR §483.95(g)(1)
  • Training and Certification of Nurse Aides for SNFs - 42 CFR §483.35(d)
IHA will update the COVID-19 Waiver Tracker webpage as the applicable waivers expire.

​​IHA​ Counsel Listserv​​

If you or a member of your team is interested in receiving relevant legal memorandums and updates, please contact IHA’s Deputy General Counsel, Laura Brown, at Lbrown@ihaconnect.org to be added to IHA’s counsel listserv.

​​ ​​ ​​HHS Distributing $1.75 Billion in Provider Relief Fund Payments

On Apr. 13, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced more than $1.75 billion in Provider Relief Fund payments will be distributed to 3,680 providers across the country.  

With this latest round of payments, nearly $21 billion of the $25.5 billion in funding has been distributed.  Phase 4 payments reimburse smaller providers for a higher percentage of losses during the pandemic and include bonus payments for providers who serve Medicaid, Children's Health Insurance Program, and Medicare beneficiaries.

Providers can use Provider Relief Fund payments received in the first half of 2022 to cover losses and expenses until June 30, 2023.  With these latest payments, approximately 92% of all Phase 4 applications have been processed.  IHA is learning to what extent Phase 4 funds were received by hospitals and will keep members updated accordingly. 

​​​ ​​IHA COVID-19 Operations Transition Resource

The goal to ensure the safety of patients, visitors, and staff against COVID-19 and all infectious diseases remains paramount for Indiana hospitals. As COVID-19 cases decline in communities, policies and procedures for managing operations may be adjusted. As organizations consider these adjustments, it may benefit establishing thresholds to determine how screening, masking, and visitation will be impacted during low and high periods of high hospitalizations and community spread. The IHA team has developed COVID-19 Operations Transitions Resource.

While we are seeing this period of decline, as health care providers, we must keep in mind that the prospect of new variants remain a concern. To ensure Indiana is prepared for a next surge of COVID-19, the Indiana Department of Health asks that its partners have updated their emergency plans in place. State Health Commissioner Kristina Box​ encourages everyone to maintain support capabilities developed during the COVID-19 pandemic to best prepare for future surges.   


IHA Weekly News - April 6, ​2022​ 

State Lawmakers Review ​Feedback from Hospitals, Insurers

Senator Bray and Speaker Huston released a statement on their receipt of the responses submitted to them based on their December letter to certain hospitals and insurers. In their response, they released the response letters​ submitted to them.

Prior to their statement, IHA released a statement reaffirming Indiana hospitals’ commitment to affordability and our willingness to continue working with stakeholders and policy makers to further advance the momentum our members have generated to ensure Hoosiers receive the best value when seeking and receiving health care services.

In the next few weeks, IHA will meet with the legislative leaders to further discuss their feedback and determine next steps. For more information, the full article can be found here.

Important:  Updated No Surprises Act Toolkit

IHA worked with our partners at Hall Render to update the No Surprises Act Toolkit and model forms to reflect two recent changes.  Specifically, the recent Texas Medical Association v. HHS decision, which invalidated the presumption that the qualifying payment amount is the appropriate in-network rate, and House Enrolled Act (“HEA") 1238 from the 2022 legislative session, which helped align state and federal law. 

Please note, while the impact of the Texas Medical Association v. HHS decision is effective immediately, the changes as a result of HEA 1238 are not effective until July 1, 2022.  Accordingly, the updated model forms should not be utilized until July 1, 2022. 

Thank you to Angela Smith and Matt Reed for their work on the updated toolkit, and please contact Laura Brown at Lbrown@ihaconnect.org with any questions.

Indiana’s Hospital Systems Stand Committed to Affordability
​​

Indiana’s health care heroes stood at the bedside of those battling COVID-19 for the last two years. As we emerge from the pandemic, hospitals continue to stand with Hoosiers, united in our commitment to high-quality care and affordability. Despite the unprecedented strain of the pandemic, we have implemented new tools that provide an unprecedented level of price transparency. 

This new era of transparency has fueled rapid change in the marketplace, and lower costs will come from the fundamental change in the way health care is delivered in Indiana. Learn more about CEO committment to healthcare affordability.

Deadline Extended to Submit Speaker Proposals for IHMPRS Conference

The Indiana Healthcare Marketing & Public Relations Society (IHMPRS) Board of Directors invites individuals and organizations to submit proposals to present at our annual Strategic Communications Summit to be held July 21-22, 2022 at Good Samaritan in Vincennes, Indiana.  We are looking for presenters with innovative topics addressing the advancement of healthcare-related marketing.

Topics include: Strategic Planning, Marketing, Communications / Public Relations, Digital Engagement, Diversity  Equity and Inclusion, Pandemic Recovery, Crisis Communication, Career and Leadership Development, Artificial Intelligence. 

The deadline to submit a proposal has been extended to April 15. Submit a proposal.​

IHCP Extends Medicaid Postpartum Coverage to 12 Months

On March 31, the Indiana Health Coverage Programs issued Bulletin BT202226, announcing that effective April 1, the postpartum coverage period for Healthy Indiana Plan Maternity and Hoosier Healthwise members will be extended from 60 days to 12 months of continuous eligibility, regardless of change in circumstance that would otherwise result in loss of eligibility.

There are no changes to the benefits covered, and members will continue to be exempt from cost-sharing during pregnancy and the postpartum coverage period.

 ​IHA Weekly News - March 30​, 2022​ 

​​OSHA ​Seeking Comments on Final Healthcare ETS Standard – Feedback Requested

On M​ar. 22, the U.S. Department of ​Labor's Occupational Safety and Health Administration (OSHA) announced that it has reopened the rulemaking record to seek comments on the development of a final standard to protect healthcare workers from workplace exposure to COVID-19.  OSHA is therefore seeking feedback as it works toward making the Healthcare ETS, originally issued on June 21, 2022, a permanent rule (as a reminder, the COVID-19 log and reporting provisions of the Healthcare ETS at 29 CFR 1910.502(q)(2)(ii), (q)(3)(ii)-(iv), and (r) remain in effect per OSHA's announcement here). ​

A list of those specific items OSHA is seeking feedback on as it considers a final standard can be found here.  IHA intends to submit comments by the Apr. 22 deadline.  Please contact Laura Brown at Lbrown@ihaconnect.org by Apr. 8 if you have any feedback on those items listed. ​​

​ ​IHA Invites You to Attend AHA's Annual Meeting on April 25-26

After not taking place in 2020 and 2021, the American Hospital Association (AHA) will hold an in-person Annual Meeting April 25-26 at the Marriott Marquis in Washington, D.C. IHA will attend along with hospital a​nd health systems leaders and trustees. If you plan to attend, please read the memo​​ and complete the form​ by April 15 so that we can include you in our events. We will host a dinner on Monday night for IHA members and are arranging Capitol Hill visits with our Congressional delegation on Tuesday, April 26.

Visit the AHA's Annual Meeting webpage for more details and registration information for AHA-specific programming.

 ​​​​​​​​​​​IHA Weekly News - March 23​, 2022​

Health care was a major focus for lawmakers during the 2022 session of the Indiana General Assembly and IHA successfully passed important legislation impacting hospitals, including addressing Indiana's health care workforce shortage, exempting health care facilities from conflicting state and federal COVID-19 vaccine requirements, streamlin​ing Indiana's good faith estimate law with the federal No Surprises Act, extending Medicaid coverage for pregnant women, and more. In addition, IHA successfully defeated numerous harmful proposals, including those that would have prohibited physician non-compete contracts, cut hospital reimbursement for worker's compensation claims, made changes to Indiana's public forum law, and more.

Some of these proposals will be back under consideration next session as special interest groups continue to attack hospitals to advance their own agendas. We cannot afford to fall short next session – there is simply too much at stake. 

So far, we have raised $21,000 of our $215,000 goal for 2022. Please consider raising your donation to Friends and contributing today to help us jump-start the campaign. You can find your hospital's goal here  and you can donate online here.  In addition, please find information on how to run a campaign at your facility here.  Please contact Laura McCaffrey to begin that process. ​

​​​​​​​​​​​ ​​​​​​​​​​​IHA Weekly News - March 9​, 2022​

​​​IDOH to Reissue COVID-19 Waivers through June

​The Indiana Department of Health (IDOH) has communicated with IHA its intention to reissue all of its current COVID-19 Waivers through June. 

The Waivers currently in effect are linked below and are effective for 45 days following the end of the state's Public Health Emergency declaration, which was withdrawn on Mar. 3, 2022, per IDOH's Order issued on Aug. 9, 2021.  IDOH then intends to reissue the Waivers once again through June.  IHA will distribute the renewed Waivers as soon as they are available. 

  • COVID-19 NATIONAL/STATE EMERGENCY HOSPITAL BLANKET WAIVER: CONVERSION OF STANDARD PATIENT ROOMS TO NEGATIVE PRESSURE ISOLATION ROOMS:  Link HERE
  • SECOND COVID‐19 NATIONAL/STATE EMERGENCY HOSPITAL BLANKET WAIVER: PATIENT ROOMS:  Link HERE
  • THIRD EMERGENCY ORDER GRANTING TEMPORARY BLANKET WAIVERS FOR HOSPITALS:  Link HERE
  • EMERGENCY ORDER GRANTING TEMPORARY BLANKET WAIVERS FOR AMBULATORY OUTPATIENT SURGICAL CENTERS:  Link HERE ​


I
HA Weekly News - March 2, 2022​

​IDOI Releases 2022 Patient’s Compensation Fund Surcharges


On February 22, 2022, the Indiana Department of Insurance (IDOI) published Bulletin 263 outlining the surcharges for physicians and hospitals for the Patient’s Compensation Fund (PCF) effective July 1, 2022. Notably, Bulletin 263 provides that the 2022 PCF surcharges for physicians and hospitals will remain flat and will not change from the current effective rates as outlined in the Bulletin. 

For more information, please access IHA’s Memorandum on the 2022 PCF Surcharges here.

 IDOI’s Bulletin 263 can be accessed here​.  ​

IDOH Issues Engineering Standards Update


The Indiana Department of Health recently issued the following letter regarding the engineering standards for hospitals and ambulatory surgical centers. 

As outlined in the letter, the COVID-19 pandemic has delayed IDOH from adopting formal rules to update the constructure standards per Senate Enrolled Act 575 from the 2019 legislative session.  However, IDOH’s letter clarifies that notwithstanding the current administrative code, the following apply to a publication that is referred to in 410 IAC 15 (Hospital Licensure Rules):

  • ​​​​The Guidelines for Construction and Equipment of Hospital and Medical Facilities refers to the following:
    • The 2018 edition or most recent publication of the Guidelines for Design and Construction of Hospitals.
    • ​​The 2018 edition or most recent publication of the Guidelines for Design and Construction of Outpatient Facilities.
  • The National Fire Protection Association (NFPA) 101, Life Safety Code publication refers to the 2012 edition as adopted by CMS.
  • The National Fire Protection Association 99, Health Care Facilities Code publication refers to the 2012 edition as adopted by CMS, excluding chapters 7, 8, 12, and 13.
IDOH will seek to update its administrative code to reflect the above changes.

​Surprise Billing Litigation


On February 23, 2022, the U.S. District Court for the Eastern District of Texas struck down​ the following provisions of the federal regulations implementing the No Surprises Act (NSA), finding the regulations conflicted with the statutory text of the NSA, as a result of the lawsuit brought by the Texas Medical Association:

  • The requirement that the Independent Dispute Resolution (IDR) entity select the offer closest to the Qualified Payment Amount (QPA) unless there is credible information to demonstrate that the QPA is not the appropriate rate;​
  • The requirement that “additional information” clearly demonstrate that the QPA is materially different from the out-of-network rate;
  • The definition of “material difference” at 45 C.F.R. § 149.510(a)(2)(viii);
  • All four examples on how IDR entities should choose between competing offers at 45 C.F.R. § 149.510(c)(4)(iv); and
  • The requirement that the IDR entity explain why it chose an offer not closest to the QPA.

 At this time, HHS/CMS have not indicated whether they will update the regulations accordingly, and HHS/CMS are expected to appeal the Texas District Court decision.  A similar lawsuit filed by AHA and AMA is currently pending in the U.S. District Court for the District of Columbia.  IHA will continue to keep you updated on this front.​

IHCP Rescinds Certain Temporary COVID-19 Policy Changes​

On Mar. 1, the Indiana Health Coverage Programs issued Bulletin 202215, announcing that certain temporary policy changes that were enacted in response to the public health emergency will expire as of Mar. 31.  Those temporary policy changes include those outlined in the following bulletins:  ​​​​​

  • BT202174IHCP temporarily reinstates revisions to PA process for acute care hospital non-elective inpatient admissions
  • BT202178IHCP temporarily revises time frames for certain PA approvals
  • BT202179: IHCP reinstates inpatient SUD and psychiatric admission policy changes
  • BT202180: PA changes temporarily reinstated for some DME/HME supplies and services
  • BT202181: IHCP reinstates temporary PA changes for managed care SNF admissions
  • BT202182: IHCP temporarily reinstates PA policy for LTAC and AIR facility admissions​

​​​IHA Announces Friends PAC Award Winners for 2021​

IHA is pleased to announce that Community Health Network, Rush Memorial Hospital, and Cameron Memorial Hospital have been recognized by IHA for their exceptional contributions to the 2021 Friends Political Action Committee (PAC)​ campaign. IHA will formally recognize these members at the 2022 Annual Awards Luncheon as part of our Annual Meeting on November 2, 2022. Community Health Network will be recognized for contributing the greatest total amount to Friends, raising $13,350 in 2021. Rush Memorial Hospital will be recognized for contributing the highest percentage of their individual goal, raising 286% of their goal last year. Cameron Memorial Hospital will be recognized for most improved, raising 160% of their goal in 2021 compared to 7% of their goal the year before. IHA wants to thank all members who donated to the Friends campaign last year – we successfully increased donations by 30%. With much at stake in the year ahead, your donations make a real impact. While the 2022 Friends campaign does not formally launch until March, members can get a head start by donating online and contacting Melissa Vise to begin running a campaign. Find your hospital/system’s individual goal here.​


IHA Weekly News - February 23, 2022

FSSA: Changes to Postpartum Coverage

On Feb. 16, the Family and Social Services Administration published a notice of changes to postpartum coverage for Indiana Medicaid recipients. The changes include:

  • Expanding the eligibility group to pregnant women whose income level does not exceed two hundred eight percent (208%) of the federal poverty level for the same family size;
  • Removing Medicaid limitations for eligible pregnant women seeking medical assistance coverage for only pregnancy-related services; and
  • Extending postpartum coverage for eligible women from sixty (60) days to twelve (12) months.

These changes will be effective April 1, 2022. Access the full notice here.​

IDOH: Updated Abortion Reporting Forms

The Indiana Department of Health (IDOH) recently released updates to three (3) abortion reporting forms to include notarization changes in Indiana Code. Hospitals should ensure they are using the most updated versions of the following forms found below, and all forms can be found on IDOH’s website here.

IHA Distributes COVID-19 HRSA Funds to Participating Indiana Hospitals​

The Indiana Hospital Association team distributed the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP) funding through the American Rescue Plan (ARP) for COVID -19 testing and mitigation initiatives. Last week, checks were mailed to the contacts provided by each of the 40 hospitals. If participating hospitals have not received their checks by Feb, 28, please contact Becky Royer​

HRSA awarded the funding to existing Small Rural Hospital Improvement Program (SHIP) grantees. In Indiana, the grantee is the Indiana Department of Health’s State Office of Rural Health (SORH). SORH partnered with IHA to assist with the fund distribution for eligible Indiana rural hospitals and the reporting requirements back to HRSA. The grant is intended to help rural hospitals in increasing COVID–19 testing efforts, expand access to testing in rural communities and expand the range of mitigation activities to meet community needs within the Centers for Disease Control and Prevention (CDC) Community Mitigation Framework. Eligible rural hospitals included those with fewer than 50 beds and critical access hospitals.        

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