Weekly News Updates

​​​​​​​​​​​IHA Weekly News - May 18, ​2022​ 

​​ IHAAwards6.jpgIndiana 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. 


​​ shutterstock_1607029330.jpgNew 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.



​​hall render.pngMay 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.


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

​​ basics.jpgJune 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.  

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 week.jpgNational 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. 


friends cover2.pngJoin 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: Goshen Health, Greene County Memorial Hospital, Hancock Regional Hospital, Harsha Behavioral Center, King’s Daughters’ Health, Lutheran Health Network, Northwest Health, OrthoIndy Hospital, River Bend Hospital, Rush Memorial Hospital, St. Elizabeth Dearborn, Terre Haute Regional Hospital, and Wellstone Regional Hospital.



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​​ 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.

​​ request.jpgDMHA 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.

​​ b7b4d79e-de09-6d16-c18a-46c2e86294fd.pngIHCP 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

​​ JJ.jpgFDA 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.


​​ Ambulance.jpgIHCP 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

​​ shortage.jpgDrug 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​ 

​​wheelchair.jpgReminder: 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)

​​ ​​ bird flu2.jpgCDC 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 2022AHA.jpg

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.



​​ survey2.jpgMay 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). 

​​ FSSA_logo_banner_sm.jpgDMHA 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 PrPlay2.pngovides 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​.


​​ cdc.jpg 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.
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​​ b0d03657-1d10-9985-ee34-e7dc1b41b2f2.jpgUpcoming 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​ 
​​
BMHW 22 Intro Flier.pngBlack 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/



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​​ 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​.


​​ vaccine3.jpgCMS 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.
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​​ walker.jpgCMS 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.

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​​ 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.




​​ ​​ ​​PRF.jpgHHS 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. 


​​​ ​​ covid2.jpgIHA 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.   

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IHA Weekly News - April 6, ​2022​ 

statehouse.jpgState 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 Toolkitbills.jpg

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.


ceos affordability2.pngIndiana’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.

IHMPRS.png 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.​


maternity.jpgIHCP 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​ 

​​ comments.jpgOSHA ​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 hereIHA 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. ​​


register now.jpg

​ ​ 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​

friends cover.PNGHealth 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​


​​waivers stock image.jpg​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 ​

IHA Weekly News - March 2, 2022​


funds.png​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​.  ​





engineering2.pngIDOH 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-bills.png​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.​



covidpt.pngIHCP 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:  ​​​​​

  • BT202174: IHCP temporarily reinstates revisions to PA process for acute care hospital non-elective inpatient admissions
  • BT202178: IHCP 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​



awards1.png​​​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


Mama.pngFSSA: 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.​




forms.pngIDOH: 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.




funding.pngIHA 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.