Month: May 2023

Medicare Cost Report Compliance Camp

May 24, 2023

Medicare Cost Report Compliance Camp

Click Here to Download Information Packet w/Camp Syllabus

AIHC has partnered with KraftCPAs LLC to bring you this exciting program and opportunity to Certify as a Cost Report Specialist. Certification is optional after camp. Network with other professionals, learn the Medicare cost report process, and train to become a Certified Cost Report Specialist (Optional) Online, after camp!

This training camp is designed for novice or seasoned cost report preparers who would like to enhance their skillset by obtaining a professional certification and recommended for:

  • Chief Financial Officers
  • Accounting staff
  • Revenue cycle professionals
  • Reimbursement professionals
  • Employees tasked with gathering information for Medicare cost reports at healthcare organizations.

Experienced Cost Reporting Professionals will have the option to certify as a Certified Cost Report Specialist (CCRS) after successful completion of the Medicare Cost Report Training Camp.

Upon registration you are given ready access to downloadable information such as:

  • COVID and Cost Reporting
  • Overview of DSH
  • FAQ
  • e-Filing requirements
  • Documentation Requirements
  • Abbreviations & Terms
  • Sample cost report
  • Cost Report and Compliance Video.

Prerequisites: Basic knowledge of the preparation of Medicare cost reports, with some experience either gathering information for cost reports or actively preparing cost reports for an institutional healthcare organization.

Advanced Preparation: A number of documents will be provided to you electronically before camp begins. You are responsible for reviewing these documents prior to the first day of camp.

Program Level: Basic

Instructional Delivery Method: Group Live

A hard copy training manual is provided at camp. Additional training materials are provided to you electronically after the training camp ends.

Earn Continuing Education Units:

18 CEUs – This program has been approved for 18 continuing education units by the American Institute of Healthcare Compliance for AIHC Certified Professionals. These continuing education units may be applied towards the Ethics or HIPAA Category CEU Renewal Requirements for all AIHC credentials. They may also be applied towards the Core Category CEU Renewal Requirements for ALL AIHC credentials.

Participants will earn 12 CPE credits/ Field of Study:

  • Specialized Knowledge – The American Institute of Healthcare Compliance is registered with the National Associate of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors.
  • State boards of accountancy have final authority on the acceptance of individual courses for CPE credit.
  • Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.nasbaregistry.org

Earn your “CCRS” credential – attend camp, certify online after camp. Cost to certify is already included in camp tuition.

Medicare-certified institutional providers, such as hospitals, SNFs, HHA, FQHC, and RHCs are required to submit an annual cost report to a Medicare Administrative Contractor (MAC).

Certification is recommended for:

  • Chief Financial Officers (CFOs)
  • Accounting staff
  • Revenue cycle and reimbursement professionals
  • Employees tasked with gathering information for Medicare cost reports at all healthcare organizations.

Who should attend?

  • Novice or seasoned cost report preparers working for an institutional provider
  • CPA or consulting firm assisting institutions to file cost reports who desire training and certification as a cost report specialist

When: October 24 – 25

Where: Dallas, TX

Cost

  • AHIC members pay $695
  • Non-members (public) pay $825

Registration Deadline: October 10 @12:00 pm EDT

Click Here to Download Information Packet w/Camp Syllabus

Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility for a Low-Income Subsidy and Disability Stratified Report

May 23, 2023

Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility for a Low-Income Subsidy and Disability Stratified Report

The Centers for Medicaid Services” Office of Minority Health (CMS OMH) released a report detailing the quality of care received by people enrolled in Medicare Advantage (MA).

The Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability report presents summary information on the performance of Medicare Advantage plans on specific measures of quality of health care reported in 2021, which corresponds to care received in 2020. Specifically, this report compares the quality of care for four groups of Medicare Advantage enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability.

Overall, the report showed that people who were dually eligible for Medicare and Medicaid or eligible for the Low-Income Subsidy received worse clinical care than those who were not. The largest differences between the two groups were in the areas of Follow-up After Hospital Stay for Mental Illness (within 30 days of discharge), Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with Dementia, and Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with a History of Falls. Disparities by dual eligibility status/Low-Income Subsidy eligibility status were least common among Hispanic individuals and most common among White individuals. The report also shows more pronounced disparities in clinical care for dually eligible/Low-Income Subsidy eligible individuals in urban areas as compared to rural areas.

This report is based on an analysis of data from the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS collects information from medical records and administrative data on the technical quality of care that Medicare Advantage enrollees receive for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease.

Health care professionals, organizations, researchers, and hospital leaders can utilize this report along with other CMS tools and resources to help raise awareness of health disparities, develop health care interventions for Medicare Advantage enrollees who are dually eligible for Medicare and Medicaid/Low- Income Subsidy eligible and those with disabilities, and implement quality improvement efforts that improve health equity.

Help CMS to advance equity by sharing this report and our resources on prevention and health equity initiatives. Also, sign up for CMS’ listserv or visit https://go.cms.gov/omh for more information.

Webinar – Addressing the C in ACEs Roundtable

May 22, 2023

Webinar – Addressing the C in ACEs Roundtable

The American Public Health Association (APHA) is hosting its second Adverse Childhood Experiences (ACEs) roundtable, Addressing the “C” in Aces: Building Community Resilience. This two-day event will bring together experts and community organizations to discuss the essence of building community resilience to combat ACEs. The webinar will focus on efforts to prevent and respond to the ACEs crisis. The roundtable allows attendees to gain new insights and leave with actionable strategies to address the ACEs crisis.

Topics Include:

  • Building Community Resilience – Child Welfare, Domestic & Community Violence Prevention
  • Building Community Resilience – Restorative Practices, Healing Circle and Justice
  • Building Community Resilience through Strategic partnerships with Culturally Specific Organizations
  • The Power of Healing: Supporting Children to Overcome Trauma
  • The Way Forward

Agenda

All sessions will be recorded and available a week after the meeting. This event is free for APHA members and non-members thanks to a grant.

Register Here

HRSA’s National Maternal Mental Health Hotline

May 22, 2023

HRSA’s National Maternal Mental Health Hotline

HRSA recently celebrated the first anniversary of the National Maternal Mental Health Hotline. Since its launch on Mother’s Day 2022, the Hotline’s professional counselors have provided emotional support, resources, and referrals to almost 12,000 pregnant and postpartum individuals who struggled with mental health concerns, and their loved ones.

HRSA is also introducing an updated toll-free number for the Hotline: 1-833-TLC-MAMA (1 833-852-6262). The former number (1-833-9-HELP-4-MOMS or 1-833-943-5746) will continue to work for another year.

The National Maternal Mental Health Hotline provides 24/7, free, confidential emotional support, resources, and referrals before, during, and after pregnancy. The Hotline is accessible by phone or test in English and Spanish and offers interpreter services in more than 60 languages. Pregnant and postpartum individuals and their loved ones can get the help and resources they need when they need it.

Read the full press release.

Free Mental Health Awareness Month Toolkits and Resources

May 22, 2023

Free Mental Health Awareness Month Toolkits and Resources

The American Hospital Association (AHA) – This Mental Health Month, challenge yourself to examine your world and how it can affect your overall health. Look around, look within – from your neighborhood to genetics, many factors come into play when it comes to your mental health. AHA’s Mental Health Month toolkit includes information about how an individual’s environment impacts their mental health, suggestions for making changes to improve and maintain mental well-being, and how to seek help for mental health challenges.

Download AHA’s Mental Health Awareness Toolkit

Substance Abuse and Mental Health Services Administration (SAMHSA) – Check out what SAMHSA is doing and share their materials. Remember we all play active roles in caring for our mental health!

The SAMHSA toolkit is a one-stop shop:

  • Social media content to help spread awareness about the vital role mental health plays in our well-being, promote acceptance and support of anyone living with a mental illness, and share key resources.
  • Best practices for engaging in healthy discussions about mental health.
  • Promotional materials for mental health awareness in May and beyond.

All of the SAMHSA materials are designed to be shared with your audiences and across your media channels; they are downloadable and shareable, and some of the material is customizable.

How to Use the Toolkit:

  • Copy, download, and share our social messages, graphics, and promotional materials in ways that fit the needs of your audiences and channels.
  • Use SAMHSA hashtags, including #MHAM2023, when sharing any Mental Health Awareness Month-related content.
  • Use SAMHSA tools in tandem with the actions recommended in Best Practices with your communities and networks.

SAMHSA Mental Health Awareness Month Toolkit:

  • Key Messages and Weekly Themes
  • Social Media Sharables
  • Hashtag Guidance
  • Stickers
  • Resources for Content Development
  • Tips for Engaging in Respectful Conversations Around Mental Health

Click here for SAMHSA Mental Health Awareness Toolkit

National Institute of Mental Health (NIMH) – During National Mental Health Awareness Month, be part of the conversation about mental illness and raise awareness about the National Institute of Mental Health’s (NIMH) resources related to mental health.

Click here to download the NIH Digital Toolkit for Mental Health Awareness Month with sample messages for Twitter, Facebook, LinkedIn, Instagram and for Email content.

The Joint Commission releases new public education campaign, Speak up For Your Mental Health, to help consumers understand the signs and symptoms of mental illness, as well as how they can receive help and advocate for their care.

“Since the beginning of the COVID-19 pandemic, we have seen an increase in rates of anxiety, depression and substance use disorder,” says Haytham Kaafarani, MD, MPH, FACS, chief patient safety officer and medical director, The Joint Commission. “It is more important than ever to reduce the stigma of mental illness and made sure that individuals speak up to get the help they need. I encourage anyone who feels that they may need help to talk with a family, friend or someone they trust, and reach out to a provider who can work with them to navigate the best treatment and journey forward.”

Click Here for Joint Commission Resources

HRSA Funding Opportunity – Rural Maternity and Obstetrics Management Strategies Program – HRSA-23-049

May 19, 2023

HRSA Funding Opportunity – Rural Maternity and Obstetrics Management Strategies Program – HRSA-23-049

The Health Resources Services Administration (HRSA) announces the funding opportunity HRSA-23-049 – Rural Maternity and Obstetrics Management Strategies (RMOMS) program. The purpose of the RMOMS program is to establish or continue collaborative improvement and innovation networks to improve access to and delivery of maternity and obstetrics care in rural areas.

Goals of program:

  • Identify and implement evidence-based and sustainable delivery models for the provision of maternal and obstetrics care in rural hospitals and communities
  • Enhance and preserve access to maternal and obstetric services in rural hospitals
  • Provide training for professionals in health care settings that do not have specialty maternity care
  • Collaborate with academic institutions that can provide regional clinical expertise and help identify barriers to providing maternal health care, including strategies for addressing such barriers
  • Assess and address disparities in infant and maternal health outcomes

Applicants are encouraged to propose novel ways to achieve these goals through the establishment or continuation of collaborative improvement and innovation networks. The RMOMS program seeks to document and monitor progress on these goals through the collection of aggregate data from each RMOMS award recipient and their network members. All network members will be REQUIRED to collect and share aggregate data.

This program intends to preserve access to and continuity of maternal and obstetrics care in rural communities that address the following RMOMS Focus Areas:

  • Rural Hospital Obstetric Service Aggregation A regional network with several rural hospitals that are facing challenges in providing obstetric services could aggregate obstetric services to a targeted rural hospital or Critical Access Hospital (CAH) within the rural region to revive or sustain rural obstetric and maternal services.
  • Approaches to Risk-Appropriate Care Pregnant patients in a rural region should receive care in a facility that best meets their needs and those of their neonates through appropriate risk stratification.
  • Financial Sustainability Rural hospitals who have coordinated and aggregated their obstetrics services, in partnership with Medicaid and other payers, should aim to demonstrate improved outcomes and potential savings with the goal of ensuring ongoing support of the network once federal funding ceases.

Eligible Applicants

  • Non-profit or for-profit entities providing prenatal care, labor care, birthing, and postpartum care services in rural areas, frontier areas, or medically underserved areas, or to medically underserved populations
  • Indian Tribes or Tribal organizations

Join the Applicant Technical Assistance Webinar: May 31, 2023, 2 – 3 p.m. ET

Dial-In Toll-Free (833-568-8864

Meeting ID: 160 363 0214

Passcode: 42409094

Application Deadline: July 7, 2023

Apply Here

Webinar – Secrets of Compassionate Accountability

May 18, 2023

Webinar – Secrets of Compassionate Accountability

Join Custom Learning Systems for their webinar “Secrets of Compassionate Accountability” on June 9, 10 a.m. CT.

You will learn how to:

Build stronger, more trusting relationships while maintaining high standards of accountability

Implement leadership behaviors that uplift and empower your people

Continuously affirm the principles that all people are valuable, capable and responsible

Ask 3 questions that will guarantee a new and valuable perspective on culture change and engagement

Practical Take-away Action Tools:

Compassionate Accountability Culture Assessment

Building Compassionate Cultures in Healthcare

Register Now

Funding Opportunity Now Open! Up to 3 Grants Totaling $1 Million for Health Equity Researchers at Minority Serving Institutions

May 18, 2023

Funding Opportunity Now Open! Up to 3 Grants Totaling $1 Million for Health Equity Researchers at Minority Serving Institutions

The Centers for Medicare & Medicaid Services Office of Minority Health’s (CMS OMH) Minority Research Grant Program (MRGP) is proud to release a Notice of Funding Opportunity (NOFO) for researchers at minority-serving institutions (MSIs). As a grantee, you will partner with CMS OMH to grow your research credentials, increase public knowledge of health equity, and join the ranks of other published MRGP awardees.

The funding opportunity supports researchers at MSIs, who are investigating or addressing health care disparities affecting CMS OMH focus populations, including:

  • Racial and ethnic minority groups
  • Members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community
  • People with disabilities
  • Individuals with limited English proficiency
  • Individuals who live in rural areas
  • Individuals otherwise adversely affected by persistent poverty or inequality.

CMS will award up to 3 grants, totaling up to $333,000 each.

Eligible MSIs include:

  • Historically Black Colleges and Universities (HBCUs)
  • Hispanic-Serving Institutions (HSIs)
  • Tribal Colleges and Universities (TCUs)
  • Asian American and Native American Pacific Islander-Serving Institutions (AANAPISIs)
  • Newly Eligible MSIs in 2023: Native American Serving Non-Tribal Institutions (NASNTIs), Alaska Native and Native Hawaiian-Serving Institutions (ANNHSIs), and Predominantly Black Colleges (PBCs)

Review the notice of funding opportunity CMS-1W1-23-001 on grant.gov.

Deadline to submit applications is July 12, 2023. 

To learn more about CMS OMH and the MRGP, visit go.cms.gov/minorityresearch, watch the MRGP overview video, or email OMHGrants@cms.hhs.gov.

Xylazine-Involved Fatal Drug Overdoses in Missouri, 2019-2022

May 17, 2023

Xylazine-Involved Fatal Drug Overdoses in Missouri, 2019-2022

Xylazine is used in veterinary medicine as a sedative and muscle relaxant, but it is not approved by the Food and Drug Administration (FDA) for use in humans. Persons who use xylazine-adulterated opioids are at high-risk for fatal overdose. The White House Office of National Drug Control Policy declared xylazine and the use of fentanyl adulterated or associated with xylazine (FAAX) an emerging threat on April 12, 2023. Missouri DHSS detected a sharp increase in xylazine involved deaths in Missouri from 39 deaths in 2021 to 109 deaths in 2022, a 180% increase. Nearly two thirds (65%) of those deaths occurred in adults between 25 and 44 years of age. For all xylazine-involved deaths in 2019-2022, synthetic opioids were also found in 99.4% of these deaths. Increased surveillance and public education, as well as expanded postmortem testing for xylazine is needed, especially in Missouri jurisdictions with a high prevalence of fentanyl use.

Xylazine is an α-2 agonist similar to clonidine, lofexidine, and dexmedetomidine. It is used in veterinary practice as a sedative and analgesic. Xylazine is not FDA approved for human use and is not controlled under the federal Controlled Substances Act (CSA). This non-opioid agent is increasingly being found in combination with opioids such as fentanyl. Xylazine is known as “tranq” or “tranq dope” in the illicit drug market. The drug’s reported duration of effect is longer than that of fentanyl; therefore, it may enhance the euphoria and analgesia induced by fentanyl and reduces the frequency of injections. Recreational use of xylazine can occur via oral ingestion, smoking, snorting, or intramuscular, subcutaneous, or intravenous injection (most common). When used in combination with an opioid, such as heroin or fentanyl, xylazine may worsen respiratory depression during the drug overdose.

Xylazine was found in over 90% of illicit drug samples tested in Philadelphia in 2021 (1). As of March 2023, fentanyl mixed with xylazine had been found in drug seizures in 48 states (2). According to the CDC, the estimated number of drug-poisoning deaths in the

United States involving xylazine went from 260 in 2018 to 3480 in 2021, a 1238% increase (2). The analysis published in MMWR found that among 45,676 overdose deaths reported from 38 states and the District of Columbia in 2019, xylazine was detected in 1.8% of the deaths, and xylazine was listed as a cause of death in 64.3% of deaths in which it was detected (3). In a Cook County, IL study, fentanyl or fentanyl analogs were detected on forensic testing in most xylazine-involved deaths (99.2%). Other common co-occurring substances included diphenhydramine (79.7%), cocaine (41.1%), and quinine (37.3%) (4). Many coroners and medical examiners may not include xylazine in their routine toxicology testing which would leave it largely undetected when investigating cause of death.

Xylazine Involved Deaths in Missouri

A sharp increases in xylazine-associated deaths were observed in Missouri in 2021 and 2022 (Figure 1.). Among death cases, 73% were males. Nearly two third (65%) of xylazine involved deaths occurred in adults between 25 and 44 years of age (Figure 2.). Four adjacent Missouri jurisdictions (St Louis City, St Louis, St Charles, and Jefferson counties) comprise 86% of death cases during the 2019-2022 time period. It is likely that better availability of xylazine testing in the St Louis metropolitan area is contributing to those jurisdictions being overrepresented. For all xylazine-involved deaths in 2019-2022, synthetic opioids were also found in 99.4% of these deaths. Improved availability of xylazine testing in the recent years could be contributing to the sharp increase of xylazine associated death reports in 2021 and 2022.

Clinical Information

As a centrally acting α2 -agonist medication, xylazine inhibits the release of norepinephrine and epinephrine. The effects on the central nervous system include sedation, analgesia, and euphoria. Reduced sympathetic outflow from the central nervous system causes decreased peripheral vascular resistance, heart rate, and blood pressure. All routes of exposure to xylazine have been associated with drowsiness or coma, and in rare instances, apnea and death. Xylazine also causes decreased sensitivity to pain, respiratory depression, bradycardia (low heart rate), hypotension (low blood pressure), and potentially hypothermia. After taking xylazine with an opioid, a person may experience bradycardia and hypotension not explained by heroin or fentanyl alone. Respiratory depression reported in people using xylazine is likely due to the drug increasing the risk of opioid-induced respiratory depression. Xylazine can cause severe circulatory changes with peripheral vasoconstriction leading to poor tissue perfusion, skin ulceration, and necrosis. People who inject drugs containing xylazine can develop severe skin wounds and patches of dead and rotting tissue that easily become infected and, if left untreated, may lead to amputation (Picture 1.). These wounds can develop in areas of the body away from the injection site and may become life-threatening. Soft tissue infections at injection sites and loss of digits have been reported as well. Because xylazine’s duration of effect is longer than that of fentanyl or heroin, repeated intake may allow xylazine levels to accumulate.

People who use xylazine may develop dependence, and have severe withdrawal symptoms, such as irritability, anxiety, and dysphoria when the drug is stopped abruptly. Severe xylazine withdrawal symptoms are unlikely to be managed by medications for opioid use disorder (MOUD) (i.e., methadone, buprenorphine, or naltrexone). Limited data are available for clinical management of the xylazine withdrawal in inpatient settings. Therefore, xylazine presents new potential public health challenges associated with possible withdrawal signs and symptoms in those with xylazine-related substance use disorder.

Routine toxicology tests do not test for xylazine. It may therefore be under-detected and under-accounted for in overdose cases and other life-threatening events. Since xylazine is not an opioid, it does not respond to naloxone, and there is no antidote or reversal agent for xylazine. Even though naloxone is not effective in treating drug overdoses caused solely by non-opioids, such as xylazine, the administration of naloxone may be helpful in drug overdoses caused by a combination of xylazine and opioids like fentanyl and its analogues. Therefore, when a patient presents with a possible exposure to xylazine, practitioners should provide routine care for opioid intoxication, particularly the administration of naloxone, as indicated. The treatment for overdoses involving xylazine is supportive: airway maintenance, breathing and circulation support, and infusion of IV fluids. If indicated, early administration of atropine may mitigate the onset or severity of bradycardia.

Recommendations

  • Public education, especially among people who use illicit drugs, regarding the possible presence of xylazine in illicit drugs and the need for emergency medical care even when naloxone is administered.
  • Any individual suspected of consuming substances containing xylazine should receive counseling about the dangers of this substance and extensive advice on harm reduction.
  • Because xylazine is most often mixed with opioids, the individual exposed to xylazine should also be offered access to medications for opioid use disorder (MOUD) (i.e., methadone, buprenorphine, or naltrexone) and referral to treatment to reduce opioid overdose risk.
  • Health care providers should consider the presence of xylazine when managing drug overdose, especially when naloxone administration is ineffective.
  • Expand postmortem testing for xylazine and co-occurring substances in opioid-related deaths.
  • While routine toxicology tests do not test for xylazine, local jurisdictions may establish partnerships with toxicology laboratories that can identify xylazine in drug or biologic samples.

For questions on management of these patients, contact the Missouri Poison Center (1-800-222-1222)

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Tuition-free Public Health Certificate for Missouri Residents

May 16, 2023

Tuition-free Public Health Certificate for Missouri Residents

A.T. Still University’s College of Graduate Health Studies has been awarded a grant from the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services to offer the Public Health Workforce Certificate program to Missouri residents’ tuition free.

This grant will increase public health leadership for COVID-19, health equity, and emergency services in rural and urban underserved areas of Missouri and among racial/ethnic individuals.

Program Benefits

  • No application fee, tuition, or technology fee for qualified students. Students will be responsible for textbooks and any course retake costs
  • Courses will carry into the Master of Public Health (MPH) program or Master of Public Health – Dental Emphasis (MPH-D) program degree for advanced standing
  • After completing the certificate program, students are eligible for a 20% tuition discount toward the full MPH program. The MPH-D program does not qualify for this discount.

Application Requirements

  • Bachelor’s degree from an accredited university
  • Minimum cumulative 2.5 GPA
  • Proficiency in English (TOEFL testing required if English is not your first language)
  • Grant requirements (see below)

Grant qualifications

  • Must meet certificate requirements
  • Must be a Missouri resident
  • Must be one of the following:
    • BIPOC
    • LGBTQ+
    • Person with disabilities
    • Live in an underserved or rural community
    • Member of religious minorities

Contact an enrollment rep today at (877) 626-5577 or email cghsonlineadmissions@atsu.edu