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MHA has a Health Care Finance Council that has 19 members and works with all hospital chief financial officers and reimbursement managers to develop strategy for financial and reimbursement policy. MHA develops financial impact analysis for all potential changes in Medicare, Medicaid and other governmental agency policies. At the state level, MHA serves as the primary liaison with the Department of Health and Human Services, the Maine Health Data Organization, the Maine Health and Higher Educational Facilities Authority, HealthInfoNet, the Office of the State Coordinator, the Worker’s Comp Board and other agencies to advance hospital priorities. At the federal level MHA also works with the Centers for Medicare & Medicaid Services, the Health and Human Services Regional Office, and the Medicare Administrative Contractor to influence those policies.
MHA works with the Administration and the Department of Health and Human Services understand the full impact of any law or policy changes. MHA also works with the Department of Health and Human Services (DHHS) Audit Division, to assure that prior year MaineCare settlements are accurately calculates and paid according the budgeted schedule.
Health Care Finance Council
HIT Meaningful Use Payments
MHA works with the CMS and DHHS to develop a system to qualify hospitals for Medicare and Medicaid meaningful use incentive payments. Payments were successfully distributed to hospitals beginning in 2011 and will continue for a multi year period.
Medicaid Recovery Audit Contractor
Beginning in 2012, all states are required to have a Medicaid Recovery Audit Contractor. It is expected that MHA will work with DHHS as it develops this new program.
Medicare Recovery Audit Contractor
MHA continues to monitor the work of the Medicare RAC and helps hospitals work with the AHA tool RAC
AHA RacTRAC Survey
Free Care Policies Survey
Transition to New Medicaid Claims Processing System
MHA worked with the state to design the new Medicaid DRG system, which will largely eliminate the need for prospective payments and subsequent settlements. The Association also helped with the conversion to the DRG system, assisting the department with training hospitals.
MHA will work with the Department in a similar fashion to develop and implement the new APC payment system for outpatient services. This new system is scheduled to go into place on July 1, 2012.
MHA coordinates the work of a Wage Index Consulting firm which audits the state’s non-critical access hospitals. The contractor develops cost report information which is then included in the state’s Medicare wage index calculation.
Worker’s Compensation Fee Schedule
MHA works with the Worker’s Compensation Board to transition payments to a new fee schedule based upon the same payment level that was previously in place.
This new fee schedule leads to more predictable payment of workers’ compensation claims. MHA is also involved in all of the hospital training to help hospitals implement the new fee schedule.