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November Hospital View E-Newsletter

Oregon Association of Health and Hospital Systems

HHS Announces Final Rule on 340B Ceiling Prices is Effective January 1

The Department of Health and Human Services issued its final ruling on prescription drug ceiling prices and monetary penalties for 340B hospitals. The 340B Drug Pricing Program will take effect January 1, 2019.
The American Hospital Association issued a statement in support of the ruling, which followed a lawsuit brought by the AHA. OAHHS was one of the organizations in favor of the lawsuit, and filed an amicus brief in a show of support. The collective effort urged prompt implementation of the program with the goal of bringing fair pricing and transparency to the process. HHS had previously announced a July 1 implementation date.
"We continue to strongly urge HHS to make available online drug pricing information for 340B hospitals as this rule requires as soon as possible after January 1, and no later than April 1, so that instances of drug company overcharging can be uncovered and penalties enforced," said AHA Executive Vice President Tom Nickels.
HHS has said in the past that it needed more time to consider additional rulemaking to replace the Obama-era regulation with one drafted by the Trump administration.
Agency leaders had a change of heart, as evidenced by this decision. "HHS does not believe that any further delay is necessary and is changing the effective date," according to a statement from HHS.
In addition, HHS noted that the Jan. 1 start date will not interfere with any subsequent rulemaking it may release on 340B ceiling prices.


Governor Brown Issues Recommended Budget for 2019-2021

Governor Kate Brown released her recommended budget for the 2019-2021 biennium. The budget outlines her policy priorities and direction. It offers insight into the governor's views on health care and hospitals, particularly regarding the Medicaid budget. Here are some of the highlights of her proposals, as outlined by OAHHS' Andy Van Pelt:
• Increases the reimbursable hospital provider tax to a full 6 percent producing $98M in new state funds
- Eliminates the .07 percent true tax on DRG hospitals that sunsets in 2019
• Increases the Health Insurance, Managed Care and Stop-Loss Assessment to 2 percent. This generates $410M in new state funds, with $90M being allocated to the Oregon Reinsurance Program in the individual market
• Creating a Subsidized Employer Assessment to generate $119.5M in new state funds. This new assessment is on employers who do not provide health care coverage to low-income workers, or whose workers cannot afford the coverage they are offered.
• Increasing the tobacco tax by $2/pack (smokeless tobacco, cigars, vapes and e-cigarettes included)
- December 2020 start date of the increased tobacco tax would bring in $95M in new state funds and $346M in the 2021-2023 biennium.
Key Takeaways
• Hospitals have been part of a year-long process to seek and identify sustainable solutions for Medicaid funding. The Governor’s budget represents the culmination of that process.
• We support the outcome which represents a very positive step forward towards a long-term solution that puts Medicaid on a stable funding platform.
• We now will turn to working with the Legislature to pass this package during the Legislative Session.
As always, it is now up to the Legislature to pass the final budget. We will keep you apprised with regular updates during the upcoming session.

We Did It! Thank You for Voting YES on Measure 102

OAHHS was an active supporter of Measure 102. We believe that housing is health, and that creating more affordable housing across our state is one of Oregon's top priorities.
So we were happy with the election results. Measure 102 passed by nearly 14 percentage points.
The measure will enable local governments to partner with private and nonprofit partners to build more affordable housing with bonds.
Research has shown the connection between health and safe, stable, and affordable housing.
We thank all of you who voted yes on Measure 102.

Hospital Charity Care Spending on the Rise Again

Oregon’s community hospitals are again spending more on charity care, despite having one of the lowest rates of uninsured residents in the country, according to financial performance reporting by Apprise Health Insights from the third quarter of 2018. Despite the increase, median operating margins held steady from the same period last year.
“While the notion was that charity care would be basically eliminated as result of the ACA, and there was a dramatic drop, we’re seeing it increase again,” said Andy Van Pelt, executive vice president at the hospital association. “That would imply the coverage isn’t covering the cost of health care.”
The charity care numbers stand in contrast to the widely held view that charity care has been essentially eliminated in Oregon due to the Affordable Care Act. While charity care costs are below pre-ACA levels, they are on an upward trend as many patients continue to need free or reduced-price services.

Save the Dates: Oregon Hospital Meetings in 2018

Below are some of the upcoming meetings and events that are scheduled for this year. More information about each of these will be sent out as the events approach.
-- Dec. 5: Oregon Nurse Staffing Collaborative Meeting
-- Dec. 12-14: Legislative Days, State Capitol, Salem

A View from Capitol Hill

This month, we bring you a breakdown of federal policy and political topics from the election.
Read the latest issue of A View from Capitol Hill here.

Updated price data now available on Oregon Hospital Guide

Patients can now check the latest prices by hospital for the most common inpatient and outpatient procedures. The new data is now available on the Oregon Hospital Guide website under "procedure costs."
OAHHS leaders say the information, based on state reporting, shows member hospitals' commitment to transparency. "Hospitals are dedicated to the concept that every Oregonian, whether insured, uninsured, or out of network, should be empowered with the financial information they need to make better health care decisions for themselves and their families," said Andy Davidson, president and CEO.
The new cost data shows the media amount paid by commercial insurers, including deductibles and co-pays for members. The website also shows the statewide media price per procedure.