NYC Health + Hospitals is the largest public health care system in the United States, and their facility in Elmhurst, Queens serves one of the nation’s most ethnically and linguistically diverse neighborhoods. NYC Health + Hospitals/Elmhurst’s medical residents come from near and far to train in one of their seven residency programs. In this edition…

GNYHA released its Emergency Preparedness Initiatives and Activities: 2017 Annual Report, which details trainings and programs covering various emergency preparedness topics; collaborative workgroups that addressed complex issues; and our monthly Emergency Preparedness Coordinating Council, during which GNYHA, government response partners, and hospital and health system emergency managers from across the region gather to discuss various…

On Monday, GNYHA submitted comments on the US Department of Health and Human Services’ (HHS) request for information on the Trump Administration’s Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. The letter focuses on protecting the 340B Drug Pricing Program, increasing competition in the generic drug space, the challenges facing providers in the proposal…

GNYHA has filed the attached formal complaint with the New York State Department of Financial Services (DFS) regarding Aetna’s practice of down-coding billed diagnosis-related groups if Aetna determines that codes included in the bill did not impact hospital resource use. Numerous hospitals brought this practice to our attention by raising concerns about the arbitrary nature…

GNYHA held meetings on July 12 of the Delivery System Reform Incentive Payment (DSRIP) Analytics Workgroup and the DSRIP Finance and Strategic Planning Workgroup. More than 75 representatives from 22 DSRIP performing provider systems (PPSs) gathered to discuss the DSRIP payment methodology, novel analytic methods for improving patient care with data, and performance on DSRIP…

GNYHA’s inaugural Health Care Systems Engineering Community of Practice meeting on June 28 included presentations by systems engineers at Montefiore Health System, Mount Sinai Health System, Northwell Health, and NewYork-Presbyterian Hospital. GNYHA’s Engineering Community of Practice is a platform for individuals in the systems engineering field to meet, network, learn, share, and get peer feedback….

The Medicare Payment Advisory Commission (MedPAC) has released its June 2018 report to Congress, which details various issues affecting the Medicare program. Mandated report: The effects of the Hospital Readmissions Reduction Program (HRRP) MedPAC analyzed the impact of the HRRP on hospital 30-day readmissions and determined that between 2010 and 2016, unadjusted readmission rates fell…

On July 11, the New York State Department of Health (DOH) published a notice of adoption of amendments to section Part 405.9 of Title 10 of the New York Codes, Rules, and Regulations (NYCRR) pertaining to identifying, assessing, and referring individuals with substance use disorders (SUD). The amendments, which go into effect immediately, require hospitals…

I’m writing to update you on two important organ transplantation-related issues: a GNYHA-supported lawsuit challenging Federal liver distribution policies, and GNYHA’s organ donation advocacy in the context of the status of the organ procurement organization (OPO) LiveOnNY. GNYHA-Supported Lawsuit Challenges HHS’s Liver Distribution Policies A lawsuit was filed today against the Department of Health and…

The New York State Department of Health (DOH) released a “Dear Administrator Letter” (attached), along with preliminary rate schedules for the July 1, 2018, acute care rebased rates for Medicaid fee-for-service, Medicaid managed care, and Workers’ Compensation/No-Fault. Hospitals have until August 1 to submit appeals to DOH. Appeals are limited to mathematical or clerical errors;…

The New York State Department of Health (DOH) has recast the 2015 disproportionate share hospital (DSH) Indigent Care Pool (ICP)/Upper Payment Limit (UPL) distribution model (file attached). This was done to incorporate data corrections based on the final audited 2015 Institutional Cost Reports, and to process outstanding hospital appeals. The changes have positive and negative…