State news: Calif. insurer to close for one week; math mistakes cost hospitals in Mass, R.I. millions

Here’s a roundup of the latest state healthcare news, including a deadly bacteria closing down a Maryland neonatal intensive care unit and why one state lawmaker in Missouri has been blocking efforts to create a prescription drug monitoring database.

Blue Shield of California taking 4-day break to combat ACA losses

The San Francisco Business Times reported Blue Shield of California will require thousands of employees to stay away from Sept. 6 to 9 in order to reduce “payroll-related liabilities,” and save money after claiming losses from its insurance exchange business.

Employees will be paid for the time off. Company spokesman Steve Shinvisky said it wanted to reduce the paid time off liability on its books before the end of the year, and do so before open enrollment begins.

Some workers, like customer service and IT employees, will be expected to remain on the job.

The insurer said the strategy would save about $4 million. The company has already cut about 400 jobs this year, and asked for a 20 percent increase in premiums for 2017 exchange plans. It didn’t mention how much it expects to lose from its exchange business in 2016.

CMS denies appeal on mistake affecting Medicare for Mass., R.I. hospitals

Massachusetts hospitals could lose $84 million thanks to one hospital’s math mistake which CMS ruled it won’t be allowed to fix.

A quirk in Medicare rules gives Partners Healthcare a disproportionate impact on the state’s reimbursement rates. It owns Nantucket Cottage Hospital, the state’s only rural hospital, and since Medicare rules require rural hospitals to be paid as least as much as urban facilities for employee wage reimbursement, Nantucket sets the floor for the entire state.

This year, consultants hired by Partners erroneously reported lower wages by overestimating hours and not including enough physician hours and overtime pay. Partners didn’t submit corrected data to CMS until April 5—two months after the deadline to submit corrections. While lawmakers and hospital groups encouraged the agency to consider the updated data, CMS denied the request.

“We have consistently stated in annual (inpatient reimbursement rules) rulemaking that hospitals that do not meet the procedural deadlines set forth in the IPPS rule will not be afforded a later opportunity to submit wage index data corrections,” CMS said in its ruling, according to the Boston Business Journal.  “Therefore, we are not incorporating the adjustments requested by Nantucket Cottage Hospital for the FY 2017 final rule wage index.”

While hospitals were already going to see reimbursements reduced by $26 million in 2017, $84 million is directly attributable to the accounting errors.

The ruling would also cost Rhode Island hospitals $7 million, since reimbursement rates there are based on Massachusetts data, according to WPRI in Providence.

Mary. hospital closes NICU after potentially dangerous bacteria found

Prince George’s Hospital Center temporarily shut down its neonatal intensive care unit on Aug. 9 after tests discovered the potentially fatal pseudomonas bacteria.

The Washington Post reported the bacteria was found in the nasal swabs of three infant patients at the Cheverly, Maryland, hospital. Nine patients in total were transferred to the NICU of Children’s National Medical Center in Washington, D.C. “out of an abundance of caution,” according to hospital spokeswoman Delores Butler.

The Post said two infants had died in the unit recently, but the hospital said there’s no evidence those deaths were due to the bacteria, adding no patients had shown any symptoms of illness from the infection.

Advocates blame one Mo. lawmaker for blocking drug monitoring database

Missouri is the only state without a prescription drug monitoring program (PDMP), and those advocating for one said one doctor and legislator is the reason why.

POLITICO said Republican state Sen. Robert Schaff, MD, a family physician from St. Joseph, Missouri, has been leading efforts to block the formation of such a database over privacy concerns for several years.

One advocate for the creation of the PDMP, Democratic U.S. Sen. Claire McCaskill, said “If I could wave a magic wand and get a certain senator locked in a closet, we can get this done in Missouri.”

POLITICO reported Schaff’s opposition is built on a mistrust of government and his fellow physicians, even going as far as to suggest the Pentagon will use information from the databases to determine which Missouri residents own guns.