This week, 125 Wisconsin hospitals confirmed that their billing and collection practices meet or exceed the Billing and Collection Guidelines approved by the WHA Board in April 2007.

Wisconsin hospitals were asked to confirm in writing that their policies and practices on charges, charity care, billing and debt collection meet or exceed the principles set down in the WHA Billing and Collection Guidelines. The "Confirmation of Commitment" assures patients that hospital billing practices reflect respect and compassion for all patients while also communicating the need to obtain fair payment for services from patients who are able to pay.

Every day, Wisconsin hospitals provide medical care for thousands of patients without regard to their ability to pay. Hospitals later assist these patients and their families in the billing process and help qualify them for charity care or a medical assistance program, offer them a discount, or work out a payment plan that takes their financial and family situations into consideration.

Speaking at WHA’s 2007 Advocacy Day May 1, Attorney General J.B. Van Hollen applauded the Association’s Billing and Collection Guidelines for providing clear guidance to hospitals in this highly sensitive, and often misunderstood, aspect of the American health care system. Van Hollen stated, "Wisconsin hospitals have stepped up to the plate to address concerns about certain billing practices for the poor and uninsured and moved forward with a set of patient-centered guidelines. My office worked with the hospital association and reviewed the new guidelines to ensure transparent billing practices for the uninsured and charity care. The uninsured are entitled to know what services will likely cost, before they incur charges. I am satisfied that the new guidelines provide a thoughtful approach to bill and to collect payments from those that are uninsured, and I applaud the hospital association’s efforts," he added.

WHA Senior Vice President George Quinn said, "Every hospital has evaluated their policies to determine if they meet or exceed the WHA guidelines. We are only a few hospitals short of our goal of 100 percent confirming that their policies meet or exceed the guidelines set down by the WHA Board, and we expect to receive those confirmations pending approval from their hospital’s board of directors."

The hospitals that have confirmed their commitment to the WHA Billing and Collection Guidelines follows:

Amery Amery Regional Medical Center

Appleton Appleton Medical Center

Appleton St. Elizabeth’s Hospital

Arcadia Franciscan Skemp Healthcare - Arcadia

Ashland Memorial Medical Center

Baldwin Baldwin Area Medical Center

Baraboo St. Clare Hospital & Health Services

Barron Barron Medical Center

Beaver Dam Beaver Dam Community Hospital

Beloit Beloit Memorial Hospital

Berlin Berlin Memorial Hospital

Black River Falls Black River Memorial Hospital

Bloomer Bloomer Medical Center

Boscobel Boscobel Area Health Care

Brookfield Wheaton Franciscan Healthcare - Elmbrook Memorial Hospital

Burlington Aurora - Memorial Hospital of Burlington

Chilton Calumet Medical Center

Chippewa Falls St. Joseph’s Hospital

Columbus Columbus Community Hospital

Cudahy Aurora - St. Luke’s South Shore

Cumberland Cumberland Memorial Hospital

Darlington Memorial Hospital of LaFayette County

Dodgeville Upland Hills Health

Durand Chippewa Valley Hospital

Eagle River Eagle River Memorial Hospital

Eau Claire Sacred Heart Hospital

Eau Claire Luther Midelfort Mayo Health System

Edgerton Edgerton Hospital and Health Services

Elkhorn Aurora Lakeland Medical Center

Fond du Lac Agnesian HealthCare, Inc. - St. Agnes Hospital

Fort Atkinson Fort Health Care, Inc.

Friendship Moundview Memorial Hospital

Glendale Orthopaedic Hospital of Wisconsin

Grantsburg Burnett Medical Center

Green Bay Aurora Baycare Medical Center

Green Bay Bellin Hospital

Green Bay Bellin Psychiatric Center

Green Bay St. Mary’s Hospital Medical Center

Green Bay St. Vincent Hospital

Hartford Aurora Medical Center of Washington County

Hayward Hayward Area Memorial Hospital

Hillsboro St. Joseph’s Community Health Services

Hudson Hudson Hospital

Janesville Mercy Health System

Kenosha Aurora Medical Center

Kenosha Children’s Hospital of Wisconsin

La Crosse Franciscan Skemp Healthcare - La Crosse

La Crosse Gundersen Lutheran Health System

Ladysmith Rusk County Memorial Hospital and Nursing Home

Lake Geneva Mercy Walworth Hospital and Medical Center

Lancaster Grant Regional Medical Center

Madison Meriter Hospital

Madison St. Mary’s Hospital

Madison UW Hospital & Clinics

Manitowoc Holy Family Memorial, Inc.

Marinette Bay Area Medical Center

Marshfield St. Joseph’s Hospital

Mauston Mile Bluff Medical Center

Medford Memorial Health Center

Menomonee Falls Community Memorial Hospital

Menomonie Red Cedar Medical Center - Mayo Health System

Mequon Columbia St. Mary’s, Inc. - Ozaukee Campus

Merrill Good Samaritan Medical Center

Milwaukee Aurora - St. Luke’s Medical Center

Milwaukee Aurora Sinai Medical Center

Milwaukee Children’s Hospital of Wisconsin

Milwaukee Columbia St. Mary’s, Inc. - Columbia Campus

Milwaukee Columbia St. Mary’s, Inc. - Columbia Center

Milwaukee Columbia St. Mary’s, Inc. - Milwaukee Campus

Milwaukee Columbia St. Mary’s, Inc. - Sacred Heart Rehabilitation Institute

Milwaukee Froedtert Memorial Lutheran Hospital

Milwaukee Wheaton Franciscan Healthcare - St. Francis

Milwaukee Wheaton Franciscan Healthcare - St. Joseph

Monroe The Monroe Clinic

Neenah Children’s Hospital of Wisconsin

Neenah Theda Clark Medical Center

Neillsville Memorial Medical Center

New London New London Family Medical Center

New Richmond Westfields Hospital

Oconomowoc Oconomowoc Memorial Hospital

Oconomowoc Rogers Memorial Hospital

Oconto Bond Health Center

Oconto Falls Community Memorial Hospital

Osceola Ladd Memorial Hospital

Oshkosh Aurora Medical Center

Oshkosh Mercy Medical Center

Osseo Osseo Medical Center

Park Falls Flambeau Hospital

Platteville Southwest Health Center

Portage Divine Savior Healthcare

Prairie du Sac Sauk Prairie Memorial Hospital

Racine Wheaton Franciscan Healthcare - All Saints

Reedsburg Reedsburg Area Medical Center

Rhinelander Sacred Heart - St. Mary’s Hospitals

Rice Lake Lakeview Medical Center

Richland Center The Richland Hospital

Ripon Ripon Medical Center

River Falls River Falls Area Hospital

Shawano Shawano Medical Center

Sheboygan Aurora - Sheboygan Memorial Medical Center

Sheboygan St. Nicholas Hospital

Sparta Franciscan Skemp Healthcare - Sparta

Spooner Spooner Health System

St. Croix Falls St. Croix Regional Medical Center

Stanley Our Lady of Victory Hospital-Ministry Health Care

Stevens Point St. Michael’s Hospital

Stoughton Stoughton Hospital

Sturgeon Bay Door County Memorial Hospital

Tomah Tomah Memorial Hospital

Tomahawk Sacred Heart - St. Mary’s Hospitals

Two Rivers Aurora Medical Center Manitowoc County

Viroqua Vernon Memorial Healthcare

Watertown Watertown Memorial Hospital

Waukesha Waukesha Memorial Hospital

Waupaca Riverside Medical Center

Waupun Agnesian HealthCare, Inc. - Waupun Memorial Hospital

Wausau Aspirus Wausau Hospital, Inc.

Wauwatosa Wheaton Franciscan Healthcare - The Wisconsin Heart Hospital

West Allis Aurora - West Allis Memorial Hospital

West Bend SynergyHealth St. Joseph’s Hospital

Weston St. Clare’s Hospital - Ministry Health Care

Whitehall Tri-County Memorial Hospital

Wild Rose Wild Rose Community Hospital

Wisconsin Rapids Riverview Hospital Association

Woodruff Howard Young Medical Center

Earlier this month, the 2007 Wisconsin Hospitals Political Action Funds fundraising campaign kicked off. While the campaign has been underway for less than a month, the total raised is already nearly $62,000. Compared to this same time last year, the campaign is off to a good start with nearly $10,000 more raised to date.

"This year the campaign goal is $195,000, which is $10,000 more than last year. Our 2006 goal of $185,000 was achieved with 100 additional individuals contributing compared to the previous year," said WHA Advocacy Committee Chair Mary Starmann-Harrison.

The Wisconsin Hospitals Political Action Funds, which include the Wisconsin Hospitals PAC, Wisconsin Hospitals Conduit and WHA Federal PAC, disbursed more than $228,000 to candidates running for office in 2006. This was up 36 percent from the 2002 election year and 20 percent from the 2004 election year.

The Campaign mailed fundraising packets earlier this month. For more information, contact Jodi Bloch or Jenny Boese at 608-274-1820.

• About a week ago, WHA staff distributed a hospital-specific spreadsheet (prepared by the Doyle Administration) that purports to identify the impact of the hospital tax and higher Medicaid payments. In summary, the analysis states that the two year, $418 million dollar tax, when offset by over $700 million in higher payments, will net out about $284 million, in aggregate, for Wisconsin hospitals. According to the Administration’s analysis, there would be 52 hospital "winners" and 21 "losers." Half of Wisconsin hospitals are exempt from the tax. A lot of assumptions go into the analysis, including the acceptance of the notion that hospitals will actually receive hundreds of millions of dollars from HMOs, the largest of which has a sorry track record of partnering with Medicaid providers. Nevertheless, the new plan appears to address several significant flaws exposed by WHA when the first plan was unveiled in February.
  
  Some of the strongest hospital tax advocates decry hospital opposition to the tax, often wondering "how can WHA oppose an initiative that is such a ‘good deal’ for their members, especially given the fact that they’ve complained about the ‘hidden tax’ for years." But consider this—if the proposal did not skim $120 million from the $418 million tax "for other uses," the hospital tax could be lowered by 30 percent, and the net impact (on hospitals) would actually be $406 million. On a hospital-specific basis, there would be eight fewer "losers" and the remaining "losers" would see their losses diminish significantly.
  
  Given the scenario mentioned above, one might ask, "Is this really about helping community hospitals and reducing the ‘hidden tax,’ or is this about backfilling potholes in the Wisconsin budget, using a new revenue stream that will constantly be under pressure to be diverted to other uses in the not-so-distant future?"
  
  
• More than 120 Wisconsin hospital leaders have signed "Confirmation of Commitment" pledges, indicating that their hospital policies and practices will align with WHA’s new hospital billing and collection guidelines. This remarkable effort, to date, was anticipated by the WHA Board in April when the special and very visible commitment process was embraced as to demonstrate the hospital field’s willingness to make their billing practices transparent to the public, easy to understand and consistently applied.
  
  Speaking at the WHA Advocacy Day on May 1, Attorney General Van Hollen applauded the initiative, which represents a partnership with his office, as representative of his intent to "pursue collaboration over confrontation" as he deals with public policy issues. WHA is committed to achieving 100 percent statewide hospital participation in the effort, and we will continue to provide regular updates as to the status of the campaign.
  
  
• Speaking of successful campaigns with remarkable, voluntary participation, our political action fundraising efforts are off to an auspicious start again this year. Our ambitious goal of $195,000—unimaginable just a few years ago—can be met if we replicate the steady growth in member commitment and participation we’ve witnessed in recent years. We are making a special effort this year to recruit new, first-time contributors. We will continue to report progress toward our goal during the summer months.

Steve Brenton
President

The Nevada Hospital Association launched its PricePoint Web site last week, bringing to eleven the number of states using WHA Information Center’s PricePoint system.

"We recognize that there is a growing demand for hospital pricing information," said Bill Welch, the Association’s CEO. "PricePoint has become a national model to respond to this demand in a user-friendly way."

PricePoint systems are also operating in Georgia, Iowa, New Hampshire, New Mexico, Oregon, Texas Utah, Virginia and Washington. WHA Information Center expects to bring on several additional clients over the next 12 months.

Beginning July 1, 2007, hospitals must deliver to their patients who are Medicare beneficiaries a new notification of hospital discharge appeal rights. Medicare beneficiaries who are hospital inpatients have a statutory right to appeal to a Quality Improvement Organization (QIO) for an expedited review when a hospital, with a physician concurrence, determines that inpatient care is no longer necessary. A revised version of the Important Message from Medicare that informs Medicare beneficiaries who are hospital inpatients about their appeal rights is available on the CMS Web site at www.cms.hhs.gov/BNI/12_HospitalDischargeAppealNotices.asp#TopOfPage. Beneficiaries who choose to appeal a discharge decision must receive a more detailed notice, which is also available at the link above. Concerning this notification requirement, hospitals should keep in mind the following:

• The revised notification requirement applies to all hospitals, including critical access hospitals.
• Hospitals must notify Medicare beneficiaries who are hospital inpatients about their discharge appeal rights by delivering the mandatory revised Important Message from Medicare within two calendar days of admission, obtaining the signature of the beneficiary, and providing a copy to the beneficiary at that time.
• Hospitals must provide follow-up copies of the Important Message as far in advance of discharge as possible, but no more than two calendar days before the planned discharge date.
• When discharge seems likely within 1 – 2 calendar days, hospitals should make arrangements to deliver the follow-up copy of the notice so the beneficiary has a meaningful opportunity to act on it. If discharge cannot be predicted in advance, the follow-up copy may be delivered as late as the day of discharge, but hospitals must give beneficiaries who need it at least four hours to consider their right to request a QIO review (beneficiaries may choose to leave prior to that time).
• When a QIO notifies the hospital that a beneficiary has requested an expedited review, the hospital must deliver a Detailed Notice of Discharge to the beneficiary as soon as possible, but not later than noon of the day after the QIO’s notification.
• After notification of a beneficiary’s request for an expedited review, the hospital must supply any and all information that the QIO needs to make the determination. This information should be provided as soon as possible, but no later than noon of the day after the QIO notifies the hospital of the request.
• The hospital has the burden of proof that the discharge is the correct decision either on the basis of medical necessity or based on other Medicare coverage policies.
• When a beneficiary makes a timely request for an expedited review, the QIO must make its determination and notify the beneficiary, the hospital, and the physician of its determination within one calendar day after it receives all requested information.
• The QIO determination is binding on the beneficiary, the physician, and hospital except in limited circumstances.

The CMS Web site includes detailed information about this requirement and special considerations, including what CMS considers a discharge, notification requirements when a beneficiary is not competent, and documentation requirements. Hospitals should read the CMS 4105 Manual Instructions at the link below for more details. The final versions of the "Important Message from Medicare" and the "Detailed Notice of Discharge" are available at www.cms.hhs.gov/BNI/12_HospitalDischargeAppealNotices.asp#TopOfPage.

Kristin Baird, Baird consulting, and Kevin Stranberg, Memorial Medical Center in Ashland, will acquaint participants with the newest tools that can be used to develop a communications plan that has the flexibility to address nearly every situation. Using the tools from this session, participants will be prepared to address the following crucial topics with various stakeholders. These issues include:

Hospital Tax – "Taxing hospitals to pay hospitals." Find out what’s current; how to develop a local response.

Union Campaigns – There isn’t time to plan once a campaign on your hospital has started. Identify the early warning signs and get recommendations for internal and external communications that can be developed in advance to prepare for a union campaign in your community.

Billing and Collection Policies – The number of patients who have high deductible plans is growing, and with it, public concern about hospital costs and the billing process. Learn your pivotal role in ensuring that patients are aware of, and understand, this process.

Public Reporting:

CheckPoint will expand to include more than 70 measures by the end of 2007. Soon, mortality, volume and patient experience of care information will be publicly available on CheckPoint. Learn how information now available on CheckPoint can help the public relations professional address questions related to the current measures and know how to plan for the new measures.

PricePoint is a valuable tool for public relations professionals to use when working with reporters on everything from hospital costs to discounts. What you don’t know about PricePoint can come back to you in the form of a question from a reporter or consumer. Learn how to put it to work for you.

The registration form is available at www.wha.org/education/pdf/2007IssuesForum6-29.pdf. The fee for this seminar is $95. For information on content, contact Mary Kay Grasmick, mgrasmick@wha.org or 608-274-1820. For registration or hotel information contact Lisa Geishirt at lgeishirt@wha.org or 608-274-1820.

The Kalahari Resort Room Reservation Cut-Off:  June 6 (or when block is full)
Conference & Golf Registrations: Due June 6 to WHA

The Board of Nursing has received letters of concern from nursing school faculty regarding varying policy requirements in hospitals. The letters have reflected the reluctance of faculty to comply with the policy that requires a co-signature on charting done by students. In response to these letters, the Board of Nursing had issued a white paper that can be found on the Regulation and Licensing Department website at http://drl.wi.gov/boards/nur/pap/pap18.pdf . The paper affirms hospitals’ authority to set policy relating to entries in the patient record, and offers suggestions for both faculty and clinical facilities relating to oversight of students and charting. This document may be a helpful part of faculty orientation as well as good information for policy committees.

If you have questions, examples or concerns relating to this topic, please contact Judy Warmuth, Vice President, Workforce, WHA at jwarmuth@wha.org or 608-274-1820.

Patients and consumers may have questions about the regulation of physicians, and most likely do not understand the role and function of the Medical Examining Board. The Board has recognized the need for education and is doing several things to increase knowledge about the Board’s mission, how to file a complaint against a practitioner, and how the Board deals with physicians impaired by substance abuse.

Aurora Medical Center of Manitowoc County–Two Rivers, in conjunction with the Wisconsin Department of Natural Resources, is hosting a seminar on designing and implementing pharmaceutical waste management programs in health care facilities. Speakers are scheduled to discuss topics including implementation pitfalls and solutions, compliance with pharmaceutical waste regulations, and reverse distribution options for health care providers.

The program will be at the Best Western Lakefront Hotel in Manitowoc June 22, from 9 a.m.—2 p.m. The workshop is free; lunch is not provided. Registration is limited to 70 registrants.

Upland Hills Health and the Family Resource Center of Iowa County have teamed up to develop a support group for new parents. Julie Statz, early Childhood and Family Educator, will facilitate the program called Parenting: The First Year.

Designed to ease the burden and feeling of being overwhelmed in the new parent role, the group is available at no charge for anyone with a child from 0 to 12 months old. It’s a great way for new moms and dads to gather and discuss the joys and challenges of being new parents. The meetings are informative with guest speakers facilitating discussions on the topics the group determines to be most pertinent.

The meetings take place on the first and third Monday of each month and are held from noon to 1:30 pm in the Upland Hills Health Center Café. Upland Hills Health provides the promotion and development of the support group as well as the refreshments and facility. There is no charge to participants.

"This is a wonderful resource for new parents," stated Patricia Lawson, director of marketing & community relations at Upland Hills Health. "And as premiere birthing center in Southwest Wisconsin, we feel compelled to continually develop and improve the programs available to new parents in our community."

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