From: Utah Hospital Association
To: Scott Jenkins,
Subject: June 2014 Newsbyte
Date: Wed Jun 04 16:52:58 MDT 2014
NEWS byte
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June 2014
HOSPAC Golf Tournament  Set For June 23
Time is running out to register for Utah HOSPAC's 2014 Golf
, taking place Monday, June 23 at the Thanksgiving Point Golf Course in Lehi. The tournament is a Shotgun Best Ball Scramble format and will begin with check-in and continental breakfast at 7:30 a.m.; shotgun start at 8. 

Individual registration fee for the tournament is $250 per person, or $1,000 per foursome. Registration fee includes continental breakfast, greens fee, cart, lunch and prizes. Hole sponsorships for the tournament are also available for $350 per hole.

For more information or to register for this year's tournament, click here. UHA staff Jackie Wilkinson and Dave Gessel are also available to answer your questions about the tournament.

We hope to see you at Thanksgiving Point on June 23!   
Noridian Hosting Utah Seminars in June
Noridian Healthcare Solutions will be hosting a series of face-to-face meetings with Utah providers this month. Noridian education teams will be addressing a variety of issues, including the provision of resolutions to common billing issues and ways to reduce claim denial.

Providers can review the seminar agenda and register by clicking here .
Ohio KePRO to Replace HealthInsight for Medical Case Review

The Centers for Medicare & Medicaid Services (CMS) has separated medical case review from quality improvement work, creating two separate structures:

  • Medical case review - to be performed by Beneficiary Family Centered Care Quality Improvement Organizations (BFCC-QIO)
  • Quality improvement and technical assistance QIOs - to be performed by Quality Innovation Network QIOs (QIN-QIO).

Going forward, organizations will specialize exclusively in either quality improvement or case review. HealthInsight chose to pursue the quality improvement work as a QIN-QIO. As a result, beginning on August 1, 2014, case review work will be performed by a separate contractor and not HealthInsight. HealthInsight will continue to perform clinical review work, including Medicare appeal reviews, until July 31, 2014.


How will this change impact your hospital?

Beginning in August, hospitals will have a new point of contact for Medicare coverage and discharge appeals and quality of care concerns. CMS has named Ohio KePRO, in Seven Hills Ohio, as the new Beneficiary Family Centered Care Quality Improvement Organizations (BFCC-QIO) contractor for Utah. They will begin conducting case review activities on August 1, 2014.


The new BFCC-QIO, Ohio KePRO, will continue to protect beneficiaries and strive to improve health care services for Medicare beneficiaries through quality of care reviews, beneficiary complaint reviews, discharge and termination of service appeals in various provider settings, medical necessity reviews, and Emergency Medical Treatment and Active Labor Act (EMTALA) reviews. QIN-QIOs will support hospitals with quality improvement plans that stem from the BFCC-QIO reviews.


Transition updates

Hospitals can expect to receive communication from CMS and Ohio KePRO regarding this transition including contact information necessary for beneficiary notifications. Steps hospitals will need to take on or before August 1 include:

  • Update all copies of the "Important Message from Medicare" which informs beneficiaries of their right to appeal the decision to be discharged;
  • For hospitals with swing beds, update all copies of the Notice of Medicare Non-Coverage forms;
  • Replace all print and electronic copies of beneficiary resources that include the QIO's contact information, and 
  • Update policies and procedures that contain a reference to contact HealthInsight (contacts, address, telephone numbers, fax numbers.)

CMS has planned an Open Door Forum to discuss this recent announcement and has sent advisories to providers and practitioners across the country with additional information.


HealthInsight is proud to be the federally designated QIO for Utah, having served Medicare beneficiaries and their families through the medical case review services for over 30 years. HealthInsight will work to make the transition to their successor for medical case review services as smooth as possible.


Quality Innovation Network QIOs

HealthInsight recently learned that they are the sole bidder for the Quality Innovation Network (QIN) QIO contract in all three HealthInsight states (Nevada, New Mexico and Utah). They are currently in the negotiation process with CMS. Once awarded, HealthInsight will continue their primary focus on facilitating continuous quality improvement activities in support of learning systems aimed at transforming healthcare. The Quality Innovation Network (QIN) QIO contracts are anticipated to be awarded in July of 2014.


For more information, contact HealthInsight Utah Executive Director, Juliana Preston at 801-892-6625 or

Call for UHA Award Nominations 

UHA is now accepting nominations for its 2014 Awards Program, to be presented as a part of the Fall Leadership Conference at Deer Valley on Thursday, September 25th. The brochure includes nomination forms for the UHA Trustee Service Award, Distinguished Healthcare Executive Award and Distinguished Service to Healthcare Award. To review the call for nominations brochure, click here. 


The deadline for nominations is Friday, August 15th. 
Hospital Happenings
Charles Sorenson, MD, president and CEO of Intermountain Healthcare, has been named among Modern Healthcare's "50 Most Influential Physician Executives in Healthcare." He was listed at #12 in the 2014 rankings.

Intermountain Healthcare has named Clayton Christensen to serve on its Board of Trustees. Christensen is he Kim B. Clark Professor of Business Administration at the Harvard Business School.

Have news to share? 
Please send your announcement to Jill Vicory, by the 20th of the month for inclusion in the next issue of Newsbyte. 
Educational Update
The annual Utah Flex Program Administrators Summit is scheduled for July 18th at the Park City Marriott. All rural hospital CEOs or designees are invited to participate. There are no registration fees, and those traveling more than 50 miles may request a room at no cost the night before the summit. Mileage is also reimbursable. To request a room, please contact Erin Olsen at as soon as possible.

Mark your calendar for the 2014 UHA Fall Leadership Conference--September 24-26 at Silver Baron Lodge at Deer Valley. Registration and lodging information will be available later this month.

Carelearning Webinar Calendar-UHA continues to partner with Carelearning to provide a variety of educational sessions online for the convenience of our members. Go to to view the available programs.

News from HealthInsight

Big Changes on the Horizon for Hospital Reporting 


Another reporting deadline has passed and all Utah hospitals entered and submitted their quality data prior to the deadline. There were a few issues on the QualityNet side, but everyone was able to work through these challenges. The next reporting deadlines will be:

  • July 2, 2014: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
  • August 1, 2014: Outpatient Clinical Measures
  • August 15, 2014: Inpatient Clinical Measures / Perinatal Care Measures
  • August 15, 2014: Healthcare-Associated Infections

Big changes are ahead with these deadlines. First, the new QualityNet secure portal will be the only option for submitting data after July 1, 2014. All QualityNet users will have to complete the verification process.  


Secondly, beginning August 1, 2014, the new Medicare Quality Improvement Program contract cycle for the Centers for Medicare & Medicaid Services (CMS) will be in effect. One change outlined for the new contract cycle is for a national center to provide hospitals with technical support for QualityNet reporting. Instead of HealthInsight being the primary resource to hospitals for technical support, responsibility will shift to the national center. Although it is still unclear how this change will take place, rest assured that HealthInsight will do all we can to make this as smooth a transition as possible.


Finally, CMS has identified the last hospitals for data validation. The "targeted" group consists of those who have missed submission deadlines, have had major shifts / changes in data entry, or have other identified issues. There were no hospitals in Utah targeted--a positive recognition for the excellent ongoing work by Utah hospitals and staff.


If you have any questions please contact Linda Egbert for assistance at 801-892-6670 or by email at


UHA Calendar of Events for June 2014
June 4
Utah Disaster Advisory Committee, Noon, Intermountain Center for Disaster Preparedness at LDS Hospital
June 11-13
Western Regional Trustee Symposium, Green Valley Resort, Las Vegas
June 23
UTAH HOSPAC Golf Tournament, 8 a.m. shotgun start, Thanksgiving Point, Lehi
June 24
Medicaid Program Task Force, Noon-2 p.m., UHA Board Room
July 4
Independence Day Holiday
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