NASH Applauds HHS Movement Toward Extending Public Health Emergency

NASH has thanked Health and Human Services Secretary Alex Azar for his department’s public indication that it intends to extend the COVID-19 public health emergency.

With the declaration of a public health emergency has become regulatory flexibilities that have enabled private safety-net hospitals and other providers to do a better job serving their patients and their communities in the current, challenging environment.

See NASH’s letter here.

Private Safety-Net Hospitals Need More CARES Act Money, NASH Writes

The federal government should direct another round of CARES Act grants to safety-net hospitals, NASH wrote yesterday in a letter to Health and Human Services Secretary Alex Azar.

While all recipients of the latest round of CARES Act grants benefited from those funds, NASH noted in its letter, too many private safety-net hospitals did not receive grants at all.

In its letter, NASH suggested that HHS use different criteria for selecting future safety-net hospital recipients of CARES Act grants:  hospitals that are “deemed DSH hospitals” or those that are eligible to participate in the section 340B program.

These two categories of hospitals, NASH wrote,

…most accurately and precisely capture safety-net hospitals that serve the highest proportions Medicaid patients and that most need these essential resources.

See NASH’s letter here.

New Distributions of Provider Relief Fund Money

On Tuesday morning the Department of Health and Human Services announced that it will distribute $10 billion to hospitals located in COVID-19 hotspots that have cared for especially large numbers of COVID-19 patients.  It also will distribute $25 billion in CARES Act Provider Relief Fund money to safety-net providers, including $10 billion specifically for safety-net hospitals.  (Some of the language in this memo is taken directly from HHS’s news release.)

Just last week, NASH wrote to HHS Secretary Alex Azar asking him to distribute additional CARES Act payments to private safety-net hospitals.

The $10 Billion Distribution to COVID-19 Hotspot Hospitals

On Monday HHS sent messages to all hospitals asking them to update information on their COVID-19 positive-inpatient admissions for the period January 1, 2020, through June 10, 2020.  This information will be used to determine a second round of funding to hospitals in COVID-19 hotspots and is due to HHS through its teletracking portal no later than 9:00 pm (eastern) on Monday, June 15.

The data reporting is similar to what hospitals previously submitted from the start of the pandemic to April 10.  The data to be reported will be cumulative, through June 10.  At this point, HHS has not decided what the threshold will be to receive payments; it will make this decision after it receives the data.

There is one major difference between the next distribution and the previous one:  this time, HHS wants data submitted, and will make distributions based on, individual facilities and not Medicare provider numbers or tax identification numbers.  HHS has updated its Provider Relief Fund web page to reflect today’s developments; find that page here.  HHS also has made extensive changes in the Provider Relief Fund’s FAQ to reflect the planned distribution of funds to COVID-19 hotspot hospitals; those changes are identified within the FAQ, which you can find here.

The $10 Billion Allocation for Safety-Net Hospitals

HHS will distribute $10 billion in Provider Relief Funds to safety-net hospitals that serve vulnerable patients in recognition of “the incredibly thin margins these hospitals operate on.”  This payment is being sent directly to these hospitals via direct deposit.

These payments will be made to hospitals that serve a disproportionate number of Medicaid patients or provide large amounts of uncompensated care.  Qualifying hospitals will have:

  • A Medicare disproportionate payment percentage of 20.2 percent or greater.
  • Average uncompensated care of $25,000 per bed or more.  For example, a hospital with 100 beds would need to provide $2.5 million in uncompensated care in a year to meet this requirement.
  • Profitability of three percent or less, as reported to CMS in its most recently filed cost report.

Recipients will receive a minimum distribution of $5 million and a maximum distribution of $50 million.

If your hospital meets the criteria for safety-net hospital payments you will receive them through direct deposit.  If you wish to receive hotspot payments, however, you must submit relevant data through HHS’s teletracking portal; the deadline for data submission is June 15 at 9:00 pm (eastern).

Coronavirus Update for Thursday, June 4, 2020

Coronavirus update for Thursday, June 4 as of 2:30 p.m.

NASH Advocacy

Today NASH sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma expressing safety-net hospitals’ disappointment that HHS still has not made a targeted distribution of CARES Act Provider Relief Funds to providers of especially high volumes of care to Medicaid and government-insured patients and urging them to do so as soon as possible.  See NASH’s letter here.

 

Centers for Medicare & Medicaid Services

Department of Health and Human Services

Centers for Disease Control and Prevention

Food and Drug Administration

  • The FDA has introduced a new web-based resource, Testing Supply Substitution Strategies, that includes detailed information to help support labs performing authorized COVID-19 tests.
  • The FDA has updated the question-and-answer appendix in its guidance Conduct of Clinical Trials of Medical Products during COVID-19 Public Health Emergency with new information about compliance for electronic systems used to generate electronic signatures on clinical trial records.
  • The FDA has issued an alert to providers about the temporary absence of the “paralyzing agent” warning statement on the vial caps of the neuromuscular blocking agents vecuronium bromide and rocuronium bromide, both of which are often used for patients requiring medical ventilation.
  • The FDA has issued emergency use authorizations (EUAs) for five new commercial diagnostic tests for COVID-19. Find them here, here, here, here, and here.
  • Federal Funding Opportunities for Hospitals

    • NASH has prepared a document that collects and presents in one place the various new federal funding opportunities for hospital resulting from legislation addressing the COVID-19 public health emergency.  Find that document here.

    (To receive this daily update directly, sign up for our mailing list at info@safetynetalliance.org.)

NASH Calls for More COVID-19 Legislation

On Tuesday the National Alliance of Safety-Net Hospitals wrote to Senate leaders and asked them to advance legislation with five major COVID-19-related policy initiatives that private safety-net hospitals seek:

  1. An additional $100 billion for hospitals.
  2. A 14-point increase in the federal medical assistance percentage (FMAP).
  3. A 2.5 percent increase in states’ Medicaid disproportionate share (Medicaid DSH) allotments and another delay in implementation of Affordable Care Act-mandated cuts in those allotments.
  4. Reduced interest rates and a longer payback period for Medicare payments advanced to hospitals through the CARES Act’s Accelerated and Advance Payment Program.
  5. Prevention of implementation of the Medicare fiscal accountability regulation (MFAR).

Learn more from NASH’s letter to Senate majority leader Mitch McConnell and Senate minority leader Chuck Schumer.

Coronavirus Update for Tuesday, June 2

Coronavirus update for Tuesday, June 2, 2020 as of 2:45 p.m.

NASH Advocacy

On Tuesday, the National Alliance of Safety-Net Hospitals wrote to Senate leaders and asked them to advance legislation with five major COVID-19-related policy initiatives:

  1. An additional $100 billion for hospitals.
  2. A 14-point increase in the federal medical assistance percentage (FMAP).
  3. A 2.5 percent increase in states’ Medicaid disproportionate share (Medicaid DSH) allotments and another delay in implementation of Affordable Care Act-mandated cuts in those allotments.
  4. Reduced interest rates and a longer payback period for Medicare payments advanced to hospitals through the CARES Act’s Accelerated and Advance Payment Program.
  5. Prevention of implementation of the Medicare fiscal accountability regulation (MFAR).

Learn more from NASH’s letter to Senate majority leader Mitch McConnell and Senate minority leader Chuck Schumer.

On Monday NASH submitted formal comments to CMS on an interim final rule published in April to help health care providers respond to the COVID-19 emergency.  NASH expressed support for the changes CMS introduced.

Centers for Medicare & Medicaid Services

Food and Drug Administration

The Joint Commission

Federal Funding Opportunities for Hospitals

  • NASH has prepared a document that collects and presents in one place the various new federal funding opportunities for hospital resulting from legislation addressing the COVID-19 public health emergency.  Find that document here.

(To receive this daily update directly, sign up for our mailing list at info@safetynetalliance.org.)

Coronavirus Update for May 27, 2020

Coronavirus update for Wednesday, May 27 as of 2:30 p.m.

NASH Advocacy

  • NASH has written to congressional leaders and asked them to include forgiveness for loans provided to hospitals through the CARES Act’s Accelerated and Advance Payment Program in future COVID-19/economic stimulus legislation.  The letter notes how helpful the loans were but also explains that private safety-net hospitals continue to face major financial challenges, including a possible second wave of COVID-19 cases.  See that letter here.

Centers for Medicare & Medicaid Services

Department of Health and Human Services

  • ASPR TRACIE, sponsored by HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) to provide Technical Resources, Assistance Center, and Information Exchange (TRACIE) services, in collaboration with the HHS/FEMA COVID-19 Healthcare Resilience Task Force, is hosting the webinar “Ensuring Healthcare Safety Throughout the COVID-19 Pandemic” to share experiences and lessons learned from innovators in the field. Learn more here.

Centers for Disease Control and Prevention

Food and Drug Administration

Federal Funding Opportunities for Hospitals

  • NASH has prepared a document that collects and presents in one place the various new federal funding opportunities for hospital resulting from legislation addressing the COVID-19 public health emergency.  Find that document here.

(To receive this daily update directly, sign up for our mailing list at info@safetynetalliance.org.)

NASH Asks Congress to Forgive Loans From Accelerated and Advance Payment Program

Include forgiveness for the resources the federal government provided to hospitals through the Accelerated and Advance Payment Program in the next COVID-19/economic stimulus bill, NASH has asked congressional leaders.

In a letter to House Speaker Nancy Pelosi, Senate majority leader Mitch McConnell, House minority leader Kevin McCarthy, and Senate minority leader Chuck Schumer, the National Alliance of Safety-Net Hospitals acknowledged the importance of the program’s funds in enabling private safety-net hospitals to “…keep their lights on, their supply closets fully stocked, and their teams of heroic caregivers paid” but observed that

…COVID-19 has done profound damage to our people and to our economy, and it has had a similar impact on many providers, including private safety-net hospitals.

Because health experts believe the COVID-19 pandemic has not ended and may return later this year, NASH wrote that

Forgiving the loans provided through the Accelerated and Advance Payment Program and continuing the uninterrupted flow of payments for the services we provide to our Medicare patients will help ensure that we are there when our communities and our country need us, now and in the future.

See NASH’s letter to congressional leaders here.

NASH Seeks Delay in Provider Relief Fund Attestation

NASH has asked federal regulators to extend the June 3 deadline for attesting to the terms and conditions for receiving general distribution grants from the CARES Act’s Provider Relief Fund.

In a letter to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma, NASH urges their agencies to

…spend the next month developing definitive, consistent answers to questions that may arise as hospitals prepare to attest to the terms and conditions for receiving Provider Relief Fund grants and to submit supporting data to document their need for the grants they have already received.

See NASH’s letter here.

Coronavirus Update for May 21, 2020

Coronavirus update for Thursday, May 21 as of 3:30 p.m.

NASH Advocacy

Department of Health and Human Services

Centers for Disease Control and Prevention

Food and Drug Administration

Federal Funding Opportunities for Hospitals

  • NASH has prepared a document that collects and presents in one place the various new federal funding opportunities for hospitals resulting from legislation addressing the COVID-19 public health emergency.  Find that document here.

(To receive this daily update directly, sign up for our mailing list at info@safetynetalliance.org.)