NASH Recommends Targets for Next CARES Act Grants

New COVID-19 “hotspot” hospitals and private safety-net hospitals serving especially high proportions of Medicaid and government-insured patients should be singled out for grants in the next round of CARES Act funding from the Provider Relief Fund, NASH declared on Wednesday in a letter to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma.

NASH also urged administration officials to develop a program to identify and assist hospitals that were overlooked by previous methodologies used to identify recipients of CARES Act grants.

See NASH’s letter here.

NASH Asks Administration to Modify Approach to Emergency Hospital Funding

The manner in which the federal government is distributing COVID-19-related CARES Act funding is unfair to private safety-net hospitals, the National Alliance of Safety-Net Hospitals has written in a letter to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma.

The formula CMS used for its second round of funding from the $100 billion designated by the CARES Act for health care providers poses a distinct disadvantage to private safety-net hospitals, NASH wrote, because

With its emphasis on net patient revenue, this formula is damaging to safety-net hospitals that care for especially high proportions of Medicaid and low-income Medicare patients. As a result, hospitals that care for significant numbers of Medicaid and low-income patients are getting smaller grants, no grants at all, and in some cases a warning that they will be expected to return some of the money they have already received.

To address this problem, NASH asked administration officials to

…address these concerns by using the troubling outcome of this second tranche of payments to develop a consistent, appropriate funding formula that focuses more on hospitals than on other health care providers; that is fairer to safety-net hospitals than the second tranche formula; and that makes a concerted effort specifically to direct additional resources to safety-net hospitals. We also ask you to act immediately to ensure round one and round two grant recipients that there have been no “overpayments” of CARES Act funds and that the administration will not be asking them to repay some of the grants they have already received because the formula was changed.

See NASH’s letter here.

Coronavirus Update for April 28, 2020

Coronavirus update for Tuesday, April 28 as of 4:00 p.m.

NASH Advocacy

NASH has written to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma to express concern about how CMS distributed the second round of grants from CARES Act funding for hospitals and problems that approach will cause and to ask for a change of direction in the future distribution of federal COVID-19-related grants to hospitals.

White House

The Trump administration has released two new documents to support its plan for reopening the country and its economy:  a testing overview and an accompanying testing blueprint.

Centers for Disease Control and Prevention

The CDC has updated its COVID-19 guidance for different types of clinical facilities.

Food and Drug Administration

Federal Funding Opportunities for Hospitals

  • The National Alliance of Safety-Net Hospitals 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.

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Coronavirus Update for April 21, 2020

Coronavirus update for April 21 as of 5:00 p.m.

Congress and Administration Agree on Next Aid Package

Congressional leaders and the Trump administration have agreed to provide $75 billion for hospitals as part of a $484 billion COVID-19 and economic relief package.  This $75 billion would be addition to the money from the CARES Act and would have the same parameters as the CARES Act money.

The bill also includes $25 billion to research, develop, validate, manufacture, purchase, administer, and expand capacity for COVID-19 tests.  Among others, this $25 billion would be distributed as follows:

  • $11 billion for states, localities, and territories to develop, purchase, administer, process, and analyze COVID-19 tests, increase laboratory capacity, trace contacts, and support employee testing.
  • $1 billion to the Centers for Disease Control and Prevention for surveillance, epidemiology, lab capacity expansion, contact tracing, public health data surveillance, and the modernization of analytics infrastructure.
  • $1.8 billion to the National Institutes of health to develop, validate, improve, and implement testing and associated technologies, accelerate research and development of point-of-care testing, and partnerships with other entities.
  • $1 billion for the Biomedical Advanced Research and Development Authority (BARDA) for advanced research, development, manufacture, production, and purchase of diagnostic, serologic, and other COVID-19 tests and supplies.
  • $825 million for Community Health Centers and rural health clinics.
  • Up to $1 billion to pay for testing for the uninsured.

Other major components of the bill include $310 billion to replenish the Paycheck Protection Program and $60 billion for the Small Business Administration’s disaster relief fund.

The Senate has already passed the bill and the House will vote on it on Thursday.

Department of Health and Human Services

Centers for Medicare & Medicaid Services

Centers for Disease Control and Prevention

Food and Drug Administration

Accreditation Association for Ambulatory Health Care

In the wake of CMS’s announcement earlier this month that ambulatory surgery centers would temporarily be permitted to operate as hospitals to increase the capacity of the health care system during the COVID-19 emergency, the Accreditation Association for Ambulatory Health has posted resources for use in facilitating those temporary transitions.

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.

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NASH Endorses New COVID-19 Legislation

NASH has urged congressional leaders to adopt a new proposal that would, among other things, provide $75 billion for hospitals to help them respond to the COVID-19 crisis.

In a letter to House Speaker Nancy Pelosi, House minority leader Kevin McCarthy, Senate majority leader Mitch McConnell, and House minority leader Charles Schumer, NASH noted that private safety-net hospitals report that they have already exhausted their share of the $30 billion distributed to hospitals under the CARES Act and that they need additional help to offset the high cost of treating COVID-19 patients and the revenue they have lost because they have suspended non-urgent procedures.

NASH also asked congressional leaders to urge the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to distribute the remaining $70 billion designated for hospitals in the CARES Act as soon as possible.

See NASH’s letter here.

NASH Asks HHS for More Coronavirus Grants

Private safety-net hospitals should be among high-volume Medicaid providers that receive priority consideration in the distribution of additional grants from the CARES Act, NASH has written in a letter to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma.

With CMS already conceding that high-volume Medicaid providers may be shortchanged in the initial distribution of funds from the $100 billion designated for hospitals and health care providers in the CARES Act, NASH asked the two officials to “…acknowledge the special needs of these hospitals and the roles they play in their communities by ensuring that they will receive much-needed assistance in the second round of grants as well.”

See NASH’s letter here.

NASH Asks Congress for More COVID-19 Funding

More federal funding is needed for hospitals that serve especially high proportions of Medicaid patients and patients insured by government programs, the National Alliance of Safety-Net Hospitals has written to congressional leaders.

This is especially important now, NASH emphasized in its letter, because of new plans to use some of the $100 billion designated for hospitals and health care providers in the federal CARES Act to pay instead for care for uninsured patients who contract COVID-19.  Those payments, which NASH supports, do not address the needs for which the original $100 billion was designated:  to help hospitals – including private safety-net hospitals – with the cost of the investments they made to prepare for the expected influx of COVID-19 patients and to help them with cash flow problems arising from the loss of revenue associated with suspending elective procedures.

See NASH’s letter to congressional leaders here.

Coronavirus Update for April 3, 2020

The following is the latest information from federal regulators and others as of 4:30 p.m. on Friday, April 3.

NASH Writes to Secretary Azar

NASH has written to Health and Human Services Secretary Alex Azar asking him to distribute, as soon as possible, the $100 billion designated in the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act) for hospitals and health care providers.  See NASH’s letter to Secretary Azar here.

Department of Labor

The Labor Department has published a program letter with a summary of key unemployment insurance provisions of the CARES Act and guidance regarding temporary emergency state staffing flexibility.

Federal Communications Commission

The FCC has adopted a $200 million telehealth program to support provider responding to the COVID-19 crisis.  The money will help providers purchase telecommunications, broadband connectivity, and devices necessary for providing telehealth services.  See the FCC’s news release and its formal report and order.

Centers for Disease Control and Prevention

Food and Drug Administration

Centers for Medicare & Medicaid Services

Department of Health and Human Services

  • HHS’s Office of Civil Rights has announced that it will not impose penalties for violations of certain provisions of the HIPAA privacy rule against health care providers or their business associates for the good faith uses and disclosures of protected health information by business associates for public health and health oversight activities during the COVID-19 nationwide public health emergency.  See the Office of Civil Rights announcement of this temporary policy and a pre-publication version of the formal notice of this policy that will appear shortly in the Federal Register.
  • Along with the Department of Justice, HHS has announced that the two agencies have ordered the distribution of medical supplies that in their judgment were being hoarded.  The federal government paid fair market value for 192,000 N95 masks, nearly 600,000 pairs of medical grade gloves, and 130,000 other types of masks, surgical gowns, disinfectant towels, and other supplies and is sending these supplies to the New Jersey Department of Health, the New York state Department of Health and the New York City Department of Health and Mental Hygiene.

The White House

President Trump has invoked the Defense Production Act to compel companies to undertake the manufacture of N95 respirators and ventilators.

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NASH Asks Azar to Distribute CARES Act Money Now

“Distribute as soon as possible the $100 billion designated in the [CARES] Act to assist health care providers as they deal head-on with the biggest public health crisis our country has faced in more than a century,” NASH asked Health and Human Services Secretary Alex Azar in a letter to Azar on Friday.

In the letter, the National Alliance of Safety-Net Hospitals wrote of private safety-net hospitals tackling the COVID-19 crisis that

Hospitals and other providers need these resources – and need them in a very timely manner. Hospitals invested heavily in preparations for the challenge to come and are still paying for those and continuing investments at a time when their cash flow is at an historic low because they are no longer performing elective surgery, which provides a major portion of their revenue. Thus, hospitals need this money to pay our bills, to keep the lights on and the medical supplies coming in, and to pay our courageous caregivers.

See NASH’s letter to Secretary Azar here.

NASH Asks Feds for Resources for Hospitals

Private safety-net hospitals will need federal financial support to help in the fight against COVID-19.

That was the message the National Alliance of Safety-Net Hospitals sent in a letter to Centers for Medicare & Medicaid Services administrator Seema Verma.

The letter explained that

Hospitals need consistent, reliable, adequate cash flow to support the challenge ahead.  Our private safety-net hospitals, and others like us, are already incurring significant costs preparing for the influx of patients to come.  Most of these hospitals have stopped performing elective surgeries and have lost an important source of revenue.  Now, they are concerned about their ability to pay their bills until the anticipated surge of patients and also concerned about the potential for delays in payments once those patients arrive.  This is revenue they need to pay their bills:  to keep the lights on, the water running, the staff paid, and the patient rooms supplied and equipped.  Hospitals need this reliable, consistent flow of money – and they need it sooner rather than later.

See NASH’s letter here.