NASH Seeks Changes in Provider Relief Fund Distributions

Concerned that some private safety-net hospitals have not received Provider Relief Fund Phase 3 distributions and that others have not received adequate grants, the National Alliance of Safety-Net Hospitals has written to Health and Human Services Secretary Xavier Becerra to ask for changes in HHS’s approach to the CARES Act grants intended to help hospitals absorb the additional expenses they have incurred and the revenue they have lost as a result of the COVID-19 emergency.

Specifically, NASH urged HHS to:

  • Review the eligibility criteria and methodology for determining Provider Relief Fund grants to ensure that they reach true safety-net hospitals, and in particular those that serve especially large numbers of Medicaid patients.
  • Recalculate Phase 3 grants in a way that better reflects the true financial obstacles safety-net hospitals have faced throughout the COVID-19 emergency.
  • Apply more appropriate criteria and a better methodology for calculating payments in future Provider Relief Fund distributions.

Learn more from NASH’s letter to HHS Secretary Becerra.

Federal Health Policy Update for Friday, May 14

The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, May 14.  Some of the language used below is taken directly from government documents.

NASH Advocacy

  • NASH has written to Health and Human Services Secretary Xavier Becerra to urge his department to apply more appropriate criteria and a better methodology for calculating payments in all future Provider Relief Fund distributions.  Learn more from NASH’s letter to HHS Secretary Becerra.

The CDC and Mask Guidance

The White House

COVID-19

Centers for Medicare & Medicaid Services

COVID-19

  • CMS has released data highlighting the continued impact of the COVID-19 emergency on Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries and their utilization of health care services.  The data show that from March through October 2020, beneficiaries skipped millions of primary, preventive, and mental health care visits due to COVID-19 in comparison to the same time period in 2019.  Although utilization rates for some treatments have rebounded to pre-pandemic levels, mental health services show the slowest rebound.  Learn more from the following resources:

Health Policy News

  • CMS has issued guidance to states on how they can receive enhanced American Rescue Plan funding to increase access to home and community-based services (HCBS) for Medicaid beneficiaries.  This guidance seeks to assist states with leveraging federal resources to increase health equity in Medicaid beneficiaries’ access to HCBS, positive health outcomes, and community integration.  Those resources include a one-year increase of 10 percent in federal Medicaid matching money for such expenditures.  The guidance was issued to states through a CMS letter to state Medicaid directors.  Go here to see CMS’s announcement about the enhanced HCBS funding and go here to see the CMS letter to state Medicaid directors.

Centers for Disease Control and Prevention

COVID-19

FEMA

Federal Health Policy Update for Friday, March 26

Beginning this week, NASH is expanding its regular updates to encompass a broader scope of federal health policy endeavors to include other matters of importance to providers.  Feel free to share this newsletter with others in your organization or to send us the email addresses of those you think might be interested and we will send it directly to them.

The following is the latest such information from the federal government as of 2:30 p.m. on Friday, March 26.

NASH Advocacy

The Senate voted 90-2 to extend the moratorium on the two percent sequester of Medicare payments through the end of 2021.  The House will take up the bill when it returns to Washington, DC in mid-April.  The current moratorium will expire on March 31, but CMS is expected to use its authority to hold Medicare payments for up to 14 days to give the House time to pass the legislation.  NASH sent a thank you note to all 90 senators who voted for the bill.

The White House

COVID-19

Department of Health and Human Services

COVID-19

Centers for Medicare & Medicaid Services

COVID-19

Health Policy News

  • CMS has posted the latest edition of MLN Connects, its online publication with the latest information about Medicare reimbursement policy.  The following is the table of contents of the March 25 edition, with links to the individual articles:

News

Compliance

Claims, Pricers, & Codes

MLN Matters® Articles

Centers for Disease Control and Prevention

COVID-19

Food and Drug Administration

COVID-19

  • The FDA announced that “Given the sustained increase in [COVID-19] viral variants in the United States that are resistant to bamlanivimab administered alone, and the availability of other authorized monoclonal antibody therapies that are expected to retain activity to these variants, the U.S. Government, in coordination with Eli Lilly and Company, will stop the distribution of bamlanivimab alone starting today, March 24, 2021.”  Using the other monoclonal antibody therapies, the FDA reasons, will increase the likelihood of successful treatment against COVID-19 variants.  Go here to see the FDA’s announcement and explanation and for links to resources that describe the available monoclonal antibodies and their differences in greater detail.

NASH Asks HHS for Provider Relief Fund Grants

Phase 3 distributions of Provider Relief Fund grants are long overdue and sorely needed by private safety-net hospitals, the National Alliance of Safety-Net Hospitals has declared in a letter to new Department of Health and Human Services Secretary Xavier Becerra.

NASH’s letter to Becerra notes that the COVID-19 emergency has posed a special challenge to private safety-net hospitals and that in too many cases, those safety-net hospitals have not received appropriate support from the CARES Act’s Provider Relief Fund.  In its letter, NASH asks Secretary Becerra to direct HHS staff to distribute the more than $20 billion remaining in the Provider Relief Fund as soon as possible and to make safety-net hospitals a priority in that distribution.

Learn more from NASH’s letter to Secretary Becerra.

House to Consider Extending Medicare Sequester Delay

The moratorium on the two percent sequestration of Medicare payments could be extended under a bill the House may consider this week.

If adopted, the bill would extend the sequester delay for nine months, providing financial relief that many health care providers seek as they continue to deal with the financial challenges posed by COVID-19.

The sequester delay was implemented early in the pandemic as a means of providing additional Medicare revenue to hospitals and other health care providers at a time when many people were delaying seeking medical attention out of fear of contracting COVID-19.

Without action by Congress, the current delay of the Medicare sequester will expire at the end of March.

NASH has urged Congress to extend the Medicare sequestration delay on a number of occasions, doing so most recently in this March 4 message.

Learn more about the latest effort to extend the Medicare sequester delay in the Fierce Healthcare article “House to vote later this week on bill to delay Medicare sequestration payment cuts.”

2019 Change in Public Charge Rule to Disappear

Shortly after taking office the Biden administration stopped enforcing 2019 changes in the so-called public charge rule and now the Supreme Court has agreed to a Justice Department request to dismiss an upcoming case challenging that rule.

The public charge rule, as updated in 2019, calls for all legal immigrants enrolled in Medicaid and certain other safety-net programs to be designated public charges and denied access to permanent U.S. residency and green card status.  Hospitals – including private safety-net hospitals and the National Association of Safety-Net Hospitals – feared that the revised rule would have a chilling effect on the willingness of some legal citizens and legal non-citizens to seek out government health care programs for which they legally qualify.  This, they feared, could lead to many low-income legal citizens and non-citizens choosing not to seek the care to which they are entitled by law and ignoring serious illnesses and injuries until they become a crisis.  This could lead to continuing health problems for such individuals and a potential surge of uncompensated care for the safety-net hospitals to which such individuals turn when their medical conditions absolutely require medical attention – a surge that could jeopardize jobs at those hospitals and access to care in the generally low-income communities safety-net hospitals serve.

Between this action by the Justice Department and the Supreme Court agreement not to hear the case, it appears that the next step will be for the administration, which has already directed its agencies to review such regulations, either to revise or rescind the 2019 changes in the public charge rule.

NASH expressed its opposition to the 2019 changes in the public charge rule on several occasions, including in this letter to the Department of Homeland Security when the changes were proposed and in this 2019 position statement.

Learn more about the public charge rule and recent actions affecting it in the article “Supreme Court agrees to dismiss challenge to Trump public charge rule,” from the online publication The Hill.

NASH Stresses Three Needs From COVID Relief Bill

Extension of the current moratorium on Medicare sequestration.

Additional resources for the Provider Relief Fund.

Another delay in hospital repayment of funds they received from the federal government through the Medicare Accelerated and Advance Payments Program.

These are the three greatest needs of NASH members and private safety-net hospitals that NASH communicated to members of Congress on Thursday afternoon as the Senate begins consideration of the COVID-19 relief bill.

Learn more from NASH’s message to members of Congress.

NASH Unveils 2021 Advocacy Agenda

NASH has introduced its 2021 agenda.

In the coming year, NASH will:

  • Work to ensure that private safety-net hospitals receive the federal resources and regulatory assistance they need to help their low-income, medically underserved communities through the COVID-19 crisis.
  • Advocate the development and implementation of laws, regulations, and programs that enhance the ability of private safety-net hospitals to serve their communities more effectively.
  • Pursue enhanced access to Medicaid and to affordable, high-quality health insurance.
  • Urge Congress and the administration to work with safety-net hospitals and do more to address the social determinants of health to bring about health equity and better health outcomes in diverse and underserved communities.

To see NASH’s complete 2021 advocacy agenda, go here.

Coronavirus Update for Friday, February 5

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Friday, February 5.

NASH Advocacy

  • This week NASH wrote to congressional leaders on behalf of private safety-net hospitals asking them to include in the administration’s COVID-19 relief bill:
    • more resources for the Provider Relief Fund
    • additional targeted funding for safety-net hospitals
    • help with staffing
    • an extension of the current moratorium on the Medicare sequestration
    • forgiveness for safety-net hospitals for loans they received under the Medicare Accelerated and Advance Payment Program

See NASH’s letter to congressional leaders here.

NASH will engage in additional advocacy in the coming days.

The White House

Provider Relief Fund

A new proposal has been adopted by the Senate to include $35 billion for the Provider Relief Fund in the administration’s proposed $1.9 trillion COVID-19 relief bill.

Centers for Medicare & Medicaid Services

HHS and CMS COVID-19 Stakeholder Calls

HHS Clinical Rounds Peer-to-Peer Virtual Communities of Practice

HHS’s Office of the Assistant Secretary for Preparedness and Response sponsors COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice that are interactive virtual learning sessions that seek to create a peer-to-peer learning network in which clinicians from the U.S. and abroad who have experience treating patients with COVID-19 share their challenges and successes.  These webinar topics are covered every week:

  • EMS:  Patient Care and Operations (Mondays, 12:00-1:00 PM eastern)
  • Critical Care:  Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM eastern)
  • Emergency Department:  Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM eastern)

Go here for information about signing up to participate in the sessions and go here for access to materials and video recordings of past sessions.

CMS Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information about the agency’s response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer participants an opportunity to ask questions of CMS and other subject matter experts.

CMS COVID-19 Office Hours Calls

Tuesday, February 23 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2528725

Audio Webcast link:  go here

Tuesday, March 16 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  4177586

Audio Webcast link:  go here

Tuesday, April 6 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2769397

Audio Webcast link:  go here

Food and Drug Administration

Centers for Disease Control and Prevention

The National Academies of Sciences, Engineering, and Medicine

Administration to Review Public Charge Rule

President Biden has ordered a review of the federal public charge rule.

The controversial rule, which would limit immigration to the U.S. for people who might at some point become dependent on public aid programs, has been the subject of litigation since it was proposed in 2019.

The White House executive order directs

…the Secretary of State, the Attorney General, the Secretary of Homeland Security, and the heads of other relevant agencies, as appropriate…[to] review all agency actions related to implementation of the public charge ground of inadmissibility…

The officials were ordered to report their findings to the president within 60 days.

The public charge rule authorizes the U.S. Citizenship and Immigration Services to deny a green card to any immigrant who receives certain public benefits – such as food stamps, public housing vouchers, welfare, or Medicaid – for more than 12 months within any three-year period.  The expressed purpose of the rule is to deny green cards to individuals who may become dependent on publicly funded services – a so-called “public charge.”

Health care advocates feared the rule would discourage some immigrants to whom the rule does not even apply from seeking to participate in certain public aid programs and even encourage some to whom the rule does not apply to disenroll from the public aid programs, such as Medicaid, in which they are already legally enrolled.

NASH has expressed its opposition to the public charge rule on a number of occasions, including in this position statement.

Implementation of the rule, which was proposed in 2019 and took effect in September of last year, was delayed in November by a federal court.

Learn more about the administration’s latest action in this presidential executive order.