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Feds Update Provider Relief Fund Spending, Reporting Requirements

The Department of Health and Human Services  has revised its requirements for reporting on and expending CARES Act Provider Relief Fund payments.

Today HHS and its Health Resources and Services Administration  announced that they have increased the amount of time providers will have to report information and extended key deadlines for expending Provider Relief Fund payments for recipients that received payments after June 30, 2020.

The revised reporting requirements will be applicable to providers that received one or more payments exceeding, in the aggregate, $10,000 during a single payment received period from the Provider Relief Fund General Distributions, Targeted Distributions, and/or Skilled Nursing Facility and Nursing Home Infection Control Distributions.

Highlights of the revisions are:

  • The period of availability of funds is based on the date the payment is received (rather than requiring all payments be used by June 30, 2021, regardless of when they were received).
  • Recipients are required to report for each Payment Received Period in which they received one or more payments exceeding, in the aggregate, $10,000 (rather than $10,000 cumulatively across all PRF payments).
  • Recipients will have a 90-day period to complete reporting (rather than a 30-day reporting period).
  • The reporting requirements are now applicable to recipients of the Skilled Nursing Facility and Nursing Home Infection Control Distribution in addition to General and other Targeted Distributions.
  • The PRF Reporting Portal will open for providers to start submitting information on July 1, 2021.

For additional information, see the following resources:

 

Safety-Net Hospitals Need More COVID Aid, NASH Tells Congress

The federal government should direct more of its remaining CARES Act Provider Relief Fund money to private safety-net hospitals, the National Association of Safety-Net Hospitals told members of Congress in a message delivered yesterday.

While the Provider Relief Fund has been a lifesaver for safety-net hospitals, NASH noted, the formula for distributing money put high-volume Medicaid hospitals at a disadvantage compared to the typical community hospital while separate distributions of the CARES Act money specifically for safety-net providers missed many such hospitals entirely

Last week NASH wrote to Health and Human Services Secretary Xavier Becerra to bring this situation to his attention and seek his assistance, and in its Monday message to members of Congress, NASH asked those members to convey to Secretary Becerra their support for greater aid to private safety-net hospitals in future Provider Relief Fund distributions.

See NASH’s message to members of Congress.

MACPAC Looks at Recipients of Provider Relief Fund Grants

What kinds of providers did and did not receive grants from the CARES Act’s Provider Relief Fund?  What were the obstacles to receiving those COVID-19 relief grants and why did some providers fare better in the distribution of Provider Relief Fund resources than others?

These questions and more are addressed in “COVID Relief Funding for Medicaid Providers,” a new analysis released by the Medicaid and CHIP Payment and Access Commission.

Coronavirus Update for Friday, January 15

The following is the latest COVID-19 information from the federal government as of 2:45 p.m. on Friday, January 15.  We also present a summary of selected aspects of the “American Rescue Plan” that President-elect Biden presented on Thursday night and an introduction to the newest members of his COVID-19 response team.

Provider Relief Fund

  • HHS has amended the reporting timeline for the Provider Relief Fund in response to passage of the Coronavirus Response and Relief Supplemental Appropriations Act.  Starting today, recipients may begin registering for gateway access to the reporting portal where they ultimately will submit their information in compliance with new reporting requirements HHS is issuing.  There is no deadline for registering.  While reporting was supposed to begin today, it has been delayed and will begin at a later date to be announced.  See HHS’s news release explaining its revisions.
  • HHS has updated its Provider Relief Fund web page to reflect these changes.
  • The reporting requirements and auditing page has been updated to list the types of providers to which the new reporting requirements do not apply.  Find that information here.
  • That page also announces the opening of the new reporting portal and directs readers to that new Provider Relief Fund Reporting Portal.
  • HHS also has updated its Provider Relief Fund FAQ with two modified questions:  one, on pages 26-27, shares new timelines for providers to report on their use of their Provider Relief Fund grants; and the other, on page 36, addresses what providers should do if they expected Phase 2 payments but did not receive them.  Provider Relief Fund recipients should review these notices carefully.

Department of Health and Human Services

CMS COVID-19 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 2  at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  4956655

Audio Webcast link:  go here

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

Centers for Disease Control and Prevention

Food and Drug Administration

Pandemic Response Accountability Committee

  • The Pandemic Response Accountability Committee (PRAC), which consists of the inspectors general of federal departments and agencies, was established by the CARES Act to promote transparency and support independent oversight of the funds provided by the CARES Act and other related emergency spending bills.  Its PRAC Health Care Subgroup, which consists of the inspectors general that oversee federal agencies providing or reimbursing for health care services, has released the report “Federal COVID-19 Testing Report: Data Insights from Six Federal Health Care Programs,” examines COVID-19 testing efforts for six federal health care programs during the first seven months following the declaration of the COVID-19 public health emergency.  Read the news release about the report and go here to see the report itself.

The President-Elect’s “American Rescue Plan”

On Thursday night President-elect Biden unveiled part of his COVID-19/economic stimulus proposal, his “American Rescue Plan” (economic recovery components will be released in the coming weeks).  The key components released last night are:

  • $160 billion to mount a national vaccination program, including expanding FMAP to 100 percent for the administration of vaccines
  • $400 billion to safely reopen schools and provide paid leave for workers to contain COVID-19
  • add 100,000 public health workers
  • expand funding to Community Health Centers (FQHCs) and tribal health services
  • deploy strike teams to long-term-care facilities
  • $30 billion to procure supplies and protective gear and provide 100 percent federal reimbursement to states and local governments for critical emergency response resources
  • $10 billion for expanding domestic manufacturing for pandemic supplies
  • expand health coverage:  extend COBRA and reduce health insurance premiums
  • funding for OSHA protections for vulnerable workers
  • support the international health and humanitarian response to COVID-19
  • require employers to provide emergency paid sick leave and family medical leave and extend the refundable tax credit for employers with fewer than 500 employees for 100 percent of the cost of this leave
  • send $1,400 per-person checks to households across America
  • extend unemployment insurance benefits
  • extend the eviction and foreclosure moratorium until September 30, 2021
  • expand housing and nutrition assistance
  • increase the minimum wage to $15 an hour, enhance unemployment insurance, and expand support for child care
  • $50 billion for small businesses relief programs
  • protect jobs of essential workers
  • modernize federal information technology to protect against cyberattacks

There is no legislative language for this proposal at this time.

Go here for a more detailed summary of the proposal.

The Biden-Harris Administration’s COVID Response Team

The following is a list of individuals recently named to President-elect Biden’s health care team:

  • David Kessler, chief science officer of COVID Response.  Dr. Kessler, who serves as a co-chair of the COVID-19 Task Force for President-elect Joe Biden, was the commissioner of the Food and Drug Administration from 1990 to 1997 under presidents George H. W. Bush and Bill Clinton.
  • Rosa Po, COVID response team deputy chief of staff.  Ms. Po serves as an advisor for domestic/ economic agency review on the Biden-Harris transition and served on the platform team on the Biden-Harris campaign.  Previously she served as deputy chief of staff and senior counsel to Senator Amy Klobuchar and as Senator Klobuchar’s policy director and senior advisor during her presidential campaign.
  • Andy Slavitt, senior advisor to the COVID response coordinator.  Mr. Slavitt served as the acting administrator of the Centers for Medicare & Medicaid Services under President Obama.  Prior to that he helped lead the successful turnaround of the healthcare.gov web site.
  • Vidur Sharma, policy advisor for testingMr.Sharma served in the Obama-Biden administration as a health policy advisor on the Domestic Policy Council.  In this role he supported the implementation of the Affordable Care Act, aligned federal departments and agencies, and collaborated with community stakeholders to further the administration’s health policy agenda.
  • Ben Wakana, deputy director of strategic communications and engagement.Mr. Wakana serves as the COVID-19 and health care outreach lead on the Biden-Harris transition.  Prior to joining the transition he was executive director of Patients For Affordable Drugs, a nationwide non-profit focused on lowering prescription drug prices.
  • Dr. B. Cameron Webb, senior policy advisor for COVID-19 equity.Dr.Cameron Webb currently serves as assistant professor of medicine and public health sciences and as director of health policy and equity at the University of Virginia School of Medicine.  A general internist, Dr. Webb has worked clinically in the university’s COVID-19 unit since the beginning of the pandemic.
  • Amy Chang, policy advisor.  Amy Chang is a member of the Biden-Harris transition’s COVID-19 team.  She previously worked in the Obama-Biden administration as a special assistant in the Office of the Secretary at the U.S. Department of Health and Human Services.

 

 

Coronavirus Update for Wednesday, December 23

The following is the latest COVID-19 information from the federal government as 2:30 p.m. on Wednesday, December 23.

Provider Relief Fund

Centers for Medicare & Medicaid Services

Food and Drug Administration

Centers for Disease Control and Prevention

National Institutes of Health

American Medical Association

Coronavirus Update for Wednesday, December 16

The following is the latest COVID-19 information from the federal government as 2:45 p.m. on Wednesday, December 16.

Provider Relief Fund

  • HHS announced that it has completed its review of Phase 3 applications from the Provider Relief Fund program and will distribute $24.5 billion to more than 70,000 providers.  HHS said this distribution will satisfy up to 88 percent of each applicant’s reported net lost revenues and net change in expenses caused by COVID-19 in the first half of 2020.  See HHS’s announcement here.
  • Phase 3 was originally announced as a $20 billion distribution.  According to HHS, “As HHS began analyzing applications, it realized the submissions for lost revenues and net changes in expenses would exceed the $20 billion budgeted for the Phase 3 allocation.  In an effort to meet the demand, HHS worked to add another $4 billion to the allocation bringing the new total to over $24 billion.”
  • More than 35,000 applicants for Phase 3 grants will not receive additional payments either because they experienced no change in revenues or net expenses attributable to COVID-19 or because they have already received funds that equal or exceed reimbursement for 88 percent of reported losses.
  • Payments to Phase 3 applicants begin today and will continue as application quality reviews and recipient payment set up are completed before payment can be made.  A state-by-state breakdown of the first batch of Phase 3 payments can be found here.

COVID-19 Relief Legislation

Work continues at this hour on what is being called the Bipartisan Emergency COVID Relief Act of 2020.  As of this writing the bill is expected to include the following health care provisions:

  • $35 billion for the Provider Relief Fund, including $7 billion for rural providers.
  • more than $16 billion for testing, contact tracing, and vaccine development and distribution
  • $5 billion in emergency funding for substance abuse prevention and treatment and mental health services.

The bill does not include liability protections for health care providers and businesses or the $152 billion in aid to states and local governments that had been proposed by a bipartisan working group.  Instead, negotiators are looking for ways to include around $90 billion for other emergency fund programs that could help direct financial support to states.

Funding for the federal government expires at midnight this Friday, December 18.  Lawmakers are hoping to wrap up details of this bill and possible legislation to address surprise billing before that deadline.

NASH will keep its members abreast of the progress of this bill and any changes from the key points noted above.

CMS COVID-19 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.

COVID-19 Office Hours Call

Tuesday, December 22 at 5:00 (eastern)

Toll Free Dial In:  833-614-0820; Access Passcode:  3968359

Audio Webcast link:  go here.

Conference lines are limited so CMS encourages interested parties to join via audio webcast.

To listen to the audio files and read the transcripts for past stakeholder calls, go here.

Department of Health and Human Services

Food and Drug Administration

Centers for Disease Control and Prevention

Coronavirus Update for Monday, December 14

The following is the latest COVID-19 information from the federal government as 2:30 p.m. on Monday, December 14.

Centers for Medicare & Medicaid Services

Provider Relief Fund

  • The “Reporting Requirements and Auditing” section of the Provider Relief Fund web page has been updated with a link to a new overview of Provider Relief Fund allowable expenses.  The purpose of this document is to clarify the intent and provide examples of allowable expenses for the use of Provider Relief Fund general and targeted distribution payments.
  • HHS’s Provider Relief Fund FAQ has 13 updates marked “12/11/2020.”  They can be found on pages 2 (two changes), 3, 11, 15, 16 (four changes), 17 (two changes), and 27 (two changes).  Of particular interest to providers, the update on page 11 addresses sharing of Provider Relief Fund grants among related entities; the changes on pages 16 and 17 address allowable expenses and offsets of other revenue; and the change on page 27 addresses allowable costs for vaccine purchase and distribution.

CMS COVID-19 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.

COVID-19 Office Hours Call

Tuesday, December 22 at 5:00 (eastern)

Toll Free Dial In:  833-614-0820; Access Passcode:  3968359

Audio Webcast link:  go here.

Conference lines are limited so CMS encourages interested parties to join via audio webcast.

To listen to the audio files and read the transcripts for past stakeholder calls, go here.

Department of Health and Human Services

Food and Drug Administration

Centers for Disease Control and Prevention

National Institutes of Health

NASH Asks Congress to Help Hospitals Keep Provider Relief Fund Grants

Safety-net hospitals could lose some or all of their CARES Act Provider Relief Fund grant money and the National Alliance of Safety-Net Hospitals is asking members of Congress to intervene to prevent it.

At issue are financial reporting requirements that at first directed hospitals to estimate their anticipated revenue losses and extra expenses associated with the COVID-19 pandemic in one way and then shifted to a new approach.  The first grant distribution was based on the original reporting requirements, and now, hospitals fear that the change in reporting requirements could leave them vulnerable to a demand that they return some, much, or all of that grant money.

The Department of Health and Human Services announced one set of reporting requirement in June and then proposed modifying them in September.  In response to widespread expressions of concern, including from NASH, HHS revised those proposed changes – but not enough, according to many stakeholders, leaving them concerned that HHS would ask them to return some of their grant money.  Now, NASH is asking the same members of Congress who asked HHS to reconsider the reporting requirements to do so again.

See NASH’s letter members of Congress asking them to sign onto a bipartisan letter asking HHS to revise its reporting requirements once again.  Go here to see the letter members of Congress are being asked to sign.

Coronavirus Update for Tuesday, December 9

The following is the latest COVID-19 information from the federal government as 2:30 p.m. on Tuesday, December 8.

Provider Relief Fund

  • HHS announced that the Provider Relief Fund will distribute $523 million in second-round performance payments to 9248 nursing homes as rewards for successfully reducing COVID-19-related infections and deaths between September and October.  HHS concluded that between September and October, 69 percent of 13,251 eligible nursing homes met the incentive program’s infection control criteria.  See HHS’s announcement of the nursing home distribution and a list of how much of this money HHS distributed to nursing homes in individual states.
  • HHS has updated its CARES Act Provider Relief Fund FAQ with nine new or modified questions and answers.  Find the new items, all labeled “12/4/2020,” on pages 2, 6, 14, 15, 16-17, 25, 34, 47, and 55.  Fund recipients should review this new information carefully, and in particular, the question on page 6 about erroneous payments, which reverses previous policy, and questions on audit terms and extensions on pages 14 and 15.

Centers for Medicare & Medicaid Services

CMS COVID-19 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.

COVID-19 Office Hours Call

Tuesday, December 22 at 5:00 (eastern)

Toll Free Dial In:  833-614-0820; Access Passcode:  3968359

Audio Webcast link:  go here.

Hospitals Without Walls Call

On November 25, CMS announced the expansion of its Hospitals Without Walls program by introducing its Acute Hospital Care At Home program, giving eligible hospitals unprecedented regulatory flexibilities to treat eligible patients in their homes.  This program was developed to support models of at-home hospital care that have succeeded in several hospitals and networks.  A CMS Hospitals Without Walls stakeholder call will feature two organizations walking through their programs and a question and answer session.  Slides/resources will be posted on CMS.gov prior to the call.

Wednesday, December 9 at 4:00-5:00 PM (eastern)

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  1235939

Audio Webcast Link:  go here.

Conference lines are limited so CMS encourages interested parties to join via audio webcast.

To listen to the audio files and read the transcripts for past stakeholder calls, go here.

Department of Health and Human Services

  • HHS has released new hospital COVID-19 capacity data at the facility level.  Previously released data about hospital capacity that had been released was aggregated at the state level but this new, more granular data release aggregates daily hospital reports into a “week at a time” picture while providing a view of how COVID-19 is affecting hospitals and communities.  See HHS’s announcement about the new data and an FAQ about the data and go here for access to the data itself.

Food and Drug Administration

Centers for Disease Control and Prevention

Coronavirus Update for Tuesday, November 24

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Tuesday, November 24.

Provider Relief Fund

The Provider Relief Fund web page has been updated with the following notice:

The application deadline for the Provider Relief Fund Phase 3 General Distribution was Nov. 6, 2020. You must have submitted your Taxpayer Identification Number (TIN) for validation by 11:59 p.m. ET on Nov. 6, 2020 for Phase 3 relief funds. If you submitted your TIN for validation by the deadline and your TIN is validated by Nov. 13, you will be able to proceed with submitting your revenue documentation to complete your application by 11:59 p.m. ET on Nov. 27, 2020.

Department of Health and Human Services

  • HHS has announced plans to allocate doses of the investigational monoclonal antibody therapeutics casirivimab and imdevimab for treatment of non-hospitalized patients with mild or moderate confirmed cases of COVID-19 at high risk of hospitalization; this is often referred to publicly as the Regeneron antibody cocktail. HHS will allocate 300,000 federally-purchased doses to state and territorial health departments that will determine which health care facilities receive the infusion drug.  Weekly allocations of the drug will be proportionally based on confirmed COVID-19 cases in each state and territory over the previous seven days based on data that hospitals and state health departments enter into the HHS Protect data collection platform.  Learn more from HHS’s announcement about the allocation plan.  Find additional information about allocation here.
  • HHS has published a Request for Information notice in which it seeks to “…gather information on effective innovative approaches and best practices in health care in response to the COVID-19 pandemic by non-HHS health care systems and providers.” Comments are due by December 24.  Go here to see the brief notice.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response has posted a paper on the designation of individual hospitals as COVID-19 hospitals within health systems or geographic areas.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response has posted a report on crisis standards of care and patient surge management for COVID-19.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response has posted a presentation with information on the use of point-of-care tests for the diagnosis of COVID-19.

Centers for Medicare & Medicaid Services

  • CMS has posted the first episode in a series of short podcasts for frontline nursing home staff. The series, “CMS Beyond the Policy:  Nursing Home Series for Frontline Clinicians and Staff,” is designed to reinforce training and infection control practices in nursing homes to help combat the spread of COVID-19.  To listen to the podcast, go here.

Food and Drug Administration

Centers for Disease Control and Prevention

Department of Labor