CMS dropped an interim final rule on the healthcare community last week, mandating reporting on COVID-19 metrics and threatening to remove providers from participating in the Medicare and Medicaid programs if they fail to comply. While providers already are meeting the reporting requirements – which the federal government has changed through the pandemic – the punitive nature of failing to comply with the rules caught many by surprise.
  
The new rules require hospitals to provide COVID-19 cases and related data to the U.S. Department of Health and Human Services, require nursing homes to test staff and offer testing to residents for COVID-19, and require laboratories and nursing homes using point-of-care testing devices to report diagnostic test results. If a hospital fails to comply, its Medicare and Medicaid payments could be terminated. Nursing homes and labs could face penalties of $1,000 for the first day of non-compliance and $500 for each subsequent day.
  
It's important to note that hospitals have been making daily reports to the federal government throughout the pandemic, even as the Trump Administration has repeatedly changed the reporting requirements. The federal government in February requested that states begin data collection; in March the White House Task Force decided to collect data on its own and asked for American Hospital Association (AHA) assistance, but by month’s end the AHA was asked to stop; from April through June, hospitals were required to submit data on “special” dates – all through the TeleTracking system; and the administration even proposed having the National Guard submit hospital data. In mid-July, HHS suddenly announced a new change in how hospitals could submit their data, eliminating the option for hospitals to access the most commonly used pathway – the CDC’s National Healthcare Safety Network (NHSN) – and instructing hospitals they could only submit through TeleTracking or their state department of health. HHS also announced changes to the data they were asking hospitals to submit, some of which were quite burdensome. 
  
“While hospitals and health systems remain focused on patient care, they're also committed to providing our government with the public health data it needs,” AHA President and CEO Rick Pollack said. “However, a new heavy-handed regulatory approach put forward by the Administration threatens to expel hospitals from the Medicare program. This disturbing move, announced in final form without consultation, or the opportunity to provide feedback through appropriate administrative procedures prior to it becoming effective, could jeopardize access to care and leave patients and communities without vital health services from their local hospital during a pandemic.”  

MHA last week outlined a series of hospital-community recommendations to the conference committee established to resolve differences between two major pieces of healthcare legislation that the Massachusetts Senate and House passed this legislative session – S.2769, An Act putting patients first, and H.4916, An Act to promote resilience in our health care system. 
  
The bills were sent on July 31 to the conferees: House Majority Leader Ron Mariano (D-Quincy), Rep. Dan Cullinane (D-Boston), and Rep. Randy Hunt (R-Sandwich), and Senators Cindy Friedman (D-Arlington), Julian Cyr (D-Truro), and Dean Tran (R-Fitchburg).
  
In the letter, MHA asks that the telehealth flexibilities put in place by executive order during the COVID-19 pandemic be maintained for two years, requiring all health plans – including MassHealth and the Group Insurance Commission – to cover all telehealth services if the same in-person service is covered through a patient’s health plan, and to reimburse the telehealth visit at the in-person rate. The Senate bill would allow this, along with including a more flexible definition of telehealth than the House’s bill.
  
MHA also supports elements of both bills regarding scope of practice for advanced practice registered nurses (APRNs). The Senate bill would allow for permanent expanded scope of practice for all APRNs, including certified registered nurse anesthetists and psychiatric nurse clinical specialists. A section in the House bill would continue until December 31, 2021, the governor’s executive orders to extend temporary licenses to clinicians and healthcare workers, which MHA supports. 
  
MHA reiterated in the letter its support of “baseball style” arbitration to resolve out-of-network billing issues, but since neither bill includes this provision, MHA told conferees it favors the House’s temporary resolution of the issue.
  
Among other conference priorities, MHA endorses sections of the House bill that would provide for accelerated MassHealth payments for certain acute care hospitals and inpatient services at chronic disease hospitals serving children and adolescents. In making that ask for public funding, the association noted, “MHA firmly believes that the commercial insurance market needs to play a stronger role in COVID-19 recovery, especially as health plans reported historically high profits in their most recent quarter. Looking long term, we continue to endorse measures to rebalance commercial dollars to increase reimbursement to hospitals that serve our most vulnerable populations.”

As the end of summer nears and a possible second surge in COVID-19 looms, the provider community is assessing the regulatory flexibilities state and federal government have put into place, and determining which ones need to be extended.
 
A major order from the state’s Division of Insurance that has assisted in the COVID-19 fight is the one that among other things directed health insurance companies to forego the administratively burdensome prior review, or concurrent reviews, for any scheduled surgeries and admissions at acute care and mental health hospitals. DOI’s original order early in the pandemic suspended the reviews through June 2020, and then Bulletin 2020-21 extended that order through September 30.
Last week, MHA joined by the Mass. Medical Society called on DOI to further extend the prior authorization suspension.
 
“Unfortunately, the need for these flexibilities will not magically end on September 30,” MHA and MMS wrote, and called on DOI to “recognize our collective uncertain future and the potential for a resurgence of COVID 19 cases in Massachusetts and extend the provisions of Bulletin 2020-21 through at least the end of this year with the opportunity to revisit the timeframe as December approaches.”

Congratulations to Holyoke Medical Center’s President & CEO Spiros Hatiras, who has received the Studer Group’s 2020 Healthcare Hero Award. 
  
The award was based on the quick response of Hatiras and the team at Holyoke Medical Center in supporting the Holyoke Soldiers’ Home during the COVID-19 pandemic. Faced with the crisis at the home, the Executive Office of Health and Human Services reached out and Holyoke Medical Center arranged to provide room and care to residents in a matter of hours.
  
“Spiros exemplifies what it means to be a healthcare hero,” said Debbie Ritchie, president of Huron’s Studer Group business. “He is a leader in the community and continues to improve the healthcare organization and the patient experience.”
  
The What’s Right in Health Care Hero Award honors individuals positively affecting the healthcare sector. Studer Group is a global consultant that works with healthcare organizations on mission, leadership, and organizational culture.
  
MHA President & CEO Steve Walsh congratulated Hatiras, saying, “Spiros’ work during the pandemic has been extraordinary, and it’s nothing new. He applies the same commitment to his hospital and the patients and communities he serves each and every day.”
  

Falls Prevention Awareness Week is less than a month away. The National Council on Aging has included a toolkit and other resources for healthcare professionals on this page to assist them in spreading the message about fall prevention.
  
The CDC also has comprehensive falls resources, including its new STEADI-Rx guide that can help pharmacists play a role in fall prevention by assessing medication regimens. 
 

Peter Markell, the CFO of Mass General Brigham Health, announced last week that he intends to step down from the post he has held for 21 years, effective March 31, 2021. Markell has had a long association with MHA, serving on its Standing Committee on Finance and lending his expertise in hospital financing to the association’s advocacy efforts on Beacon Hill and in Washington, D.C.

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