Vaccine Approval, SJC Ruling, and more...

Vaccine Approved and Delivery Expected Shortly in Mass.

Following the Food & Drug Administrations (FDA’s) vote on Friday to approve the Pfizer/BioNTech COVID-19 vaccine, Massachusetts healthcare workers and long-term care facility residents can expect to get vaccinated as early as this week. The fact that this vaccine, and another from Moderna that is expected to be approved shortly, went from conception to large-scale distribution within a year is unparalleled in the history of vaccinations.
The state released its three-phase vaccination priority plan last week. After distributing vaccines to those most liable to be in contact with the virus, followed by those populations that face the greatest health threat from COVID-19, the state will reach the general population beginning in April – if the massive distribution goes as planned.
Massachusetts hospitals have the experience and the infrastructure to deliver the vaccine. An MHA-led vaccine workgroup, consisting of approximately 80 members from nearly all hospitals across the state has been meeting to share best practices and address potential problems. One area of the concern is that the two-dose vaccine, delivered about three weeks apart, has been reported to cause some recipients discomfort for a day or more after the initial dose – a similar reaction to other viral vaccines. Hospitals plan to stagger the vaccine delivery so that they don’t create gaps in their workforce if employees take a sick day.

Surprise Billing Deal Reached; Neal Nixes Benchmark Rate Setting

Late last Friday, the leaders of the House and Senate authorizing committees, including House Ways and Means Committee Chairman Richard Neal (D-Mass.), announced a legislative agreement on surprise medical billing.
The proposal’s effective date is January 1, 2022, and would hold patients harmless for out-of-network rates, making them responsible only for in-network payment rates. Importantly, it creates an arbitration mechanism for resolving payment disputes between providers and insurers.
In recent weeks, Senators Lamar Alexander (R-Tenn.) and Bill Cassidy (R-La.), along with Representative Frank Pallone (D-N.J.) sought to include benchmark rate setting and thresholds for arbitration as the mechanism for resolving provider-insurer disputes. Neal has stated his long-standing opposition to benchmark rate setting and shared with the Massachusetts healthcare community his desire to find an approach that would protect patients and give hospitals and doctors a more fair fair place at the negotiating table with insurers. Friday’s agreement allows insurers to make a payment to the provider that is determined either through negotiation between the parties or an independent dispute resolution (IDR) process. If the parties choose the IDR process, both parties would each submit an offer to the independent arbiter. When choosing between the two offers, the arbiter is required to consider the median in-network rate, information related to the training and experience of the provider, the market share of the parties, previous contracting history between the parties, complexity of the services provided, and any other information the parties submit.
While the details of this late Friday announcement are still being reviewed, House leaders have indicated they hope to include the proposal with the health extenders and Fiscal 2021 spending bill later this week.
MHA and its membership have long advocated for legislation to end the issue of surprise billing. When the agreement was announced Friday, MHA President & CEO Steve Walsh said, “The healthcare community is grateful for Chairman Neal’s tireless leadership to resolve the issue of out-of-network billing. Hospitals have long advocated that patients should be taken out of the middle when it comes to surprise billing and this approach accomplishes that goal in a fair and balanced manner. We thank Congressman Neal for his persistence throughout this process and for not being pushed to accept anything less than our patients and providers deserve.”

SJC Concurs with MHA, MMS & ONL on Gov’s Executive Orders

The state’s Supreme Judicial Court has rejected a lawsuit challenging the governor’s authority to declare a state of emergency and issue executive orders during the COVID-19 pandemic. 
"We conclude that the [Civil Defense Act – CDA] provides authority for the Governor's March 10, 2020, declaration of a state of emergency in response to the COVID-19 pandemic and for the issuance of the subsequent emergency orders,” the justices wrote in their 41-page decision. “The emergency orders do not violate art. 30 of the Massachusetts Declaration of Rights; and the emergency orders do not violate the plaintiffs' Federal or State constitutional rights to procedural and substantive due process or free assembly."
MHA, the Massachusetts Medical Society, and the Organization of Nurse Leaders had joined to file an amicus brief in September defending the governor’s actions. That brief stated, “To put it simply, the battle cannot be won (and could yet be lost) if the Governor's office is prevented from using the authority granted to it by the CDA. The levels of sickness and death caused by the virus, and the accompanying strains placed on our healthcare infrastructure, have been unprecedented in modern Massachusetts history. It is self-evident that the pandemic has been a ‘disaster’ and a ‘catastrophe’ resulting from natural causes, as the Act requires for the Governor to invoke it.”
The suit was brought by two hair salons, a tanning salon, a boxing gym, two restaurants, two houses of worship and their pastors, the head of a religious academy, a family entertainment center, and a conference center.
The SJC noted that its ruling does not permit the governor to act as he has for all public health emergencies the state may face. “The distinguishing characteristic of the COVID-19 pandemic is that it has created a situation that cannot be addressed solely at the local level,” the justices wrote. “Only those public health crises that exceed the resources and capacities of local governments and boards of health, and therefore require the coordination and resources available under the CDA, are contemplated for coverage under the CDA.”

MHA is Conduit for Some Federal Relief Funding to Hospitals

MHA informed member hospitals last week that they were each eligible for $30,000 in COVID-19 relief funds for a variety of actions they have taken to prepare their facilities for fighting the virus and for the care they provided to COVID-19 patients.
The funding is from the Coronavirus Preparedness and Response Supplemental Appropriations Act, and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). It flowed to the Office of the Assistant Secretary for Preparedness and Response (ASPR) and then to state hospital associations, which are distributing the money to individual hospitals. 

MAT Waiver Training Courses

A program offered through Boston Medical Center (BMC) is providing free Medications for Addiction Treatment (MAT) training for a variety of caregivers.
MAT involves a combination of a medications that targets the brain, and psychosocial interventions (counseling, skills development) aimed at improving treatment outcomes. One medication regimen involves buprenorphine (considered safer than methadone), which can be prescribed by primary care providers who complete a special training course.
Physicians, nurse practitioners, and some other caregivers must complete eight hours of training that BMC’s Office Based Addiction Treatment Training and Technical Assistance program is offering in two, four-hour Saturday courses on January 16 and 23, 2021. View this notice for times and registration information.
Advanced practice practitioners (APP) must complete 24 hours of specialized training to obtain a waiver to prescribe buprenorphine — the eight-hour MAT waiver training course plus an additional 16 hours of training. This eight-part, 16-hour training begins on Saturday, January 23. View this notice for details and registration.

Congress Nears Another COVID Aid Package

Congressional talks on a COVID stimulus package have advanced significantly in the past few weeks. Late last week Congress quickly approved an extension of the deadline on government spending and many health policy programs that otherwise would have expired on December 11. This leaves the clock ticking this week for Congress to finish its work on a FY2021 appropriation spending package, and address the policies and funding for expiring health bills, including the delay of the scheduled Medicaid disproportionate share hospital reduction. 
Focus will also be on whether Congress can reach agreement on a COVID-19 stimulus package. A bipartisan bicameral congressional group offered its own $908 billion proposal two weeks ago, which brought attention to a center ground between the Senate GOP $500 billion proposal from this summer and the original House Democratic $2.4 trillion proposal from last spring. The $908 billion bipartisan proposal included additional provider relief fund aid, liability protection, state and local assistance, sequester cut delay, and several other important hospital priorities. The House and Senate leadership, often called the “four corners,” continued to talk through the weekend, but there was no news of movement.

Transitions: MWMC, Biden's Health Team 

Ava Collins, FACHE is the new CEO of MetroWest Medical Center, which operates two hospitals: Leonard Morse in Natick and Framingham Union in Framingham. Collins is leaving her role as COO of Saint Vincent Hospital to take the MetroWest post. MetroWest and Saint Vincent are subsidiaries of Tenet Health. Collins also served as Group COO for the Massachusetts and South Carolina Markets of Tenet Health. She earned her bachelor’s degree from Northeast Louisiana University and a master’s in healthcare administration from Tulane University.
President-elect Joe Biden’s healthcare team has a distinctly Massachusetts pedigree. He named Rochelle Walensky, M.D., the chief of infectious diseases at Massachusetts General Hospital, as the next director of the Centers for Disease Control and Prevention. Biden nominated former Surgeon General Vivek Murthy, M.D., as the next Surgeon General. Murthy completed his internal medicine residency at Brigham and Women's Hospital. Biden’s choice for Secretary of the Department of Health and Human Services is California Attorney General Xavier Becerra, who began his career as a lawyer for the Legal Assistance Corporation of Central Massachusetts. Marcella Nunez-Smith, M.D., the current associate dean for Health Equity Research at the Yale School of Medicine, will serve as Biden’s COVID-19 Equity Task Force chair. She completed her residency at Brigham and Women’s. Anthony Fauci, M.D. – a Holy Cross graduate – was named Biden’s chief medical adviser on COVID-19 and will continue as director of the National Institute of Allergy and Infectious Diseases.

Annual Design, Operations and Construction Conference

4-Part Virtual Webinar Series
January 26, February 2, February 9 & February 16 
Weekly on Tuesdays from 9-10 a.m.

Registration is open for MHA’s Annual Design, Operation & Construction Conference, always a timely and relevant program for facility leaders, architects, builders, and those doing business in the healthcare design and construction business. The program for the conference has been revised to include the latest updates on COVID-19 as it relates to design and construction. We will feature expert faculty on the topic and include opportunities for engagement and interaction. If you are unable to attend the live webinar sessions, all registrants will have access to the session recordings to view at your convenience. Don’t miss out!
Reminder: This virtual conference is FREE for MHFPS, NEHES, or other facility professionals working for a hospital or system. The event is supported by the vital consultant and vendor community in the healthcare design, operation, and construction sector. Through generous sponsorship and registrations, this event is made available to all facility professionals at all levels; please encourage your staff to attend. Register early as this event fills up quickly.

John LoDico, Editor