02.15.2021

Hospitals and the Federal Relief Bill; Vaccines Curtailed, and more ...

Congressional Committees Propose Health Provisions for COVID Package

Congressional committees quickly moved forward last week on numerous proposals that they want included in the larger COVID-19 emergency stimulus legislation. Overall budget instructions were passed earlier this month in the budget resolution directing committees to complete the detailed work in their areas of jurisdiction by February 16. Key health proposals have been included in committee COVID reconciliation documents the U.S. House made final last week.

 

The health provisions include:

 

  • A 5% Federal Medical Assistance Percentage (FMAP) increase for two years for states that newly expand Medicaid, plus mandatory Medicaid COVID-19 vaccine and treatment coverage without beneficiary cost sharing, among other targeted Medicaid increases.

  • Increased Affordable Care Act (ACA) exchange subsidies for lower-income individuals for 2021 and 2022, and maximum ACA subsidies for individuals receiving unemployment benefits in 2021.

  • Subsidies for 85% of the cost of premiums for COBRA continuation coverage for workers who are laid off or have reduced hours.

  • $350 billion in state and local pandemic aid.

  • $7.6 billion for community health centers for pandemic response activities.

  • $7.5 billion in funding for vaccines and therapeutics for distribution to the state and local public health departments.

  • $46 billion for state and local public health departments for testing, contact tracing, surveillance, and mitigation.

  • $7.6 billion for establishing, supporting and expanding the public health workforce at the state and local levels.

Noticeably absent from the congressional package provisions proceeding through committees last week was language to increase the Provider Relief Fund, which directs funding to hospitals. However, negotiations continue on this and other issues.

 

Once the committees complete their work – perhaps by this week – their separate documents will be combined into one COVID aid package for consideration before both legislative bodies. Congressional leaders hope to complete action by early March.

Hospital Vaccine Supply to be Constrained

MHA has informed member hospitals that their supply of COVID-19 vaccines will be curtailed over the next two weeks, as Massachusetts directs available doses to mass vaccination sites, retail pharmacies, and community health centers.

MHA advised hospitals not to schedule any new first dose vaccination appointments until further notice, but also not to cancel any currently scheduled appointments. The state said it would provide vaccines to hospitals for already-scheduled first doses and assured MHA that all second doses will be provided to hospitals this week as needed.

Massachusetts hospitals have navigated a deluge of challenges throughout the pandemic, often taking extraordinary measures to be there for their patients and communities. The challenge of vaccine distribution is no different, with providers administering more than 450,000 doses since late December. They have also stood up vaccination sites in more than 20 locations as a part of this effort, many of which are in hard-hit communities and designed to engage underrepresented residents. Hospitals have shown to be in a prime position to help steer a rollout that is safe, equitable, and efficient, and MHA will continue to work closely with the state as the supply from the federal government improves.

Hospitals Go to Court (Again) Over Drug and Outpatient Payments

The American Hospital Association (AHA) and other hospital groups filed petitions last week asking the U.S. Supreme Court to overturn two U.S. Appeals Court rulings related to the 340B drug program and outpatient care provided at off-campus sites. The two issues have been contested in the courts for more than a year.

In 2018 and 2019, U.S. Health & Human Services through the outpatient prospective payment system rule cut drug payments to hospitals participating in the 340B drug program. For Part B drugs administered in physician offices and hospital outpatient departments, Medicare cut drug payments to 340B hospitals from Average Sales Price (ASP) plus 6% to ASP minus 22.5% – or nearly a 30% cut. Hospitals sued and won a reversal in the U.S. District Court for the District of Columbia, but that ruling was subsequently overruled by a U.S. Court of Appeals last July. Now AHA is challenging that Appeals Court ruling before the Supreme Court. 

The other case involves HHS’ payment cuts in the 2019 outpatient payment rule for certain hospital off-campus provider-based departments. A lower court twice found that HHS exceeded its statutory authority when it reduced these payments. But, again in July, a three-judge appeals panel reversed this decision, leading to last week’s Supreme Court filing.

MHA will be joining with other state hospital associations on amicus briefs in support of the AHA position in each case.

Helping Young Adults with Disabilities Find Employment

A new worker training program for young adults with disabilities has been announced by the Commonwealth Corporation. Working with the Executive Office of Labor and Workforce Development on the project, the Commonwealth Corporation is seeking applications from partnerships led by a community-based organization that have success and expertise in preparing young adults with disabilities for employment, and have had success in ultimately placing the individuals in positions at their workplaces.

Many hospitals, through their community benefit programs, have undertaken such programs and could benefit from the Commonwealth Corp’s expected grants of approximately $50,000. Questions on the program will be accepted in writing through February 19, and the submission deadline for applications is March 2 by 5 p.m.

Full details on the request for proposals are here: Employment Program for Young Adults with Disabilities.
 

MHA Executive Insights Series, New Year, New Hope: A Look at the Year Ahead

Series Premiere: Tuesday, February 23, 8-8:30 a.m.

Ever wanted to pick a hospital CEO's brain about some of the most pressing issues facing our healthcare system?

MHA is excited to announce the launch of our Executive Insights Series, which will feature candid interviews with hospital leaders throughout 2021. We welcome you to pour a cup of coffee and start your day with us as we hear directly from the CEOs who help power our world-class healthcare community.

To kick off the series, Dr. Eric W. Dickson, president & CEO of UMass Memorial Health Care, will join us on Tuesday, February 23 to discuss his unique perspective as we continue to battle the COVID-19 pandemic. Register here and see you on February 23!

John LoDico, Editor