Pennsylvania safety-net hospitals Archives - Page 2 of 14 - Safety-Net Association of Pennsylvania

SNAP Asks PA Congressional Delegation to Help Preserve Federal COVID-19 Aid for Hospitals

Protect the COVID-19 aid the federal government has given to Pennsylvania safety-net hospitals and others, SNAP has asked in a letter to members of Pennsylvania’s congressional delegation.

Safety-Net Association of Pennsylvania logo The letter refers to changes in how the federal Department of Health and Human Services wants hospitals to calculate the revenue they lost as a result of COVID-19 – the justification in part for the Provider Relief Fund payments hospitals have received through the CARES Act. In June, HHS told hospitals how to make that calculation but late last month it changed those directions in ways that could force many Pennsylvania safety-net hospitals to return some or even much of the federal aid they received.

In the letter, SNAP asks members of Pennsylvania’s congressional delegation to join a bipartisan letter asking HHS Secretary Alex Azar to restore the June instructions for calculating COVID-19-related lost hospital revenue.

Go here to read SNAP’s message to Congress.

PA Safety Net Admin2020-10-14T11:43:19+00:00October 14th, 2020|Coronavirus, COVID-19, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Payer Mix to Change, Providers Anticipate

Health care providers expect to serve higher proportions of Medicaid and uninsured patients in the coming year, according to a new survey.

The shift will be driven by the COVID-19 pandemic, which as unemployment remains high is leading to fewer patients with commercial insurance and more with Medicaid or no insurance all, according to provider financial executives.

Such a shift would be especially challenging for Pennsylvania safety-net hospitals because they already serve higher proportions of Medicaid and uninsured patients than the typical community hospital.

Learn more about the reimbursement changes health care providers expect to see over the next twelve months in the Healthcare Dive article “Provider finance execs bracing for unfavorable shift in payer mix, survey finds.”

PA Safety Net Admin2020-10-05T06:00:21+00:00October 5th, 2020|Pennsylvania safety-net hospitals|Comments Off

MFAR is Dead

At least for now.

The controversial Medicaid Fiscal Accountability Regulation, slated for implementation this fall over the objections of many health care stakeholders, will not move forward at this time.

In a tweet earlier this week, Centers for Medicare & Medicaid Services Administrator Seema Verma wrote that

We’ve listened closely to concerns that have been raised by our state and provider partners about potential unintended consequences of the proposed rule, which require further study. Therefore, CMS is withdrawing the rule from the regulatory agenda.

If implemented, opponents maintained, the regulation would have:

Deprived states of important, established policy-making prerogatives.
Created major new administrative burdens for state governments and hospitals.
Inappropriately regulated financing of the state share of Medicaid spending.
Introduced new, unspecified standards for state Medicaid programs.

While CMS maintained that MFAR would have enhanced the transparency of state Medicaid programs, the rule’s opponents maintained that it could lead to a major reduction of resources for serving the Medicaid population.

SNAP was among those opponents, arguing that the regulation could have hurt Pennsylvania safety-net hospitals and others that serve low-income communities by inappropriately regulating how states can finance their Medicaid programs. CMS proposed the rule last November; SNAP submitted formal comments expressing its opposition in January; and SNAP rallied Pennsylvania’s congressional delegation to oppose the rule in February, March, and July.

It is worth noting that in “withdrawing the rule from the regulatory agenda,” Verma did not preclude the possibility of reintroducing MFAR at some point in the future.

Learn more from article “Trump administration backing off Medicaid rule that states warned would lead to cuts” in the online publication The Hill.

PA Safety Net Admin2020-09-17T06:00:46+00:00September 17th, 2020|Federal Medicaid issues, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Medicaid Enrollment on the Rise

More people are enrolling in Medicaid, and much of the increase is driven by the COVID-19 emergency.

Or so reports the organization Families USA in a new study.

Pennsylvania State Map According to the study,

Over half of the 38 states reporting monthly enrollment through May or later have seen greater than 7% growth in enrollment since February. For the eight states reporting August enrollment, their average enrollment growth since February is approximately 11%.

But the implications are even greater, according to the analysis, which found that in large part because of COVID-19 job loss,

Medicaid enrollment among the 38 states reporting has already increased by 4.3 million people and is poised to increase much more in the near future. Analysis by Health Management Associates projects that up to 27 million people will lose their job-based insurance this year and that Medicaid will see an increase in enrollment of up to 18 million people by the end of 2020, depending on the severity of the economic downturn.

The effects of COVID-19 job loss and accompanying loss of insurance already appears to be visible in Pennsylvania, where Medicaid enrollment rose from 2.84 million in March of 2020 to 2.89 million in April, 2.94 million in May, and 2.977 million in June. Growing Medicaid enrollment poses a challenge for Pennsylvania’s safety-net hospitals because they care for so many low-income patients and payments from the state’s Medicaid program often do not cover the cost of the care they provide.

Learn more about the nation-wide trend in the Families USA report “Rapid Increases in Medicaid Enrollment: A Review of Data from Six Months.”

PA Safety Net Admin2020-09-16T06:00:58+00:00September 16th, 2020|Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania safety-net hospitals|Comments Off

Eliminate Medicaid DSH Cut, SNAP Asks PA Delegation

A Continuing Resolution to fund the federal government in FY 2021 should eliminate a cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states, and the Safety-Net Association of Pennsylvania has written to the state’s congressional delegation asking its members to convey this message to congressional leaders.

The cut was mandated by the 2010 Affordable Care Act but has never been implemented.

In its letter to the delegation, SNAP wrote that

The Medicaid DSH cut was predicated on the expectation that the Affordable Care Act would greatly reduce the number of uninsured Americans, and while it has, millions remain uninsured, including nearly 700,000 Pennsylvanians – a number thought to be rising because of the job loss associated with COVID-19. When these people are sick or injured, most will turn to the state’s 41 private safety-net hospitals for care. These hospitals depend heavily on their Medicaid DSH payments to underwrite the cost of care for their uninsured patients, so they have never needed the resources afforded by Medicaid DSH more than they do today. Congress has always questioned the wisdom of this cut and has never permitted those cuts to go into effect. The most recent delay expires after November 30..

Because they serve so many uninsured and underinsured patients, Medicaid DSH payments from the state are especially important for Pennsylvania’s safety-net hospitals.

PA Safety Net Admin2020-09-15T06:00:16+00:00September 15th, 2020|Affordable Care Act, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

SNAP Asks PA Delegation to Help Prevent Attempt to Undermine 340B

Pharmaceutical companies are attempting to prevent safety-net hospitals and others from receiving the full benefits of the section 340B prescription drug discount program and the Safety-Net Association of Pennsylvania has asked of the state’s congressional delegation to sign a congressional letter to Health and Human Services Secretary Alex Azar asking to him intervene and stop the pharmaceutical companies.

Safety-Net Association of Pennsylvania logo In asking members of the delegation to sign onto the bipartisan letter, SNAP notes that

The 340B program is essential for Pennsylvania’s safety-net hospitals, other qualified Pennsylvania providers, and others like us throughout the country, enabling us to obtain discounts on prescription drugs we dispense on an outpatient basis to qualified, low-income patients. The program greatly enhances the ability of hospitals to serve their low-income patients and does not cost taxpayers a single dime, but in recent weeks several pharmaceutical companies have taken steps to prevent hospitals from receiving the prescription drug discounts that Congress clearly intended when it created the 340B program nearly 30 years ago.

Learn more about the 340B problem and what SNAP and others are asking Secretary Azar to do to help in this SNAP message to members of Pennsylvania’s congressional delegation.

PA Safety Net Admin2020-09-09T16:05:44+00:00September 9th, 2020|340b, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

SNAP Asks PA Senators for COVID-19 Help

Pennsylvania’s safety-net hospitals need help with the challenges posed by the COVID-19 public health emergency, SNAP wrote yesterday in a letter to Pennsylvania senators Pat Toomey and Bob Casey.

In its letter, SNAP asked the senators to advocate:

An additional $100 billion for hospitals.
Forgiveness for money provided to hospitals through the federal CARES Act’s Accelerated and Advance Payment Program.
An increase in the federal Medicaid matching rate (FMAP).
An increase in states’ Medicaid disproportionate share (Medicaid DSH) allotments and a delay in the scheduled implementation of Medicaid DSH allotment cuts to the states.
Action to prevent implementation of the Medicaid fiscal accountability regulation.
A moratorium on changes in hospital eligibility for the 340B prescription drug discount program, Medicare indirect medical education program, Medicare disproportionate share (Medicare DSH) program, and other programs.

See SNAP’s letter here.

PA Safety Net Admin2020-07-08T06:00:13+00:00July 8th, 2020|340b, Coronavirus, COVID-19, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

COVID-19 Update: June 4, 2020

Coronavirus update for Thursday, June 4 as of 2:30 p.m.

Pennsylvania Update

SNAP Advocacy

Safety-Net Association of Pennsylvania logo Today SNAP wrote to Pennsylvania senators Robert Casey and Pat Toomey to ask them to pursue legislation with five major COVID-19-related policy initiatives that Pennsylvania safety-net hospitals need:

A 14-point increase in the federal medical assistance percentage (FMAP).
An additional $100 billion for hospitals.
Another delay in implementation of Affordable Care Act-mandated cuts in Medicaid disproportionate share (Medicaid DSH) allotments.
Prevention of implementation of the Medicare fiscal accountability regulation (MFAR).
Reduced interest rates and a longer payback period for Medicare payments advanced to hospitals through the CARES Act’s Accelerated and Advance Payment Program.

See SNAP’s letter here.

Governor Wolf

Governor Wolf announced that the Office of State Fire Commissioner will be working to enact recent legislation to provide $50 million in direct financial relief to fire and emergency medical service (EMS) companies hurt by the ongoing COVID-19 outbreak. $6 million of this money is targeted for EMS companies.

Governor Wolf and Secretary of Health Levine signed amended yellow phase orders to include 10 counties (including Bucks, Chester, Delaware, Montgomery, and Philadelphia counties) moving to the yellow phase at 12:01 a.m. tomorrow, June 5 and signed amended green phase orders to include 16 counties moving to the green phase at 12:01 a.m. tomorrow. With these orders, there are no counties in the red phase. In total, on June 5, there will be 34 counties in the green phase and 33 in the yellow phase. See the announcement here.

Department of Health – by the numbers

Yesterday’s new case and death totals are very similar to those of the previous day.
The number of health care workers who have contracted COVID-19 now exceeds 5600.
1174 Pennsylvanians are currently hospitalized with COVID-19 and 257 of them are on ventilators.
45 percent of acute-care beds, 38 percent of ICU beds, and 24 percent of pediatric ICU beds are currently unoccupied, as are 53 percent of hospital isolation rooms.

Department of Human Services/Office of Long-Term Living

The Office of Long-Term Living has issued guidance for modification to nursing facility bed increase requests during the COVID-19 pandemic.
With many of its employees working at home, OLTL has introduced a temporary change in the processing of 180-day claims exception requests.
OLTL has posted a notice explaining that due to COVID-19, it cannot access information necessary to calculate the healthcare-associated payments for MA-11 cost reports with acceptance letters normally mailed in March.

Department of Aging

The Department of Aging has published guidance for the reopening and operation of adult daily living centers during the COVID-19 crisis in counties that have transitioned to the green phase.
The department has created an older adult daily living center reopening checklist for facilities reopening in green phase areas.
The department also has created a staff and participant COVID-19 wellness check screening tool for older adult daily living centers that are reopening.
The department also clarified that OLTL is requiring LIFE Centers to follow adult daily living center guidance for reopening.

Federal Update

Centers for Medicare & Medicaid Services

CMS has published a compendium of Medicare physician fee schedule changes implemented in recent months in response to the COVID-19 crisis.
CMS has posted a table that describes COVID-19 adjustments announced yesterday for CMMI model programs.
CMS announced that the Nursing Home Compare web site now provides data on COVID-19 cases and deaths in individual nursing homes. Accompanying this announcement is publication of an FAQ on this nursing home data and a memo to state Medicaid programs about the data.

Department of Health and Human Services

HHS has updated its CARES Act’s Provider Relief Fund FAQ with additions on pages 3, 20, and 21. Hospitals should review these changes carefully.
HHS announced new lab data reporting guidance that specifies what additional data must be reported to HHS by laboratories along with COVID-19 test results. This guidance standardizes reporting. See HHS’s announcement, the guidance itself, and an FAQ for the guidance.

Centers for Disease Control and Prevention

The CDC has updated its web page on COVID-19 in racial and ethnic minorities.

Food and Drug Administration

The FDA has introduced a new web-based resource, Testing Supply Substitution Strategies, that includes detailed information to help support labs performing authorized COVID-19 tests.
The FDA has updated the question-and-answer appendix in its guidance Conduct of Clinical Trials of Medical Products during COVID-19 Public Health Emergency with new information about compliance for electronic systems used to generate electronic signatures on clinical trial records.
The FDA has issued an alert to providers about the temporary absence of the “paralyzing agent” warning statement on the vial caps of the neuromuscular blocking agents vecuronium bromide and rocuronium bromide, both of which are often used for patients requiring medical ventilation.
The FDA has issued emergency use authorizations (EUAs) for five new commercial diagnostic tests for COVID-19. Find them here, here, here, here, and here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at info@pasafetynet.org.)

PA Safety Net Admin2020-09-01T18:36:23+00:00June 5th, 2020|Coronavirus, COVID-19, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

SNAP Asks HHS for More Coronavirus Grants

Private safety-net hospitals should be among high-volume Medicaid providers that receive priority consideration in the distribution of additional grants from the CARES Act, SNAP has written in a letter to Centers for Medicare & Medicaid Services Administrator Seema Verma.

Safety-Net Association of Pennsylvania logo With CMS already conceding that high-volume Medicaid providers may be shortchanged in the initial distribution of funds from the $100 billion designated for hospitals and health care providers in the CARES Act, SNAP asked Ms. Verma to “…acknowledge the special needs of these hospitals and the roles they play in their communities by ensuring that they will receive much-needed assistance in the second round of grants as well.”

See SNAP’s letter here.

PA Safety Net Admin2020-04-12T06:00:57+00:00April 12th, 2020|Coronavirus, COVID-19, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

SNAP to PA Delegation: Help Us Fight Coronavirus

Pennsylvania safety-net hospitals need help fighting COVID-19, the Safety-Net Association of Pennsylvania declared in a letter to members of the state’s congressional delegation.

In addition to the resources sought by hospitals everywhere – equipment, supplies, funding for expanded capacity to accommodate patients suffering from COVID-19 – SNAP emphasized three specific types of assistance in its letter to the delegation:

Help with cash flow. As requested by the federal government and others, SNAP hospitals have limited or suspended elective surgery so they can focus their resources on COVID-19 patients. This will create a cash-flow problem for them: while they will be doing everything they can to care for their patients and will be expending considerable resources doing so, their revenue will decline. These hospitals need up-front funding to replace the revenue they will lose and to help compensate them for the considerable costs they are incurring to prepare for the surge of patients they have been told to expect so they can keep the lights on, patient rooms and supply closets adequately stocked, and staff paid.
The elimination of Affordable Care Act-mandated reductions of Medicaid DSH allotments to the states. Congress has already delayed these reductions on numerous occasions and late last year there was every indication that Congress would do so again. At a time when hospitals are facing the gravest threat to the public health that they have seen in many years they should not be forced to waste valuable time planning the reductions in staffing and spending they would need to make if the cuts are implemented as scheduled on May 23.
No new programs or requirements in future COVID-19-related legislation that would increase hospitals’ regulatory burden. In recent weeks Congress and the administration have appropriately reduced certain regulatory requirements on a temporary basis and it would be counterproductive to offset this much-needed regulatory relief by introducing new regulations and requirements.

See SNAP’s letter to the Pennsylvania congressional delegation here.

PA Safety Net Admin2020-03-23T13:00:25+00:00March 23rd, 2020|Coronavirus, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

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