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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.

Safety-Net Association of Pennsylvania logoIn 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.

2020-07-08T06:00:13+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 on SNAP Asks PA Senators for COVID-19 Help
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SNAP Warns State About Use of COVID-19 Survey Data

Safety-Net Association of Pennsylvania logoOn Thursday SNAP wrote to Pennsylvania Department of Human Services Secretary Teresa Miller to point out challenges that arise in the potential use and interpretation of the data hospitals have reported to DHS in that agency’s survey of hospitals’ financial condition as a result of the COVID-19 pandemic.  In the letter, SNAP cautioned against possibly inappropriate interpretations of some of this data and offered to work with DHS officials to address these concerns. 

See SNAP’s letter here.

2020-06-12T16:33:21+00:00June 12th, 2020|Coronavirus, COVID-19, Safety-Net Association of Pennsylvania|Comments Off on SNAP Warns State About Use of COVID-19 Survey Data
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COVID-19 Update: June 11, 2020

Coronavirus update for Thursday, June 11 as of 4:00 p.m.

Safety-Net Association of Pennsylvania logoSNAP Advocacy

SNAP wrote to Department of Human Services Secretary Teresa Miller to point out challenges that arise in the potential use and interpretation of data hospitals have reported in DHS’s survey of hospitals’ financial condition as a result of the COVID-19 pandemic.  SNAP cautioned against possibly erroneous interpretations of some of this data and offered to work with DHS officials to address these concerns.  See SNAP’s letter here.

Department of Human Services

DHS has published a report on its most recent stakeholder meeting.  Two passages in that report are of particular interest and relevance:

CARES Funding Update

Work continues to prepare for distribution of funds for providers from the Coronavirus Aid, Relief, and Economic Security (CARES) Act. At this point, we are on pace to begin distributing one-time gross adjustment funds to intellectual disability and autism service providers beginning next week through July 1. Payments to nursing facilities and other long-term care facilities like personal care homes will begin in early July.

It is important to note that Act 24 of 2020 requires these funds to be expended by November 30, 2020 or returned to the commonwealth. Additionally, these funds must be used for COVID-19 related expenses. Providers will need to keep documentation to prove that these funds were used for their response to the COVID-19 pandemic in case of an audit. Further information about reporting requirements for these funds will be sent to providers in the coming weeks.

Regional Response Health Collaborative (RRHCP)

As we mentioned last week, Act 24 of 2020 establishes a Regional Response Health Collaborative (RRHCP), which essentially formalizes the existing Education Support and Clinical Coaching Program DHS established in partnership with the Jewish Healthcare Foundation and seven health systems to provide support to personal care homes, assisted living residences, and nursing facilities as they protect residents and staff from COVID-19.

The new RRHCP will be very similar but will operate under grant agreements, not a voluntary basis. The General Assembly allocated $175 million to be awarded among selected grantees for that purpose. In addition to this, funding from the CDC will also be available to the collaboratives to support testing in long-term care facilities to include asymptomatic staff and residents in facilities to bolster public health surveillance. Specifically, the collaborative will provide operations, management, and administrative support to protect residents in facilities from COVID-19. The collaboratives will promote health and stabilize the economy of the region by directly supporting COVID-19 readiness and response in facilities and improve the quality of care related to infection prevention and other priority health care conditions common to facilities. The network will also help long-term care facilities implement best practices in infection control, implement contact tracing programs in facilities, support clinical care through on-site and telemedicine services, provide remote monitoring and consultation with physicians, and enhance testing capability at facilities. Additionally, the collaboratives will provide alternate care arrangements for patients no longer requiring acute care but who are not ready to return to long-term care facilities.

We are close to issuing a Request for Applications to determine which health systems will be part of this partnership. This solicitation is available through eMarketplace, and applications are due by June 25, 2020.

Find the entire DHS meeting summary here.

Department of Health – by the numbers

  • Today’s new COVID-19 case and death counts are comparable to what they have been in recent days.
  • More than 19,000 residents and employees of long-term-care facilities have contracted COVID-19.
  • And residents of long-term-care facilities account for 69 percent of the 6113 COVID-19 deaths in Pennsylvania to date.
  • 950 Pennsylvanians are currently hospitalized for COVID-19 and 208 of them are on ventilators.
  • 40 percent of state hospitals’ acute-care beds, 39 percent of their ICU beds, 57 percent of their pediatric beds, and 30 percent of their pediatric ICU beds are currently unoccupied.

Centers for Medicare & Medicaid Services

CMS issued a news release explaining that nursing homes may not seize their residents’ economic impact payments (stimulus checks) authorized under the federal CARES Act.  This practice is prohibited and nursing homes that seize these payments from residents could be subject to federal enforcement actions, including potential termination from participation in Medicare and Medicaid.

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.)

2020-06-12T06:00:30+00:00June 12th, 2020|Coronavirus, COVID-19, Safety-Net Association of Pennsylvania|Comments Off on COVID-19 Update: June 11, 2020
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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 logoToday 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:

  1. A 14-point increase in the federal medical assistance percentage (FMAP).
  2. An additional $100 billion for hospitals.
  3. Another delay in implementation of Affordable Care Act-mandated cuts in Medicaid disproportionate share (Medicaid DSH) allotments.
  4. Prevention of implementation of the Medicare fiscal accountability regulation (MFAR).
  5. 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

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

Department of Health and Human Services

Centers for Disease Control and Prevention

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.)

 

2020-09-01T18:36:23+00:00June 5th, 2020|Coronavirus, COVID-19, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on COVID-19 Update: June 4, 2020
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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 logoWith 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.

2020-04-12T06:00:57+00:00April 12th, 2020|Coronavirus, COVID-19, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on SNAP Asks HHS for More Coronavirus Grants
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SNAP Asks PA Delegation for More COVID-19 Funding

More federal funding is needed for hospitals that serve especially high proportions of Medicaid patients and patients insured by government programs, the Safety-Net Association of Pennsylvania has written to members of the state’s congressional delegation.Safety-Net Association of Pennsylvania logo

This is especially important now, SNAP emphasized in its letter, because of new plans to use some of the $100 billion designated for hospitals and health care providers in the federal CARES Act to pay instead for care for uninsured patients who contract COVID-19.  Those payments, which SNAP supports, do not address the needs for which the original $100 billion was designated:  to help hospitals – including Pennsylvania safety-net hospitals – with the cost of the investments they made to prepare for the expected influx of COVID-19 patients and to help them with cash flow challenges arising from the loss of revenue associated with suspending elective procedures.

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

2020-04-10T13:00:10+00:00April 10th, 2020|Coronavirus, COVID-19|Comments Off on SNAP Asks PA Delegation for More COVID-19 Funding
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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.

Safety-Net Association of Pennsylvania logoIn 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.

2020-03-23T13:00:25+00:00March 23rd, 2020|Coronavirus, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on SNAP to PA Delegation: Help Us Fight Coronavirus
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MFAR Backlash Continues

Diverse health care and government interests are rallying around their opposition to the proposed Medicaid fiscal accountability rule.

Bookshelf with law booksThe regulation, proposed by the Centers for Medicare & Medicaid Services in November would impose new limits on the ability of states to finance their share of their Medicaid spending, potentially jeopardizing provider payments and the ability of high-volume Medicaid providers to operate without suffering great losses.

In all, CMS received more than 4200 written comments in response to the proposed regulation, most of them expressing opposition.  Among those doing so were state governments, the National Governors Association, hospitals and hospital associations, nursing home operators, and health advocacy organizations.  Also among them was the Safety-Net Association of Pennsylvania.  In summarizing its opposition, SNAP wrote in a formal comment letter to CMS on behalf of Pennsylvania safety-net hospitals that

SNAP is concerned that this proposed regulation would inappropriately restrict the state’s ability to finance the non-federal share of the Medicaid program, would impose significant additional regulatory burdens – the cost of which would far outstrip their benefit – would inappropriately introduce subjectivity into the application of previously clear and objective regulatory standards, and is beyond the scope of the statutory authority granted to CMS.

See SNAP’s entire letter here.

Learn more about the Medicaid fiscal accountability rule, what it seeks to do, and why so many oppose in the Stateline article “Medical Groups Slam Trump Medicaid Rule.”

 

2020-03-04T06:00:15+00:00March 4th, 2020|Federal Medicaid issues, Medicaid supplemental payments|Comments Off on MFAR Backlash Continues
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SNAP Rallies PA Delegation to Oppose MFAR

A proposed federal Medicaid regulation could limit Pennsylvania’s ability to finance its Medicaid program and jeopardize supplemental payments to the state’s private safety-net hospitals, so SNAP has asked members of the state’s congressional delegation to sign a letter to CMS Administrator Seema Verma asking her to reconsider the potentially damaging Medicaid fiscal accountability regulation.

Safety-Net Association of Pennsylvania logoIn its letter to members of the state’s congressional delegation, SNAP wrote on behalf of private Pennsylvania safety-net hospitals that

The proposed Medicaid fiscal accountability regulation (MFAR) would, if implemented, impose new limits on how states may raise their share of funds to support their Medicaid programs. If adopted, the commonwealth would face a serious challenge raising the money it needs to finance its share of the cost of its Medicaid program. In addition, MFAR would take a great deal of states’ Medicaid policy-making authority away from state governments and give it instead to the federal Department of Health and Human Services.

Two members of the state’s congressional delegation, Representatives Brendan Boyle (D-Montgomery/Philadelphia) and Mike Kelly (R-Butler/Crawford/Erie/Lawrence/Mercer), have written a bipartisan letter to be sent to CMS Administrator Seema Verma asking her to reconsider the troubling aspects of MFAR.  SNAP wrote to members of the state’s congressional delegation asking them to sign onto the letter.

Go here to see the full SNAP letter to the delegation.

 

2020-03-03T06:00:10+00:00March 3rd, 2020|Federal Medicaid issues, Pennsylvania Medicaid policy, Uncategorized|Comments Off on SNAP Rallies PA Delegation to Oppose MFAR
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Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company.

MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could

…reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone.  States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications.

Bookshelf with law booksBlock grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch explaining that

Capping federal Medicaid contributions, even for a subset of beneficiaries, poses risks to state budgets and those entities reliant on state funding, including local governments and providers.  States would need to find revenue or cost savings, either in Medicaid or elsewhere, to offset reduced federal contributions.

Because Pennsylvania safety-net hospitals care for more Medicaid patients than the typical hospital, both proposed policy changes have a potentially greater impact on them.

Last month SNAP conveyed its opposition to the proposed MFAR regulation in a formal comment letter to the Centers for Medicare & Medicaid Services in response to the regulation’s publication late last year.  Pennsylvania Governor Tom Wolf has already rejected the idea of using block grants in the state’s Medicaid program.

Learn more about the potential impact of the proposed Medicaid fiscal accountability regulation and Medicaid block grants in the Fitch Ratings analysis “Fitch Rtgs: Medicaid Changes Will Affect States, NFP Healthcare Providers.”

2020-02-20T06:00:08+00:00February 20th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on Fitch: Medicaid Block Grants, MFAR Threaten States, Providers
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  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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