SNAP Archives - Page 4 of 11 - Safety-Net Association of Pennsylvania

Congress Gives Hospitals Medicaid DSH Relief

Medicaid DSH allocations to states will not be reduced right away thanks to a new continuing resolution to fund the federal government through December 11.

The Medicare disproportionate share allocation cuts to the states, mandated by the Affordable Care Act but delayed by Congress several times, were delayed again earlier this year but scheduled to take effect on November 11. With the latest continuing resolution, the cuts will be delayed yet another month.

SNAP worked hard to encourage Congress to include the Medicaid DSH delay in the continuing resolution, doing so most recently in this September 14 letter to members of Pennsylvania’s congressional delegation. Medicaid DSH payments are an important tool in helping Pennsylvania safety-net hospitals serve their predominantly low-income communities, so SNAP also is urging Congress to eliminate the Medicaid DSH cut entirely.

Learn more about the delay of Medicaid DSH cuts and other aspects of the continuing resolution that affect hospitals in the Healthcare Dive article “Providers win Medicare loan extension, DSH relief but lose other asks in stop-gap spending law.”

PA Safety Net Admin2020-10-08T13:00:02+00:00October 8th, 2020|Federal Medicaid issues, Medicaid supplemental payments|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

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

Loan Repayment Looms for Hospitals

Unless Congress intervenes, hospitals will soon begin repaying massive federal loans they received to help them cope with the COVID-19 public health emergency.

The loans, authorized by the federal CARES Act, were made through the Accelerated and Advance Loan Program, and in all, Medicare made nearly $100 billion in such loans to providers. Under the legislation, Medicare was to begin recouping the loans 120 days after hospitals received them, with recoupment coming by Medicare ceasing to pay hospitals’ Medicare claims until the full amount of the loan was repaid.

Now the loans are coming due but hospitals are saying they are not ready to forego all of their Medicare revenue.

While some hospital groups have asked for 100 percent forgiveness for the loans, others are calling for a combination of extending the payback period and reducing the interest rate for those that fail to complete repayment in a timely manner.

Safety-Net Association of Pennsylvania logo In a letter to Pennsylvania senators Pat Toomey and Bob Casey, SNAP weighed in on this issue, urging them to work with their colleagues

… to forgive the federal Medicare revenue advanced to hospitals through the CARES Act’s Accelerated and Advance Payment Program. Because of the unprecedented length and persistence of this public health emergency, we believe many hospitals – especially safety-net hospitals – will never recover the revenue they have lost in recent months. Most of them expect to be able to restore financial equilibrium, but they will not be able to do so if they have this enormous debt hanging over their heads. Fourth, we

Both House Democrats’ HEROES Act and Senate Republicans’ HEALS Act attempt to address the loan situation – albeit in different ways – but neither calls for forgiving the loans entirely.

Learn more about the challenges hospitals face with their obligation to repay Accelerated and Advance Loan Program money and how Congress is looking at that challenge in this Washington Post article.

PA Safety Net Admin2020-08-06T06:00:36+00:00August 6th, 2020|Medicare|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 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.

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.

PA Safety Net Admin2020-04-10T13:00:10+00:00April 10th, 2020|Coronavirus, COVID-19|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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