| HHS Announces Additional $4B in Relief Payments for Providers
The Department of Health and Human Services (HHS) recently announced additional COVID-19 relief funding for healthcare providers. About $3 billion will be distributed to hospitals that service a significant percentage of vulnerable patients on thin margins which is estimated to be about 215 acute care facilities, bringing the total payments for safety net hospitals from the Provider Relief Fund to $12.8 billion and to 959 facilities. HHS expanded the criterion for payment qualification so that hospitals with a profitability threshold of less than three percent averaged consecutively over two or more of the last five cost reporting periods are now eligible for payment. About $1 billion will also go to specialty rural hospitals, urban hospitals with specific rural Medicare designations, and hospitals located in small metropolitan areas, which is estimated to total about 500 hospitals. The agency noted that close work with stakeholders informed how it targeted this new round of funds. Read the HHS press release…
AAOS Submits Comments on the IPPS Proposed Rule
On July 9, the AAOS submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the Fiscal Year (FY) 2021 Inpatient Prospective Payment System proposed rule. The Association focused on CMS’ proposals to further implement price transparency initiatives aimed at potentially shifting the Medicare Severity-Diagnosis Related Groups (MS-DRGs) to a market-based payment methodology, create new MS-DRGs for total hip arthroplasty with a diagnosis of hip fracture, and include greater flexibility in regulations impacting graduate medical education. We also stressed the importance of reducing the burden of prior authorization. In addition to our comments on these proposals, AAOS requested that CMS make permanent many of the regulatory flexibilities granted under the national emergency which were enacted in response to the COVID-19 pandemic. These include the expansion of telehealth, Stark law flexibilities, remote resident supervision requirements, and the Hospitals without Walls initiative. Read AAOS’ full comments on the proposed rule…
Fourth COVID-19 Relief Package Expected Soon in Senate
A fourth COVID-19 related relief package is expected to come together in the Senate over the next few weeks, as both the number of positive cases and the unemployment rate in the United States continue to rise. Senate Majority Leader Mitch McConnell (R-Ky.) insists that any bill passed in his chamber will include coronavirus-related liability protections for everyone. Republicans in the Senate are also expected to include financial incentives to encourage schools to reopen and aid for businesses and hospitals. Democrats, on the other hand, are still calling for $1 trillion in state and local funding. They have also expressed concern over tying financial incentives to schools reopening, as well as liability protections for employers. This package will come months after the Democrat-led House of Representatives passed the $3 trillion HEROES Act, which would have provided another round of stimulus checks to millions of eligible Americans and extended expanded unemployment benefits, among other provisions. Read more about the forthcoming bill…
AAOS Voices Concern Over UnitedHealthcare Imaging Requirements
In a recent letter to UnitedHealthcare, the AAOS expressed serious concern regarding its new commercial medical policy requiring health care providers to send clinical images to justify a clinical intervention for several procedures on or after April 1, 2020. Specifically, we noted that the policy will impede timely patient care and care continuity, and shift time away from patients and towards unnecessary administrative tasks. We also noted the ambiguity around the images required for various policies and the amplified security and patient concerns. The AAOS believes that the UnitedHealthcare policy is misguided and sets a dangerous precedent for patient safety and appropriate clinical care. We strongly asked that this requirement be immediately suspended and withdrawn, and we have since received acknowledgement from the company that our concerns are being considered. Read the letter to UnitedHealthcare… |
