Elective surgeries to resume in Arizona May 1, 2020

In an announcement Wednesday, Governor Doug Ducey declared elective surgeries can resume if hospitals meet certain criteria effective May 1, 2020.

The Arizona Hospital and Healthcare Association raised concerns over the past month on the severe loss of hospital revenue since the elective surgery ban went into effect on March 19, 2020, through an Executive Order.

In a statement shortly after the Governor’s announcement, AzHHA President and CEO Ann-Marie Alameddin said, “Governor Ducey made the right decision to protect public health and our healthcare workforce to pause elective procedures by using the best data available to him at the time. Now that we have a month’s worth of meaningful data that Governor Ducey’s stay at home measures are working and flattening the curve he is right to evaluate how we can get back to the business of healthcare and treat patients in our communities.”

Read the Governor’s announcement here.

Read AzHHA’s statement here.

TIME SENSITIVE - Eligibility for targeted CARES Act funding tied to data submission; deadline April 23

The Department of Health and Human Services (HHS) yesterday sent a letter to hospital administrators announcing that an additional tranche of funding from the CARES Act will be released soon. At least some of the funds will target facilities that have been particularly affected by the increased burden of caring for COVID-19 patients. To inform the department’s distribution formula, HHS is requiring hospitals to report the following data elements by 11:59 p.m. PT April 23, 2020:

• Total number of Intensive Care Unit beds as of April 10, 2020,
• Total number of admissions with a positive diagnosis for COVID-19 from January 1, 2020, to April 10, 2020, and
• National Provider Identifier.

Hospitals and other submitters are being asked to provide this information through an authentication portal established by an HHS vendor, TeleTracking. HHS states that administrators should have received an email from HHS on or around Sunday, April 12, 2020, with instructions and a link to register for the data submission portal, and further explains that questions should be directed to TeleTracking Technical Support at 877-570-6903.

The HHS notes data submission is a prerequisite for payment, but not a guarantee. In addition, this data submission is separate from the situational awareness data the Arizona Department of Health Services has requested and is currently reporting to HHS on behalf of hospitals.

HHS releases information on second tranche of CARES Act funding

The U.S. Department of Health and Human Services (HHS) today announced the next allocation of funding pursuant to the $100 billion CARES Act provider relief fund.  HHS will distribute:

• $20 billion in a general allocation to all providers based on net patient revenue from all sources in 2018.  This is in addition to the initial $30 billion that was allocated to providers according to Medicare fee-for-service reimbursements.  HHS indicated that some significant rebalancing will be required to ensure that the entire $50 billion allocation is based on net patient revenue from 2018.  These payments will be distributed on a weekly basis beginning this Friday, April 24, 2020.  Providers who receive funds from the general allocation must sign an attestation confirming receipt of funds and agreeing to certain terms and conditions of payment.
• $10 billion in a targeted allocation to hospitals that have been disproportionately impacted by the COVID-19 pandemic.  To be eligible for these funds, hospitals must submit prescribed data via an authentication portal before midnight PT, Thursday April 23.
• $10 billion to rural providers on the basis of operating expenses, using a methodology that distributes payments proportionately to each facility and clinic.  These funds will be distributed as early as next week.
• $400 million to the Indian Health Service to distribute to facilities on the basis of operating expenses.  These funds will be distributed as early as next week.
• An unspecified amount to reimburse providers for COVID-related treatment of the uninsured at Medicare rates. Providers can register for the program on April 27, 2020, and may begin submitting claims in early May 2020

HHS noted that certain providers will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.  For more information, click here.

Senate passes COVID-19 relief package 4.0

The U.S. Senate yesterday voted to approve the Paycheck Protection Program and Health Care Enhancement Act — a $484 billion COVID-19 relief package — which includes an additional $75 billion for the Public Health and Social Services Financial Services Emergency Fund established by the CARES Act.  The $75 billion in additional funding would be available to reimburse hospitals and other providers for health care expenses or lost revenues not otherwise reimbursed that are attributable to COVID-19.  The package also includes an additional $310 billion for the Paycheck Protection Program, which makes loan opportunities available for organizations with fewer than 500 total employees, and $25 billion to support efforts to research, develop, validate, manufacture, purchase, administer and expand capacity for COVID-19 tests. The House of Representatives is expected to vote on the bill tomorrow, and the President is expected to sign the bill into law.

Surge Line activated

The Arizona Department of Health Services (ADHS) activated the Arizona Surge Line Tuesday to assist in COVID-19 patient management. The Arizona Surge Line is a 24/7 toll-free call line that acts as a “doorway” to facilitate the transfer of confirmed or suspected COVID-19 cases to the appropriate level of care. This is a free service to hospital providers and systems. It will be facilitated by the Arizona Department of Health Services, protocolized by the input from hospital facilities and systems in Arizona. For this emergency, it will be used for COVID patients only.

Read more about the Surge Line plan and principles of structure here. Additional information has been sent directly to AzHHA member CEOs and CMOs.

Additional Announcements

The Centers for Medicare & Medicaid Services (CMS) issued recommendations to re-open healthcare systems in communities that have a low incidence of COVID-19 and are in Phase 1 of the Guidelines for Opening Up America Again press release. This guidance updates previous recommendations on limiting non-essential surgeries and medical procedures during the COVID-19 pandemic.

The National Institutes of Health announced the first treatment guidelines for COVID-19 patients, intended for healthcare providers.

CMS released a virtual toolkit to help states respond to health care workforce shortages by leveraging new emergency flexibilities offered during the public health emergency. The toolkits also contain best practices for states and localities to reference as they implement changes in their respective areas.

CMS announced additional blanket waivers for Medicare providers, including RHCs, FQHCs, LTCHs, and Intermediate Care Facilities. The changes also include flexibilities around current substitute billing (locum tenens) rules.

HHS announced $165 million was awarded through the Health Resources and Services Administration (HRSA) to support rural hospitals and HRSA-funding Telehealth Resource Centers (TRCs).

The Small Business Administration issued an interim final rule to supplement the first interim final rule on the Paycheck Protection Program (PPP) with additional guidance regarding eligibility for individuals with self-employment income and certain businesses.

COVID-19 resource website

View our COVID-19 resource pages to guide you through current and past announcements, advisories and information related to our healthcare pandemic response. Our financial toolkit is posted to provide an overview of funding opportunities available to hospitals at a state and federal level. Visit our website at https://www.azhha.org/covid19.