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Connection Newsletter - 12 states challenge CMS vaccine mandate

Twelve states including Arizona file a lawsuit challenging the interim final rule and lawmakers urge the White House to investigate nursing staffing agencies are the stories leading this week's Arizona healthcare news. 

12 states challenge CMS vaccine mandate marking second challenge from a group of states

Twelve states including Arizona have filed a lawsuit in a federal district court in Louisiana challenging the Centers for Medicare & Medicaid Services (CMS) interim final rule mandating COVID-19 vaccines for workers at Medicare/Medicaid participating facilities. The plaintiff states maintain, among other things, the rule exceeds CMS’s statutory authority, violates the Tenth Amendment, is arbitrary and capricious and that CMS failed to follow proper procedural requirements. The states request the federal court declare the regulation unconstitutional and issue a preliminarily and permanent injunction to stop CMS from imposing the vaccine mandate.

This lawsuit follows the complaint filed last week by a different group of states in a U.S. district court in Missouri also challenging the CMS interim final rule on similar grounds. For more information about the CMS rule, please refer to AzHHA’s Summary and CMS’s FAQs.

In related news, the 6th Circuit Court of Appeals will hear arguments over the Occupational Safety and Health Administration (OSHA) Emergency Temporary Standard (ETS) mandating employers with at least 100 employees to require vaccination or weekly testing. Dozens of lawsuits challenging the OSHA ETS filed in federal courts are now consolidated in the 6th Circuit, which is dominated by judges appointed by Republican presidents.

Sen. Mark Kelly urges White House to investigate nursing staffing agencies

Senator Mark Kelly along with Senator Cassidy and Representatives Matsui and McKinley have sent a letter urging the White House to investigate suspected anticompetitive behaviors among nursing staff agencies. The letter notes reports of staffing agencies vastly inflating prices during the most recent COVID-19 surge, which has increased costs for hospitals and exacerbated the current nursing shortage. Ann-Marie Alameddin, AzHHA President and CEO, is quoted in a press release issued by Senator Kelly’s office referencing the dire financial impact on hospitals and the emotional toll on permanent staff caused by staffing agencies’ exorbitant prices and expressing AzHHA’s support for the investigation.

Hospital Assessments and HEALTHII Payments 101

AzHHA will host Hospital Assessments and HEALTHII payments 101, December 8, for hospital members interested in learning about the two hospital assessments and the quarterly HEALTHII payments. The presentation will include an overview of why the assessments were created, which types of hospitals are exempt from the assessments, how the amounts have changed over time, why hospitals receive quarterly HEALTHII payments and why payments will be reconciled in future years. AzHHA members who have not received an invitation but are interested in attending may contact Amy Upston, director of financial policy and reimbursement, at [email protected].

PRF reporting deadline approaching

Providers who received one or more Provider Relief Fund (PRF) payments exceeding $10,000, in the aggregate, during the first payment received period were required to report on their use of funds by September 30, 2021. The U.S. Department of Health and Human Services is currently observing a 60-day grace period to help providers who failed to meet the reporting period 1 deadline so they may come into compliance. The PRF Reporting Portal will close on November 30 at 11:59 p.m. EST. Any non-compliant providers who fail to submit a completed report may be subject to further enforcement actions such as repayment or other debt collection activities.

To get started, providers must register in the PRF Reporting Portal. Technical assistance resources are listed on the PRF Reporting webpage.

CMS finalizes hospital co-location guidance

The Centers for Medicare & Medicaid Services has issued final guidance for hospitals interested in co-locating with other hospitals or healthcare facilities. Under the guidance, hospitals, except for Critical Access Hospitals due to distance requirements, will have increased flexibility when entering into co-location partnerships. In the guidance, CMS describes how CMS and state agency surveyors will evaluate a hospital’s space sharing or contracted staff/service arrangements with another hospital or healthcare entity when assessing the hospital’s compliance with the co-location partnerships.

Today’s COCA call: What clinicians, pharmacists and public health partners need to know about antibiotic prescribing and COVID-19

The Centers for Disease Control and Prevention (CDC) is holding a Clinician Outreach and Communication Activity (COCA) call on antibiotic prescribing and COVID-19, today at 2 p.m. EST. Several studies have been published by the CDC characterizing antibiotic prescribing during the COVID-19 pandemic in outpatient, nursing home and hospital settings. Findings from these studies and others inform opportunities to improve antibiotic use and guide the development of resources to support healthcare professionals and health systems. Case studies representing common clinical scenarios will be discussed to support decisions related to antibiotic prescribing. To join the COCA call, click here. First-time attendees must register for an account before connecting to the call.

FEMA funding for eligible COVID-19 costs extended

President Joe Biden, last week, extended 100% of federal reimbursement through the Federal Emergency Management Agency’s public assistance program for eligible costs associated with ongoing COVID-19 recovery efforts and vaccine initiatives. The policy was set to expire on December 31 and has been extended to April 1, 2022.

COVID-19 supportive care

Patients with acute or chronic COVID-19 symptoms and related complications are discovering COVID-19 supportive care – at no cost to them. “This is the first medical professional who has acknowledged my long COVID symptoms,” said a patient referred to the palliative care telehealth service this year. Prior to discovering the COVID-19 supportive care program, this patient noted the challenges they faced when trying to find the right care. “I’ve had the virus for eight months and had more than 40 doctor consultations!!! So, thank you.”

The service is open to people suffering with the complexities of COVID-19 related symptoms, or those chronic conditions exacerbated by COVID-19. Patients do not need a physician’s referral to receive this specialized, palliative care. Learn more at

Today is National Rural Health Day!

The National Organization of State Offices of Rural Health and the entire healthcare community comes together every third Thursday of November to “celebrate the power or rural” through National Rural Health Day. Together we bring attention to the ongoing efforts to communicate, educate, collaborate and innovate to improve the health of the estimated 57 million people living in rural America. Rural hospitals often serve as the health and human service “hub” of their communities, offering residents a range of services and providers in one location. They are also frequently one of the largest employers in the community – meaning the financial stability of a small rural hospital also has a tremendous impact on a community’s economic health. Download the National Rural Health Day promotional toolkit and join us in celebrating the power of rural.

Rural Health Day

Antibiotic Awareness week starts today

This Antibiotic Awareness Week the Centers for Disease Control and Prevention (CDC) encourages healthcare professionals to prescribe antibiotics only when necessary to help fight antibiotic resistance, the spread of superbugs and to protect their patients from antibiotic-related adverse drug events. During U.S. Antibiotic Awareness Week, November 18-24, and throughout the year, CDC promotes Be Antibiotics Aware, an educational effort to raise awareness about the importance of safe antibiotic prescribing and use.

Be Antibiotics Aware has resources to help healthcare professionals educate patients and families about antibiotic use and risks for potential side effects. For more information, visit

Upcoming Events

December 1 – Coding and Documentation for Telehealth

AzHHA is excited to partner with the New Jersey Hospital Association to bring the Coding and Documentation for Telehealth course to Arizona coding specialists on December 1 at 1:30 p.m. EST. This program will define telehealth services, identify differences in reimbursement models and cover applicable current procedural terminology codes and required documentation. To learn more about the course, visit the registration site.

December 2 - Introduction to POLST

Interested in learning how to use the Arizona POLST form with your patients? The one-hour Introduction to POLST workshop equips healthcare professionals with knowledge and resources to begin using POLST, Physician Orders for Life-Sustaining Treatment, in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. Register, here.

In the News

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NIH long-term study on children who had COVID-19 enrolls first participant
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