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Connection Newsletter - 2020 Year in Review

Our 2020 Annual Report details the impact of AzHHA’s advocacy efforts to return $750 million for hospital and provider supplemental payments, our defeat of the union ballot initiative and our successful effort to withdraw the federal rule that would severely limit Medicaid financing.

2020 year in review

While the COVID-19 response took over most of our collective work in 2020, AzHHA’s Annual Report showcases many other significant events from the past year. Our 2020 Annual Report details the impact of AzHHA’s advocacy efforts to return $750 million for hospital and provider supplemental payments, our defeat of the union ballot initiative and our successful effort to withdraw the federal rule that would severely limit Medicaid financing. Read more at azhha.org/2020annualreport.

‘Phase 3’ general distribution of $24.5 billion in provider relief funds under CARES Act begins

The Department of Health and Human Services (HHS) announced Wednesday it has begun distributing $24.5 billion in “Phase 3” funds from the Public Health and Social Services Emergency Fund to eligible hospitals, as well as other providers. This amount is an increase from the $20 billion the department had originally intended to distribute. HHS distributions will continue in the coming days and weeks as applications continue to be reviewed and payment accounts are set up.

To be eligible for the third general distribution, providers must have applied for additional payments, which HHS stated would take into account actual COVID-19-related financial losses and changes in operating expenses. In determining payment amounts, HHS first ensured that applicants had received a baseline payment of 2% of their patient revenue. It then distributed to over 70,000 providers funds totaling up to 88% of their reported revenue losses and expenses attributable to COVID-19. According to the HHS announcement, over 35,000 providers who applied for funds will not receive an additional payment either because they experienced no change in revenues or net expenses attributable to COVID-19, or because they already received funds that equal or exceed reimbursement of 88% of reported losses and expenses.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and Paycheck Protection Program and Health Care Enhancement Act included $175 billion in the Public Health and Social Services Emergency Fund to reimburse healthcare providers for healthcare-related expenses or lost revenues not otherwise reimbursed that are attributable to COVID-19.

COVID-19 relief legislation released by bipartisan group of lawmakers

A group of bipartisan senators and representatives this week released legislative text for both the Emergency Coronavirus Relief Act of 2020, a $748 billion COVID-19 relief package that boosts funding for healthcare providers, vaccines and testing, and the Bipartisan State and Local Support and Small Business Protections Act providing $160 billion in state and local aid, as well as certain liability protections for employers, which extend to healthcare providers in some instances. 

The main package would include $35 billion in additional funding for the Provider Relief Fund (PRF) and make changes to the PRF reporting guidelines. Specifically, the package would require the Department of Health and Human Services to revert back to its June reporting requirement guidance insofar as it allowed providers to use any reasonable method to calculate lost revenue. In addition, the package would allow health systems to move targeted PRF distributions within their system.

It is not clear what Senate and House leadership will do with the legislation, although it may provide the framework for COVID-19 relief that could be included as part of an omnibus government funding bill.

Vaccine update

With the Food and Drug Administration’s (FDA) granting emergency use authorization (EUA) to Pfizer for its BNT162b2 mRNA COVID-19 vaccine, Arizona has received its first shipment of the vaccine, which is being distributed to Maricopa and Pima Counties. The FDA is scheduled to review the Moderna vaccine application this week, and if approved, Arizona could begin receiving this second vaccine by the end of the week.

The Arizona Department of Health Services (ADHS) is reporting Arizona could receive about 380,000 doses of vaccine by the end of the month, with a similar allocation next month to cover the required “booster shot.” ADHS also reports the state’s allocation could increase next month to vaccinate additional healthcare workers and long-term care residents under phase 1A of the state plan.

Local public health departments have jurisdiction for developing vaccination plans within each county, and healthcare providers should be reaching out to them to learn more. ADHS will be developing a communications plan in collaboration with local public health, AzHHA and other stakeholders.

The following sites include information and resources on vaccine safety, how to complete pre-screening and sign up for an appointment when the vaccine is available:

As vaccine supplies become available over the next week, additional information about statewide vaccine availability in all Arizona counties will be added to www.azhealth.gov/covid19vaccine.

As required by the EUA, Pfizer has also made public fact sheets for providers and patients

Post Vaccine Considerations

The Centers for Disease Control and Prevention (CDC) this week posted Post Vaccine Considerations for Healthcare Personnel. This document provides guidance for healthcare facilities to appropriately evaluate and manage healthcare personnel with post-vaccination signs and symptoms, such as fever, fatigue, headache, chills, myalgia, and arthralgia. “The approach described in this document is intended to reduce the risks for disruptions in care and pathogen (e.g., SARS-CoV-2) transmission resulting from:

  • unnecessarily excluding HCP with only post-vaccination signs and symptoms from work, and
  • inadvertently allowing HCP with SARS-CoV-2 or another transmissible infection to work.”

The guidance also outlines considerations to minimize the impact of post-vaccination signs and symptoms on healthcare staffing.

FFY 2021 quarterly HEALTHII payments

AHCCCS made its Hospital Enhanced Access Leading to Health Improvement (HEALTHII) payments, directed payments, to the Managed M/Caid Plans on December 8. Managed M/Caid Plans have been instructed to make quarterly payments to hospitals by December 21 for funds to be received by end of the year. If your hospital does not receive its quarterly payments by December 28, contact the Managed M/Caid Plan directly.

If you have any questions or concerns, contact John D. Strasser, director of financial policy and reimbursement. 

Palliative care telehealth now available in Arizona

Patients experiencing acute or chronic COVID-19 symptoms and related complications now have another resource available for their care. The Arizona Hospital and Healthcare Association launched the Palliative Care Telehealth program to help give patients the option for care in their home while alleviating the current surge on our hospital systems.

Palliative Care Telehealth is a referral source for healthcare providers across Arizona to help their patients navigate through the complexities of COVID-19 related symptoms, or those chronic conditions exacerbated by COVID-19, by consulting with a palliative care specialist for symptom management or goals of care. After the consultation, the palliative care specialist will collaborate with the referring provider on any changes to the plan of care.

This program is administered by the Arizona Hospital and Healthcare Association with a grant from the Arizona Department of Health Services. Our steering committee includes a diverse group of healthcare leaders and providers, including home and community-based providers, who developed the Palliative Care Telehealth program.

Please visit our website for more resources including patient and provider flyers and frequently asked questions: https://palliative.vsee.me/u/clinic.

Webinar: Sweeping changes to the Stark and Antikickback regulations: Final rules for hospitals

In partnership with AzHHA, the Iowa Hospital Association is offering the webinar Sweeping changes to the Stark and Antikickback regulations: Final rules for hospitals to AzHHA members at a special rate on January 5 at 10 a.m. CT. The webinar will provide an overview of the federal government’s “Regulatory Sprint to Coordinated Care,” and will describe the significant changes to the Stark and Antikickback laws that are part of the Regulatory Sprint set to go into effect January 19, 2021. The session will include a description of the primary changes that will impact hospitals and will include case studies to provide illustrations of the effect these changes will have on common arrangements in healthcare. The target audience includes compliance officers, healthcare executives and legal healthcare professionals.

One hospital representative may register and share access information within their organization. An account will need to be created prior to registering. To create an account and register, click here. If you need assistance with registration, email communications@azhha.org.

Ad space available 2021 hospital directory

AzHHA has partnered with E&M Consulting, Inc. for a third consecutive year to produce the 2020-2021 Arizona Hospital Directory. The publication will be available in both print and digital formats in early 2021. You may access the 2019-2020 digital directory on the AzHHA website. E&M will be managing the project, including advertising sales, layout and graphic design. The final publication will be mailed directly to members and published on the AzHHA website – a great opportunity to promote and give your facility additional exposure. If you have questions or would like to advertise, contact an E&M sales associate at 800-572-0011 ext.1005 or advertising@emconsultinginc.com.


Upcoming Events

January 5 - Sweeping changes to the Stark and Antikickback regulations: Final rules for hospitals

This session will provide an overview of the federal government’s “Regulatory Sprint to Coordinated Care,” and will describe the significant changes to the Stark and Antikickback laws that are part of that Regulatory Sprint set to go into effect Tuesday, January 19, 2021. The session will include a description of the primary changes that will impact hospitals and will include case studies to provide illustrations of the effect these changes will have on common arrangements in healthcare. Special pricing is offered for Arizona registrants. You must create an account prior to registering, click here to register.

Multiple dates – Introduction to POLST workshop

The one-hour Introduction to POLST workshop equips healthcare professionals with knowledge and resources to begin using POLST 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. Dates for the first quarter of 2021 have been announced. Click on the date to register for a workshop.


In Other News

Arizona coronavirus cases surge, health care system overloaded as vaccines slowly roll out
KJZZ

Behind each of more than 300,000 lives lost: a name, a caregiver, a family, a story
Kaiser Health News

Fauci: 85 percent of the US needs to get the Covid-19 vaccine for “true herd immunity”
Vox

What you need to know as some Arizonans get ready for COVID-19
Fox10 Phoenix

Editor’s note: AzHHA will not be releasing its weekly distribution of the Connection Newsletter 12/24 and 12/31 in observance of the upcoming holidays. Remember to wear a mask, physically distance, get your flu shot, wash your hands frequently and spend the holidays with your pod this holiday season.