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President Trump has signed a $2 trillion package of COVID-19 aid that provides $100 billion to hospitals and other providers, averts cuts to Medicaid disproportionate share hospital (DSH) payments, suspends Medicare sequester cuts, and includes numerous other relief measures.

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The $2 trillion bill includes $100 billion for a Public Health and Social Services Emergency Fund to reimburse eligible health care providers for health care–related expenses or lost revenue attributable to COVID-19.

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With COVID-19 poised to overwhelm the nation’s health care infrastructure, the Senate vote on funding support is welcome and appreciated as hospital resources are stretched thin. We thank congressional leaders for recognizing the support our member hospitals need during this unprecedented crisis.

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CMS issued a frequently asked questions document on how the agency will implement enhanced Medicaid funding to states to support COVID-19 response. The 6.2 percent increase in the Federal Medical Assistance Percentage was included in the Families First Coronavirus Response Act, made law on March 19.

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As the Senate continues work on a third legislative package to address public health and economic needs during the COVID-19 crisis, House Democrats introduced an alternative that includes provisions important to essential hospitals and key changes absent in the Senate bill.

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The March 20 letter details additional action needed to support essential hospitals as they respond to the pandemic. The letter also explains how essential hospitals face significant financial challenges as they work on the front lines of public health threats.

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CDC recommends shelters plan for higher usage during the outbreak and consult with community leaders, local public health departments, and faith-based organizations about places to refer clients if a shelter space is full.

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HHS announced new flexibility to increase coverage of Medicare telehealth services during the COVID-19 crisis. In separate guidance, HHS’ Office of Inspector General will allow providers to use a variety of audio and video communication platforms without incurring penalties under HIPAA.

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CMS issues elective surgery guidance, telehealth toolkits, and information on quality reporting flexibility amid the COVID-19 pandemic; The Joint Commission suspends regular surveys.

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After two failed votes, senators continue negotiations on a $1.6 trillion funding package to boost the economy and improve access to care during the COVID-19 pandemic. Meanwhile, House Democratic leadership unveiled competing legislation to provide relief.

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The Health Resources and Services Administration (HRSA) has created a webpage with COVID-19 resources for providers participating in the 340B Drug Pricing Program. HRSA acknowledges 340B covered entities will need additional flexibility pertaining to program compliance during the COVID-19 crisis.

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CMS issued several checklists and templates for state Medicaid and the Children's Health Insurance Program agencies to request regulatory relief and flexibility to respond to the COVID-19 outbreak.

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States open insurance marketplace special enrollment periods; the Association of State and Territorial Health Organizations issues considerations for mobile testing.

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A third major legislative response to COVID-19 would provide $75 billion in emergency funding for hospitals and health care providers, delay until fiscal year 2022 a planned $4 billion cut to Medicaid disproportionate share hospital payments, and authorize other support.

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Washington state received approval for a Section 1135 waiver, targeted at removing additional Medicare and Medicaid regulatory barriers for providers to respond to the COVID-19 outbreak.

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Under the proposed Section 1115 waiver, Oklahoma would accept a per-capita cap on federal funds for the Medicaid expansion population and incorporate other market-based reforms.

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The law increases the Federal Medical Assistance Percentage to states, allows states to extend Medicaid eligibility, and requires diagnostic test coverage.

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An alert from U.S. Citizenship and Immigration Services clarifies testing, treatment, and preventive care — including a vaccine, if one becomes available — related to COVID-19 will not be considered as part of a public charge inadmissibility determination.

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The association sent House and Senate leaders a letter detailing the needs of essential hospitals as they face the COVID-19 outbreak. Members of America's Essential Hospitals should urge lawmakers to support the priorities in our letter.

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President Trump declared a national emergency as the number of confirmed COVID-19 cases in the U.S. nears 3,500. CMS responds to concerns about complying with Emergency Medical Treatment and Labor Act requirements and CDC released updated infection control guidance for health care providers.

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This second supplemental legislative package to address the new coronavirus would increase the federal medical assistance percentage (FMAP) to states, require insurance coverage of COVID-19 diagnostic tests and visits, extend paid leave, and more.

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In its March report to Congress, the Medicaid and CHIP Payment and Access Commission included chapters analyzing Medicaid disproportionate share hospital payments, state readiness to report on core quality measure sets, and Section 1115 waiver evaluations.

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The Centers for Disease Control and Prevention will use existing networks to award more than $560 million to states, localities, territories, and tribes to accelerate planning and operational readiness. The agency has issued a list of funding actions and a frequently asked questions document.

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America's Essential Hospitals expressed concern that a proposed drug acquisition cost survey exceeds CMS authority under Medicare statute and would impose excessive burden on hospitals in the 340B Drug Pricing Program.

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The rules, intended to increase interoperability and improve patients’ access to their health information, finalize provisions related to the MyHealthEData initiative and implement provisions of the 21st Century Cures Act.

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As U.S. cases of the new coronavirus rise to more than 400, the agency updates guidelines for testing patients and for health care workers exposed to COVID-19.

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Both chambers passed a bill providing more than $8 billion to combat the new coronavirus; House leaders now are discussing legislation to mitigate economic impacts associated with the virus. A Senate letter calling to incorporate social determinants into hospital star ratings closes tomorrow.

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The new code applies to tests conducted outside CDC laboratories; CMS also issued frequently asked questions and fact sheets about COVID-19–related billing.

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President Trump has signed the Coronavirus Preparedness and Response Supplemental Appropriations Act, which provides $8.3 billion in funding to several federal agencies for COVID-19 response.

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In a memo to state survey agencies and accrediting organizations, CMS announced it will focus survey activities solely on infection control until further notice and provided guidance for patient triage and nursing homes.

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This decision is the latest of several court cases invalidating work requirements policies in Medicaid; Utah now is the only state with these requirements in effect. It is unknown at this time if Michigan or the Department of Health and Human Services will appeal the decision.

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Members of America's Essential Hospitals should urge senators to sign a letter from Sen. Catherine Cortez Masto requesting the Centers for Medicare & Medicaid Services withdraw the damaging Medicaid Fiscal Accountability Regulation proposal. The deadline to sign is Friday, March 13.

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Current and future threats to the 340B Drug Pricing Program jeopardize the ability of essential hospitals to tailor services and programs to their community’s unique challenges.

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Unless Congress acts by May 22, Medicaid DSH will sustain a $4 billion cut—a third of all program funding. Rising numbers of uninsured and other cost pressures, including deep cuts to outpatient payments, would amplify the damage.

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The report, mandated by the 21st Century Cures Act, highlights issues and challenges pertaining to the use of health information technology and electronic health records (EHRs) in four categories: clinical documentation; usability and the user experience; EHR reporting; and public health reporting.

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Congressional leaders are holding several hearings to inform their COVID-19 response and negotiating legislation that could provide up to $8 billion in emergency supplemental funding to respond to the outbreak.

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These cases bring the total number of COVID-19 cases detected and confirmed in the United States to 16. The Centers for Disease Control and Prevention and the Food and Drug Administration have issued new guidance and resources to prevent the spread of the virus and improve testing.

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The Supreme Court announced it will review the court decision finding the Affordable Care Act’s individual mandate unconstitutional. The case, now expected to be heard this fall with a decision likely in 2021, will determine the fate of the law.

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The agency announced it will count patients repatriated by the Department of State separately from other cases. Additionally, the World Health Organization developed an emergency ICD-10 code for COVID-19.

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A new proposed rule would extend the Comprehensive Care for Joint Replacement (CJR) model by three years and add outpatient knee and hip replacement to the definition of a CJR episode. Comments are due to CMS by April 24.

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Novel Coronavirus Resources

America’s Essential Hospitals has established this resource page for its member hospitals and others with an interest in this public health crisis. Visit this page regularly for new and updated information.

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VITAL2020

Join us June 17-19 in Chicago for a program unequaled in its focus on the mission-driven hospital. VITAL2020 will arm you with the knowledge you need to keep your hospital on the forefront of innovation.

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Tour Population Health Programs

Visit EssentialCommunities.org to learn how our hospitals target social and economic factors to improve health. Take a virtual tour of population health programs nationwide, discover new resources, and share your programs.

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