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Zina Gontscharow

Senior Policy Analyst

Zina Gontscharow is a former senior policy analyst for America's Essential Hospitals.

HHS announced that assisted living facilities can now apply for a relief fund payment from the second-phase general allocation. The agency also released information on how it will determine incentive payments under the nursing home allocation.

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In a Sept. 1 letter, America's Essential Hospitals urged HHS to prioritize remaining Provider Relief Fund dollars for hospitals still in need, especially those that have yet to receive a payment from any targeted allocation, such as the safety-net and high-impact distributions.

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Providers now have until Sept. 13 to apply for additional payment from the general allocation of the Provider Relief Fund. The initial deadline was Aug. 28.

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CMS issued an information bulletin outlining two approaches for states to reflect third-party payer payments in calculations of uncompensated care costs used to determine hospital-specific Medicaid disproportionate share hospital limits.

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The Department of Health and Human Services will distribute $1.4 billion in Provider Relief Fund payments to nearly 80 free-standing children's hospitals.

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Medicare providers that did not receive payment from the $20 billion distribution from the general allocation can apply for additional funding through the portal; applications are due Aug. 28. HHS also announced a $5 billion allocation for nursing homes and long term–care facilities.

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The agency is using its discretion to allow premium credits to support continuity of coverage for individuals and families impacted by the COVID-19 public health emergency and facing difficulties paying premiums.

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America's Essential Hospitals, along with five other national associations, calls for withdrawal of the proposed Medicaid Fiscal Accountability Regulation. In a letter, the groups note that the rule, if finalized, would exacerbate public health and economic uncertainty resulting from the pandemic.

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The Department of Health and Human Services will extend the application deadline for Provider Relief Fund payments for eligible Medicaid and Children's Health Insurance Program providers, and will reopen the portal for Medicare providers to apply for additional payments from the general allocation.

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A new members-only resource tracks relevant expiration dates for additional authority and flexibility options provided during the COVID-19 pandemic.

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In a July 6 letter, the association urged HHS to use a refined methodology that directs a portion of the remaining dollars in the Provider Relief Fund to hospitals filling a safety-net role that did not receive payment in the initial safety-net allocation.

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The proposed rule, issued by CMS, aims to advance Medicaid prescription drug value-based purchasing arrangements between states and manufacturers, set standards to promote safe opioid prescribing, and amend regulations related to the Medicaid drug rebate program.

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HHS made public the 2018 Medicare cost report data sources used to determine eligibility for the $10 billion targeted safety-net allocation from the Provider Relief Fund. Hospitals had to meet three metrics to be eligible; 761 hospitals received payment.

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American Indian and Alaska Native populations have been hit particularly hard by the COVID-19 public health crisis. America’s Essential Hospitals outlines the unprecedented challenges the pandemic has posed to these communities and the efforts Congress and providers have made to mitigate its effect.

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HHS identified hospitals eligible for part of a $10 billion Provider Relief Fund allocation to aid safety-net providers. The agency also made public a list of total payments by state, including the number of hospitals in each state receiving a payment in this distribution.

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The report, requested by Republican representatives, details challenges states face in administering Medicaid programs, including with coverage exclusions and care coordination, coverage benefits and eligibility, and Medicare and Medicaid alignment.

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The Department of Health and Human Services announced two distributions from the Public Health and Social Services Emergency Fund, known as the Provider Relief Fund: $4.9 billion for skilled nursing facilities and $500 million for Indian Health Service providers.

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Providers have until June 3 to accept terms and conditions and submit necessary documentation to receive additional payments from the Provider Relief Fund to support providers incurring health care–​related expenses and lost revenue from response to the COVID-19 pandemic.

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This State Policy Snapshot summarizes how states are turning to emergency Medicaid authority to provide coverage of COVID-19 services for specific populations, such as individuals who would qualify for public assistance if not for their immigration status.

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In a new informational bulletin, CMS details temporary flexibility for states to modify provider payment methodologies and capitation rates that direct expenditures under managed care contracts to address impacts of COVID-19.

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CMS issued the 2021 final notice of benefit and payment parameters rule and letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS provides detailed options for issuers to adopt value-based designs for marketplace plans.

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Providers now have 45 days, increased from 30 days, to attest and accept the terms and conditions for payments from the Provider Relief Fund to support providers incurring health care–​related expenses and lost revenue from response to the COVID-19 pandemic.

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CMS has updated its Medicaid and CHIP COVID-19 frequently asked questions (FAQ) document, which has been reorganized for greater usability. The new FAQs offer guidance on adjusting upper payment limit demonstrations, supplemental payments, and more to reflect pandemic response.

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In a letter, America's Essential Hospitals urged the agency to reopen the comment period for the Medicaid Fiscal Accountability Regulation to allow stakeholders to address the proposed rule's impact, as the COVID-19 pandemic has fundamentally altered the health care and economic landscapes.

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America's Essential Hospitals in a May 5 letter urged the Department of Health and Human Services to allocate $20 billion specifically to essential hospitals that serve large Medicaid and low-income patient populations, to ensure the stability of the nation’s health care safety net.

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The rule requiring hospital-specific Medicaid DSH limit calculations to include payments from Medicare and commercial payers now is valid nationwide, with lower courts determining the effective date. Plaintiff hospitals filed a petition to appeal the decision to the United States Supreme Court.

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This targeted allocation distributes $12 billion to 395 hospitals that provided inpatient care for 100 or more COVID-19 patients through April 10. Of that total, $2 billion is allocated to hospitals based on Medicare and Medicaid disproportionate share hospital (DSH) and uncompensated care payments.

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Hospitals can now register as participating providers to receive reimbursement for COVID-19 testing and treatment services furnished to uninsured patients on or after Feb. 4. Participating providers can begin submitting claims May 6.

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HHS opened the verification portal for providers to submit patient revenue data for payments from the general allocation of the COVID-19 provider relief fund. The agency also answered frequently asked questions and posted a fact sheet to aid providers requesting and attesting to receipt of payments.

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Hospitals now have until April 25 at 3 pm ET to submit data to HHS that will inform how the agency will allocate $10 billion in COVID-19 provider relief funds in areas most impacted by the pandemic.

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HHS announced additional detail on how the agency intends to distribute the COVID-19 relief fund to hospitals and other providers. HHS will allocate funds through a general approach and use a targeted approach for certain hospitals, rural providers, and Indian Health Services.

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