HealthCare Roundtable e-News – April 21, 2020


REMINDER: Save The Date: 

COVID-19 Update Webinar

Thursday, April 30th, 2:00 PM (EDT)

As I announced last week, Andrew and I thought it would be good to keep our discussion regarding COVID-19 going during this unprecedented period of time. We know that you’re all dealing with unique challenges presented by the Coronavirus pandemic and we’re interested in learning more about how you’re handling them.

In that regard, I want to thank those of you who have communicated with Andrew and/or myself regarding your current experiences. We’re currently working on a letter for Congress and some of your feedback has been helpful as we frame our message. We’re looking forward to sharing that message during next week’s webinar.

If you haven’t already responded to last week’s requests, here they are again…

First, if you have a few moments to share some thoughts about your current experiences – decisions you’re making, services that you’ve modified, innovate communication strategies you’ve initiated – , we’d appreciate your feedback. Nothing fancy is required… drop a quick email Andrew or me

Second, since we’re going to use a Zoom platform for this meeting, we’ll need to send you the meeting address. In order to get on that list, please just send me your email address. NOTE: If you’ve already sent me your name/email address for the Zoom meeting, you don’t need to send it again. I’ll be sending the meeting invitation early next week.

Stay healthy!

Tom Lussier



CMS to Issue Second Round of CARES Act Grants, Will Consider Regulatory Relief Post-COVID-19, Says Verma

Health care providers in coronavirus hot spots have another round of CARES Act grants on their way to them, according to Seema Verma, the CMS Administrator confirmed last week (Apr. 15). Verma confirmed on a call with reporters that the agency is aiming to address distribution concerns, commenting that “there will be a specific portion of funds that are for providers in hot spots, and we’re expecting that there will be more detail, as well as funds, that go out by the end of this week.”

When determining the distribution of the initial round of funding, the agency said that getting the funds out as quickly as possible was the priority and primarily relied on Medicare reimbursement channels. For the second round, Verma confirmed that funding will be considered for providers “across the board, whether they serve Medicare patients, Medicaid or private insurers, to make sure that all providers across the country are addressed.”

In addition to the second wave of CARES Act funding, Verma also indicated the agency would consider not re-instating regulation that had been waived at the start of the COVID-19 pandemic, commenting specifically on the new flexibility that telehealth has given beneficiaries. CMS had instituted many regulatory changes easing telehealth restrictions in Medicare, expanding provider workforces and easing access to a number of services since the start of the crisis.

“As we continue to hear from health care providers on the front lines about what’s burdensome, it has created a lot of discussion, even within CMS about which, some of these items, do they really need to be continued. We will be assessing this fully after we get past the pandemic,” Verma said.

Senate Democrat Leaders Assert CARES Act Funds Have Not Been Distributed as Intended

As the coronavirus crisis continues, Senate Democrats are alleging that HHS did not follow Congress’ intent in how it distributed the initial $30 billion of the $100 billion in CARES Act funding for providers earlier this month. The group, which includes Senate Minority Leader Chuck Schumer (D-N.Y.), Sens. Patty Murray (D-Wash.) and Ron Wyden (D-Ore.) and other committee leaders, is demanding the remainder of the funds be distributed more equitably and target the areas hit hardest hit by the pandemic. (InsideHealthPolicy).

“While we appreciate the need to get funds out quickly, it is our strong view that the administration must allocate the remainder of the fund in a more targeted manner,” said Senate Democrats in a letter last week. The group recommended that “[a]ny and all criteria used to allocate funds to providers should be relevant to the specific needs created by the COVID-19 emergency and should not discriminate against providers in need based on payer mix.” (InsideHealthPolicy).

Senate leaders have also claimed HHS is using the $100 billion to reimburse hospitals for treating uninsured COVID-19 patients instead of opening a special enrollment period on the federal exchange, or enabling Medicaid expansion. The group alleges that paying hospitals at Medicare rates for the uninsured disadvantages providers in states that have expanded coverage, and is urging the agency to “use the funds for emergency relief purposes and to work with Congress on ways to cover the uninsured.”

Study Finds Patients Receiving Emergency Transport Are Increasingly Likely to Get Hit with Surprise Bills

A recent study released in Health Affairs found that three in four commercially insured patients will receive surprise bills after being transported by air and ground ambulances. The study analyzed 4.2 million ASC-based episodes of care in 2014-17 and involved 3.3 million patients enrolled in UnitedHealth Group, Humana, and Aetna commercial plans.

The study determined that most emergency transport is out of network and that 71 percent of all ground and air ambulance rides the researchers reviewed involved potential surprise bills, and ground ambulance bills alone will have an aggregate impact of $129 million per year, with out-of-network air ambulance bills averaging $91 million per year.

Addressing surprise medical billing has been a focus for congress for more than a year with most insurers preferring proposals to set pay rates for out-of-network changes, while providers prefer a bill put forward by the Ways & Means Committee which would not set pay rates and instead rely on arbitration.

Sens. Lamar Alexander (R-Tenn.) and Greg Walden (R-Ore.) have vocally supported adding surprise billing legislation to the coronavirus stimulus package, but received pushback from House and Senate leadership and air ambulance companies who have lobbied to keep limitations on air ambulance billing out. (InsideHealthPolicy).

Facebook Looks to Drive Users to Healthcare.gov, Learn About ACA in COVID-19 Inspired Campaign

Facebook officially launched a program on its social networking platform last week urging recently unemployed Americans to visit healthcare.gov, as part of its efforts to support outreach for special enrollment periods and Obamacare coverage. Ads on the platform, which will be run in both English and Spanish, will encourage users to learn more and see if they are eligible to receive healthcare through the Affordable Care Act.

HHS confirmed that it did not prompt the tech company to initiate the campaign, but a Facebook spokesman confirmed the company “shared with relevant contacts that we were going to run these notices,” according to InsideHealthPolicy. The ads are a result of the Trump administration refusing to open healthcare.gov, and most recently, Democrats began demanding that HHS at least conduct an outreach campaign to inform people about existing SEPs. Currently, all but one of the 13 state-based exchanges in the U.S. created SEPs that would allow any consumer to purchase needed coverage, and most have extended their deadlines through at least next month.

Facebook’s platform is currently being put to the test as it battles misinformation being spread about COVID-19. The company noted last week that part of its strategy is to invite people who had recently shared posts with misinformation with a prompt saying, “Help friends and family avoid false information about COVID-19,” which then invites them to visit a page created by the World Health Organization debunking popular COVID-19 myths.