Zotec Partners Radiology Digest | July 24

July 24, 2020

Radiology Digest: News from the week of July 24, 2020.

HHS Officially Renews Public Health Emergency for COVID-19
By Rachel Cohrs | July 23, 2020 | Included in Radiology Digest – July 24, 2020
HHS Secretary Alex Azar on Thursday officially extended the COVID-19 public health emergency designation for another 90 days.

Significant funding and regulatory relief for hospitals and other healthcare providers are tied to the emergency, which was set to expire on July 25. Lobbyists and healthcare industry players were concerned that the bureaucratic decision could get caught up in political maneuvering and pressured the administration to continue the emergency. HHS officials had repeatedly signaled HHS’ intention to continue the emergency designation, and the agency previously renewed it in April.

“Today I signed a renewal of the COVID-19 national public health emergency declaration,” Azar tweeted.

The formal declaration is listed on HHS’ website.

The renewal gives the healthcare industry certainty through the fall on several key policies to assist with the COVID-19 response. Some notable policies tied to the public health emergency are the 20% Medicare inpatient add-on payment for COVID-19 patients, increased federal Medicaid matching funds for states, a mandate that insurers cover medically necessary COVID-19 tests without cost-sharing, relaxed telehealth restrictions, and Section 1135 waivers that give providers additional flexibility to respond to COVID-19.
To read more, go to Modern Healthcare.

Provider-relief Grant-spending Reports Due in February 2021
By Rachel Cohrs | July 22, 2020 | Included in Radiology Digest – July 24, 2020
Healthcare providers will be required to account for how they spent COVID-19 relief grants by February 2021, HHS quietly announced on Monday.

When lawmakers established the $175 billion Provider Relief Fund, one of the stipulations was that healthcare providers receiving large grants would have to submit quarterly reports to HHS and to an oversight commission on their spending, starting on July 10. But HHS delayed that reporting deadline last month and said providers wouldn’t have to submit quarterly reports.

Instead, healthcare providers that received more than $10,000 from the Provider Relief Fund will have to account for all the grant funds they spent in 2020 by February 15, 2021, according to a new HHS notice document.

The $10,000 reporting threshold is a notable change from the statutory requirement in the Coronavirus Aid, Relief, and Economic Security Act, which required detailed reporting disclosures from any entity that had received more than $150,000 in total funds from any COVID-19 relief legislation.

“We think many organizations who received less than $150,000 will be surprised by the announcement that they will now be required to report to HHS,” said RSM US healthcare partner Rick Kes.

HHS said it will release detailed instructions about the reporting requirements by August 17.

The reporting system is set to open on October 1. The Health Resources and Services Administration will hold question and answer sessions via webinar before the submission deadline.
“HHS has a significant task ahead of themselves to educate the provider community about these requirements between now and the deadline,” said McDermottPlus Consulting Vice President Mara McDermott.

If healthcare providers don’t spend all the grant funds by the end of 2020, they will be required to submit a final report on the remaining funds by July 31, 2021.
To read more, go to Modern Healthcare.

American College of Radiology ‘Strongly Urges’ CMS to Delay Provider Medicare Audits
By Marty Stempniak | July 22, 2020 | Included in Radiology Digest – July 24, 2020
The American College of Radiology is “strongly” urging the feds to delay audits of providers’ Medicare claims that are set to resume on Aug. 3, according to a statement released Wednesday.
The Centers for Medicare and Medicaid Services first suspended most of such fee-for-service reviews back in March because of the COVID-19 pandemic. However, federal officials recently indicated plans to resume the site checks early next month.

ACR pushed back on those plans this week, asking CMS to hold off until at least 90 days after the public health emergency declaration expires. The college also wants the feds to seek input from radiologists and other providers before resumption, given COVID’s “resurgence in many parts of the country.”

“Restarting provider audits now will increase the administrative burden on personnel and practices at a time when sites are rightly focused on protecting patient safety, ensuring access to lifesaving radiology services, and restoring nonurgent, but necessary care delayed during the COVID-19 pandemic,” ACR said July 22.

The college further noted that all radiology practices continue to face disruptions from equipment shortages, calls to help hospitals with front-line care, and an industrywide shift toward teleradiology. And some imaging practices are just now starting to reopen or are operating with reduced staffing following orders to delay elective care.

“This is not the time to resume provider audits,” the college ended its brief statement. “The ACR looks forward to working with CMS to address this issue.”

CMS performs various such audits, often through private contractors, to gauge whether radiologists and hospitals have been overpaid for services. The current public health emergency is set to expire on July 25, but ACR and others have pushed federal officials to extend it. Health and Human Services was expected to issue such an extension earlier this month, but has yet to officially do so as of Wednesday afternoon.
To read more, go to Radiology Business.

White House and Congress at Odds Over Pandemic Relief Package
By Kelsey Snell, Susan David, Deirdre Walsh | July 21, 2020 | Included in Radiology Digest – July 24, 2020
Washington is racing to complete a fifth round of legislation to address the ongoing, and still surging, coronavirus pandemic in the next three weeks. The two parties and the White House are at odds over what the major pillars of the legislation should include and how much it should cost.

Senate Majority Leader Mitch McConnell, R-Ky., wants to get a bill to President Trump by Aug. 7 when Congress is scheduled to adjourn for the rest of the summer — a time when lawmakers traditionally hit the campaign trail in an election year.

The aggressive timeline puts pressure on Republicans in Congress and the White House to agree on their demands so that bipartisan negotiations can begin in earnest.

Republicans have not released a detailed list of their demands, but McConnell has ruled out a large spending package such as the roughly $2.5 trillion CARES Act that passed in March.
He is expected to unveil the Senate GOP proposal this week that is estimated to cost around $1 trillion.

“The legislation that I have begun to sketch out is neither another CARES Act to float the entire economy, nor a typical stimulus bill for a nation that’s ready to get back to normal,” McConnell said Tuesday on the Senate floor. “Our country is in a complex middle ground between those two things. We can’t go back to April, and we can’t snap our fingers and finish the vaccine overnight. We need to carve out a ‘new normal.’ “

McConnell has listed some components, including $105 billion for schools, some additional federal unemployment support, a second round of direct payments, and legal liability limitations to prevent lawsuits related to COVID-19.

Trump has publicly backed a different set of demands. White House press secretary Kayleigh McEnany told reporters that the president is pushing for a payroll tax cut to be part of the package. Congressional Republicans have repeatedly rejected that idea, but McEnany said a tax cut would go to the “hardest-working — middle-income and low-income workers,” but she said it was one of a number of items they are discussing, including another round of direct payments.
To read more, go to NPR.org.

7 Things to Consider with New Telehealth Legislation Proposed
By Mandy Roth | July 21, 2020 | Included in Radiology Digest – July 24, 2020
As calls for a permanent extension of emergency telehealth waivers echo in the nation’s Capital, last week members of the House Telehealth Caucus introduced the bipartisan Protecting Access to Post-COVID-19 Telehealth Act. The legislation “seeks to expand the use of telehealth beyond the current national health crisis, including permanently eliminating obsolete geographic originating site restrictions,” according to the American Telemedicine Association (ATA).
As this legislative initiative moves forward, what do health systems, hospitals, and providers need to consider? Seema Verma, administrator of the Centers for Medicare & Medicaid Services (CMS); ATA; the Healthcare Information and Management Systems Society (HIMSS); and experts at other organizations are weighing in with insights and predictions.

  1. Is the proposed house legislation enough?
  2. Evaluating the clinical appropriateness of telehealth
  3. Will parity payment continue?
  4. Licensure across state lines
  5. The impact of fraud
  6. Incentives to invest in telehealth technology
  7. Legislation to expand broadband services
    To read more, go to Health Leaders Media.

Optimism Snaps Back in Q3 Edition of MICI Poll
By Brian Casey | July 20, 2020 | Included in Radiology Digest – July 24, 2020
Radiology administrators and business managers reported a sharp rebound in optimism about their business prospects for the third quarter in the latest round of the Medical Imaging Confidence Index (MICI). The jump corrects much of the second-quarter decline that occurred at the beginning of the COVID-19 outbreak.

The composite MICI score for the third quarter was 103, which is interpreted as representing “neutral” confidence by the MICI scale. By contrast, the composite score for the second quarter was 72, indicating “low confidence” and the lowest level in the index’s history.

The second quarter of 2020 saw image volume plunge at radiology departments and imaging centers as many sites postponed elective exams as they prepared for the COVID-19 outbreak. But the current numbers for the upcoming quarter indicate that administrators and managers are gaining more confidence as radiology facilities begin to resume normal operations.

The Medical Imaging Confidence Index is derived from survey responses of radiology administrators and business managers who are members of the AHRA, the association for medical imaging management. Market research firm the MarkeTech Group queries members of the MICI panel about five important trends faced by radiology administrators in the upcoming quarter to provide a barometer of their sentiment about near-term business prospects.

For the 2020 second-quarter data, the index included 161 participants from across the U.S., with 14% based in the mid-Atlantic region, 15% in the South Atlantic region, 6% in the East South Central region, 20% in the East North Central region, 15% in the West North Central region, 12% in the West South Central region, 8% in the Mountain region, and 10% in the Pacific region.

Participants were asked to rate their optimism about the five topics, and a single composite score including all five categories was also calculated. Scores ranged from 0 to 200 and can be interpreted as follows:
• < 50 = extremely low confidence
• 50 to 69 = very low confidence
• 70 to 89 = low confidence
• 90 to 110 = an ambivalent score (neutral)
• 111 to 130 = high confidence
• 131 to 150 = very high confidence
• 150 = extremely high confidence

To read more, go to Aunt Minnie.

Radiology Providers Want 1% Medicare Pay Hike to Cover COVID Supplies, Federal Loans for Imaging Upgrades
By Marty Stempniak | July 20, 2020 | Included in Radiology Digest – July 24, 2020
Several groups representing both radiologists and imaging manufacturers are pressing U.S. lawmakers for a Medicare pay hike to help cover personal protective equipment and other supplies.

They’re also pushing congressional leaders to establish a loan program that would help cover imaging equipment upgrades, industry advocates said in a letter issued Monday. Providers have been hit hard by the pandemic and may need help in maintaining their arsenal of diagnostic tools, wrote the American College of Radiology, Society of Nuclear Medicine and Molecular Imaging, and others.

“The COVID-19 pandemic has shown the importance of having high-quality, up-to-date capital equipment to diagnose, monitor and stage treatment. With providers sustaining such extreme losses, the ability for them to continue updating and maintaining their capital equipment has diminished,” the groups wrote to Sens. Mitch McConnell and Charles Schumer, along with House Reps. Nancy Pelosi and Kevin McCarthy, on July 20. “We recommend Congress establish, or allow for the flexibility of provider relief funds, to be used for a capital equipment loan program.”

The groups noted that imaging providers have suffered “staggering losses and severe economic outlooks” since the start of the pandemic. That’s been fueled partly by postponement of nonemergent and elective procedures and further exacerbated by the need to buy costly PPE. Medicare reimbursement for providers is based around prior year’s costs, they wrote, and does not reflect the surging amount of resources practices have dedicated to the novel coronavirus. To counter this trend, ACR and others want a 1% boost for Medicare services until at least Dec. 31, of 2021.
To read more, go to Radiology Business.

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