Zotec Partners Anesthesiology Digest | June 2020

June 15, 2020

Anesthesiology Digest: News from June 2020.

ASA Endorses Legislation to Provide COVID-19-related Liability Protections for Healthcare Professionals
June 12, 2020
On June 10, the American Society of Anesthesiologists (ASA), along with a group of other health care stakeholders, sent a joint communication to Representatives Phil Roe, M.D. (R-TN) and Lou Correa (D-CA) voicing support of their recently introduced liability relief legislation, H.R. 7059, the Coronavirus Provider Protection Act.

H.R. 7059 would provide limited and targeted liability protections to healthcare professionals, and the facilities in which they practice, from the serious threat of COVID-19-related liability lawsuits. This will help ensure that healthcare professionals and facilities on the front lines of the coronavirus pandemic can focus on helping patients without the fear of getting drawn into unwarranted lawsuits. The legislation protects those providing care in good faith while appropriately excluding liability protections in situations of gross negligence or willful misconduct.
ASA and a group of medical specialty organizations also sent a formal communication to House and Senate leaders strongly urging for the inclusion of H.R. 7059 in the next COVID-19 Relief package.

ASA thanks Representatives Roe and Correa for introducing the Coronavirus Provider Protection Act. ASA will continue to advocate for legislation that impacts healthcare professionals caring for patients on the frontlines of the pandemic.
To read more, go to ASA’s website.

Bill Would Permanently Boost Medicare Telemedicine Pay for Health Centers
By Jessica Kim Cohen | June 12, 2020
A bipartisan duo of lawmakers on Thursday, June 11, introduced a bill to make Medicare reimbursement permanent for some telemedicine services.

Telemedicine has experienced substantial growth in response to the coronavirus outbreak, helped by a host of regulatory flexibilities from Medicare. Healthcare providers have voiced concern that those flexibilities expire with the public health emergency, and have said they want to see actions like expanded Medicare reimbursement continue after the outbreak subsides.

HHS officials have said the agency is reviewing possible steps to extend regulatory changes pushed through during the pandemic, but have stressed some statutory barriers would require intervention by Congress.

The new House bill, called the Helping Ensure Access to Local Telehealth—or HEALTH—Act of 2020, would tackle some of the barriers.

The HEALTH Act would codify Medicare’s expanded telemedicine reimbursement for federally qualified health centers and rural health clinics, including providing payment for telemedicine services furnished by such facilities and removing originating site requirements for Medicare beneficiaries.

“The HEALTH Act will cut red tape and provide community health centers and rural health clinics the ability to offer these vital services to their patients on a more permanent basis,” Rep. Glenn ‘GT’ Thompson (R-Pa.) said in a statement. “I have been amazed at how telehealth services make life easier for rural and underserved communities—particularly older Americans.”
To read more, go to Modern Healthcare.

2020 ASA Conversion Factor Survey
June 12, 2020
The American Society of Anesthesiologists invites you to participate in the 18th annual survey of commercial payment rates. As with previous surveys, we will publish the results in the ASA Monitor later this year. We would greatly appreciate your help with this update. As a reminder, the Statements of Antitrust Enforcement Policy in Health Care issued jointly by the Department of Justice and the Federal Trade Administration make it possible for us to gather this information as long as certain conditions are met. The most important condition, besides only publishing aggregate statistics, is that the data you provide be AT LEAST THREE MONTHS OLD.

Please provide the following information for your FIVE (5) highest-volume commercial payers (NOT MEDICARE, MEDICAID, OTHER GOVERNMENT PAYERS) based on volume of services provided on an annual basis. If you have fewer than five contracted commercial payers, please enter information for all your commercial payers. AGAIN, PLEASE ENSURE THAT YOUR DATA IS AT LEAST THREE MONTHS OLD.

To assist your participation, we are providing a pdf of the survey so you can gather the information needed to complete the survey via the Survey Monkey link.

TO PHYSICIAN ANESTHESIOLOGISTS: Please ask your practice manager or billing service to complete this questionnaire. It is important that we receive only one response from each anesthesia group. If responding for multiple groups, please contact us and we can send you a multi-response worksheet to facilitate that.

We ask that you or your staff complete the survey NO LATER THAN JULY 10, 2020.

To read more, go to ASA’s website.

HHS Announces Provider Relief Funds for Medicaid and CHIP Providers
June 9, 2020 The U.S. Department of Health and Human Services (HHS) announced the distribution of additional funds for the Provider Relief Fund (PRF) to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers who participate in these state programs.

HHS expects $15 billion will be distributed to eligible providers who have not yet received a payment from the Provider Relief Fund General Allocation.

HHS is launching an enhanced Provider Relief Fund Payment Portal that will allow eligible providers who participate in Medicaid and CHIP to report their annual patient revenue. The information will be used as a factor in determining their Provider Relief Fund payment and will be at least 2 percent of reported gross revenue from patient care.

The agency also announced the distribution of $10 billion in Provider Relief Funds to safety net hospitals that serve the nation’s most vulnerable citizens.
To learn more about eligibility and the application process Visit the HHS website.

Trump Administration Pushes for Reopening Healthcare Facilities
By Alex Kacik | June 9, 2020
The federal government is urging healthcare facilities to reopen in states that have relatively low and stable incidence of COVID-19 cases, illustrating a delicate balance between increasing access to care while ensuring providers are adequately prepared to mitigate contamination and safety concerns.

“Thanks to President Trump’s unprecedented expansion of telehealth, many patients have been able to access their clinicians while staying safe at home. But while telehealth has proven to be a lifeline, nothing can absolutely replace the gold standard: in-person care,” CMS Administrator Seema Verma said in prepared remarks. “Americans need their healthcare and our healthcare heroes are working overtime to deliver it safely. Those needing operations, vaccinations, procedures, preventive care, or evaluation for chronic conditions should feel confident seeking in-person care when recommended by their provider.”

CMS offered a guide for the second phase of resuming in-person care, recommending maintaining adequate surge capacity regarding physical space, protective equipment, testing, staff and supplies, prioritizing care for at-risk populations, and participating in a national data collection system to track outcomes, system impacts and resource allocation, among others. But regions and states should only reopen if they have met the “gating criteria” proposed by the federal government—downward trajectory of COVID-19 cases and positivity rates over a 14-day period, downward trajectory of flu-like and COVID-19-like symptoms over that span, and having robust testing programs in place.
CMS recommendations can be found here.
To read more go to Modern Healthcare.

AHA Asks for Another $50B in Coronavirus Relief for Hospitals By Jacqueline LaPointe | June 8, 2020
The American Hospital Association (AHA) is asking HHS to distribute another $50 billion in coronavirus relief funds as hospitals continue to feel the financial pressure of responding to COVID-19.

“[W]e urge HHS to distribute additional funds to all hospitals, as well as to ‘hot spot’ hospitals and hospitals serving high numbers of Medicaid and uninsured patients. At the same time, it should work to create a process by which to then reimburse eligible hospitals and health systems for healthcare-related expenses or lost revenues attributable to COVID-19 through a direct application process,” Rick J. Pollack, president and CEO of the AHA, stated in a June 2nd letter to HHS Secretary Alex Azar.

Specifically, hospitals in COVID-19 hotspots and those that treat higher numbers of Medicaid and uninsured patients should each receive an additional $10 billion in coronavirus relief funds. The remaining $30 billion should be for general distribution to all hospitals, including rural and urban short-term acute care, long-term care, and critical access hospitals, the association recommended.

Congress has already earmarked $175 billion in coronavirus relief funds specifically for healthcare providers. That includes a $50 billion in general allocation payments to all providers impacted by COVID-19 and targeted allocations of $10 billion to hospitals in COVID-19 hotspots and $10 billion to rural providers.

Hospitals and other providers have already received tens of billions of dollars in the coronavirus relief funds, including an automatic distribution of $30 billion from the general allocation pool of payments. HHS released another $20 billion from the pool mid-April.

But hospital groups have criticized how the federal government has doled out payments to providers in dire need of financial support.

In order to get coronavirus relief funds to providers quickly, HHS based general distribution disbursements based on Medicare billings and net patient revenue from the recent past. This has led to hospitals with higher operating margins and private payer revenue to receive a larger portion of the funds, according to a recent report from Kaiser Family Foundation.
To read more, go to Revcycle Intelligence.

OIG to Audit $50B in Coronavirus Relief Funds Given to Providers
By Jacqueline LaPointe | June 1, 2020
The audit will determine whether HHS controls over coronavirus relief funds to hospitals and other providers were correctly calculated and disbursed.
The Office of the Inspector General (OIG) at HHS recently announced that it will audit the distribution of $50 billion in coronavirus relief funds to hospitals and other eligible healthcare providers.
The audit will also, among other things, decide whether HHS controls over the funds ensured that the payments were correctly calculated and disbursed to eligible providers.
The federal watchdog will collect data and interview program officials to complete the audit, which is expected to conclude in 2020.

Congress has allocated approximately $175 billion to hospitals and other healthcare providers to offset the financial losses stemming from the outbreak of the novel coronavirus. The funds were authorized by the Coronavirus Aid, Relief and Economic Security (CARES) Act and later, the Paycheck Protection Program and Health Care Enhancement Act.
About $50 billion of the coronavirus relief funds were put into the Provider Relief Fund, while other monies were earmarked for providers in COVID-19 hotspots, rural areas, and those experiencing an uptick in uninsured COVID-19 patients.

Providers first received some of the $50 billion from the Provider Relief Fund in early April when HHS distributed $30 billion based on a provider’s share of Medicare fee-for-service reimbursements in 2019. The department then disbursed the remaining $20 billion in late April based on CMS cost reports of incurred financial losses from the pandemic.
However, some providers have criticized HHS’ method for distributing payments from the Provider Relief Fund, arguing that the plan disadvantages hospitals in the greatest need.
To read more, go to Revcycle Intelligence.

Expert: Hospitals Should Prepare for Pent-up Demand from Non-Covid-19 Patients
By Tina Reed | June 1, 2020
While much of the focus has been on “flattening the curve” when it comes to COVID-19, experts warn hospitals should be prepared for another potential surge: pent-up demand for deferred care.

“We’ve had an increase in procedures that are being postponed and eventually those procedures will come back,” said Tinglong Dai, Ph.D., associate professor of operations management and business analytics at Johns Hopkins Carey Business School.

While several health systems across the country have begun resuming procedures at some level, many reported their volumes are still extremely light.

But demand could potentially spike in the coming months as patients find they can no longer put off care. Dai is part of a team that is launching a study into the impact of delays in care among dermatology cancer patients at Johns Hopkins. They are also examining how health systems should respond.

“These cases are not going away. Some of them will become major procedures if they were minor before,” Dai told FierceHealthcare. “They are potentially going to be more difficult procedures and more costly procedures.”
To read more, go to Fierce Healthcare.

Learn more about what Zotec Partners can do for your anesthesiology practice here.