You're not alone. Confidential help is available for free. 1-800-662-HELP (4357)

Alerts

CMS Corrects Announcement to Say Providers Cannot Use PRF When Repaying Medicare Loans

The Centers for Medicare and Medicaid (CMS) has corrected a misstatement in its Oct. 8 news release to say the nation’s healthcare providers and suppliers cannot use Provider Relief Funds (PRF) to repay Medicare loans the agency has made during the Covid public health emergency.

The correction first appeared in an FAQ on Oct. 9. CMS subsequently corrected its original news release

Read more

CMS Gives Medicare Part A & B Providers One More Year to Repay AAP Loans

The Centers for Medicare & Medicaid Services (CMS) said Thursday it will give Medicare Part A and B providers and suppliers an additional year to repay loans the agency made to them during the Covid-19 public health emergency (PHE).

CMS had advanced payments to Medicare Part A and B providers and suppliers through the Accelerated and Advance Payment (AAP) program to help cover costs as the PHE disrupted healthcare services this year. Initially CMS had required providers to start making repayments in August 2020.

“CMS’ advanced payments were loans given to providers and suppliers to avoid having to close their doors and potentially causing a disruption in service for seniors,” CMS Administrator Seema Verma said in an announcement. “While we are seeing patients return to hospitals and doctors providing care we are not yet back to normal,” she added.

According to the agency’s new terms, after that first year, CMS will automatically recoup 25% of Medicare payments otherwise owed to the provider or supplier for 11 months. After that period, CMS will increase the recoupment amount to 50% for another six months.

CMS said it will send letters to providers who have any outstanding balances after the entire period—a total of 29 months— informing them that repayment will be subject to a 4% interest rate. Those letters will also include guidance on how to request an Extended Repayment Schedule (ERS) due to financial hardship. The agency’s announcement urged providers and suppliers to contact their Medicare Administrative Contractor for information about how to request an ERS.

An ERS will allow a provider or supplier to repay these debts over the course of three to five years. CMS also said providers and suppliers may use Provider Relief Funds to repay these Medicare loans.

CMS said it will communicate with each provider and supplier about the amount they owe and all applicable terms in the coming weeks.

Read more

New CMS Guidance Requires Psychiatric Hospitals to Report Covid-19 Data Weekly

The Centers for Medicare & Medicaid Services (CMS) has released guidance that requires Medicare- and Medicaid-participating psychiatric hospitals to report Covid-19 data to the agency on a weekly basis.

CMS published an interim final rule in early September that said hospitals would be required to submit Covid-19 data during the public health emergency in a frequent, standardized way that the U.S. Health and Human Services Department (HHS) secretary specified.

This week’s awaited guidance makes it clear that the nation’s psychiatric hospitals—along with rehabilitation hospitals—need to report their data weekly, and not on a daily basis as other hospital types are required to do.

The agency listed the required data in new guidance and also developed an infographic that highlights when the agency plans to alert hospitals about gaps in reporting and compliance. Links to these new materials are also available our Covid-19 resources webpage.

Read more

HHS Includes Behavioral Healthcare Providers in Provider Relief Fund Phase 3 Distribution

The Department of Health and Human Services (HHS) on Thursday announced an additional $20 billion is available from the Provider Relief Fund (PRF) for healthcare providers to recover Covid-19-related financial losses and changes in operating expenses.

HHS highlighted behavioral healthcare providers in its announcement and encouraged these providers to apply for this latest round of funding. HHS has developed a list of behavioral healthcare providers who are now eligible for funding, such as addiction counseling centers, mental health counselors, and psychiatrists.

“Our behavioral health providers have shouldered the burden of responding and confronting this expanded challenge triggered by the pandemic,” HHS said in the announcement. “When traditional face-to-face counseling was restricted and new telehealth flexibilities were put in place in response to the pandemic, many behavioral health providers invested in and adopted telehealth technologies to continue providing patient care.”

Providers are encouraged to apply early. Be sure to apply between Monday, Oct. 5 through Friday, Nov. 6, 2020.

Eligible providers include behavioral healthcare providers who had previously not been eligible (presumably because they did not participate in Medicare or Medicaid); providers who had already received PRF payments; and providers who began practicing in 2020 and were therefore not eligible to apply previously.

Providers who apply will be considered first for the 2% of patient care revenue that has already been made available. If they have not yet received payments from the PRF amounting to 2% of patient care revenue, they will receive funding to reach that amount.

In addition, those who apply will receive an add-on payment above the 2% from the $20 billion allocation based on the following criteria:

  • Change in operating revenues from patient care;
  • Change in operating expenses from patient care, including expenses incurred related to the coronavirus; and
  • Payments already received through the prior PRF distributions

All providers receiving PRF funding will be required to accept the associated terms and conditions including reporting requirements.

HHS said it plans to hold webinars to assist with the application process.

Read more

CMS Makes Covid-19 Data Collection a Requirement in Conditions of Participation

The Centers for Medicare & Medicaid Services (CMS) is requiring Covid-19 data collection and reporting as a condition of participation (CoP) for hospitals participating in the Medicare and Medicaid programs, including psychiatric facilities.

CMS added the requirement with other provisions in an interim final rule and said it will accept comments for 60 days. The rule noted the requirement will become effective when it is published in the Federal Register, although it did not list a specific date.

Under the new requirement, hospitals will need to report daily data, including—but not limited to—the number of confirmed or suspected Covid-19 positive patients, intensive care unit beds occupied, and the availability of supplies and equipment, such as ventilators and personal protective equipment.

CMS warned in the rule that if a hospital fails to comply with this new CoP, it could face possible termination from the federal healthcare programs.

Read more

HHS Extends Phase 2 General Distribution Deadline to Sept. 13

The Department of Health and Human Services (HHS) has extended the deadline to apply for Phase 2 General Distribution Funding for Medicaid, Medicaid managed care, Children’s Health Insurance Program, dental providers, and certain Medicare providers until Sunday, Sept. 13.

This funding is through the Provider Relief Fund, which the federal government established in this year’s Coronavirus Aid, Relief, and Economic Security Act (CARES) and Paycheck Protection Program and Health Care Enhancement Act. These payments do not need to be repaid to the government if providers comply with terms and conditions.

HHS has extended this Phase 2 General Distribution Funding deadline before, with the latest deadline scheduled for this Friday, Aug. 28. Providers now have a few extra weeks to apply.

Click here to read HHS’ six steps to applying for the Phase 2 General Distribution.

Read more

HHS to Host Provider Relief Fund Webinar on Thursday, Aug. 13

The Health and Human Services Department (HHS) will host an informational webinar for healthcare providers about applying to the CARES Act Provider Relief Fund this Thursday, Aug. 13 at 3 p.m. ET. Please click here to register.

HHS announced on July 31 that certain Medicare-participating providers would have another opportunity to receive additional Provider Relief Fund payments. These are the providers who missed an early June deadline to apply for additional funding equal to 2% of their total patient care revenue from the $20 billion portion of the $50 billion phase 1 General Distribution, including many Medicaid, Children’s Health Insurance Program (CHIP), and dental providers with low Medicare revenues. These eligible providers may now submit their application for possible funding by Friday, Aug. 28.

HHS has also extended the deadline to Aug. 28 for providers who participate in Medicaid and CHIP to apply for up to 2% of their total patient care revenue from a separate funding distribution for Medicaid providers.  To be eligible for this funding, providers must not have received any funding from the Medicare focused distribution of funding from the Provider Relief Fund.

Providers can access the same portal to apply for both Medicare-based and Medicaid-based funding.

HHS has hosted a series of webinars to address questions from providers throughout the application process, and Thursday’s webinar is the next provider and provider organization webinar in this series.

Read more

HHS Extends Deadline for Provider Relief Funding Until Aug. 28

The Department of Health and Human Services (HHS) extended the deadline to Friday, Aug. 28 from Monday, Aug. 3 for healthcare providers who participate in Medicaid and CHIP to apply to the Provider Relief Fund established in the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

HHS had previously extended this deadline to Aug. 3 from July 20. HHS said that it plans to issue a simplified application form soon.

In addition, HHS is re-opening the portal for Medicare-participating providers to apply for funding set aside from the Provider Relief Fund for Medicare providers. The previous deadline to apply for this distribution was June 3.

Providers will now have until Aug. 28 to apply for the balance of funding up to 2% of their annual patient revenue. HHS is re-opening this application process after learning that many providers, including many Medicaid and CHIP providers, did not apply to the prior Medicare-based distribution because they had relatively low Medicare revenues. 

HHS also announced it is working on another distribution of funding from the Provider Relief Fund focused on providers who have not received any of this funding, including those who only bill commercially or do not directly bill for the services they provide to Medicare and Medicaid beneficiaries.

Information on how to apply for the various Provider Relief Fund distributions is on HHS’ website.

Read more

Wit v. UnitedHealthcare Hearing Delayed to Wednesday, Sept. 2

The remedies hearing in the Wit v. UnitedHealthcare case scheduled for this week has been delayed to Wednesday, Sept. 2.

NABH has learned that U.S. Chief Magistrate Judge Joseph Spero has re-scheduled the hearing due to meetings related to Covid-19.

Members of the public and press are welcome to join the webinar, and NABH will send an updated Zoom link when it becomes available.

Read more

CMS Announces 2.2% Payment Update and Scope-in-Practice Changes for 2021

The Centers for Medicare & Medicaid Services (CMS) will update the Medicare payment rate for the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) by 2.2% in Fiscal Year (FY) 2021, the agency announced in a final rule late Friday.

In its April proposed rule, CMS had estimated a 2.4% payment rate update for IPFs next year. The agency included its updated estimates and calculations in a fact sheet accompanying Friday’s final rule.

According to the rule, CMS will allow advanced practice providers, including physician assistants, nurse practitioners, psychologists, and clinical nurse specialists, to operate within the scope of practice allowed by state law by documenting progress notes in the medical record of patients for whom they are responsible, receiving services in psychiatric hospitals. NABH has advocated for this policy change and is pleased the agency made this update.

CMS also finalized its proposal to adopt revised Office of Management and Budget (OMB) statistical area delineations resulting in wage index values that the agency said are “more representative of the actual costs of labor in a given area.”

Read more