Alerts

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.

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.

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.”

NABH is requesting information from our members to show how expanded coverage of telehealth during the Covid-19 pandemic has helped maintain and even improve access to behavioral healthcare. This information will help us advocate for continuation of this expanded coverage of telehealth after the public health emergency ends.

Here is a quick survey to share the requested data on the impact of the telehealth expansion. Please submit the survey and any additional information as soon as possible, but no later than Friday, July 31.

Please email Kirsten Beronio, Director of Policy and Regulatory Affairs (kirsten@nabh.org) with any questions.

Friday, the U.S. Department of Health and Human Services (HHS), announced that it is extending the application deadline for Medicaid and CHIP Provider Relief Fund distribution from today July 20, 2020 to August 3, 2020.

In June, HHS announced plans to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs who had not yet received a payment from earlier distributions from the Provider Relief Fund.

This HHS fact sheet explains the application process.

In addition, HHS is holding focus groups tomorrow and Wednesday to identify opportunities to increase application volumes in the current Medicaid/CHIP distribution. The focus group discussion will center on three topics-

1. Awareness of the PRF program and Medicaid/CHIP distribution
2. Understanding of program components, such as eligibility
3. Technical challenges faced during the application process

These sessions will be held on Tuesday, July 21^st from 6:30 – 7:30 pm ET and Wednesday, July 22^nd from 3:00 – 4:00 pm ET.

To confirm your participation, please send an email to preston.white@mckinsey.com with your name, email, title, organization and state, and note which session you would like to attend.

If you have any questions, please reach out to our Director of Policy and Regulatory Affairs, Kirsten Beronio.

HHS announced that as of Wednesday, July 15, the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Covid-19 module will no longer be an option for hospitals to fulfill the agency’s request for daily data reporting on bed capacity, utilization, personal protective equipment (PPE), and in-house laboratory testing data.

Instead, HHS is asking hospitals to use one of these four options to report that information:

• If your state has assumed reporting responsibility, submit all data to your state each day and your state will submit on your behalf. Your state can provide you with a certification if they are authorized to submit on your behalf.
• Submit data to TeleTracking™. All instructions about the data submission are on that site and the new and updated fields will be ready as of July 15.
• Authorize your health information technology (IT) vendor or other third party to share information directly with HHS.
• Publish to the hospital or facility’s website in a standardized format, such as schema.org.

For additional details about these options, please see page 9 in HHS’s updated guidance. This information is also posted to NABH’s Covid-19 resources page.

The Substance Abuse and Mental Health Services Administration (SAMHSA) on Monday issued a final rule to update the Confidentiality of Substance Use Disorder Patient Records known as 42 CFR part 2 (or “part 2”) regulations, further aligning the regulations with other healthcare delivery rules.

Key changes include:

• Part 2 programs may share information verbally with a non-part 2 provider without subjecting the non-part 2 record to the requirements of part 2, as long as the non-part 2 provider segregates specific substance use disorder (SUD) records.
• Patients may consent to disclosures without naming a specific individual to receive this information; the update provides instructions for disclosures to exchanges and research institutions and provides guidance on disclosures related to care coordination and case management.
• Non-part 2 providers are not required to redact information in their medical records and may redisclose information if the patient has signed a written consent, or if the disclosure is otherwise permitted under the regulations.
• Written consents expressly allow sharing information with 18 types of payment and healthcare operations, including for care coordination and case management.
• Non-opioid treatment providers have access to central registries if they have a treatment relationship to the patient.
• Opioid treatment programs have new permissions to disclose information to prescription drug monitoring programs.
• During medical emergencies, information may be shared among part 2 programs or other SUD treatment providers during state or federally declared natural and major disasters.
• Disclosures for conducting scientific research may be made to non-Health Insurance Portability and Accountability Act (HIPAA) covered entities and those who are not subject to the Common Rule.
• Permits federal, state, and local agencies to conduct audits and evaluations.
• Extends to 12 months the period of placement of undercover agents or informants, which may be further authorized by a new court order.

These changes do not include provisions that recently became law in the Coronavirus Aid, Relief and Economic Security Act (CARES Act). CARES Act provisions are effective March 27, 2021.

This rule is expected to be published in the Federal Register this Wednesday, July 15, and will become effective within 30 days of its publication.

For questions about this rule, please contact Sarah Wattenberg, NABH’s director of quality and addiction services, at sarah@nabh.org.

HHS said Tuesday it expects to distribute about $15 billion through the department’s Health Resources and Services Administration (HRSA) to eligible providers who participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution.

HRSA will also distribute about $10 billion from the Provider Relief Fund to the nation’s safety-net hospitals, which is expected to happen this week.

HHS said it will launch an enhanced Provider Relief Fund Payment Portal on Wednesday that is intended to allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor for HHS to determine their Provider Relief Fund payment.

According to an announcement, the payment to each provider will be at least 2% of reported gross revenue from patient care. HHS said it will determine the final amount that each provider receives after data is submitted, including information about the number of Medicaid patients providers serve.

To be eligible for this funding, healthcare providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020.

On Monday, HHS contacted all hospitals, asking them to update information on their COVID-19 positive-inpatient admissions for the period January 1, 2020, through June 10, 2020. This information will be used to determine a second round of funding to hospitals in COVID-19 hotspots to ensure they are equitably supported in the battle against this pandemic. To determine their eligibility for funding under this $10 billion distribution, hospitals must submit their information by June 15, 2020 at 9:00 PM ET.

HHS said close to 1 million healthcare providers may be eligible for these patients. Click here for more information about eligibility and the application process.

The Centers for Medicare & Medicaid Services (CMS) on April 10 said it expects payments to inpatient psychiatric facilities to increase by 2.4% in fiscal year 2021, boosting the federal per diem base rate to $817.59 from $798.55.

An announcement about CMS’ proposed inpatient psychiatric facility prospective payment system (IPF-PPS) rule said the agency estimates total IPF payments to increase by $100 million next year. The rule will be published in the Federal Register on Tuesday, April 14.

According to the proposed rule, CMS will adopt the Office of Management and Budget (OMB) guidelines regarding geographic delineation of statistical areas, which CMS said should result in wage index values better representing the actual labor costs in a given area.

“CMS is proposing that all IPF providers negatively impacted in their wage index, regardless of the circumstance causing the decline, be capped at a 5-percent decrease for FY 2021,” the announcement said. Table 6 at the start of page 57 in the proposed rule shows changes in 2021 from 2020 for different facility types.

The agency said it is not making changes to the IPF Quality Reporting Program.

NABH is analyzing the proposed rule and will submit comments by the June 9 deadline.

HHS announced on Friday it is distributing $30 billion immediately to healthcare providers fighting the deadly Covid-19 pandemic. The funding is the first portion of the $100 billion allotted to hospitals and other providers as part of the Coronavirus Preparedness and Response Supplemental Appropriations (CARES) Act that President Trump signed on March 27.

The funding will arrive via direct deposit to eligible providers starting on Friday, April 10. HHS’ announcement said the money is in the form of payments, not loans, so the money will not need to be repaid.

Eligible healthcare providers include all facilities and providers that received Medicare fee-for-service reimbursements in 2019. According to HHS, payments to practices that are part of larger medical groups will be sent to the group’s central billing office. Click here to learn how HHS will determine the payments and what eligible providers need to do.

To receive funding, providers must agree not to seek to collect out-of-pocket payments from a Covid-19 patient that are greater than what the patient would have otherwise been required to pay if an in-network provider had provided care, HHS said.

HHS has created a public website that shows all Covid-19 grant and cooperative agreement awards, which features a U.S. map detailing the amounts awarded by states, graphics highlighting the numbers of awards, amounts awarded by agency, and more.