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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

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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.

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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.

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NABH Letter on HHS Provider Relief Fund Reporting Requirements

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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.

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HHS Provider Relief Fund Reporting Requirements Change Terms for Recovering Lost Revenue

The Department of Health and Human Services (HHS) has issued guidance that contradicts the department’s June FAQ about calculating lost revenue from Covid-19 that may be recovered through the Coronavirus Aid, Relief, and Economic Security Act’s (CARES) Provider Relief Fund (PRF).

In the June FAQ, HHS said providers could “use any reasonable method of estimating the revenue during March and April 2020 compared to the same period had Covid-19 not appeared.” This latest guidance defines lost revenue that may be recovered as being limited to “a negative change in year-over-year net patient care operating income.” The guidance further specifies that providers generally will only be able to apply their PRF payments to lost revenue up to a facility’s net patient operating income for 2019.

As HHS announced previously, providers who have received more than $10,000 from the PRF are required to submit a report by Feb.15, 2021, on the use of those funds through Dec. 31, 2020, and, if necessary, a second and final report by July 31, 2021.

The PRF funding provided through the CARES Act and subsequent legislation was intended to reimburse eligible providers for healthcare-related expenses and lost revenues attributable to Covid-19. HHS had included a general commitment to reporting on the use of the PRF funds in the terms and conditions that PRF fund recipients agreed to for the funding. Previously HHS said it would issue detailed reporting instructions by Aug. 17, 2020 and the reporting system would be available Oct. 1. The reporting system is not yet available.

Please contact your U.S. senators and representatives today and ask them to urge the White House and HHS to reinstate the Covid-19 PRF reporting requirements that HHS outlined in June. Providers must be able to use these funds to recover any revenue lost due to Covid-19, rather than struggling to once again change course to respond to shifting guidance from HHS.

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NABH Comments on FY 2021 OPPS Rule

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NABH Letter on Covid-19 Reporting Requirements

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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.

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