Covid 19

Senate’s COVID-19 bill disappoints hospitals

July 29, 2020 7:36 pm
  • Providers impacted by the coronavirus would receive $25 billion under a bill put forth by the Republican majority in the Senate.
  • Repayments of Medicare loans would be delayed until the end of the year.
  • Telehealth waivers would be extended through 2021.

Hospital finances would remain imperiled if a new Senate COVID-19 relief package is enacted, hospital advocates say.

A package of bills, collectively known as the HEALS Act, were introduced this week by Senate Republicans. The bills follow House Democrats’ passage in May along party lines of a very different COVID-19 relief package and portend extended negotiations to reach a compromise.

“Republicans want to go even further to backstop hospitals and healthcare providers and fuel the sprint for vaccines,” Senate Majority Leader Mitch McConnell (R-Kentucky) said in a Senate floor speech. “If Democrats won’t let us, Americans will just have to cross our fingers and hope the medical system remains stable.”

Major finance provisions of the healthcare bills (including a  Senate Finance Committee bill and an Appropriations Committee bill) that comprise the HEALS Act include:

  • Adding $25 billion to the Provider Relief Fund, bringing the total allocation to $200 billion
  • Easing some requirements of the Medicare Accelerated and Advance Payment Program
  • Extending Medicare telehealth waivers until Dec. 31, 2021
  • Extending telehealth flexibilities for rural health clinics and federally qualified health centers for five years after termination of the public health emergency
  • Allocating $225 million for rural health clinics
  • Allocating $7.6 billion for community health centers

Hospital advocates, having called for as much as $100 billion in additional funding for the provider fund, responded that the financing provisions were insufficient.

“Rural providers, not just hospitals, will close their doors for good, and disparities in access to care that have been persistent in rural communities for decades will be exacerbated,” The National Rural Health Association wrote in an update for member hospitals. “To put it simply, rural health will continue to struggle.”

Changes to provisions for Medicare loans

The Federation of American Hospitals (FAH) expressed concern that the bill includes relatively minor changes to Medicare advance payments, instead of steps to minimize or eliminate required repayments as hospitals had urged.

“While recognizing that hospitals and caregivers require further assistance, unfortunately, the package does not sufficiently ease the burden of the Medicare Accelerated and Advance Payment Program loan repayment,” Chip Kahn, president and CEO of FAH, said in a written statement. “It is critical that truly sustainable terms for loan repayment are provided by Congress.”

The bills’ proposed changes to Medicare advance payments, which effectively are loans that Medicare is scheduled to begin recouping in August through withholding of payments, include:

  • Extending the start of repayments from 120 days to 270 days after receipt of the loans
  • Extending the repayment period from 12 months to 18 months

“Time is running out for providers, and action is critical before hospitals lose 100% of Medicare fee-for-service payments,” Kahn wrote. “The Federation has been warning of this impending threat. With our countdown clock now just days away from hitting zero, it is vital that Congress act quickly before patient care is affected.”

Future provisions for telehealth

On telehealth, the legislation requires the Medicare Payment Advisory Commission to report by July 1, 2021, on how telehealth flexibilities affect access, quality and cost.

The legislation also would require the Department of Health and Human Services to post data on the use of telehealth throughout the pandemic and to provide legislative recommendations to Congress.

“This section ensures that Congress has a full analysis of the impact of expanded telehealth and the opportunity to legislate before flexibilities expire,” states a detailed summary of the bill.

FAH hailed the bill’s inclusion of liability protections, which hospitals have said they need to resume their full array of elective surgeries without facing the prospect of crippling lawsuits.

The bill would “protect frontline healthcare workers and hospitals from COVID-19 lawsuit abuse,” Kahn wrote.


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