Hospital advocates urged immediate withdrawal of new requirements to immediately begin reporting test results and other COVID-19 data to HHS.
Emergency regulations from CMS require hospitals and critical access hospitals to report results daily, including:
- The number of confirmed or suspected COVID-19-positive patients
- The number of occupied ICU beds
- Availability of “essential supplies and equipment,” such as ventilators and personal protective equipment (PPE)
Many hospitals already voluntarily report the information, but CMS said doing so will be required “to support broader surveillance of COVID-19.” The new rules make reporting a requirement of participation in Medicare and Medicaid. Hospitals not meeting the requirements will be warned and then face loss of Medicare payments and possible termination from Medicare and Medicaid eligibility.
But the new requirements came as a surprise to hospital advocacy groups.
“…a new heavy-handed regulatory approach put forward by the administration threatens to expel hospitals from the Medicare program,” Rick Pollack, president and CEO of the American Hospital Association, said in a written statement. “This disturbing move, announced in final form without consultation, or the opportunity to provide feedback through appropriate administrative procedures prior to it becoming effective, could jeopardize access to care and leave patients and communities without vital health services from their local hospital during a pandemic.”
Similarly, Chip Kahn, president and CEO of the Federation of American Hospitals, wrote in a tweet that the new requirements were “not vetted” and “blindsides industry.”
Both organizations urged immediate reversal of the new rule.
In March, the Trump administration wrote all hospitals to request the results of COVID-19 tests performed in their in-house laboratories, seeking to better understand and track disease patterns.
“CMS’s new rules require such reporting of test results in order to ensure a more complete picture in the nationwide surveillance of COVID-19, as well as a more efficient allocation of PPE and other vital supplies,” a CMS release states.
Additional requirements included
Other COVID-19 requirements of the rule include:
- Testing nursing home staff for COVID-19
- Offering tests to nursing home residents
- Reporting of daily COVID-19 test results by laboratories
Both labs and nursing homes face fines for not meeting the reporting requirements. All labs testing for COVID-19, including hospital labs, were given a three-week grace period to begin reporting the required data.
CMS is also revising previous policies that paid for repeated COVID-19 testing of Medicare beneficiaries without practitioner orders. Going forward, each beneficiary can receive one COVID-19 test without a physician or other clinician order, with orders required for subsequent tests.
“This change helps ensure that beneficiaries receive appropriate medical attention if they need multiple tests,” the release states. “It is also designed to stop fraudsters from performing or billing for unnecessary tests.”
Medicare will pay for tests ordered by a pharmacist or other healthcare professional authorized under state law. Medicare usually pays for services of pharmacists and certain other healthcare professionals only when they have an arrangement with a physician or other billing practitioner. During the public health emergency, Medicare will continue to pay for tests ordered without such an arrangement.
CMS is accepting comment on the new rule for 60 days after it is published in the Federal Register. Details on submitting comments are located in the rule.