In The News

HHS Announces the Availability of $25.5 Billion in COVID-19 Provider Funding

Combined application for American Rescue Plan rural funding and Provider Relief Fund Phase 4 will open on September 29

The Biden-Harris Administration announced today that the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making $25.5 billion in new funding available for health care providers affected by the COVID-19 pandemic. This funding includes $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children's Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.

"This funding critically helps health care providers who have endured demanding workloads and significant financial strains amidst the pandemic," said HHS Secretary Xavier Becerra. "The funding will be distributed with an eye towards equity, to ensure providers who serve our most vulnerable communities will receive the support they need."

Consistent with the requirements included in the Coronavirus Response and Relief Supplemental Appropriations Act of 2020, PRF Phase 4 payments will be based on providers' lost revenues and expenditures between July 1, 2020, and March 31, 2021. As part of the Biden-Harris Administration's ongoing commitment to equity, and to support providers with the most need, PRF Phase 4 will reimburse smaller providers—who tend to operate on thin margins and often serve vulnerable or isolated communities—for their lost revenues and COVID-19 expenses at a higher rate compared to larger providers. PRF Phase 4 will also include bonus payments for providers who serve Medicaid, CHIP, and/or Medicare patients, who tend to be lower income and have greater and more complex medical needs. HRSA will price these bonus payments at the generally higher Medicare rates to ensure equity for those serving low-income children, pregnant women, people with disabilities, and seniors.

Similarly, HRSA will make ARP rural payments to providers based on the amount of Medicaid, CHIP and/or Medicare services they provide to patients who live in rural areas as defined by the HHS Federal Office of Rural Health Policy. As rural providers serve a disproportionate number of Medicaid and CHIP patients who often have disproportionately greater and more complex medical needs, many rural communities have been hit particularly hard by the pandemic. Accordingly, ARP rural payments will also generally be based on Medicare reimbursement rates.

"We know that this funding is critical for health care providers across the country, especially as they confront new coronavirus-related challenges and respond to natural disasters," said Acting HRSA Administrator Diana Espinosa. "We are committed to distributing this funding as equitably and transparently as possible to help providers respond to and ultimately defeat this pandemic."

In order to expedite and streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application. HRSA will use existing Medicaid, CHIP and Medicare claims data in calculating payments. The application portal will open on September 29, 2021. To help ensure that these provider relief funds are used for patient care, PRF recipients will be required to notify the HHS Secretary of any merger with, or acquisition of, another health care provider during the period in which they can use the payments. Providers who report a merger or acquisition may be more likely to be audited to confirm their funds were used for coronavirus-related costs, consistent with an overall risk-based audit strategy. 

To promote transparency in the PRF program, HHS is also releasing detailed information - PDF (PDF - 175 KB) about the methodology utilized to calculate PRF Phase 3 payments. Providers who believe their PRF Phase 3 payment was not calculated correctly according to this methodology will now have an opportunity to request a reconsideration. Further details on the PRF Phase 3 reconsideration process are forthcoming.

Additionally, in light of the challenges providers across the country are facing due to recent natural disasters and the Delta variant, HHS is announcing today a final 60-day grace period to help providers come into compliance with their PRF Reporting requirements if they fail to meet the deadline on September 30, 2021, for the first PRF Reporting Time Period. While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate collection activities or similar enforcement actions for noncompliant providers during this grace period.

For more information about eligibility requirements, the documents and information providers will need to complete their application, and the application process for PRF Phase 4 and ARP Rural payments, visit: https://www.hrsa.gov/provider-relief/future-payments.

Announcement posted on: https://www.hhs.gov/about/news/2021/09/10/hhs-announces-the-availability-of-25-point-5-billion-in-covid-19-provider-funding.html

 

Recognizing RSV

More Than the Common Cold

News in Health

COVID-19 measures lessened how often we get sick from many other viruses. But one common virus has been on the rise this year. It’s called respiratory syncytial virus, or RSV.

RSV is usually more common in the fall, winter, and spring. But this year, infections have surged over the summer. This is likely because of the lifting of COVID-19 precautions, like masking and social distancing, says Dr. Barney Graham, a physician who studies viruses at NIH.

Almost everyone catches RSV before the age of 2. It’s one of the most common causes of illness in children. But unlike many other viruses that infect the lungs, you can catch RSV over and over again.

“RSV has a number of ways of evading the immune system,” says Graham. “So people are re-infected with RSV on average every three to 10 years.”

RSV infects the cells that line your lungs and breathing passages. Many symptoms mimic the common cold, like a runny nose, loss of appetite, and coughing or wheezing.

Symptoms usually stay mild in older children and adults. But some people are at risk of more serious disease. These include infants, older adults, and people with a weakened immune system.

Some people develop pneumonia or inflammation in the lungs from RSV. Watch for symptoms that get worse over time or trouble breathing or drinking fluids. People with these symptoms should see a health care provider right away. A blood test can show if you have RSV or another virus with similar symptoms. . . 

Read full article at https://newsinhealth.nih.gov/2021/09/recognizing-rsv

 

House committee proposes funding for long-term care worker retention

Modern Healthcare / By Jessie Hellmann
 
States could receive $1.6 billion in new funding from the federal government to help recruit and retain long-term care workers under a proposal released Tuesday by a key congressional committee.
 
The U.S. House of Representatives' Ways and Means Committee on Tuesday released the first of several bills it hopes to include in the $3.5 trillion healthcare, education and climate change package Democrats are working on.
 
Congressional Democrats plan to pass the package through budget reconciliation, meaning it doesn't need support from Republicans.
 
The committee's bills include several provisions aimed at improving care for people living in nursing homes after COVID-19 left thousands of residents dead.
 
Under the proposal, states could receive grant funding to help long-term care and post-acute care workers by giving them wage subsidies, helping with student loan repayments or tuition assistance for degrees or certifications in relevant fields, and offering them childcare access, paid leave and transportation. The proposal is aimed at home health aides, nurse aides, personal care aides, hospice aides, licensed practical nurses who work in nursing facilities, home health agencies, or for home-and-community based services organizations.
 
There's currently a shortage of long-term care workers in the U.S., which experts partially attribute to low pay and poor benefits. The industry is notorious for high turnover rates, which in turn lead to poorer patient outcomes.
 
The Ways and Means proposal also includes funding to beef up audits of nursing home reports sent to the Health and Human Services Department.
 
Under the provision, nursing homes that are found to have submitted inaccurate information can have their Medicare payment rates cut. HHS would also get more funding to audit skilled nursing facilities.
 
The bill would also fund a study to determine if staffing ratio requirements might be necessary.
 
The other bills released Tuesday by the committee would add dental, hearing and vision coverage to Medicare and build up a grant program that provides training to low-income individuals looking to enter the healthcare workforce.
 
The bill would provide funding to expand the Health Profession Opportunity Grant Program to train low-income individuals to enter the healthcare workforce and address shortages in rural and under-served areas.
 
The competitive grant program would be funded at $425 million per year and expanded to all 50 states. The program was initially created under the Affordable Care Act and it currently funds 32 organizations in 21 states at $85 million per year.
 
The committee will markup the proposals Thursday and Friday for potential inclusion in the $3.5 trillion package, which congressional Democrats hope to pass by the end of the month. The package is also expected to extend or make permanent Affordable Care Act subsidies for middle-income earners first passed earlier this year as part of a COVID-19 relief bill, expand Medicaid coverage of home-and-community-based services, close the Medicaid coverage gap in the 12 states that haven't accepted the ACA's Medicaid expansion and take aim at high drug prices.

 

Dem Aide: House Working From $150B HCBS Budget Set By Senate

Inside Health Policy / By Maya Goldman

House Democrats might now include closer to $150 billion for home- and community-based services, down from the $400 billion originally called for by President Joe Biden and the $250 billion reported to be in the offing last week, in their emerging reconciliation package, a senior Democratic aide indicated to Inside Health Policy Wednesday (Sept. 8).

The aide said the House heard from the Senate that their allotted number for HCBS was $150 billion. That’s the figure the House is working from, the aide said.

A different aide said last week (Sept. 2) that Senate advocates for the policy were pushing for a $250 billion investment in HCBS. Shannon McCracken, senior vice president of government relations for disability services provider ANCOR, said she believes HCBS advocates in the Senate are still advocating for $250 billion.

A third Democratic aide said last week that the numbers negotiated by Sens. Bernie Sanders (I-VT) and Mark Warner (D-VA) for the budget package make it difficult to fit all priorities into reconciliation instructions at full size.

The president initially called for a $400 billion investment in the Medicaid home care services. Advocates continue to push for the full amount, but representatives from ANCOR said they could deal with a $250 billion investment.

Accomplishing the intent of the policy wouldn’t be possible at $150 billion, though, McCracken said. She’s worried the money wouldn’t be enough to incentivize states to participate, or raise wages for home care providers, among other concerns.

Ady Barkan, the health care advocate who co-founded Be A Hero, launched a six-figure advertising campaign Wednesday (Sept. 8) to urge Congress to fully fund HCBS in reconciliation.

“This is the largest investment by a disability rights organization to urge Congress to fully fund HCBS ever. Millions of lives are at stake and Senators Sinema, Kelly, Manchin, Warner and the rest of Congress must hear why it is important to make this historic investment in home care,” Barkan said in a statement. -- Maya Goldman ([email protected])

 

Biden-Harris Administration to Expand Vaccination Requirements for Health Care Settings [Published by CMS]

New action will protect patients of the 50,000 providers and over 17 million health care workers in Medicare and Medicaid certified facilities

The Biden-Harris Administration will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities to protect both them and patients from the virus and its more contagious Delta variant.  Facilities across the country should make efforts now to get health care staff vaccinated to make sure they are in compliance when the rule takes effect.

The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), announced today that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs. The decision was based on the continued and growing spread of the virus in health care settings, especially in parts of the U.S. with higher incidence of COVID-19. 

“There is no higher priority for us than patient health and safety. As the Delta variant strengthens, the Biden-Harris Administration is committed to doing everything we can to keep patients, and those who care for them, safe,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health. Ensuring safety and access to all patients, regardless of their entry point into the health care system, is essential.”

Nursing homes with an overall staff vaccination rate of 75% or lower experience higher rates of preventable COVID infection. In CMS’s review of available data, the agency is seeing lower staff vaccination rates among hospital and End Stage Renal Disease (ESRD) facilities. To combat this issue, CMS is using its authority to establish vaccine requirements for all providers and suppliers that participate in the Medicare and Medicaid programs. Vaccinations have proven to reduce the risk of severe illness and death from COVID-19 and are effective against the Delta variant.  CMS will continue to work closely with all Medicare and Medicaid certified facilities to ensure these new requirements are met.

“We know that those working in health care want to do what is best for their patients in order to keep them safe,” said CMS Administrator Chiquita Brooks-LaSure.  “As the Delta variant continues to spread, we know the best defense against it lies with the COVID-19 vaccine. Data show that the higher the level of vaccination rates among providers and staff, the lower the infection rate is among patients who are dependent upon them for care. Now is the time to act. I’m urging everyone, but especially those fighting this virus on the front lines, to get vaccinated and protect themselves, their families, and their patients from COVID-19.”

CMS is developing an Interim Final Rule with Comment Period that will be issued in October.  CMS expects certified Medicare and Medicaid facilities to act in the best interest of patients and staff by complying with new COVID-19 vaccination requirements.  Health care workers employed in these facilities who are not currently vaccinated are urged to begin the process immediately. Facilities are urged to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.

Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov

 
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