The Trump administration has no plans to delay implementation of its hospital price transparency rule on Jan. 1, a White House official said.
Hospitals have implored the Trump administration to delay the January 2021 implementation of hospital price transparency requirements, but the White House does not appear to be backing down.
A White House official said that the administration already delayed implementation when HHS published the final rule and pushed the deadline to Jan. 1.
“As of right now we have no plans to delay implementation further,” the official said.
Hospital groups including the American Hospital Association, Federation of American Hospitals, Association of American Medical Colleges and Children’s Hospital Association in June wrote to HHS Secretary Alex Azar arguing the rule would be burdensome for hospitals to adhere to amid the COVID-19 pandemic and asked HHS to delay implementation until after the rule’s legality is settled by the courts.
“Even attempting to comply with the rule will require a significant diversion of financial resources and staff time that hospitals and health systems cannot afford to spare as they prepare to or care for patients with COVID-19,” the hospital groups wrote.
Oral arguments before the U.S. Court of Appeals for the District of Columbia Circuit are set for Oct. 15. A District Court judge upheld the rule in June.
Instead of acceding to hospitals’ demands for a delay, President Donald Trump signed an executive order that requires CMS to make data on compliance with the price transparency rule publicly available in March.
“At this point hospitals have shown they want to fight us tooth and nail in court and we think the statutory grounding is sound,” the White House official said.
Source: White House sticks to Jan. 1 hospital price transparency deadline
The Cleveland Clinic came under fire Friday after President Donald Trump announced that he and Melania Trump tested positive for COVID-19, days after participating in a presidential debate held on the clinic’s campus.
Numerous media reports and photos showed the Trump family not wearing masks while in attendance at the debate, which was held Sept, 29 at the Sheila and Eric Samson Pavilion at the Health Education Campus at Case Western Reserve University and the Cleveland Clinic. The president and first lady went into quarantine Oct. 1, after one of the president’s closest advisors, Hope Hicks, tested positive for COVID-19.
Ohio Gov. Mike DeWine on July 23 implemented a statewide mask mandate requiring individuals to wear masks in public if indoors and not at a residence, unless a medical condition prohibits it. Likewise, the clinic requires all caregivers, patients and visitors to its campus wear masks unless a health or behavioral issue prevents it.
Cleveland Clinic in July was chosen as a site for the first presidential debate after the University of Notre Dame withdrew over COVID-19 concerns. The clinic serves as the health security advisor for the Commission on Presidential Debates’ fall debates. Health and safety plans developed for the first debate will guide future debates, the clinic said.
During the first debate, Cleveland Clinic and Case Western Reserve University said they took many precautions, including distancing between seats, personal health screening and safety measures and disinfectant measures. Reporters at the debate said a clinic doctor tried to get the Trump family to wear masks but was rejected.
In a statement released Friday, the Cleveland Clinic said it had safety requirements in place for social distancing, hand sanitizing, temperature checks and masking and that everyone allowed inside the debate hall had a negative COVID-19 test.
“Based on what we know about the virus and the safety measures we had in place, we believe there is low risk of exposure to our guests,” the clinic said.
The health system plans to reach out to those who were in attendance out of caution.
The commission did not immediately respond to requests for comment.
The Centers for Disease Control and Prevention recommends wearing masks in public, as do most healthcare associations, including the American Hospital Association, to prevent the spread of COVID-19.
The AHA, in partnership with the American Medical Association and the American Nurses Association, are running a Wear a Mask campaign, urging people “to follow science: continue social distancing, washing hands for at least 20 seconds, and most importantly, to wear a face covering when outside the home.”
In April, the Mayo Clinic also was criticized after Vice President Mike Pence refused to wear a mask while visiting with patents and staff. Mayo had put a mask requirement in place earlier that month for all patients and visitors. The vice president later publicly acknowledged that he should have worn a mask.
Trump has repeatedly refused to wear a mask in public, and his supporters booed Ohio Lt. Gov. Jon Husted during a campaign rally in Dayton Sept. 21 when the Republican encouraged mask usage.
In the U.S., there have been 7,213,419 cases of COVID-19 and 206,402 deaths, as of Oct. 1, according to the latest CDC data.
Source: Cleveland Clinic under the microscope after Trump tests positive for COVID-19
California Gov. Gavin Newsom Tuesday signed two bills into law requiring healthcare providers to create stockpiles of personal protective equipment or face up to $25,000 in fines per violation.
The most immediate impact will be felt on general acute-care hospitals, which must build up a three-month supply of PPE by April 1, 2021. A second bill Newsom signed, S.B. 275, requires providers, including hospitals, clinics and home health agencies, to create a 45-day supply and the California Department of Public Health to have a 90-day stockpile by June 1, 2023, or one year after the adoption of the regulations, whichever is later.
“Unfortunately, in signing both bills about personal protective equipment supply, the administration has created double jeopardy for hospitals—subjecting them to disparate requirements and penalties,” Carmela Coyle, president and CEO of the California Hospital Association said in a statement. “But, as always, California’s hospitals stand ready to work together with others on the front lines of COVID to find meaningful, long-term solutions to increase the availability of appropriate personal protective equipment to keep patients and workers safe.”
SEIU-United Healthcare Workers West and the California Nurses Association backed the legislative efforts.
“This law will make sure we will never be caught off-guard again when a pandemic or other health emergency hits our state,” Jessica Rodriguez, an emergency department technician at Kaiser Oakland, said about S.B. 275 in a SEIU press release. “Too many healthcare and other essential workers have gotten sick and needlessly died because we did not have the supplies of PPE we desperately needed to treat COVID-19 patients. Many lives will be saved because of this new law.”
Earlier this month, Jan Emerson-Shea, vice president of external affairs for CHA, told Modern Healthcare that the April 1 deadline will be “complicated by the continuing global supply shortage and the fact that we will likely still be in the midst of the pandemic.”
Source: New California laws will force providers create PPE stockpiles
By a narrow 214-207 margin, House Democrats passed a $2.2 trillion stimulus bill on Thursday called the HEROES Act. 2.0, essentially a slimmer version of the $3 trillion HEROES Act that was passed in May and blocked by Republicans due to the cost.
The new measure includes another $50 billion in provider relief funds and improvements to Medicaid disproportionate share hospital (DSH) funding. It aims to address hardships caused by the COVID-19 pandemic by including a second round of $1,200 stimulus checks and extended $600 weekly unemployment benefits, as well as emergency funds for state and local governments totaling $436 billion.
On top of that, it allocates $225 billion for schools and childcare and Paycheck Protection Program funding. It also includes assistance for airlines and the restaurant industry.
Also included is a $100-per-month increase in SNAP benefits in most states, rental assistance and an Affordable Care Act premium subsidy. That means those who have lost jobs during the COVID-19 pandemic would be eligible for the maximum health insurance premium subsidy under the ACA, a $1,386 benefit.
The bill passed the House despite opposition from 18 Congressional Democrats.
Ultimate passage seems unlikely, however. Newsweek reported that Senate Majority Leader Mitch McConnell has signaled doom for the new package in the Senate, with Republicans in favor of a much smaller, $500 billion package. That’s about half of the $1 trillion they had proposed for their HEALS Act legislation.
WHY THIS MATTERS
The bill matters to hospitals, especially those caring for a large share of Medicaid patients.
“With the addition of $50 billion in Provider Relief Fund aid and improvements to Medicaid disproportionate share hospital (DSH) funding, this bill would help ease the heavy financial pressures our hospitals face. We also welcome the bill’s recognition of the need to account for race, ethnicity, gender, and other demographic data to reduce persistent disparities in health, such as those amplified by the pandemic,” Beth Feldpush, senior vice president of Policy and Advocacy for America’s Essential Hospitals said.
Pelosi has spent the week trying to negotiate an agreement with Treasury Secretary Steve Mnuchin, the main GOP negotiator, and according to Politico the two are still in talks, with some hope that a deal could be reached today. Today is the final day the House is slated to be in Washington before returning home to campaign for the upcoming election, though Democratic leaders said they would keep lawmakers at the Capitol through the weekend if a deal is close to fruition.
McConnel has signaled little hope for a new deal.
THE LARGER TREND
A legislative relief package passed the House in May, but at an estimated cost of $3.5 trillion, the original HEROES Act got nowhere in the Senate. That bill also proposed providing subsidies for laid-off workers to remain on their employer-provided health insurance plans through COBRA, the Consolidated Omnibus Budget Reconciliation Act that extends benefits, and would have created an open enrollment period for plans under the Affordable Care Act.
Other relief has been in the form of regulatory measures, the biggest being the flexibility to use telehealth.
ON THE RECORD
“In a family of four, this is a lifeline for workers and families who are facing this coronavirus disaster,” said House Speaker Nancy Pelosi in a floor speech on Thursday. “For a family of four earning $24,000, Heroes 2 would mean direct payments, a $3,400 direct payment; unemployment benefits, $600 per week enhanced UI benefits; tax credits, up to $5,920 through the EITC and a fully refundable $4,000 (Child) Tax Credit, equaling additional $1,200 in refunds.”
Source: House passes $2.2 trillion HEROES Act 2.0, including $50 billion in provider relief funds
We’ve seen a similar trend with the pharmaceutical industry, with drug manufacturing slowly moving out of the U.S. As of August 2019, only 28% of the manufacturing facilities making active pharmaceutical ingredients, or APIs, to supply the U.S. were in America. time
The remaining 72% were overseas, and 13% were in China, which has doubled its number of registered facilities making APIs between 2010 and 2019.
U.S. manufacturers are struggling to compete, and we’ve allowed it to happen. Instead of building our own supply chain of American-made PPE and pharmaceuticals, we turned a blind eye to the problem and accepted China’s dominance.
Not only did our reliance on China fail us during this pandemic, it has broader implications for our safety and economic success.
In July, Federal Emergency Management Agency Administrator Pete Gaynor called our reliance on overseas suppliers “a national security issue,” and testified to Congress that, “PPE and lifesaving equipment is just as important as building an aircraft carrier. We need to have that capacity here in the United States. We cannot rely on peer competitors to manage our destiny.”
He’s right. We can’t forget that relying on China for critical supplies means putting our health and security in the hands of a nation that wants to be the dominant world power. Their success depends on our failure. And since the Communist Party controls every company in China, every time we buy their supplies we are supporting a regime that is stealing our technology and intellectual property, building up their military to compete with us, abusing human rights, stripping Hong Kong residents of their freedoms and threatening Taiwan.
We have to stand up and say that we, as Americans and freedom-loving people, are better than this.
President Donald Trump did the right thing by enacting the Defense Production Act to compel U.S. companies to begin manufacturing PPE. But we have a long way to go.
We need to build up domestic manufacturing. As Florida’s governor, I focused on keeping taxes low for manufacturers and eliminated the sales tax on capital equipment. In the Senate, I’m working to pass a bill that will help build the national stockpile of goods from American-based producers and remove China from the U.S. supply chain.
All of us, whether in the healthcare industry or not, need to recognize the threat of China and start taking real steps to stop relying on our adversaries and focus on supplies and products “Made in America.”
The future of our nation and the health and safety of our people depend on our action.
Source: It’s time we stop relying on our adversaries for critical medical supplies
Carilion Clinic in Roanoke, Va., had been planning to roll out a multipronged digital front door strategy over the next 24 months. Power
But as COVID-19 cases mounted in the spring, executives realized they needed to move faster.
Executives in healthcare for years have been discussing the so-called “digital front door,” wanting to use new technologies to engage patients outside a facility’s walls. But with many health systems compelled to restrict patients from walking into their actual physical front doors at the height of the COVID-19 pandemic, executives had to revisit those plans, pushing out new chatbot symptom checkers and at-home virtual visits.
COVID-19 “hasn’t changed our thinking” about patient-centered care, said Nancy Agee, Carilion Clinic’s CEO. But it has accelerated “how far and how fast” the system moved toward implementing tasks already on its to-do list.
Agee is in good company. Seventy-three percent of CEOs in Modern Healthcare’s Power Panel survey said their focus on consumerism increased amid COVID-19, with the remaining 27% saying their focus stayed the same.
At Carilion Clinic, that included expanding the roster of tools that patients use to connect with the system online, such as rolling out options to self-schedule appointments and pay bills. And Carilion is developing an app, dubbed MyCarilion, which will centralize where patients access those services as well as educational videos, directions to facilities and on-demand telehealth.
Across the board, telehealth has played a major role in how health systems are keeping patients outside of the hospital, but still connected to their care team.
All CEOs who responded to Modern Healthcare’s Power Panel survey indicated they’d increased their telehealth investments during the pandemic. CEOs are chosen to participate in the survey.
Dartmouth-Hitchcock Health in Lebanon, N.H., was averaging just three telehealth visits per week before COVID-19 hit; at the height of the pandemic, it was conducting up to 2,000 virtual visits a day. To make sure patients were prepared for a telehealth visit, medical assistants called patients the day before their appointment to walk them through the process and how to use the technology.
Even if telehealth use slows as the pandemic subsides, as some experts predict will happen, it’ll still be a powerful option for patients, said Dr. Joanne Conroy, Dartmouth-Hitchcock Health’s CEO. In the health system’s territory in New Hampshire and Vermont, telehealth could prove a useful tool to avoid missed patient appointments during snow storms, she said.
“People appreciated the importance of virtual everything during the pandemic,” she said. “I don’t think all of that is going to go away.”
Moving forward, Dartmouth-Hitchcock sees telehealth as a market opportunity. The health system is working to create a direct-to-consumer urgent-care telehealth program, which could help to attract new patients, according to Conroy. The program, which is still being developed, will initially roll out to the health system’s employees, who will provide feedback.
Source: CEO Power Panel: Strategies for consumer-centered care shift amid COVID-19