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AHA asks HHS for more COVID-19 flexibilities for providers

One request is for commercial plans to cover all approved COVID-19 therapies without prior authorization and to reimburse hospitals for costs.

Mallory Hackett, Associate Editor

In a letter sent today by the American Hospital Association to Department of Health and Human Services Secretary Alex Azar, the provider organization asked for more flexibilities to be granted to providers as they continue to respond to the COVID-19 pandemic.

The AHA said that, while it recognized some of the previous flexibilities granted by HHS and the Centers for Medicare and Medicaid Services, it urged more.

Regulatory requirements, like routine compliance surveys and quality data reporting, take providers away from patients – something that cannot happen as healthcare organizations respond to the public health emergency, the AHA said.

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Provider flexibilities are especially important now as COVID-19 cases, hospitalizations and deaths rise across the country, the letter said.


The AHA asked HHS and CMS to take specific actions, including: suspending requirements such as routine survey process and quality data reporting; removing the threat of penalties for hospitals that don't send daily COVID-19 data reports; encouraging the Health Resources and Services Administration and other agencies to cross-train healthcare workers to allow currently underutilized personnel to fill holes in the COVID-19 response; a coordinated approach to support childcare and other frontline workers through ride-sharing, temporary housing and bonuses; and to consider adding additional targeted distributions to hospitals.

It asked CMS to expand the physician supervision requirement waiver to include nurse practitioners in order to help reduce nationwide staffing shortages. It also wants CMS to finalize proposals from the Medicare physician fee schedule rule to allow for direct supervision flexibility and the retention of additional telehealth services until the end of the public health emergency.

In the physician fee schedule final rule released Tuesday night, CMS is allowing non-physician practitioners to practice at the top of their license and is expanding the number of allowed telehealth services, though Congressional action is needed to allow many of these virtual services beyond rural areas.

The association for hospitals also wants a delay in the implementation of CMS's price transparency rule that's scheduled to go into effect on January 1, 2021. This is so providers can focus their resources on treating patients with COVID-19, the AHA said.

It wants the removal of administrative and financial barriers to COVID-19 coverage for all individuals; coordination with the Department of Defense and other agencies to provide staffing relief for hard-hit hospitals; and an end to restrictions that limit access of 340B drug discounts.

It also requests a requirement for commercial plans serving the Medicare Advantage and federal health insurance marketplace to cover all approved or authorized COVID-19 therapies without prior authorization and to reimburse them at rates that cover the cost of drug acquisition, handling and administration.


As a part of the $2 trillion coronavirus stimulus package that was passed in the spring, hospitals got $175 billion in relief funding, including targeted distributions.

Congress continues to go back and forth on passing another relief bill due to bipartisan disagreements. Senate Majority Leader Mitch McConnell reportedly yesterday shot down a new $908 billion stimulus plan.

House Democrats initially passed a $3.4 trillion bill before dropping their price tag to $2.2 trillion in October. Senate Republicans initially offered a $1.1 trillion package before dropping to roughly $500 billion amid pushback from conservatives.

A Senate runoff election in Georgia on January 5 could be the deciding factor in the two sides coming to an agreement. Republicans now hold 50 seats in the Senate going into 2021. Fifty-one seats are needed for a Republican majority, since Vice President-elect Kamala Harris would be the tie-breaking vote for Democrats.

Providers have continued to ask for more support in the form of financial relief, federal liability protections, support for frontline healthcare workers, coverage for the uninsured and full accelerated payment-forgiveness for all hospitals.


"These regulatory requirements are taking caregivers away from patients," the AHA said in its letter. "These and other regulatory relief efforts will be critical to continue as our members respond to this emergency. And, while the recent good news around several vaccine candidates is encouraging, we cannot lose sight of the difficulties that lie ahead in the upcoming weeks and months. Prior to widespread distribution and administration of an effective vaccine or vaccines, providers need more assistance in managing and responding to the public health emergency."

Twitter: @HackettMallory
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