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Facing COVID-19 surges, hospitals want additional money for the provider relief fund

Providers are also looking for full accelerated payment forgiveness for all hospitals, among other provisions.

Susan Morse, Managing Editor

As the number of COVID cases soars, hospitals in surge areas are again becoming overwhelmed, suffering from a shortage of beds, staff and certain personal protection equipment.

The number of daily cases is estimated at 100,000. More than 10 million people in the United States have been infected and over 240,000 have died.

For the first time, on Tuesday the number of people hospitalized with COVID-19 topped 60,000, according to the COVID Tracking Project.

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A shortage of healthcare workers has led to Indiana asking retired employees to return to work. Cases have become more widespread, reaching into more rural areas than the urban concentrations of the spring.

WHY THIS MATTERS

Last spring, hospitals got an initial $100 billion from a $2 trillion coronavirus stimulus bill to keep the economy, businesses and the unemployed afloat during the pandemic. Total relief funding rose to $175 billion for hospitals, including targeted distributions.

With the numbers continuing the rise, questions loom over a new relief bill.

Prior to the election, Republicans and Democrats couldn't come to an agreement, since they were far apart on the amount of funding. Further talks were postponed until after the election.

A new deal is possible, but both sides will likely remain in disagreement on the price tag. In a lame duck session, the balance of power in the Senate awaits the results of a runoff election in Georgia on January 5, where two seats will be decided. 

One Georgia race is between GOP Sen. Kelly Loeffler and Democratic challenger Raphael Warnock. The second race sees Republican incumbent Sen. David Perdue facing Democratic challenger Jon Ossoff. None of the candidates got the 50% majority needed in the regular election to decide the winner.

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.

WHAT HOSPITALS WANT

In the spring, the American Hospital Association and other providers called for more funding to keep the doors open for hospitals struggling from the loss of their bread-and-butter elective surgery revenue as the number of COVID-19 cases were rising. 

Patients are coming back for routine care and postponed elective surgeries. A Commonwealth Fund study found patient numbers are back to pre-pandemic levels, though not for all hospitals.

Telehealth visits were paid at parity for the duration of the public health emergency, and other virtual flexibilities have helped the bottom line.

Asked what is needed now, the AHA cited COVID-19 relief, including additional money for the provider relief fund. The organization did not give a figure.

Providers are also looking for federal liability protections, support for frontline healthcare workers, coverage for the uninsured and full accelerated payment forgiveness for all hospitals.

The AHA also supports an elimination of the cuts to the Medicaid disproportionate share hospital program in the next fiscal year and an extension of the congressionally enacted moratorium on the application of the Medicare sequester cuts until the public health emergency ends.

The American Medical Association this week released a public service announcement to promote three key actions as COVID-19 cases spike: handwashing, physical distancing and mask wearing.

"Physicians are particularly concerned by the latest spike in cases, especially as it coincides with the start of flu season," the AMA said. "Over the past week, there have been more than 100,000 new COVID-19 cases per day. The significant increase in new cases worsens shortages of personal protective equipment, tests and testing supplies and further stretches hospitals' intensive care unit capacity in many states."

THE LARGER TREND

Senate Majority Leader Mitch McConnell said this week he believes Congress needs to pass a highly targeted coronavirus relief deal, similar to the roughly $500 billion GOP bill that was blocked earlier this year, according to The Hill. House Democrats initially passed a $3.4 trillion bill before dropping their price tag to $2.2 trillion, according to the report. Senate Republicans initially offered a $1.1 trillion package before dropping to roughly $500 billion amid pushback from conservatives.

The Senate Committee on Appropriations this month released all 12 of its fiscal year 2021 funding measures, including the appropriations bill for the departments of Labor, Health and Human Services, and Education, and related agencies.

The bill would provide $96.3 billion in discretionary funding for the Department of Health and Human Services, an increase of $1.9 billion over FY 2020.

It includes $4.2 billion for public health preparedness, a $161 million increase. This would go towards investments in programs that help communities and hospitals prepare for, respond to, and recover from public health and medical disasters and emergencies, including natural disasters, pandemic diseases and human-made threats. Since 2015, the Senate Finance Committee has increased public health preparedness funding by $1.4 billion, or nearly 50%.

Other increases include $2 billion more in discretionary funding for the National Institutes of Health, $194 million more for mental health programs, $88 million more to combat the opioid epidemic, $161 million more for public health preparedness, $15 million more for Children's Hospitals Graduate Medical Education and $7 million more for rural health.

ON THE RECORD

AMA President Dr. Susan R. Bailey said, "Cases are at record highs across the country, and with the holidays quickly approaching, each of us must do everything possible to reduce the spread of COVID-19. Failing to do our part will prolong the suffering and disruption to our lives, and inevitably lead to more deaths of our friends, neighbors and loved ones."
 

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com