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June 9, 2020

HHS announces Medicaid-only Provider Relief Fund tranche. At long, long, long last, it is official. Medicaid-only providers are in line for funding from the Provider Relief Fund under the Coronavirus Aid, Relief, and Economic Security Act. According to a news release from the Department of Health and Human Services (HHS), the agency will open a portal tomorrow through which Medicaid providers can apply for a portion of the $15 billion that HHS set aside for them. HHS does not list all Medicaid-only providers who can participate. Instead, they are defined simply by having billed Medicaid or Medicaid managed care between January 1, 2018, and May 31, 2020, and not receiving a payment under the General Distribution, otherwise known as tranches 1 and 2. Those tranches were limited to Medicare providers, but did take into account their Medicaid and other revenue. HHS provides some non-exclusive examples of providers who will receive payments from this tranche: "pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities, and other home and community-based services providers." Although not specifically listed, ICFs/IID clearly meet the general definition of Medicaid-only providers.

HHS indicates they will use the portal to gather information needed to make payments to the eligible providers, including patient revenue data. HHS suggests that the payments will be at least 2% of each provider's annual patient revenue, but leaves wiggle room for adjustments to that formula. The release also does not specify how long after a provider enters their data into the portal their payment will be made, although as we reported yesterday, HHS is under heavy pressure to disburse the money quickly. As with previous tranches, HHS requires recipients of funding to agree to Terms and Conditions.

CMS issues CMPs related to NHSN reporting. Today, OHCA SNF members began to report that they received notices from the Centers for Medicare and Medicaid Services (CMS) of citations under F884 and civil money penalties (CMPs) for not reporting COVID-19 data to the National Healthcare Safety Network (NHSN). There are somewhere between 1,000 and 2,000 centers nationwide that did not report. Although one OHCA member submitted an incorrect file type, others explain to us that they were unable to get registered for NHSN or to submit data for technical reasons. This is a developing story, and we will inquire of AHCA how members best should address the CMPs.

FDA pulls in reins on decontaminating certain respirators. The Food and Drug Administration (FDA), which allows decontaminating and re-using N95 respirators under certain circumstances, issued a press release withdrawing approval for decontamination of certain respirators because they do not fare well in the process. If you utilize a decontamination process for N95s, you should review the press release and accompanying links to make sure your respirators are appropriate for decontamination.

AHCA payment rule comments focus on COVID-19. This year, CMS proposed a clean SNF payment rule, meaning that the proposed rule does not seek to roll back the market basket increase (other than the statutorily-required adjustments) or to recalibrate the Patient-Driven Payment model. In filing comments on the proposed rule, AHCA pointed out a number of ways that COVID-19 affects assumptions and structures in the overall SNF payment system. These items include, for example, the MDS-based definition of isolation, the composition of the market basket, and inclusion of COVID-19 testing in consolidated billing.