Category: Health Care

Webinar Series: State of the Healthcare Industry: Market Updates for Rural Strategy

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NOSORH, in partnership with Stroudwater Associates, announces and invites you to participate in a series of quarterly market updates for rural healthcare stakeholders to stay current on the changes in the healthcare marketplace in order to strategize responses to ensure vital services for rural communities.

By the end of these sessions, participants will be able to:

  • Describe the current market dynamics of the healthcare industry
  • Evaluate the effects of these trends on rural providers
  • Apply this understanding to their own organization

Who:

State Offices of Rural Health, rural hospitals, primary care practices, non-profit organizations, rural philanthropy organizations, policymakers, government agencies, and other rural health stakeholders will gain from the insight and discussion provided during these unique quarterly updates.

When:

Quarterly at 2:00 pm ET

  • July 15, 2020
  • Oct 27, 2020
  • Jan 26, 2021
  • April 27, 2021
  • July 27, 2021

Presenter:

Eric K. Shell

Director and Chairman

Stroudwater Associates

HHS Posted Reporting Guidance for Provider Relief Funds

Reporting Requirements and Auditing

All recipients of Provider Relief Fund (PRF) payments are required to comply with the reporting requirements described in the Terms and Conditions and specified in future directions issued by the Secretary.

For Recipients of Payments more than $10,000

Final Reporting Data Elements – PDF: This document provides the complete, detailed information on provider reporting guidelines, including intent, use of funds, and data elements requested. The purpose of this notice is to inform Provider Relief Fund (PRF) recipients that received one or more payments exceeding $10,000 in the aggregate of the data elements that they will be required to report as part of the post-payment reporting process. This is a supporting document to the July 20, 2020 Post-Payment Notice of Reporting Requirements (General and Targeted Distribution Post-Payment Notice of Reporting Requirement – PDF). The reporting system will now be available in early 2021.

Please note that these reporting requirements do not apply to the Nursing Home Infection Control distribution or the Rural Health Clinic Testing distribution. Separate reporting requirements will be announced for these distributions. These reporting requirements also do not apply to reimbursement from the Health Resources and Services Administration (HRSA) Uninsured Program. Additional reporting may be announced in the future for these payments.

Auditing

The recipients of Provider Relief Fund payments may be subject to auditing to ensure the accuracy of the data submitted to HHS for payment. Any recipients identified as having provided inaccurate information to HHS will be subject to payment recoupment and other legal action. Further, all recipients of Provider Relief Fund payments shall maintain appropriate records and cost documentation including, as applicable, documentation described in 45 CFR § 75.302 – Financial management and 45 CFR § 75.361 through 75.365 – Record Retention and Access, and other information required by future program instructions to substantiate that recipients used all Provider Relief Fund payments appropriately.

Upon the request of the Secretary, the recipient shall promptly submit copies of such records and cost documentation and the recipient must fully cooperate in all audits the Secretary, Inspector General, or Pandemic Response Accountability Committee conducts to ensure compliance with applicable Terms and Conditions. Deliberate omission, misrepresentation, or falsification of any information contained in payment applications or future reports may be punishable by criminal, civil, or administrative penalties, including but not limited to revocation of Medicare billing privileges, exclusion from federal health care programs, and/or the imposition of fines, civil damages, and/or imprisonment.

For more details, please refer to the Terms and Conditions associated with each payment distribution and the Reporting Requirements and Auditing FAQs.

https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/reporting-auditing/index.html

post-payment-notice-of-reporting-requirements 9.19.20.pdf

CMS Announces Innovative Models for the Care of Chronic Kidney Disease and Cancer Patients

September 18, 2020

The Centers for Medicare & Medicaid Services (CMS) finalized the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model, to improve or maintain the quality of care and reduce Medicare expenditures for patients with chronic kidney disease. The ETC Model delivers on President Trump’s Advancing Kidney Health Executive Order and encourages an increased use of home dialysis and kidney transplants to help improve the quality of life of Medicare beneficiaries with ESRD. The ETC Model will impact approximately 30 percent of kidney care providers and will be implemented on January 1, 2021 at an estimated savings of $23 million over five and a half years.

Additionally, CMS finalized a new Innovation Center model expected to improve the quality of care for cancer patients receiving radiotherapy and reduce Medicare expenditures through bundled payments that allow providers to focus on delivering high-quality treatments. The new Radiation Oncology (RO) Model allows this focus on value-based care by creating simpler, more predictable payments that incentivize cost-efficient and clinically effective treatments to improve quality and outcomes. The RO Model, part of a final rule on specialty care models issued by CMS, will begin on January 1, 2021 and is estimated to save Medicare $230 million over 5 years.

For a fact sheet on the ETC Model, please visit: https://www.cms.gov/newsroom/fact-sheets/end-stage-renal-disease-treatment-choices-etc-model-fact-sheet. More information on the model is available at: https://innovation.cms.gov/initiatives/esrd-treatment-choices-model.

For a fact sheet about the RO Model, please visit: https://www.cms.gov/newsroom/fact-sheets/radiation-oncology-ro-model-fact-sheet. More information on the Model is available at: https://innovation.cms.gov/initiatives/radiation-oncology-model/.

Independent Nursing Home COVID-19 Commission Findings Validate Unprecedented Federal Response

September 17, 2020

The Centers for Medicare & Medicaid Services (CMS) has received the final report from the independent Coronavirus Commission for Safety and Quality in Nursing Homes (Commission), which was facilitated by MITRE. CMS also released an overview of the robust public health actions the agency has taken to date to combat the spread of the coronavirus disease 2019 (COVID-19) in nursing homes. The Commission’s findings align with the actions the Trump Administration and CMS have taken to contain the spread of the virus and to safeguard nursing home residents from the ongoing threat of the COVID-19 pandemic. Yesterday’s announcement delivers on the Administration’s commitments to keeping nursing home residents safe and to be transparent for the American people in the face of this unprecedented pandemic.

“The Trump Administration’s effort to protect the uniquely vulnerable residents of nursing homes from COVID-19 is nothing short of unprecedented,” said CMS Administrator Seema Verma. “In tasking a contractor to convene this independent Commission comprised of a broad range of experts and stakeholders, President Trump sought to refine our approach still further as we continue to battle the virus in the months to come. Its findings represent both an invaluable action plan for the future and a resounding vindication of our overall approach to date. We are grateful for the Commission’s important contribution.”

As the capstone to the Commission’s extensive report, Administrator Verma will join Vice President Mike Pence and the Centers for Disease Control and Prevention (CDC) Director Dr. Robert R. Redfield, some members of the Commission, and other public health and elder care experts at the White House. The Vice President, Dr. Redfield and Administrator Verma will lead the group in a discussion regarding the Commission’s findings and general issues facing the nation’s elder care system.

Nursing homes and other shared or congregate living facilities have been severely affected by COVID-19, as these facilities often house older individuals who suffer from multiple medical conditions, making them particularly susceptible to complications from the virus. To help CMS inform immediate and future actions, as well as identify opportunities for improvement, the Commission was created to conduct an independent review and comprehensive assessments of confronting COVID-19. The Commission’s report contains best practices that emphasize and reinforce CMS strategies and initiatives to ensure nursing home residents are protected from COVID-19.

As outlined in the released overview, the Trump Administration has already taken significant steps to implement many of the Commission’s findings. The Administration has worked to support nursing homes financially during this challenging time, distributing over $21 billion to America’s nursing homes – more than $1.5 million each on average. To ensure nursing homes had access to supplies, the Trump Administration shipped a 14-day supply of personal protective equipment (PPE) to more than 15,000 nursing homes across the Nation in May.

The Administration has also required facilities to report data about COVID-19 cases, deaths, and supply levels, with 99.3 percent of facilities currently reporting. CMS took action to keep COVID-19 out of nursing homes by requiring them to test staff, a requirement that was paired with the Administration’s distribution of 13,850 point-of-care testing devices to America’s nursing homes. The Administration has also deployed federal Task Force Strike Teams in six waves, in 18 states so far, to 61 facilities particularly affected by COVID-19 to share best practices and gain a deeper understanding of how the virus spreads. CMS also required states to conduct focused infection control inspections at their nursing homes; between June and July, states completed these inspections at 99.8 percent of Medicare and Medicaid certified nursing homes.  

Additionally, since March, CMS has conducted weekly calls with nursing homes, issued over 22 guidance documents and established a National Nursing Home COVID-19 Training program focused on infection control and best practices. CMS is also using COVID-19 data to target support to the highest risk nursing homes. In May, CMS released a new toolkit developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to nursing homes. The toolkit is a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19. CMS updates the toolkit on a biweekly basis.

To view the full independent Coronavirus Commission for Safety and Quality in Nursing Homes report, visit here:  cms.gov/files/document/covid-final-nh-commission-report.pdf

To view the Trump Administration Response to Commission findings, visit here: cms.gov/files/document/covid-independent-nursing-home-covid-19-federal-response.pdf

To view the COVID-19 Guidance and Updates for Nursing Homes during COVID-19, visit here: cms.gov/files/document/covid-guidance-and-updates-nursing-homes-during-covid-19.pdf