MiraMed Global Services Podcast

On January 20, CMS directed its surveyor agents to significantly relax their scope of operations within the hospital setting for 30 days from the issuance of the directive.  Moreover, this temporary guidance is subject to possible renewal involving additional 30-day periods.  The move was sparked, in part, by a request from the American Hospital Association (AHA) to eliminate or severely restrict surveying activities during the pandemic.  In response, CMS has announced that, during this initial 30-day period, it will be suspending certain hospital surveying activities .

Numerous studies have demonstrated that about one quarter of healthcare spending amounts to waste.  This is an astounding figure.  Imagine how a hospital’s financial health could be bettered by simply trimming this fat. 

By way of background, the Department of Health and Human Services (HHS) had previously published a set of reporting instructions that would apply to those receiving PRF funds in excess of $10,000 in the aggregate.  The Department had originally planned on opening a reporting portal by January 15, 2021, and had set February 15, 2021 as the first deadline for submissions.  However, with the passage of the Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act in December, an additional $3 billion was added to the PRF program fund.  This, along with the inclusion of new language within CRRSA implicating PRF reporting requirements, created new roadblocks to the original timeline.

On Friday, January 8, the Department of Health and Human Services (HHS) issued a final rule, to be known as the Securing Updated and Necessary Statutory Evaluations Timely (SUNSET) rule. Essentially, the rule builds on the efforts of previous administrations—going all the way back to the Carter presidency—to review and improve the federal regulation process. The broad-stroke take on this latest government effort is that there will be a mandated decadal review of certain health-related regulations; and—here’s the kicker—if the government fails to review a particular regulation, it goes off the books.

With the recent promotion and extension of virtual medicine, including telehealth services, many hospital workers are wondering: when is it appropriate to utilize telehealth in this determination process? Is there a checklist that makes the decision to go virtual more supportable?

While millions of Americans have been stuffing wrapping paper and ribbons in the trash or heading to the store to return or exchange unwanted gifts, the federal government has delivered one more present to the American healthcare industry. This package comes in the form of the Consolidated Appropriations Act (CAA)—otherwise known as the COVID-19 relief bill—passed by Congress on December 21 and signed into law by President Trump on December 27. It is a nearly 5,600-page document that covers a wide range of topics and will take some time to fully digest; but, based on multiple societal publications and other sources we have reviewed, we have taken note of a few key highlights found in the CAA that we believe will be of interest to our readers. They are summarized in this message.

As we head toward the end of another year, there are the obligatory “year in review” offerings provided via television, print media and websites.  Some might argue that there are years we’d just as soon forget—2020 perhaps being one of them.  However, end-of-the-year stories aren’t always about the year that was, but about the year ahead.  That is especially true when it comes to the rash of releases by the federal government concerning changes for the healthcare industry slated for the new year.  In that spirit, we want to bring you a summary of a set of regulations that will impact hospitals in 2021.

Hospital patients should be able to rely on the expertise of their nurses and clinical staff as they undergo treatment and recuperation, rather than having to worry if they are putting themselves in harm's way. A 2016 report appearing in Johns Hopkins Medicine found that over 250,000 deaths occur in the U.S. due to medical error in the hospital setting. When comparing that figure with total U.S. deaths, hospital-based medical errors account for 9.5 percent of all deaths in this country, ranking third behind heart disease and cancer.

Since we are in the midst of a second wave of COVID-19, it may be a good time to revisit some of these government allowances as they pertain to the issue of site of service.  In November, CMS provided an updated document outlining place of service options that are available to hospitals during the public health emergency (PHE).  The agency, which falls under the jurisdiction of HHS, explained that these temporary provisions are meant to fulfill its “Hospitals Without Walls” initiative—an effort to allow off-site locations for care events that would nonetheless act as extensions of the hospital setting.

Hospitals are in trouble. There is no getting around it. At least as it pertains to those facilities in and around the COVID hotspots, staffing is becoming an increasingly problematic component of the overall care mission.