Hospital group CEOs offer more federal aid, more flexible Medicare loan terms
- The heads of the three biggest hospital lobbies on Monday opposed more federal aid and more flexible repayment terms under a massive Medicare loan program, as the coronavirus and its deleterious economic effects continue to slam American suppliers.
- At a conference on the healthcare system’s response to COVID-19, CEOs of the American Hospital Association, Federation of American Hospitals, and Essential Hospitals of America said congressional funds have been invaluable , but wouldn’t be enough to keep providers afloat if the coronavirus doesn’t let go anytime soon.
- Vendor executives also noted that an impending deadline to repay accelerated Medicare loans on August 1 was too early given the current economic pressure on hospitals. If participating providers who applied for loans at the start of the program are unable to begin repaying them, they could lose all of their Medicare fee-for-service payments, which on average represent about a quarter of a hospital’s income. American.
In addition to being an unprecedented public health disaster, the pandemic has fomented a difficult economic situation for providers, who have bled money to prepare COVID-19 patients as revenues stagnate following the postponement of lucrative elective procedures.
Congress has valued some $ 175 billion through a series of relief laws this year, but the prize pool is not large enough to make hospitals and doctor’s offices in the United States a whole, according to Rick Pollack, chief of the 5,000-member AHA hospital, Bruce Siegel, CEO of AEH, which lobbies for safety net facilities, and Chip Kahn, CEO of FAH, which represents for-profit hospital chains.
If there is a big increase in COVID-19 in the fall, as many epidemiologists predict, “a lot more money will have to be put in,” Kahn said. The average number of daily cases continues to climb in more than half of the country, especially in the South and West.
“Is the money enough? No,” Siegel noted. “I think this emergency is going to last much longer than we would like.”
HHS faces criticism for the way it disbursed the tranche of funds allocated by Congress, with some wealthy hospitals receiving billions while smaller peers serving a higher number of vulnerable populations scored considerably less.
The Department changed its allocation strategy earlier this month to secure more funds for Medicaid and safety net facilities. But the whole process “hasn’t been perfect,” Kahn said, “many providers – not just safety net hospitals, but dentists, pediatricians and others have been left out.”
The Democratic-led House of Representatives passed the $ 3 trillion HERO Act in mid-May, that would allocate an additional $ 100 billion to reimburse suppliers. Although leaders of the White House and the Republican Senate have called the bill a non-starter, President Donald Trump has said he is open to signing another stimulus package, though details are not yet clear. not clear.
Executives also want the Trump administration to adjust the terms of Medicare’s accelerated payment and prepayment programs, which speed up Medicare payments to emergency providers based on historical payments. The system helped ease short-term financial pressure, but could come back to haunt participating providers due to the tight repayment window.
Most providers can claim up to 100% of their Medicare payment amount for a period of three months and start paying it back. 120 days after CMS has issued the payment. Medicare’s fee-for-service payments will be waived until the borrowed funds are repaid, provider chiefs said.
For suppliers who entered the ground floor of the program at the end of March, that deadline is in less than 40 days, while the economic headwinds have not yet eased.
“The idea of having that money repaid the way it’s structured – not only will it be a health care disaster, but it will also be an economic disaster,” Siegel said.
CMS has stopped receiving new inquiries from physicians, non-physician offices and durable medical equipment supplies April 27 after sending about $ 100 billion in loans. The agency continued to review new requests from hospitals, but said approvals would be more stringent.
Vendor lobby leaders have urged CMS to reopen the program, while pushing back the deadline, lowering interest rates (which can be as high as 10%) and considering a loan forgiveness for struggling facilities.
“That money is gone,” Kahn said. “Paying it back will have to be done with future dollars.”
A CMS spokesperson told Healthcare Dive that the agency balances legal requirements to collect “quickly and aggressively” debts in order to preserve the besieged Medicare trust fund, with the needs of suppliers in the midst of the pandemic.
“CMS continues to monitor the current situation and will inform practitioners and providers if additional flexibilities are made available to them, ”the spokesperson said.