DCMedical News: Monday, June 1, 2020
DCMedical News-DCMN
Washington, D.C.
Monday, June 1, 2020
DCMedical News is published every day both the House and the Senate are in session and on pre-pandemic Regularly Scheduled Session days (see CQ calendar, below).
THE BIG STORY IN HEALTH CARE
Coronavirus News: (reference pages below under Reading & References)
Tracking by Johns Hopkins shows on 5-31 at 8:00 p.m. EST worldwide 6,152,160 confirmed cases; 371,700 deaths worldwide; 104,356 U.S. deaths (28%).
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Doctor Contributions to Hospital Revenue
Merritt Hawkins reports (here) on its 2019 survey of how much revenue physicians contribute to hospitals, and also the average compensation for each specialty. Physicians generated an average of $2.38 million each for their affiliated hospitals, an increase from $1.6 million in 2016. Merritt Hawkins found that the average revenue generated per cardiovascular surgeon for a hospital was $3.7 million, for invasive cardiology, $3.48 million. These number one and number two positions are followed in the top five by neurosurgery, orthopedic surgery and gastroenterology.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Unused Field Hospitals for COVID-19
The Associated Press reports (here) that “When virus infections slowed down or fell short of worst-case predictions, the globe was left dotted with dozens of barely used or unused field hospitals . . . Many of the facilities will now be kept on standby for a possible second wave of infections.” The report adds, “Gleaming new tent hospitals sit empty on two suburban New York college campuses, never having treated a single coronavirus patient. Convention centers that were turned into temporary hospitals in other cities went mostly unused.”
Hospital Operating Margins Plummet
The firm Kaufman Hall reports (here) that the median operating margin for hospitals fell to negative 29% in April, operating room minutes decreased 61%, gross revenue declined 30% and outpatient revenues fell 50% compared to last year. Other measures: discharges fell 30% and emergency department visits dropped 43%. Industry solon Jeff Goldsmith, founder and president of Health Futures, told Modern Healthcare "There is going to be 40% less revenue per unit of service rendered for Medicaid patients compared to when they were commercially insured . . . There is no way on Earth that the additional 6.2 percentage point increase in federal Medicaid matching funds is going to offset the $100 billion of state revenues that have gone away. There is a Medicaid funding crisis on the back end of this that people need to look out for."
MEDICARE, MEDICAID, AND COMMERCIAL HEALTH INSURANCE
Final Rule on MA and Drug Programs to be Published Tomorrow
The “final rule” (here) on the Medicare program’s Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program will be published in tomorrow’s Federal Register. It will implement statutory changes (in the Bipartisan Budget Act of 2018 and the 21st Century Cures Act) in anticipation of MA 2021 plan bids.
Update on COVID-19 Payment Policies from the Centers for Medicare and Medicaid Services and from HRSA
CMS has updated it’s waiver FAQs on Medicare Fee-for-Service billing, with the additions addressing questions related to: the 20% increase in Medicare MS-DRG operating payments for COVID-19 discharges (pg. 15), payment for “Virtual services” provided in RHCs/FQHCs (pg 30), policies for COVID-19 testing administered prior to and in association with a procedure to be performed in a Medicare-enrolled setting (pg. 57) and billing and coverage of outpatient therapy services (pg. 70).
The Health Resources & Services Administration has updated (here) its “Frequently Asked Questions for the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured Program,” including clarification that providers do not have to ascertain a patient’s immigration status before submitting a claim, that the fund will cover E&M services provided via telehealth if the virtual visit is coded appropriately, and a listing of appropriate diagnosis codes required to trigger coverage for testing and treatment in different scenarios.
Proposed FY 2021 IPPS Rule
The FY 2021 proposed payment rule known as the Inpatient Prospective Payment System has its own “home page,” here.
DSH funds will continue to decline. For Disproportionate Share Hospitals, CMS projects that the amount available to distribute as payments for uncompensated care for FY21 will decrease by $534 million, 7% lower than 2020 DSH spending in the prior year’s final rule. The Healthcare Financial Management Association notes that “CMS’s estimates . . . appears to have been calculated prior to the COVID-19 pandemic and resulting economic downturn. The proposed rule estimates that for FY20 and FY21, the uninsured rate will be 9.5%.”
DRUGS & DEVICES
Becker’s publishes (here) the 20 top earning health companies from the Fortune 500. Score: drug manufacturers 13; commercial health insurers 5; medical devices 1; hospitals (HCA) 1. Modern Healthcare reports (here) that large commercial health insurers appear immune to COVID-19: “The largest national health insurers emerged from the first quarter of the year without so much as a scratch from the COVID-19 crisis.”
READINGS & REFERENCES
Coronavirus Public Health Resources and References (alphabetical):
Association of American Medical Colleges Clinical Guidance Repository, here.
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here.
American Public Health Association information here.
CDC information page here.
CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here.
Council of State Governments, here.
JAMA Network’s COVID-19 resource center here.
Library of Congress Coronavirus Research Guide, (here) from the In Custodia Legis blog of the Library of Congress (LoC), with links to Congressional Research Service (CRS) reports.
NIH information page here.
National Library of Medicine Coronavirus page here,
New England Journal of Medicine update here, New England Journal of Medicine Journal Watch here.
The Lancet COVID-19 Resource Centre here and real-time dashboard to monitor clinical trials, here.
State actions, Kaiser Family Foundation, here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here.
The White House open research dataset (CORD-19) here.
World Health Organization COVID-19 page here.
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
June 2, 3, 4, 9, 10, 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
July 21, 22, 23, 24, 27, 28, 29, 30, 31
August, none
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.