IHA Daily Briefing: July 20

Tuesday, July 20, 2021
CMS Releases CY 2022 OPPS/ASC Proposed Rule
CMS Stakeholder Call on Surprise Billing
IHA OB Survey: Response Requested by Wednesday
State, National, Global COVID-19 Updates
Briefly Noted

CMS Releases CY 2022 OPPS/ASC Proposed Rule
On Monday, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) proposed rule.

In addition to statutorily required payment updates, CMS proposed several modifications to the Hospital Price Transparency final rule, including increased civil monetary penalties (CMPs) for noncompliant hospitals. Specifically, CMS proposed a CMP of $300 per day for smaller hospitals with 30 or fewer beds, and a CMP of up to $5,500 per day for larger hospitals ($10 per bed per day). The total annual penalty for noncompliance would range from $109,500 for smaller hospitals to $2,007,500 for larger hospitals. CMS seeks comments on additional approaches to modifying the CMP amount, and may increase the penalty for larger hospitals in the future.

CMS also proposed requiring hospitals to make machine-readable files accessible via automated searches and direct downloads, two modifications that address access issues identified by the Wall Street Journal and other media outlets earlier this year.

CMS also proposed maintaining 340B payment at average sales price (ASP) minus 22.5%, halting the elimination of the inpatient only list, and making separate payments for non-opioid pain management drugs or biologicals that function as surgical supplies in the ASC setting. CMS requests feedback on temporary telehealth policies granted under the COVID-19 public health emergency specific to mental health and cardiac rehab services, as well as considerations for addressing health equity, modernizing quality measurement, and establishing rural emergency hospitals.

Finally, CMS outlines several proposed modifications to the Radiation Oncology Model that was postponed until Jan. 1, 2022 under the Consolidated Appropriations Act of 2021.

A CMS fact sheet describing major provisions of the proposed rule is here. Comments are due Sept. 17; an IHA summary of the proposed rule is forthcoming.


CMS Stakeholder Call on Surprise Billing
The Centers for Medicare & Medicaid Services will hold a national stakeholder call on Thursday, July 22 at 2:30 p.m. CDT on “Requirements Related to Surprise Billing; Part I.” CMS recently issued an interim final rule that will restrict excessive out-of-pocket costs to consumers from surprise billing and balance billing.

Call Number: 888-455-1397; Participant passcode: 8758359

For more information, see the interim rule and CMS’ July 1 press release.


IHA OB Survey: Response Requested by Wednesday
The Illinois Dept. of Public Health’s (IDPH) Perinatal Advisory Committee (PAC) is beginning its work to develop recommendations for the implementation of a maternal levels of care system in Illinois. As part of its early work on this project, IDPH and the PAC are trying to better understand the factors leading to the availability of obstetric services throughout Illinois. IHA has volunteered to collect this information regarding obstetric services via a hospital survey.

As a reminder, all hospitals are asked to complete this survey (click here) by the end of Wednesday, July 21 even if not currently providing OB services. To see the questions prior to completing survey, click here for a PDF of the survey. The survey should take approximately 10-15 minutes to complete, but will likely require a coordinated response within the hospital.


State, National, Global COVID-19 Updates
The Illinois Department of Public Health (IDPH) posted data today that there were 745 new confirmed and probable COVID-19 cases and six deaths. The total number of cases in the state is 1,403,508 with a total of 23,383 deaths. IDPH says that in the past 24 hours, 24,953 test specimens have been processed, with a positivity rate of 2.99%. The preliminary 7-day statewide positivity rate for cases as a percent of total tests is 2.6%, and the 7-day test positivity rate is 2.9%.

Statewide COVID-19 hospitalizations increased from 537 patients to 601 patients in the past 24 hours. Of that figure, 116 patients were in the ICU, with 43 patients on ventilators.

A total of 12,987,990 vaccines have been administered in Illinois as of last midnight. The seven-day rolling average of vaccines administered daily is 19,569 doses. In the past 24 hours, 18,491 doses were reported administered in Illinois. Among Illinois adults 18 and older, 58% have been fully vaccinated, and 73.4% had received at least one dose.

With steady increases in COVID-19 cases in some regions of the United States, the Chicago Dept. of Public Health (CDPH) is adding Florida, Louisiana, Nevada and the Virgin Islands to its Travel Advisory (Orange list). Missouri and Arkansas remain on the list. These states and territory are on the travel advisory because they all surpassed the mark of 15 cases per day per 100,000 residents. CDPH recently transitioned from a Travel Order to an Advisory, meaning unvaccinated individuals traveling from the states or territories on the Orange list are advised – not required – to obtain a negative COVID-19 test result no more than 72 hours prior to arrival in Chicago or quarantine for a 10-day period upon arrival. Vaccinated individuals are exempt from the Advisory, which is updated weekly.

Monday’s Centers for Disease Control and Prevention (CDC) figures showed more than 33.8 million confirmed and presumptive positive cases of COVID-19 in the U.S. (a daily increase of more than 7,000 cases), with 606,618 deaths (a daily increase of 27).

Today’s WHO Coronavirus Disease Dashboard showed more than 190.6 million COVID-19 cases globally (a daily increase of more than 390,000 cases), with more than 4.09 million deaths. The Region of the Americas (includes the U.S.) continues to lead the world with more than 74.9 million cases and more than 1.96 million deaths.


Briefly Noted
The U.S. Department of Health and Human Services yesterday renewed the COVID-19 Public Health Emergency for an additional 90 days.

The Centers for Medicare & Medicaid Services is hosting a webinar on Wednesday, July 21 at 1 p.m. CDT to provide an overview of proposed policies for the 2022 performance year of the Quality Payment Program. For more information and to register, click here.