IHA Daily Briefing: May 14

In Today’s Issue
Ways and Means Cmt. Advances Extension of Medicare Telehealth Flexibilities
CMS Extends Waivers for Medicaid, CHIP Unwinding
Report: Delayed, Missing Payments to Hospitals Increased in Q1
2024 Joint Commission Standards for Infection Control Q&A
COVID-19 Information 
Briefly Noted
Leading the News


Ways and Means Cmt. Advances Extension of Medicare Telehealth Flexibilities
Last week, the U. S. House of Representatives Ways and Means Committee advanced AHA-supported legislation to extend Medicare telehealth flexibilities and provide continuing relief to rural hospitals and other providers. The Preserving Telehealth, Hospital and Ambulance Access Act (H.R. 8261):

  • Extends the Medicare hospital-at-home program for five years and requires additional reports to Congress on the program;  

  • Removes originating and geographic site restrictions for Medicare telehealth services through December 2026;

  • Delays the in-person visit requirement for telemental health services until January 2027;

  • Extends the ability to bill for audio-only telehealth through December 2026;

  • Extends Medicare programs that sustain rural and low-volume hospitals through Sept. 30, 2025; and 

  • Extends Medicare add-on payments for urban, rural, and super-rural areas to preserve access to crucial emergency ambulance services.

The House Energy and Commerce Committee has indicated that they will consider similar legislation in the near future. AHA’s testimony in support of the legislation is here.


CMS Extends Waivers for Medicaid, CHIP Unwinding
The Centers for Medicare & Medicaid Services (CMS) last week issued an informational bulletin announcing states can continue leveraging section 1902(e)(14)(A) waivers through June 30, 2025, including flexibilities applying to temporary verification plan updates and temporary Medicaid and Children’s Health Insurance Program (CHIP) state plan amendments related to the pandemic-related unwinding. These waivers were previously extended in December 2023. CMS said it was taking this action, “To continue supporting states’ efforts to establish and update income and eligibility determination systems…to ensure that eligible individuals retain coverage.” 

This week, Gov. JB Pritzker announced that approximately 2.6 million, or 73%, of Illinois’ Medicaid recipients remain on the rolls following the first redetermination cycle following the COVID-19 pandemic; around 660,000 recipients were disenrolled. Additional information and guidance related to Medicaid eligibility redetermination can be found on IHA’s COVID-19 PHE sunset webpage


Report: Delayed, Missing Payments to Hospitals Increased in Q1
There was a notable increase in delayed or missed payments to hospitals and health systems in the first quarter of 2024, according to a recently released Strata report on healthcare performance trends. 

“Hospitals and health systems nationwide saw a sizable increase in delayed or missing payments in the first quarter. A recent, large-scale disruption to payment processing services contributed to the shortfall. Depending on the size of the hospital, estimated gaps in expected versus actual revenue ranged from 16.5% to 17.9% of payments for the first three months of 2024,” the report highlighted. Notably, a February cyberattack impacted a number of systems and services operated by Change Healthcare. 

The report provides information on the expansion of the Two-Midnight Rule; the increase in outpatient demand; stabilization of hospital operating margins; overall hospital expenses; and other key findings from an analysis of financial, operational and claims data collected from hospitals, health systems and other healthcare organizations across the country. 


2024 Joint Commission Standards for Infection Control Q&A
New resources from the National Emerging Special Pathogens Training and Education Center (NETEC) address frequently asked questions on the 2024 Joint Commission Standards for Infection Control. Click here for responses to common questions, a link to watch a recent recording of an “Introduction to the 2024 Joint Commission Standards for Infection Control” webinar, and additional resources provided by The Joint Commission.


COVID-19 Information
The Illinois Dept. of Public Health (IDPH) has launched a weekly Infectious Respiratory Disease Surveillance Dashboard that will be updated weekly on Friday. This report provides the public with the latest data on hospital visits, seasonal trends, lab test positivity and demographic data. 

Click here to visit the IDPH COVID-19 resources webpage. IDPH will continue to report the weekly number of people with COVID-19 admitted to hospitals from emergency departments, deaths and vaccinations, with COVID-19, influenza and respiratory syncytial virus information also reported through the dashboard of the Illinois Wastewater Surveillance System.


Briefly Noted
Route 92 Medical Inc. has recalled nearly 1,000 catheters, citing broken catheter tips that can cause delays in surgery, harm to blood vessels, and the possibility a broken catheter tip will be left in the body, leading to a blockage or stopping of blood flow in a blood vessel. This is a Class I recall, with two related reported injuries and one report of death associated with the issue. 


Leading the News

Save this prescription drug discount program that’s a ‘lifeline’ for low-income folks
Chicago Sun-Times published a letter to the editor (5/13) saying, “Time is running short on the Illinois legislative session, and we are dialing 911 for the critical 340B drug discount program to protect patient care. For more than 30 years, we have used the federally approved 340B drug discount program as a lifeline. It dramatically decreases the cost of prescription drugs, and we use those to provide affordable access to life-saving drugs and prop up other care that is underfunded or not available without these discounts. Today, 340B is holding on by a thread, and time is running short. In some Illinois counties, patients are being forced to travel far out of their way to get vital medications. With the uninsured, that simply isn’t an option, and their health will suffer greatly for it.”

Medicare Advantage will ‘sink’ rural hospitals, experts warn
Modern Healthcare reported (5/14) that, “To explain how the accelerating penetration of Medicare Advantage is harming rural hospitals in ways that will likely require action by Congress and regulators to fix, Nemaha Valley Community Hospital CEO Kiley Floyd pointed to patients in her northeastern Kansas community who previously were covered by traditional Medicare. Facilities like hers don’t turn away patients because they have poor insurance, she said. They try to serve them just the same, but increasingly confront private payers that throw barriers in their path, requiring time, staffing and money to overcome. And all too often, the plans simply don’t pay. It’s a trend that rural healthcare analysts say is rapidly driving the demise of small, remote hospitals across the country, and likely to exacerbate healthcare access difficulties for populations already at risk.” 

How the ransomware group linked to Ascension hack operates
Becker’s Hospital Review reported (5/13) that, “The hacking group that reportedly attacked St. Louis-based Ascension typically gives victims between 10 to 12 days to pay ransom before leaking their data. Black Basta affiliates usually send a ransom note — without a monetary demand — asking the victim to contact the group through the anonymous browser Tor, HHS and two other federal agencies said May 10. The cybercriminal gang has been targeting the healthcare industry.”