Hospitals have 14 weeks to comply with CMS’ COVID-19 and influenza reporting requirements or risk losing Medicare and Medicaid payments.
Agency officials spelled out the timeline on a conference call with reporters Tuesday. The agency first announced its intentions to collect the data in an interim rule in late August.
CMS will issue notices to the approximately 6,000 hospitals currently participating in Medicare and Medicaid Wednesday, explaining whether or not they are complying with the data requirements. About three weeks later, hospitals that still aren’t in compliance will receive another notice. For hospitals still failing to comply, CMS will send a notice every week for four weeks. Hospitals still not following the data requirements at the end of that time will have their Medicare and Medicaid reimbursement terminated 30 days later. Hospitals can appeal the agency’s decision.
“This enforcement timeline is designed to help hospitals come into compliance and we are here to support their efforts around reporting, providing technical assistance as needed,” CMS Administrator Seema Verma said. “At the same time, we will hold hospitals accountable for their obligation to report this data.”
Some of the information hospitals are required to report daily related to COVID-19 are total mechanical ventilators in use, the number of COVID-19 confirmed or suspected hospitalized patients and the previous day’s COVID-19 deaths. Some of the influenza data includes total hospitalized patients with the flu, total ICU beds for patients with the flu and deaths from the previous day for patients with both COVID-19 and influenza. Data related to influenza was just added and will begin Oct. 19. Reporting is optional but the administration intends to make it part of the mandatory reporting “within the coming weeks,” according to guidance from the agency.
The American Hospital Association once again criticized the decision to remove a hospital’s participation in Medicare and Medicaid if it fails to comply with reporting requirements, with CEO Rick Pollack calling it “an overly heavy-handed approach that could jeopardize access to hospital care for all Americans.” Although he added that the guidance should give “hospitals the necessary time to adjust their data collection to come into compliance if need be.”
Verma said for hospitals CMS only has the authority to revoke Medicare and Medicaid reimbursement as opposed to nursing homes where it can issue financial penalties for failing to comply with reporting requirements.
Centers for Disease Control and Prevention Director Dr. Robert Redfield said data on influenza is critical as flu season approaches along with the continued presence of COVID-19. “This new data will give us an improved situational awareness of several respiratory illness, provide local hospitalization trends and help direct resources such as antiretrovirals.”
Reporting influenza data to CMS doesn’t impact the current reporting mechanisms CDC uses to track influenza in the U.S., Redfield added.
About 86% of hospitals are reporting the required information daily, according to Deborah Birx, coordinator of the White House Coronavirus Task Force.
The agency is also going to start publishing publicly on Oct. 21 how every hospital is complying with the data requirements.