Some 6,200 U.S. hospitals will have 14 weeks beginning Wednesday to comply with federal Covid-19 data-reporting requirements or risk being excluded from the Medicare and Medicaid programs.
The aggressive timeline announced Tuesday allows the Centers for Medicare & Medicaid Services to notify noncompliant hospitals, inform them of their violations, work with them to correct the problems— and if after 14 weeks that doesn’t work: “Termination from Medicare and Medicaid is the only sanction at our disposal,” CMS Administrator Seema Verma said.
The hard line is the result of an interim final rule that took effect Sept. 2 that requires all Medicare- and Medicaid-certified hospitals to provide daily updates to the Department of Health and Human Services on numerous Covid-related measures like infections, test results, ICU patient counts, and supplies of protective gear.
Hospitals will also have to provide similar data about the seasonal flu, including total hospital patients with lab-confirmed influenza, influenza deaths, the previous day’s admissions for flu, number of ICU patents with flu, and patients with both influenza and Covid-19.
In conjunction with the announcement, federal officials Tuesday also released an FAQ guidance for hospitals.
The new “conditions of participation” apply to most U.S. hospitals, including short-term acute care facilities; long-term care hospitals; and rehabilitation, cancer, children’s, psychiatric and critical access hospitals. Deborah Birx, coordinator of the White House’s coronavirus task force, said 98% of hospitals are already reporting Covid data weekly, and 86% report the information daily.
The American Hospital Association and the Federation of American Hospitals both oppose the rule, which took effect only days after it was announced on Aug. 25. They say it was enacted without consultation and without feedback through the formal rulemaking process.
Over 14 weeks, hospitals that don’t report will receive multiple notices that spell out the facility’s options to correct the problem, Verma said. They will provide “more than enough time to remedy any deficiencies in reporting,” Verma said.
Starting Wednesday all facilities will get an initial notice saying whether they are meeting the requirements. Three weeks later, if the hospital hasn’t fixed the problem, they’ll get another advisory notice, followed by another 3-week period for the hospital to come into compliance. If they remain noncompliant, the CMS will send “an enforcement notice on a weekly basis for four weeks,” Verma said.
“If the hospital persists in its failure to report, they will be terminated 30 days after the final of the four enforcement letters, 14 weeks after the first letter,” Verma said.
Hospitals will have the right to appeal the termination decision, Verma said. The timeline is designed to help hospitals come into compliance, Verma added.
“And we’re here to support their efforts around reporting, providing technical assistance as needed. At the same time, we will hold hospitals accountable for their obligations to report this data,” Verma added.
Verma said sub-regulatory rules that interpret the new data reporting requirements will be forthcoming.
In a statement, Rick Pollack, president and CEO of the American Hospital Association, called the threat of termination “an overly heavy-handed approach that could jeopardize access to hospital care for all Americans.”
“The reality is many hospitals could not keep their doors open should they no longer receive payment from Medicare and Medicaid, affecting care for all Americans in the midst of a global pandemic,” Pollack said.
He said Tuesday’s guidance “will give hospitals the necessary time to adjust their data collection to come into compliance if need be. The guidance also reduces the reporting burden on psychiatric and rehabilitation hospitals, which generally do not treat COVID-19 patients.”