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June 26, 2020

Health Law Weekly

COVID-19 Updates and Developments (Week of June 22)

  • June 26, 2020

The Centers for Medicare & Medicaid Services (CMS) released June 22 the first set of Medicare claims data breaking down COVID-19 cases and hospitalizations for beneficiaries by state, race/ethnicity, age, gender, dual eligibility for Medicare and Medicaid, and urban/rural locations.

According to the data, which covers the period between January 1 and May 16, Blacks had the highest hospitalization rate for COVID-19, with 465 hospitalizations per 100,000 beneficiaries; Hispanics had 258 per 100,000; Asians had 187 per 100,000; and Whites had 123 per 100,000, CMS said. 

CMS also noted that those with end-stage renal disease and dual-eligibles had the highest hospitalization rates among Medicare beneficiaries, with 1,341 and 437 hospitalizations per 100,000 beneficiaries, respectively.

The data also showed that rural areas had fewer cases and lower rates of hospitalizations than urban areas (57 versus 205 hospitalizations per 100,000 beneficiaries).

Overall, more than 325,000 Medicare beneficiaries were diagnosed with COVID-19 and 110,000 were hospitalized for treatment from January 1 through May 16. CMS plans to update the data monthly. 

“The disparities in the data reflect longstanding challenges facing minority communities and low-income older adults, many of whom face structural challenges to their health that go far beyond what is traditionally considered ‘medical’,” said CMS Administrator Seema Verma. “Now more than ever, it is clear that our fee-for-service system is insufficient for the most vulnerable Americans because it limits payment to what goes on inside a doctor’s office. The transition to a value-based system has never been so urgent." 

The agency has faced pressure from lawmakers and other groups to release Medicare demographic claims data for COVID-19. In a June 16 letter to Verma, House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ) said he requested access to the data nine weeks ago.

“It is critical that CMS release this data immediately in order to effectively respond to and address clear demographic disparities in care that have become apparent as a result of the COVID-19 pandemic but have long persisted in our health care system,” Pallone wrote last week. 

Multiple reports and data from the Centers for Disease Control and Prevention have indicated that individuals of color are dying from COVID-19 at disproportionately higher rates.

Earlier this month, the Department of Health and Human Services (HHS) required COVID-19 testing labs to report demographic data. But some House lawmakers have pointed out that the new requirements don’t go into effect until August 1.

Agency Action

Centers for Medicare & Medicaid Services

June 25—CMS is requiring all nursing homes to resume payroll-based staffing data submissions by August 14. The announcement signals the end of an emergency blanket waiver CMS granted in March to temporarily reduce administrative burden on nursing homes so they could focus on patient care during the COVID-19 pandemic. CMS said about 60% of facilities continued to submit their payroll-based staffing data while the blanket waiver was in effect.

June 19—CMS announced the 25 members of the new independent Coronavirus Commission on Safety and Quality in Nursing Homes. The Commission will conduct an independent review and comprehensive assessment of the nursing home response to the COVID-19 pandemic, CMS said. MITRE Corporation is under contract with the agency to establish the Commission and facilitate its work. Based on its assessment, the Commission will recommend actions and best practices in three key areas: protecting patients from COVID-19; strengthening efforts to identify and mitigate COVID-19 transmission and other infectious diseases in nursing homes; and improving compliance with infection control policies.

Department of Health and Human Services

June 23—The HHS Office of Minority Health (OMH) is partnering with Morehouse School of Medicine in a new $40 million, three-year initiative to fight COVID-19 in racial, ethnic minority, rural, and socially vulnerable communities. Under a cooperative agreement with OMH, Morehouse School of Medicine will coordinate a nationwide network of community-based organizations to deliver COVID-19 related educational materials and information on resources, HHS said. “Underlying social determinants of health and disparate burdens of chronic medical conditions are contributing to worse COVID-19-related outcomes in minority and socially vulnerable communities, and this partnership with Morehouse School of Medicine is essential to improving our overall response,” said Assistant Secretary for Health Adm. Brett P. Giroir, M.D.

Food and Drug Administration (FDA)

June 23—The FDA is partnering with the Critical Path Institute and the National Institutes of Health’s National Center for Advancing Transactional Sciences on the CURE Drug Repurposing Collaboratory (CDRC) to help identify existing drugs that could be used in treating COVID-19. CDRC is a forum for exchanging clinical outcomes data. Under a pilot project, CDRC will use data collected via the CURE ID platform to aggregate global clinician treatment experiences to flag existing drugs that may be worth studying further as possible treatments for COVID-19.

Other Developments

June 25—The Government Accountability Office (GAO) issued a report on the federal government’s response to the COVID-19 pandemic. The report identifies several challenges related to the federal response to the crisis, including viral testing and results reporting, distribution of supplies through the Strategic National Stockpile, and oversight of the Paycheck Protection Program to ensure program integrity and address potential fraud. The report is Opportunities to Improve Federal Response and Recovery Efforts (GAO-20-625).

June 25—Nearly 20 groups representing health care stakeholders are urging Congress to pass legislation clarifying that relief funding under the Public Health and Social Services Emergency Fund is not taxable and that entities receiving the aid maintain their tax deductions attributable to these funds. The relief fund was created under the Coronavirus Aid, Relief, and Economic Security Act to help financially struggling health care providers during the COVID-19 pandemic. “Without such a correction, tax-paying health care providers lose at least 21 percent of the benefit of these funds and are treated unequally as compared to non-tax-paying providers,” according to a letter the group sent to congressional leaders. The letter was signed by the American Hospital Association, the American Medical Association, and the U.S. Chamber of Commerce, among other groups.

June 23—Top federal health officials testified at a hearing before the House Energy and Commerce Committee on the administration’s response to the COVID-19 pandemic. National Institute for Allergy and Infectious Diseases Director Anthony S. Fauci, MD; HHS Assistant Secretary for Health Adm. Brett P. Giroir, MD, FDA Commissioner Stephen M. Hahn, MD, and Centers for Disease Control and Prevention Director Robert R. Redfield, MD testified at the hearing. The hearing was held as the virus is surging in a number of states, including Texas, Florida, California, and Arizona, raising new questions about the pace of reopening across the country.