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Analysis

What Should Hospital Leaders Focus on in the Latest Coronavirus Stimulus Package Negotiations?

By Jack O'Brien  
   August 07, 2020

Heather Meade, a principal at Washington Council Ernst & Young, said it will likely take at least another week to get a bipartisan stimulus package passed.

In response to the lingering economic effects of the coronavirus disease 2019 (COVID-19), leaders on Capitol Hill are currently negotiating another stimulus package that will have important ramifications for the healthcare industry.

As of Friday afternoon, a deal has not been reached between the House or Senate on a bipartisan economic package. This represents the latest deal-making effort at the federal level to mitigate the economic damage of the pandemic, which has killed over 150,000 Americans and caused millions to lose their jobs.

In late March, President Donald Trump signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act, a $2.2 trillion stimulus package which included more than $100 billion in provider relief funding for hospitals and health systems suffering from the widespread cancellation of elective procedures to handle the influx of patients infected with COVID-19.

Heather Meade, a principal at Washington Council Ernst & Young, told HealthLeaders that negotiations "have not been going particularly well," adding that it will likely take at least another week to get a bipartisan stimulus package passed.

A challenge for hospitals and health systems is that the talks have focused on unemployment insurance and other issues, Meade said, instead of advanced Medicare payments, loan forgiveness, or telehealth.

Meade did note that a positive development has been an agreement between Democrats and Republicans to move forward on provisions of mutual understanding in both the HEALS Act and the HEROES Act.

She pointed to additional provider relief funding, on top of the $14 billion remaining at the Department of Health and Human Services (HHS) under the CARES Act, as well as a provision in the Senate bill to extend the date for advance Medicare payments and a provision in the House bill which included loan forgiveness and a reduction in the payment rates.

Meade also added that there is significant separation between lawmakers on the issue of telehealth. She said the Senate bill includes a one-year extension of HHS rules, including the payment policy, which has become a sticking point on Capitol Hill as Congress, "can't quite agree on what the right rate is to pay providers" for virtual care services.

Meade said she has had conversations with health system finance leaders about the disconnect between the issues Congress is looking to address in this stimulus package and the issues hospital executives are primarily focused on right now, like the future of advanced Medicare payments and loan forgiveness.

"You could have a potential situation where you have some hospitals that start to get their payments clawed back, Congress acting to delay those pull backs, but if [Congress] doesn't get the dates right because they're moving in a sort of quick pace to try to get that done, you could have some [hospitals] that get those payments clawed back without any ability to go backwards and hold on to that money," Meade said.

Beyond issues of advance payments and telehealth, Meade said that some issues hospital finance leaders have raised to her, like permanent licensing across state lines, surprise billing, and support for COBRA coverage, are not part of the current negotiations.

Looking ahead to a potential deal being reached, Meade stressed that hospital CFOs should remain in constant communication with their representatives in Washington, D.C., to ensure that their concerns are being discussed during this stimulus negotiations.

"I think Washington is hungry for accurate information about what hospitals and other providers need from Congress, and how they can help them fulfill their needs," Meade said. "They want to know what challenges [hospitals] are having, do they still need PPE, and are they going to be capable of providing the vaccine? They're interested in what it looks like on the ground and what holes are still left."

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


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