Month / Year
Subject

Category: COVID-19

Postponement of FY 2022 Application Deadline to the Medicare Geographic Classification Review Board

Per requirements at section 1886(d)(10)(C)(ii) of the Social Security Act (the Act) and 42 CFR 412.256(a)(2), September 1, 2020 is the deadline to submit an application to the Medicare Geographic Classification Review Board (MGCRB) for FY 2022 reclassifications.

These provisions require applications to be filed through OH CDMS (https://www.cms.gov/Regulations-and-Guidance/Review-Boards/MGCRB/Electronic-Filing) not later than the first day of the 13-month period preceding the Federal fiscal year for which reclassification is requested. 

Due to the COVID-19 Public Health Emergency (PHE), under the authority of section 1135(b)(5) of the Act, CMS is postponing the September 1 deadline until 15 days after the public display date of the FY 2021 IPPS/LTCH final rule by the Office of the Federal Register. See https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf.

If you have questions regarding this extension or any MGCRB data or policy issues, please direct them to CMS at wageindex@cms.hhs.gov.

Toyon anticipates the extended deadline will be on or around September 15, 2020. To discuss this further, please contact Ryan Sader at Toyon Associates, Inc. 888.514.9312 or ryan.sader@toyonassociates.com

Back to top

CARES Act Funding Update

HHS allocates $14 billion in targeted “Round Two” payments.
Toyon’s August Series of CARES Updates

Toyon is pleased to provide this update on the CARES Act Public Health and Social Services Emergency Fund (PHSSEF). Toyon’s updates on the PHSSEF will be issued as a series this August. The first update applies to “Round Two” of CARES relief funding from July 2020. During the rest of August, Toyon will be providing these other important updates:

  • Toyon’s Take on HHS Reports due February 14, 2021 – HHS is releasing funding and documentation reporting instructions by August 17. Recipients have 45 days from the end of 2020 (Sunday, February 14, 2021) to report COVID-19 related expenditures through December 31, 2020.
  • Toyon’s Take on PHSSEF and Cost Reporting – Key takeaways on the importance of filed cost reports and the PHSSEF.

 

In July, HHS announced a second round of $14 billion related to three targeted distributions from the PHSSEF.

  • $10 billion High Impact Payments

  • $3 billion Safety Net Payments

  • $1 billion Rural Payments

 

 

 

 


Toyon is preparing estimates on PHSSEF qualification and funding for hospitals nationally. Please contact Fred Fisher if you would like an evaluation for your hospital(s).

Fred Fisher — fred.fisher@toyonassociates.com
888.514.9312
Toyon’s Covid-19 Funding Resources


HHS Releases $14 billion of “Round Two” Funds
Listed below is further insight on HHS’s Round Two targeted funding distributions totaling $14 billion. Based on a current tally of the PHSSEF, HHS committed to spend $116.4 billion of the $175 billion, leaving $58.6 billion remaining in the fund (not accounting for the HRSA COVID-19 Uninsured Program).

$10 Billion Round Two High Impact Payments
On July 17, HHS announced distribution of High Impact payments eligible to more than 1,000 providers
reporting any of the following (based on data submitted June 15):

  • Over 161 COVID-19 admissions between January 1 and June 10, 2020.
  • One COVID-19 admission per day.
  • A disproportionate intensity of COVID admissions that exceeds the average ratio of COVID
    admissions per bed. Responding to an FAQ dated July 22, HHS states the average
    admissions per bed ratio (threshold) is 0.54864.

Eligible hospitals are paid $50,000 per COVID-19 admission. In Round One, payment per admission
was $76,975, and included a DSH add-on. High Impact payments received from Round One were
considered in the second distribution.
As of August 3,HHS distributed $9.1 billion of the 10 billion, leaving $900 million HHS will likely be
paying hospitals over the coming weeks.

$3 Billion Round Two Safety Net Payments
On July 10, HHS announced $3 billion in Round Two distribution of Safety Net payments. In this
Second Round, HHS acknowledged shortcomings of qualifying hospitals for safety net payments in
Round One. HHS accounts for recognizing an additional 215 hospitals as safety nets in Round Two by
expanding safety net criteria as follows:

  • Like Round One, providers must have an Uncompensated Care Cost per Bed measurement at
    or over $25,000. In Round Two, HHS corrected this measurement, “annualizing” this data, so
    hospitals with short cost reporting periods are properly evaluated.
  • Like Round One, providers must also have a profitability margin of 3% or less to qualify for
    safety net payments. In Round Two, HHS expanded this measurement by evaluating 5 years of financial data reported on the Medicare cost report Worksheet G-3 (as opposed to Round One whereby HHS evaluated one year of financial data). Hospitals qualified in Round Two with a
    “profit margin threshold of less than or equal to 3% averaged consecutively over two or more of
    the last five cost reporting periods.”
  • In Round Two, providers still must have a DSH percentage equal to or greater than 20.2% to
    qualify for safety net funds (no change from Round One).

$1 Billion in Round Two Rural Payments
On July 10, HHS also announced $1 billion in Round Two distributions for rural providers. In Round Two, sole community hospitals (SCH), Medicare dependent hospitals (MDH), and hospitals in small metro areas with fewer than 250,000 people qualified for payment. Hospitals are eligible for funds of 1% of operating expenses with a minimum payment of $100,000, a supplement of $50 for each “rural inpatient day,” and a maximum payment of $4.5 million. HHS also made payments to rural inpatient psychiatric facilities, inpatient rehabilitation facilities, and long-term acute care hospitals.

Back to top

Another COVID-19 Deadline Extension – Calendar Year 2019 Occupational Mix Survey

CMS collects data every three years on the occupational mix of employees for each short-term, acute care hospital participating in the Medicare program. Completed calendar year 2019 Occupational Mix Surveys, Hospital Reporting Form CMS-10079, for the Wage Index Beginning FY 2022, were initially due to the Medicare Administrative Contractors (MACs) by July 1, 2020. CMS granted an extension for hospitals nationwide affected by COVID-19 until August 3, 2020.

Due to continued COVID-related concerns from hospitals about meeting this deadline, CMS is further extending this deadline to September 3, 2020. Hospitals must submit their occupational mix surveys along with complete supporting documentation to their MACs by no later than September 3, 2020. Hospitals may then submit revisions to their occupational mix surveys to their MACs, if needed, by no later than September 10, 2020.  Hospitals must use the Excel hospital reporting form available at: 
 
 
Please contact Ryan Sader at ryan.sader@toyonassociates.com with any questions or should you require assistance with your occupational mix survey filing. 
Back to top
Toyon Associates Healthcare Finance

Here TO HELP

Receive a no obligation consultation on how Toyon can help make your cost reporting simpler, easier, and trusted.