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Category: News

FFY 2022 IPPS Proposed Rule Webinar

Toyon Associates invites you to a
complimentary one-hour webinar
10:00 a.m. PDT on May 21.
 
Toyon Associates invites you and your team to a live conversation on the FFY 2022 IPPS Proposed Rule. Our discussion will dive into the components of proposed FFY 2022 IPPS rates, highlighting areas of significance for providers. Please join us for this important conversation. A news alert will also be issued soon, summarizing Toyon’s Take on critical topics.
 
This is an important session you won’t want to miss.
 
 

Toyon University® is a virtual ‘university’ created for our clients. For further information on our curriculum, contact Tim Vanderford at tim.vanderford@toyonassociates.com or 888.514.9312.
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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.

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COVID-19 Estimates of CARES Act Hospital Relief Payments

Toyon is pleased to provide this interactive model estimating hospital relief payments from the Public Health and Social Services Emergency Fund (PHSSEF). These hospital relief payment estimates are for discussion purposes only. This model includes estimated amounts from the $50bn general allocation, $12bn High Impact (with estimated hospital admissions and DSH portion isolated) and rural hospital funding.   HHS is dispersing actual funds using tax documentation and is collecting information from Sole Proprietor/Disregarded Entities (LLC). HHS published a user guide here.  
 
Please find below the estimates by CCN number, hospital type, state, county, and city (county and city are only provided with available data, some providers are not listed by county and/or city).  Provided amounts are for hospital estimates only and include acute care, critical access, skilled nursing, psychiatric, rehabilitation, LTCH, cancer, children’s hospitals as well as outpatient dialysis providers and rural health clinics.  Non-hospital providers (i.e., physicians), home health, community health medical centers and federal qualified health centers are not included in this analysis.
 
Please contact Robert Howey at 925.685.9312, ext. 3147 / robert.howey@toyonassociates.com with any questions. 
 
There are 7 distinct pages of analytics that can be navigated via the arrows at the bottom center of the visuals. For best viewing, we recommend expanding analysis to full screen by selecting the expansion arrows in the lower right-hand corner.

 

Data Sources:
 – Medicare FY 2019/2020 IPPS DRG Impact File (Updated for Correction Notice) 
 – FFY 2019 Final Rule Standard Operating (Labor and Non-Labor) and Capital Rates 
 – FFY 2019 Final Rule Post-Reclassified Wage Index Factor 
 – Medicare discharges from Medicare cases for the provider from the FY 2018 MedPAR, March 2019 update 
 – Medicare case mix index from the transfer adjusted Case Mix Index under Grouper V37 and FY 2020 Post-Acute Transfer Policy 
 – All add-ons and adjustments from this file (DSH, IME, etc) are included and be turned “on and off” on tab 2 “File Notes” 

2. Estimated Outpatient Payments for Acute Care Hospitals
    
– Worksheet E Series settlement data for Sub-providers and all other hospital types: critical access, skilled nursing, psychiatric, rehabilitation, cancer, children’s hospitals, dialysis and rural health clinics  
 – Net Patient Service Revenue from worksheet G-3, line 3, column 1
 – Total Patient Days from worksheet S-3, Part I, column 8.
 
 
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