March 31, 2021

We’re being bombarded. The assault comes not in the form of laser-guided missiles or long-range howitzers, but rather in wave after wave of never-ending information. We can’t get away from it, and the reason is clear. It is our inability to disconnect from an array of electronic devices—devices that are just dying to fill us in on the latest political scoop or social commentary post or sports headline. In this age of 24-hour news, it’s hard to wade through all the chatter to see what really matters; so, we’ve done the wading for you. In today’s article, we provide you with three recent news stories that are particularly applicable to hospitals and those that run them.

Reconsideration of Sequestration

On March 25, the United States Senate passed, with overwhelming bipartisan support, a measure that would place on hold the scheduled two-percent, across-the-board cuts to Medicare payments. These mandated cuts in reimbursement, known as sequestration, were postponed last year in legislation passed by Congress as part of the package of pandemic waivers. However, that legislation had set April 1, 2021 as the new date for implementing the sequester cuts.

The recent action taken by the Senate in a 90-to-2 vote follows passage of a similar measure in the U.S. House of Representatives that occurred the previous week. The House is expected to take up the Senate’s version of the bill after they go back in session, beginning April 12. “But that’s several days after the automatic April 1 sequester implementation date,” you rightfully point out. Yes, but according to sources, the Centers for Medicare and Medicaid Services (CMS) is expected to hold claims with April 1 and later dates of service until the new sequestration postponement legislation is signed into law. In other words, it is anticipated that claims with those dates of service would not contain the two-percent reduction in reimbursement when payments are disbursed.

How long will this new postponement last? That depends on the final verbiage of the bill. The Senate’s version ties it to the end of the public health emergency (PHE), while the House has expressed a desire to see the payment cuts pushed back to the end of this calendar year. Of course, at some point, you have to pay the piper. In the Senate’s provisions, the cost of postponement would be offset by increasing the amount of the sequestration cut in FY 2030. It’s an old story: kicking the can down the road.

Return of the Joint Commission

Sounds like an episode straight out of Star Wars, doesn’t it? Though not as intimidating as the Jedi knights, hospital surveyors—such as the Joint Commission (TJC)—can create a certain amount of stress by simply walking into your facility. For several weeks now, hospital administrators and department directors have been able to breathe a little easier, knowing that they were temporarily shielded from the full protocols of surveying agencies, due to one of the many COVID-related waivers. That has now changed.

On March 26, CMS announced the immediate resumption of survey activities for all complaints. Back in January, CMS had suspended surveying activities except to address Immediate Jeopardy (IJ) complaints. In the newly released guidance, CMS made it clear that it was not going to extend the suspension past March 22, 2021—meaning the resumption of survey activities is retroactive to March 23, 2021.

As part of the CMS statement, any non-IJ complaints received during the hospital survey suspension must be investigated within 45 days of the March 23, 2021 effective date. Furthermore, facilities are required to submit any delayed plan of correction (POC) within 10 days of March 23, 2021 for any surveys that ended on or after Jan. 20, 2021. If this presents a difficulty due to a COVID surge in your hospital, you are advised to contact “your state agency or CMS location” and request an extension.

For a full treatment of the announcement concerning the resumption of full surveying activities, please go to the following link: QS0-21-16-Hospitals (cms.gov).

Rigging the System

No one likes favoritism—at least in principle. However, when they’re the ones receiving the big promotion, the fat check or the cut in line because they’re known by the right people, their objections to favoritism seem to mysteriously fade into the mist. The fact is, showing favoritism to certain individuals is a common occurrence; and, while unfair to others, the negative impact is often benign. However, when it comes to providing unfair access to medical treatment at the expense of others, that is going beyond the pale and reveals a chink in one’s ethical armor.

That is what happened recently in Chicago, when it was discovered that the CEO of a particular hospital in that city had authorized the provision of the COVID jab to those who were not yet in line to receive it, including associates of hospital executives, neighbors, Cook County judges and their spouses, and even fellow church congregants. According to the Associated Press, the CEO has been suspended for two weeks by the hospital’s board of directors.

This is a cautionary tale, and one that other hospital executives must carefully consider. Do not put your reputation and that of your institution in jeopardy over showing partiality in medical treatment. It’s not a good look, and it’s not an appropriate practice.

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