A new federal stand-off may undermine healthcare for Medicare and Medicaid recipients.

A little noticed new federal mandate announced today may put many U.S. hospitals at risk.

The federal coronavirus task force, led by Dr. Deborah Birx, decided to demand additional information from hospitals today. By the end of the year, the requirements for reporting of influenza and COVID-19 cases will become more exacting and carry remarkable penalties for failure to comply.

Dr. Deborah Birx, White House coronavirus response coordinator, speaks during a briefing on coronavirus in the Brady press briefing room at the White House. (AP Photo/Alex Brandon)

The changes were made to bolster hospital disease reporting in the ad hoc federal system created to monitor the pandemic. Remarkably, the existing U.S. federal disease monitoring system lacked the ability to collect up-to-the-moment hospital data as Covid-19 gripped the country earlier this year. This lead to conflicts about resource distribution, despite more than a decade of warnings that federal reporting capability would be essential in an emergency.

In seeking to increase compliance, federal officials have faulted hospitals’ efforts. But errors in federal data collection and reporting also created problems. In contrast, local hospital officials have criticized the repeated, and sometimes abrupt, changes to federal data requests for sowing confusion and slowing their response efforts

This time, the request is very specific and has teeth. Letters from federal health officials will notify hospitals of missing data, and the hospitals will have 14 weeks to correct gaps. After that, hospitals will lose payments from Medicare and Medicaid, a penalty hospitals have criticized as extreme. In fact, it will assure that these hospital will cease to exist at a time when they are most vulnerable.

“The reality is many hospitals could not keep their doors open if they no longer receive payment from Medicare and Medicaid, affecting care for all Americans in the midst of a global pandemic,” said Rick Pollack, chief executive of the American Hospital Association.

The administration will also publicly report which hospitals have missing data starting in late October, according to a senior HHS official. The Wall Street Journal reported the administration’s plans to publish online how much data each hospital submits.

Hospitals have worked to boost reporting, despite changing federal requirements, Mr. Pollack said. “We have observed errors in data processing and confusion about exactly what was being requested at the hospital, state, contractor and federal level and have worked diligently with the federal agencies to identify and correct those problems.”

Aerials of UM Campus and Hospital and Ann Arbor area. The Hospital provides most of the care for Medicaid in the area.

So what is the bottom line here? The federal government needs data to understand the extent of the pandemic, but their system to monitor it is cumbersome and does not work well. Hospitals are straining to deal with the pandemic and now have increased reporting requirements without any additional resources to deal with these requirements. Sounds like a stand off, with the country, once again, losing. 

God forgive if the feds stop reimbursing hospitals for Medicare and Medicaid.  Not only will these people be denied health care, but the very hospitals that actually take care of these patients will cease to exist. Let’s stop finger pointing and come up with a viable solution.

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

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