Aug. 26, 2020 -- The U.S. Department of Health and Human Services is changing COVID-19 reporting requirements for hospitals again, drawing the ire of the two major U.S. hospital associations.
The rule, issued Aug. 25 by the Centers for Medicare & Medicaid Services, goes into effect immediately, without any chance for comment or revision. CMS said the public health emergency was reason enough to skip the normal bureaucratic process.
Hospitals that fail to follow the new regulations could be ousted from Medicare and Medicaid programs. CMS estimates that 6,200 hospitals participate in those two federal health programs.
"These new rules represent a dramatic acceleration of our efforts to track and control the spread of COVID-19," CMS Administrator Seema Verma said in a statement. "Reporting of test results and other data are vitally important tools for controlling the spread of the virus and give providers on the front lines what they need to fight it," she said.
But the American Hospital Association was appalled. "This disturbing move, announced in final form without consultation, or the opportunity to provide feedback through appropriate administrative procedures prior to it becoming effective, could jeopardize access to care and leave patients and communities without vital health services from their local hospital during a pandemic," AHA President and CEO Rick Pollack said in a statement.
Chip Kahn, president and CEO of the Federation of American Hospitals, tweeted that hospitals had been working in good faith with the federal government on reporting.
"Now agency blindsides industry with mandatory reporting rules. Not only r rules not vetted but sudden change could jeopardize patient care," tweeted Kahn. "CMS action should be reversed."
Six Changes Since February
Pollack said hospitals and health systems have tried to meet federal requirements "under very trying circumstances, despite the ever-changing requests from the government on data reporting."
He noted that the federal government has "made at least six changes to how they want hospitals to report data" since February.
The last change was in mid-July, when hospitals were told they would no longer report data to the CDC. Instead, they were directed to submit to a new portal managed by a private contractor, TeleTracking.
Since that time, the data displayed on the Department of Health and Human Services' COVID-19 Hospital Reporting Dashboard have rarely been current. Hospitals and state health officials have struggled to switch to a new system. The AHA said that HHS has reported that even so, 94% of hospitals are reporting information.
A Stick, Not a Carrot
The Centers for Medicare & Medicaid Services said in its rule that it had hoped to fine hospitals that failed to comply but determined that doing so would not be legal. Instead, if facilities don’t take part, they can’t participate in Medicare and Medicaid.
Hospitals will be required to report daily on a variety of measures, including the number of confirmed or suspected COVID-19-positive patients, the number of ICU beds that are occupied, and the availability of essential supplies and equipment, such as ventilators and personal protective equipment (PPE). All facilities will also have to report the results of in-house COVID tests.
The CMS said in the rule that it aimed to "make submission of data as user-friendly as possible to reduce the strain and burden hospitals and [critical access hospitals] are currently experiencing as they face data requests from a multitude of federal, state, local, and private entities."
The rule also will require all labs that conduct COVID-19 diagnostics -- those in nursing homes and hospitals, as well as private labs -- to report the results daily to HHS. Labs have 3 weeks to start reporting. After that, CMS will fine noncompliant labs $1,000 a day for the first day and $500 for each day after.