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Hospitals ask for money as officials urge delays in elective procedures

Requests come as administration announces steps to waive regulations for health providers, facilities

Seema Verma, administrator of the Centers for Medicare and Medicaid Services, said the agency would issue guidelines recommending elective and nonessential procedures be delayed.
Seema Verma, administrator of the Centers for Medicare and Medicaid Services, said the agency would issue guidelines recommending elective and nonessential procedures be delayed. (Bill Clark/CQ Roll Call file photo)

Hospitals strapped for cash are asking Congress to provide them with financial assistance as they scramble to build up their capacity to treat more patients diagnosed with COVID-19.

The request for money comes as the Trump administration announced additional steps Wednesday to waive regulations on health care providers and facilities. Federal officials also recommended that hospitals delay nonessential or elective medical procedures to free up space and providers for COVID-19 patients.

Centers for Medicare and Medicaid Services Administrator Seema Verma said at Wednesday’s White House press briefing that the agency would release guidelines later in the day recommending that health care providers limit nonessential, elective medical and surgical procedures as a way to conserve needed medical equipment.

“We believe that these recommendations will help surgeons, patients and hospitals prioritize what is essential while leaving the ultimate decision in the hands of state and local health officials and those clinicians who have direct responsibility to their patients,” Verma said.

The administration also said it would waive rules and allow health care providers to work across state lines in states they are not licensed in, a move that could help back up the medical workforce in the hardest-hit areas, especially as some doctors report being sick themselves.

The decision to delay elective procedures may mean less income for hospitals, including some that are struggling financially during the pandemic, said Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, which represents safety-net hospitals. No matter whether patients choose to cancel elective surgeries to decrease their risks or the hospital itself cancels them, that’s less revenue a hospital is bringing in while also trying to build triage areas and pay staff.

Many of those safety-net hospitals that treat low-income people have a 1.6 percent profit margin, compared to the average U.S. hospital, which has a margin of nearly 8 percent. Some of the group’s member hospitals have said they have enough cash on hand for three to five days, she said.

“It’s really a double whammy,” she said in an interview with CQ Roll Call. “They are just running through that money to build up their capacity.”

The group sent a letter to congressional leaders this week urging them to help hospitals financially, including through extending low-interest loans and providing direct, targeted funding to hospitals that treat large populations of Medicare, Medicaid and uninsured patients.

Other hospital groups, including the American Hospital Association and the Federation of American Hospitals, said it was good that CMS was ultimately leaving the decision about whether to proceed with elective procedures to local officials and providers.

“It’s important to recognize that the cancellation of elective procedures — which the medical community needs to be prepared to implement — should be determined at the local, community level in consultation with hospitals and the clinical recommendations of physicians and nurses,” AHA president and CEO Rick Pollack said in a statement. “It is important to recognize the definition of ‘elective’ procedures includes important life saving measures that will continue to be necessary.”

The AHA also released its own letter to congressional leaders on Wednesday, urging them to include financial assistance for hospitals in a forthcoming legislative package addressing the COVID-19 pandemic. The letter follows other recent pleas.

“The AHA urges Congress to provide financial assistance for hospitals making infrastructure investments, as well as for the purchase of equipment and supplies necessary to combat the COVID-19 pandemic,” Thomas P. Nickels, executive vice president of the AHA, wrote. “If tax relief is provided, it is important to provide that assistance through payroll taxes, so as to ensure that all hospitals are able to benefit from that relief.”

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