Roughly 40 percent of Americans have postponed getting medical care due to the coronavirus outbreak. That number has stayed around 40 percent in all 12 weeks of the Census Bureau’s Household Pulse Survey. Hospitals and doctors started rescheduling surgeries and other appointments as early as mid-May, and many patient volumes are mostly back to pre-pandemic numbers, Axios’ Bob Herman writes. But this data suggests there is still a major backlog of Americans who need care – a phenomenon that existed well before the pandemic.

HRSA’s Bureau of Primary Health Care (BPHC) and Office of Federal Assistance Management (OFAM) will host a question and answer session for the recipients of Look-Alikes: Expanding Capacity for Coronavirus Testing (LAL ECT) funding. This session is an opportunity for LALs to receive clarification on key fiscal and grants management requirements and hear strategies to ensure compliance and properly manage the LAL ECT award. Join the webcast the day of the session; Wednesday, Aug. 12 from 2:00-3:00 pm. Call-in: 888-972-9343; Passcode: 2324051. If you have questions to submit ahead of time, send them to OFAMFTA@hrsa.gov. You are also encouraged to watch the BPHC/OFAM Fiscal and Grants Management Orientation webinar held last month.

On July 20, 2020, the U.S. Department of Labor (DOL) issued guidance on return-to-work issues under the Families First Coronavirus Response Act (FFCRA). Enacted on March 18, 2020, the FFCRA provides emergency paid sick leave, fully paid for by the federal government by way of refundable tax credits and paid family leave under the Family and Medical Leave Act (FMLA) for certain qualifying employees affected by the COVID-19 pandemic. The following three areas were updated in this recently issued additional guidance:

• Paid Leave Clarifications: DOL clarifies that the period an employee was furloughed cannot count against their FFCRA or FMLA leave entitlement.
• Return-to-Work Positions: Provides direction to employers who have staff returning to work after caring for a family member exposed to COVID-19.
• No Retaliation: Makes it clear that employers may not discriminate against an employee for the use of FFCRA or influence any employment decisions based on the possible future use of FFCRA leave when returning staff to the workplace.

The DOL previously issued guidance in late June which clarified worker’s rights to FFCRA leave for school, camp or other child care closures affecting them during the summer months. The FFCRA’s leave provisions are currently scheduled to expire on Dec. 31, 2020.

Health Insurance Marketplace enrollment has increased due to millions losing employer sponsored coverage and employment across the nation. This enrollment spike nationwide may draw other insurers to state-based exchanges, reducing the per-person costs for insurers with the addition of healthy people looking for coverage. An increase in Medicaid rolls nationwide is partially due to states pausing eligibility redeterminations during the public health crisis as required under the Families First Coronavirus Response Act. To date, Medicaid enrollment has increased 1.3 percent in Pennsylvania.

On August 3, President Trump signed an Executive Order on Improving Rural Health and Telehealth Access, aiming to expand rural health access and many of the telehealth policies put into place during the COVID-19 pandemic. It is important to be aware, however, that Congressional action is needed to extend telehealth services for FQHCs beyond the public health emergency declaration, a fact emphasized in the annual Medicare Physician Fee Schedule proposed rule issued shortly after the executive order. There are a number of efforts in Congress to address the need for an extension of Medicare telehealth services for FQHCs; an overview of NACHC supported bills can be found here. The proposed rule does include a provision to add Principal Care Management services for FQHCs and RHCs and to rebase the Medicare FQHC market basket.

Hospitals must start paying back the millions in federal loans that were provided at the beginning of the pandemic, but experts are worried that these payments, which will be docked from regular Medicare payments until they are completely paid off, will cause rural hospitals to struggle. Chip Kahn, President of the American Federation of Hospitals, expressed concerns that hospitals are in the middle of these COVID-19 surges and that being forced to repay these loans is “going to kill them.” NRHA is advocating for MAAP loan relief for rural hospitals in the upcoming COVID-19 relief package. However, thus far, Republicans and Democrats have failed to agree on what to include and how much to spend on the relief package.

Missouri Congressman Jason Smith introduced the Saving Rural Hospitals from Closure Act. The bill would require HHS to forgive all Medicare Advance and Accelerated Payments (MAAP) for rural hospitals that are experiencing severe financial hardship. Additionally, it would extend the timeline for rural hospitals’ repayment or lower the interest rate of their payments. The legislation stipulates that HHS must make a decision within 30 days of receiving a request from a struggling hospital. In the months since April, Congressman Smith has implored both the White House and Congressional leaders to explore cost saving opportunities to rural hospitals.

In a tweet on August 6, 2020, CMS Administrator Seema Verma said: “CMS does not intend for Paycheck Protection Program funds to impact Medicare payments to rural hospitals. More guidance will be out soon that’ll explain how hospitals should report those funds on their Medicare Cost Reports. The Trump Administration continues to use every tool to expand services & improve the healthcare communication infrastructure in rural areas – ensuring rural Americans have access to the medical care they need.” The National Rural Health Association applauds this action by Administrator Verma, but is continuing to work with Capitol Hill to ensure, through codified law, that these funds do not negatively impact Medicare Cost Reports in the future. You can find their most recent letter to the Administration on this issue linked here.

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)

 Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

• Increase Hospital Capacity – CMS Hospitals Without Walls;
• Rapidly Expand the Healthcare Workforce;
• Put Patients Over Paperwork; and
• Further Promote Telehealth in Medicare

Office Hours:

Tuesday, August 11^th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 3498643

Audio Webcast link: https://protect2.fireeye.com/url?k=6f7db93e-3329a042-6f7d8801-0cc47adc5fa2-ed718e46a02e4dc1&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2361

Tuesday, August 25^th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 8579003

Audio Webcast link: https://protect2.fireeye.com/url?k=b0ee57aa-ecbb5eb9-b0ee6695-0cc47adb5650-7cf527ad219c44d5&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2371

Weekly COVID-19 Care Site-Specific Calls

CMS hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.

Home Health and Hospice (twice a month on Tuesday at 3:00 PM Eastern)

Tuesday, August 11^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5097566
Audio Webcast Link: https://protect2.fireeye.com/url?k=b4723cca-e827351a-b4720df5-0cc47a6a52de-e4916e2be973d447&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2386

Tuesday, August 25^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 6782346
Audio Webcast Link: https://protect2.fireeye.com/url?k=d56b6f04-893e66d4-d56b5e3b-0cc47a6a52de-db676249ca56a67f&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2391

Nursing Homes (twice a month on Wednesday at 4:30 PM Eastern)

Wednesday, August 12^th 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7857618
Audio Webcast Link: https://protect2.fireeye.com/url?k=2884bdb1-74d1b4a2-28848c8e-0cc47adb5650-5b54c104cb155c28&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2411

Wednesday, August 26^th 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5718509
Audio Webcast Link: https://protect2.fireeye.com/url?k=4af88041-16ad8952-4af8b17e-0cc47adb5650-7a1a6bc3fec88107&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2416

Dialysis Organizations (twice a month on Wednesday at 5:30 PM Eastern)

Wednesday, August 12^th at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1027088
Audio Webcast Link: https://protect2.fireeye.com/url?k=6b0af8ba-375ff16a-6b0ac985-0cc47a6a52de-6400b78b7f9a7c65&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2401

Wednesday, August 26^th at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1834329
Audio Webcast Link: https://protect2.fireeye.com/url?k=660ee5d6-3a5accfd-660ed4e9-0cc47a6d17cc-f3e0100acefbe41f&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2406

Nurses (twice a month on Thursday at 3:00 PM Eastern)

Thursday, August 13^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7844289
Audio Webcast Link: https://protect2.fireeye.com/url?k=666e39a3-3a3b30b0-666e089c-0cc47adb5650-9c83dad655df67f4&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2421

Thursday, August 27^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1556623
Audio Webcast Link: https://protect2.fireeye.com/url?k=9527d1a9-c972d879-9527e096-0cc47a6a52de-3cc6130cbe1e01ac&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2426

Lessons from the Front Lines: COVID-19 (twice a month on Friday at 12:30 – 2:00 PM Eastern)

Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.

Next Lessons from the Front Lines:

Friday, August 21^st at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5956858

Audio Webcast Link: https://protect2.fireeye.com/url?k=5bbe4eed-07ea67c6-5bbe7fd2-0cc47a6d17cc-0fae9923aae1404e&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2381

For the most current information including call schedule changes, please click here

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.