HHS makes COVID-19 data reporting a Medicare CoP as of Sept. 2

By A.J. Plunkett (aplunkett@decisionhealth.com)

Get a firm handle on your COVID-19 case data now that a new interim final rule requires the information to be reported to the Department of Health and Human Services (HHS) as a Medicare Condition of Participation (CoP).

The interim rule, which was pre-published for public inspection late Thursday, says the data must be reported daily as specified by HHS and points to a July FAQ for the current list of information sets that must be reported.

The change means that as soon as the interim rule is posted to the Federal Register—scheduled for September 2, 2020—failures to report the data could result in a condition-level deficiency and impact your ability to bill Medicare.

The rule tacks on the requirement to the CoP at § 482.42 for acute care hospitals and § 485.640 for critical access hospitals requiring, “active facility-wide programs, for the surveillance, prevention, and control of healthcare-associated infections (HAIs) and other infectious diseases and for the optimization of antibiotic use through stewardship.”

Most hospitals are already familiar with the data requirements, but some have been struggling to meet all the elements.

“From what I have read to date, the majority of hospitals (92%) are already reporting some data,” said Jennifer Cowel, RN, MHSA, president and CEO of Patton Healthcare Consulting in Naperville, Illinois, and a former TJC executive.

“However, the daily mandate will be a challenge to many and according to the July 14 CDC data below there is still 8% of facilities that are not reporting at all.  The 92% could be misleading also.  This number reflects facilities reporting at least one data element—it does not mean they are collecting full datasets from that group,” she said.

After July 14, control of the data collection was switched from the CDC to HHS.

“The fact that this is now a CoP will certainly make this a priority for all hospitals,” Cowel noted.

Meanwhile, the American Hospital Association (AHA) called implementing the new CoP without public input “heavy-handed.”

The interim rule “will require hospitals to report daily data including, but not limited to, elements such as the number of confirmed or suspected COVID-19 positive patients, intensive care unit beds occupied, and availability of supplies and equipment, such as ventilators and personal protective equipment,” noted the AHA in a statement.

“In addition to the new CoP requirement, the interim final rule directs surveyors to inspect nursing homes for adherence to new COVID-19 testing requirements, with penalties including sanctions and civil monetary penalties. The rule also implements new laboratory reporting requirements in accordance with the Coronavirus Aid, Relief, and Economic Security Act. Failure to comply with these requirements could result in civil monetary penalties of $1,000 a day for the first day and $500 a day for each subsequent day,” said the AHA. 

In a statement, AHA President and CEO Rick Pollack said, “While hospitals and health systems remain focused on patient care, they're also committed to providing our government with the public health data it needs. However, a new heavy-handed regulatory approach put forward by the Administration threatens to expel hospitals from the Medicare program. 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.” 

In the interim rule, CMS acknowledges the strain the requirements may pose for some facilities, but said the data is crucial to pandemic control efforts during the public health emergency (PHE) declared in March:

“We believe that universal reporting by all hospitals and CAHs is and will be an important tool for supporting surveillance of COVID-19 and for future planning to prevent the spread of the virus, especially to those most vulnerable and at risk to its effects, and we thank the thousands of hospitals and CAHs that have voluntarily reported this data in support of our efforts. However, while we recognize the important and immeasurable role that the timely and continued delivery of COVID-19 information plays in protecting both individual patients, as well as the overall health of the general public, we also recognize the crucial need for data reporting options that will help eliminate the duplicative and sometimes competing reporting requests that continue to place a significant burden on hospitals and CAHs whose resources are already stressed during this PHE for COVID-19,” said CMS.

 “We expect that the new reporting requirements that will be specified by the [HHS] Secretary, would include reporting channel options to make submission of data as user-friendly as possible to reduce the strain and burden hospitals and CAHs are currently experiencing as they face data requests from a multitude of federal, state, local, and private entities,” according to the rule.