Trump administration extends public health emergency to October

• The federal public health emergency was extended to late October.
• Medicare telehealth waivers are among many those that can continue with the extension.
• Hospitals were given until the end of the year to submit community health needs assessments that had been due this month.

Following weeks of requests from hospitals and other healthcare providers, the Trump administration this week extended the federal public health emergency (PHE) to October.

The 90-day extension of the PHE, which was first implemented Jan. 31, stemmed from “the continued consequences of [the] Coronavirus Disease 2019 (COVID-19) pandemic,” Alex Azar, secretary of the Department of Health and Human Services, wrote in the declaration announcement.

The renewed PHE period started July 25 and followed a first renewal on April 21.

“While HHS staff telegraphed this extension a month ago, we appreciate the certainty the extension provides,” said Chad Mulvany, FHFMA, director of healthcare finance policy, strategy and development, with HFMA.

“Given the increasing caseloads facing hospitals in many parts of the country and the need for social distancing everywhere, providers need the flexibility from onerous regulations afforded to them by CMS’s various waivers, payment provisions as a result of the CARES Act, and the ability to use HHS’s Provider Relief Fund grants to cover increased expenses and lost revenue related to COVID-19.”

In a July 6 letter, the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) wrote Azar that the PHE “should be extended until there is access to a vaccine, particularly since long-term care providers, including nursing homes and assisted living communities, remain the epicenter of the fight against the pandemic.”

AHCA/NCAL represents 14,000 skilled nursing facilities, assisted living communities and intermediate-care facilities for individuals with intellectual disabilities.

“We anticipate the challenges associated with COVID-19 that our members and communities face every day will continue for many months, and potentially another entire year if we continue to experience increased cases despite extensive efforts to mitigate the spread among our membership,” wrote Mark Parkinson, president and CEO of AHCA/NCAL.

Waivers can continue

Expiration of the PHE also would have ended a large number of waivers and temporary authorities, including expansive use of telehealth services and higher Medicare payments for those services.

“These changes have enabled physician practices across the country to quickly shift much of their patient care services to virtual and telephone visits, which has played a pivotal role in mitigating the effects of the COVID-19 pandemic and ensured continued patient access to needed care, while also providing a source of much-needed revenue for physician practices across the country,” Jacqueline Fincher, MD, president of the American College of Physicians, wrote in a July 23 letter to Azar.

“Patients and physician practices would have to revert to primarily face-to-face services without any type of risk-based assessment for gradually reopening medical practices and health systems to care for non-COVID-19 and non-acute patients.”

IRS grants a CHNA extension

Another important federal policy extension was the IRS’s announcement extending the deadline for not-for-profit hospitals to submit community health needs assessments (CHNAs) from July 15 to Dec. 31.

The CHNAs must be accompanied by an implementation strategy to meet the community health needs identified through the CHNA.

Hospitals that don’t submit a CHNA and implementation strategy at least once every three years may lose their tax-exempt status and face a $50,000 tax on each hospital facility that fails to meet either or both of the requirements.

The IRS said that if a hospital organization was required to conduct a CHNA by April 30 or by the end of the third taxable year and was required to adopt an implementation strategy by Sept. 15, the extension gives the hospital until Dec. 31 to complete both steps.

The American Hospital Association, the Association of American Medical Colleges and the Catholic Health Association of the United States had urged in a letter to the IRS that the deadline be extended to April 1, 2021, or six months after the expiration of the PHE, whichever was later.

The COVID-19 pandemic “is limiting the ability of hospitals to seek input from their communities, requiring the full attention of public health authorities and personnel, and affecting the priorities and attention of hospital boards,” the groups wrote.

The typical processes for gathering CHNA data  may need to be altered to accommodate restrictions on public gatherings during the pandemic, the groups wrote.