As states face an economic downturn and Americans lose health care coverage due to job loss during the public health pandemic, U.S. Senator Bob Casey (D-PA) is introducing the Coronavirus Medicaid Response Act (S 4108). This legislation would respond to the increased need for health care during the public health and economic crisis by creating a quicker and more responsive process for supporting state Medicaid programs. It would address fluctuating demand in states for Medicaid by automatically connecting the Medicaid Federal Medical Assistance Percentage (FMAP) to state unemployment levels, so that additional federal aid would ebb and flow with a state’s economy. Read more about the Coronavirus Medicaid Response Act here.

A Department of Health and Human Services (HHS) spokesperson announced on Twitter last week that HHS will extend the Public Health Emergency currently slated to end July 24. The extension likely will be for 90 days, ending around Oct. 22. FQHCs will continue to be eligible for Medicare reimbursement for telehealth services as long at the Public Health Emergency is in effect. In addition to the waiver of telehealth restrictions, some other notable policies attached to the Public Health Emergency include increased federal Medicaid matching rates and requirements that insurers cover COVID-19 testing without cost-sharing. In a letter to HHS Secretary Alex Azar, NACHC President and CEO Tom Van Coverden underscored the critical importance of the extension.

The Department of Health (DOH) launched an online early warning monitoring dashboard that provides statewide and county level COVID-19 prevalence information to track incidence and severity of the disease on a weekly basis. The dashboard shows data points being used to assess the spread of the virus in the state and in each county, including difference in confirmed cases (last 7 days vs. previous 7 days); incidence rate (last 7 days and previous 7 days) per 100,000 residents; difference in the average daily number of COVID-19 hospitalizations in the last 7 days and the previous 7 days, and percent of hospital emergency department visits in the last 7 days and previous 7 days due to COVID-like-illness (CLI).

The Independent Fiscal Office (IFO) reported that the commonwealth ended the fiscal year with a revenue shortfall of $3.2 billion. Pennsylvania’s 2019-20 fiscal year ended with the same type of poor financial news that marked the last quarter of the year due to the COVID-19 outbreak as well as the policies implemented to address it. The commonwealth collected $32.28 billion for FY 2019-20, a decline of $2.58 billion (-7.4 percent) from the prior fiscal year. The IFO projects that business closures and mitigation efforts related to the COVID-19 virus resulted in $1.36 billion in lost revenue from reduced economic activity and $1.91 billion that shifts to FY 2020-21 because of extended tax due dates. Click here to read the IFOs complete report.

The state Supreme Court tossed out an effort from GOP lawmakers to end Gov. Tom Wolf’s COVID-19 emergency disaster declaration, terminating a month-long standoff between the legislative and executive branch over the matter and handing the governor a victory in his attempts at managing the pandemic. The 5-2 ruling held that the legislature does need to present concurrent resolutions passed under the Emergency Management Code to the governor to either approve or reject, brushing away arguments from Senate and House Republicans that the resolution, HR 836, would not require Wolf’s consent.

Effective July 8, the commonwealth’s contract for healthcare emergency management transitioned from The Hospital & Healthsystem of Pennsylvania (HAP) to Philadelphia-based Public Health Management Corporation (PHMC). The Wolf administration shocked hospital executives and others last month when it canceled its just-renewed contract for healthcare emergency management with HAP. PHMC describes itself as a nonprofit public health institute that builds healthier communities through partnerships with government, foundations, businesses and community-based organizations. According to the PHMC website, the organization has more than 2,500 employees and serves close to 350,000 clients annually with more than 350 programs in 70 locations, including five FQHC locations. It is unclear where the initiative will fall under PHMC’s organizational chart but PACHC has reached out to PHMC to identify points of contact to help facilitate FQHC participation in planning activities and infrastructure. Health Secretary Levine has stated that a “more inclusive environment for all members of our health care system through our health-care coalitions” is a goal of the change. Read more.

Between 2011 and 2017, both median overall profit margins and the proportions of profitable rural hospitals declined. This is a stark contrast to the improving financial conditions of urban hospitals during this same time. To make things worse, the COVID-19 pandemic has amplified existing financial pressures twofold on rural hospitals. The CARES act and other pieces of legislation have alleviated some of this pressure in the short run, but long run solutions will need to be implemented when the pandemic ends. Expanding eligibility for Medicaid and making explicit payments to cover the costs of standby services in rural hospitals are a few ways rural healthcare can begin to operate at a financial gain.

Telehealth is now being used much more widely to screen and diagnose patients without risking exposure to the virus. As many as 93 percent of patients who have used telehealth during the COVID-19 pandemic agreed that telehealth improved patients’ access to care. However, the majority of people that these services would be most useful to still lack access to basic infrastructure that could facilitate a virtual visit. Additionally, laws are still in place that restrict reimbursement of telehealth visits to people that meet certain criterion. As the COVID-19 pandemic fades in severity, health care providers face challenges in the implementation of permanent telehealth services for their patients.

On July 2, Senators Bill Cassidy and Tina Smith wrote to the HHS Secretary and CMS Administrator urging them to be transparent in their future plans for telehealth. The letter was supported by 38 senators in total as they advocate on behalf of their rural communities. This letter addressed the fears of Medicare patients that temporary changes to telehealth coverage will be rolled back without notice after the COVID-19 pandemic.