Florida Delegation Urges Equitable Distribution of CARES Act Hospital Funding

Last week, U.S. Sen. Marco Rubio, R-Fla. and U.S. Rep. Donna Shalala, D-Fla., rounded up the Florida delegation and U.S. Rep. Jenniffer Gonzalez-Colon, R-PR, sent a letter to U.S. Health and Human Services (HHS) Sec. Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, urging them to equitably disburse the next tranche of Public Health and Social Services Emergency Fund (PHSSE) monies to Florida hospitals.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act appropriated $100 billion for the PHSSE, of which $30 billion has been distributed to providers based on the Medicare Fee for Service (FFS) payments.

U.S. Sen. Rick Scott, R-Fla., signed the letter. So did U.S. Reps. Vern Buchanan, R-Fla., Kathy Castor, D-Fla., Charlie Crist, D-Fla., Val Demings, D-Fla., Ted Deutch, D-Fla., Mario Diaz-Balart, R-Fla., Neal Dunn, R-Fla., Lois Frankel, D-Fla., Matt Gaetz, R-Fla., Al Lawson, D-Fla.,

Debbie Mucarsel-Powell, D-Fla., Stephanie Murphy, D-Fla., Bill Posey, R-Fla., John Rutherford, R-Fla., Darren Soto, D-Fla., Ross Spano, R-Fla., Michael Waltz, R-Fla., Debbie Wasserman Schultz, D-Fla., Dan Webster, R-Fla. and Frederica Wilson, D-Fla.

The full text of the letter is below.

Dear Secretary Azar and Administrator Verma:

We write with regard to the disbursement methodology to hospitals and other healthcare providers for the Public Health and Social Services Emergency Fund (PHSSE) appropriated in the CARES Act to address the novel coronavirus (COVID-19) pandemic. We appreciate the quick disbursements of funds for the first tranche, and we urge you to provide funding in the second tranche that accounts for a payor mix that includes sources beyond Medicare fee-for-service (FFS), including accounting for states and jurisdictions with higher levels of Medicaid and Medicare Advantage enrollment that are quickly becoming hot spots for the COVID-19.

The PHSSE is intended to infuse emergency relief to providers as they incur substantial expenses, and revenue losses, in the battle against COVID-19. The initial $30 billion disbursement is based on its proportionate share of Medicare FFS payments nationally.  Unfortunately, allocating the funds to hospitals and other providers based on their Medicare FFS payments hurts hospitals that care for disproportionate numbers of patients enrolled in Medicare Advantage and Medicaid, as well as those receiving charity care. The second tranche of funding must help to address those providers whose payor mixes skew towards payors other than Medicare FFS, including from Medicare Advantage and Medicaid. In six states (FL, HI, MN, OR, PA, and WI) and Puerto Rico, more than 40 percent of Medicare beneficiaries are enrolled in a Medicare Advantage plan. In Miami-Dade County alone, Medicare Advantage enrollees account for 66 percent of the Medicare population.

The consequential impact of the initial $30 billion allocation from the PHSSE is compounded by the fact that the Medicare Accelerated and Advance Payment Program also fails to adequately consider providers with higher percentages of Medicare Advantage and Medicaid patients. The Medicare Accelerated and Advance Payment Program was also created by the CARES Act to enable providers to request up to a six-month lump sum or periodic payment from Medicare to offset revenue losses and expenses related to the pandemic. Because both the accelerated payment model and the PHSSE funding rely on Medicare FFS payments, those providers who serve a high percentage of Medicare Advantage and Medicaid patients receive limited cash flow assistance and may not have the resources they need to combat this pandemic.

Healthcare workers at hospitals are selflessly risking their lives each day working at these facilities and they cannot afford to wait. We must give our hospitals the assurance that their budgets will remain intact so they can continue to focus their efforts on ensuring that they have the resources needed to protect their workforce. Medical staff critical to the operation of our healthcare facilities, and patients that rely on their services, deserve to know that their jobs and ability to seek life-saving care are not at an immediate risk from unequal funding allocation.

We urge you to disburse the next tranche of funding equitably and to quickly give Congress the information needed to assess additional funding that is required in future legislative packages so hospitals can continue to provide the live-saving care Americans deserve.

Thank you for your attention to this important matter.

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