WASHINGTON — The Trump administration threatened hospitals on Tuesday with revoking their Medicare and Medicaid funding if they did not report coronavirus patient data and test results to the Department of Health and Human Services.
The threat was included in new emergency rules, announced by the Centers for Medicare and Medicaid Services, that make mandatory what has until now been a voluntary reporting program. Seema Verma, the centers’ administrator, said the changes “represent a dramatic acceleration of our efforts to track and control the spread of Covid-19.”
The new rules generated an immediate backlash from the American Hospital Association, which said the penalties, if enforced, would put hospitals out of business by effectively expelling them from the Medicare and Medicaid programs.
“It’s beyond perplexing why C.M.S. would use a regulatory sledgehammer — threatening Medicare participation — to the very organizations that are on the front lines in the fight against Covid-19,” Richard J. Pollack, the association’s president, said in a statement, adding that the rules were issued without any opportunity for feedback and should be “reversed immediately.”
In an interview, Mr. Pollack said it was not typical for the government to tie Medicare and Medicaid dollars to the reporting of public health information. Ordinarily, that kind of stick is used to ensure quality of care, he said.
But Tuesday’s announcement from the administration was clear. “Hospitals will face possible termination of Medicare and Medicaid payment if unable to correct reporting deficiencies,” it said.
The issuance of the new rules comes amid growing controversy over the voluntary data collection system. Hospitals have been working for months with administration officials — including Dr. Deborah L. Birx, the White House coronavirus response coordinator — to improve their Covid-19 reporting. But the administration’s shifting requirements have met resistance from hospitals and scrutiny from Democrats in Congress.
In July, the administration abruptly ordered hospitals to stop reporting coronavirus patient information to the Centers for Disease Control and Prevention and send results instead to a private vendor, the Pittsburgh-based TeleTracking Technologies, which provides the data to the Department of Health and Human Services.
Administration officials say the switch was necessary to improve hospital reporting. But the use of a private vendor and the sidelining of the C.D.C. has raised concerns among public health experts and Democrats, who worry about scientific integrity and data transparency.
Mr. Pollack and another association official, Nancy Foster, echoed that concern. “They’ve made commitments that the data would be transparent — not unlike the way C.D.C. used to do it,” Ms. Foster said, “and thus far the transparency is lacking.”
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated August 24, 2020
What are the symptoms of coronavirus?
- In the beginning, the coronavirus seemed like it was primarily a respiratory illness — many patients had fever and chills, were weak and tired, and coughed a lot, though some people don’t show many symptoms at all. Those who seemed sickest had pneumonia or acute respiratory distress syndrome and received supplemental oxygen. By now, doctors have identified many more symptoms and syndromes. In April, the C.D.C. added to the list of early signs sore throat, fever, chills and muscle aches. Gastrointestinal upset, such as diarrhea and nausea, has also been observed. Another telltale sign of infection may be a sudden, profound diminution of one’s sense of smell and taste. Teenagers and young adults in some cases have developed painful red and purple lesions on their fingers and toes — nicknamed “Covid toe” — but few other serious symptoms.
Why does standing six feet away from others help?
- The coronavirus spreads primarily through droplets from your mouth and nose, especially when you cough or sneeze. The C.D.C., one of the organizations using that measure, bases its recommendation of six feet on the idea that most large droplets that people expel when they cough or sneeze will fall to the ground within six feet. But six feet has never been a magic number that guarantees complete protection. Sneezes, for instance, can launch droplets a lot farther than six feet, according to a recent study. It’s a rule of thumb: You should be safest standing six feet apart outside, especially when it’s windy. But keep a mask on at all times, even when you think you’re far enough apart.
I have antibodies. Am I now immune?
- As of right now, that seems likely, for at least several months. There have been frightening accounts of people suffering what seems to be a second bout of Covid-19. But experts say these patients may have a drawn-out course of infection, with the virus taking a slow toll weeks to months after initial exposure. People infected with the coronavirus typically produce immune molecules called antibodies, which are protective proteins made in response to an infection. These antibodies may last in the body only two to three months, which may seem worrisome, but that’s perfectly normal after an acute infection subsides, said Dr. Michael Mina, an immunologist at Harvard University. It may be possible to get the coronavirus again, but it’s highly unlikely that it would be possible in a short window of time from initial infection or make people sicker the second time.
I’m a small-business owner. Can I get relief?
- The stimulus bills enacted in March offer help for the millions of American small businesses. Those eligible for aid are businesses and nonprofit organizations with fewer than 500 workers, including sole proprietorships, independent contractors and freelancers. Some larger companies in some industries are also eligible. The help being offered, which is being managed by the Small Business Administration, includes the Paycheck Protection Program and the Economic Injury Disaster Loan program. But lots of folks have not yet seen payouts. Even those who have received help are confused: The rules are draconian, and some are stuck sitting on money they don’t know how to use. Many small-business owners are getting less than they expected or not hearing anything at all.
What are my rights if I am worried about going back to work?
The new rule mandating hospital reporting is part of what the centers described as “sweeping regulatory changes” intended to better track and combat the coronavirus pandemic. The new rules also require nursing homes to test staff and offer testing for the virus to residents.
The agency said it would soon announce guidance for the frequency of nursing home staff testing, which will be based on the degree of coronavirus spread in individual communities.
Nursing homes are already required to offer tests to residents when there is an outbreak or when other residents show symptoms. Like hospitals, nursing homes will face penalties for not complying. They will be inspected, and those cited “may face enforcement sanctions” such as “civil money penalties in excess of $400 per day, or over $8,000 for an instance of noncompliance,” the announcement said.
“Reporting of test results and other data are vitally important tools for controlling the spread of the virus,” Ms. Verma said in the statement, “and give providers on the front lines what they need to fight it.”