CEO Message

CEO Message: Fighting a Surge on Top of a Surge

While we all are grateful to leave 2020 behind us, the first several months of the new year will not provide any respite from the relentless spread of COVID-19, especially in these early weeks as the holiday gatherings transform into mass hospitalizations throughout California. 

The projections are frightening. As many as 15,000 new COVID-19 patients could need hospital care by the middle of this month, and the cases will continue to climb through late February before things might begin to level off. 

state health order issued on Tuesday and amended Wednesday lacks many of the key flexibilities hospitals need to manage through the most challenging period of the pandemic, and additional steps must be taken to avert the worsening crisis. 

The order does two things: directs hospitals in counties overwhelmed by COVID-19 to suspend non-essential surgeries, and allows the state to direct the transfer of patients from certain hospitals, requiring other hospitals to accept those transfers “when capable and clinically appropriate.” 

Many hospitals in affected areas have already suspended non-essential surgeries as ICUs throughout the state are bursting at the seams, but the application of this suspension to ASCs is troubling. With regard to patient transfers, the approach in this health order does not address critical capacity issues for a pandemic that is touching every corner of the state. CHA is working with the state now to address concerns with the health order. 

Some additional support may be forthcoming as soon as today or tomorrow, as three new All Facilities Letters are being finalized. These letters would:  

  • Suspend certain clinical documentation requirements for nurses, allowing them to spend more time with patients 

  • Provide state financial support for small and medium-sized hospitals to hire nurses from the state’s contracted staff 

  • Limit future staff ratio waivers to 60 days 

While two of these changes – the suspension of documentation requirements and financial support for hiring and – may be helpful, the magnitude of the surge demands more support. The state needs to speed up its work and provide leadership and coordination across counties in broader regions, to ensure patients are directed to the right place in the first place and discharged to post-acute care when ready, and to remove regulatory red tape to allow caregivers to do what they do best — save lives. 

We will keep you apprised of developments as they come. Regularly updated COVID-19 information is available here and via our regular Coronavirus Response newsletter, which is published on Tuesdays and as needed. If you are not currently receiving the email and would like to be added to the list, contact Ravenna Legare at info@calhospital.org to be added to the distribution. 

~ Carmela

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COVID-19

CHA News Article

Data Reporting Updates Include ICU Surge Beds, Therapeutic Fields
For COVID-19 tracker designees

With the surge in COVID-19 cases and the decreasing ICU capacity across California, the state finds it necessary to track ICU surge beds. To capture this information, CHA will update the CHA COVID-19 Tracking Tool to include a new field called ICU Surge Beds (a subset of the Total Surge Beds field) on Jan. 8

CHA News Article

DMHC Issues All Plan Letters in Response to Public Health Order
For CEOs, CFOs, directors of reimbursement

On Jan. 6, the Department of Managed Health Care (DMHC) released All Plan Letters (APL) 21-003 and 21-004 in response to the public health order issued and amended earlier this week by the California Department of Public Health. 

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Education

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Regulations

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Pharmacy

CHA News Article

Federal Court Blocks Implementation of Medicare Part B Drug Pricing Rule
For CFOs, finance & reimbursement staff, government relations staff, pharmacy managers

On Dec. 28, a federal judge for the U.S. District Court for the Northern District of California granted a preliminary injunction preventing the Centers for Medicare & Medicaid Services (CMS) from implementing the Most Favored Nation (MFN) interim final rule.

CHA News Article

HHS Issues Guidance Requiring Manufacturers to Provide 340B Discount at Contract Pharmacies
For CFOs, finance & reimbursement staff, government relations staff, pharmacy managers

On Dec. 30,  the U.S. Department of Health and Human Services general counsel issued an advisory opinion requiring pharmaceutical manufacturers to sell covered entities 340B drugs at or below the ceiling price when those drugs are distributed through a contract pharmacy.  

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Finance

CHA News Article

Medicare Sequester Suspension Extended Through March
For CFOs, finance & reimbursement staff

The Consolidated Appropriations Act, signed into law on Dec. 27, extends the suspension of the 2% Medicare sequester until March 31. The suspension, which was included in the Coronavirus Aid, Relief, and Economic Security Act, took effect on May 1, 2020, and was scheduled to expire on Dec. 31, 2020. 

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Post-Acute Care

CHA News Article

CDPH, DHCS Issue Updates on Acute Hospital Care at Home Program
For CEOs, COOs, CFOs, compliance officers

The California Department of Public Health (CDPH) and Department of Health Care Services (DHCS) have issued additional information and guidance for hospitals that are interested in participating in the Acute Hospital Care at Home program.  

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Coverage

CHA News Article

DMHC Issues All Plan Letter on Compliance with Mental Health and Substance Use Parity Law
For CEOs, CFOs, directors of reimbursement

On Jan. 5, the Department of Managed Health Care (DMHC) issued All Plan Letter (APL) 21-002 to all commercial full-service health plans and specialized health plans offering behavioral health services that are regulated by the department. The guidance is designed to ensure health plans comply with amendments made to Senate Bill (SB) 855 (Wiener, D-San Francisco), the mental health and substance use parity law that took effect on Jan. 1.   

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CMS News Roundup

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Education

Publication

CHA Education Events

For more information about CHA education programs, visit www.calhospital.org/education.

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