Providers press White House for executive help on COVID-19 as talks with Congress falter

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President Donald Trump's flurry of COVID-19 executive orders did not touch on key issues that providers have been asking for, including help repaying advance Medicare payments. (uschools/iStock/Getty Images Plus/Getty Images)

Providers were left out of President Trump’s flurry of executive orders on COVID-19 relief, as some groups turn to the White House for help.

Trump issued a series of executive orders on Saturday meant to address several sticking points in the negotiations with Congress, which broke down at the end of last week. The orders included a deferral of payroll taxes through the end of the year and an extension of enhanced unemployment benefits of $400 a month but only if states chip in.

But providers feel left out of the orders, which did not address a lingering financial crisis caused by low patient volumes from COVID-19.

What HHS has allocated out of aid funding

Congress has in total passed $175 billion in funding to help prop up providers. This is in addition to money from the Payroll Protection Program and the Medicare Advance and Accelerated Program.

Here is how much HHS has distributed so far of the $175 billion as of July 20, the latest date available from the agency's website:

  • $50 billion in general distribution to all providers.
  • $13 billion to safety net and acute care providers.
  • $11 billion to rural providers. The agency gave $10 billion to rural hospitals and another $1 billion to specialty rural hospitals, urban hospitals with rural Medicare designations and hospitals in small metropolitan areas, HHS said on its website.
  • $5 billion to nursing homes and long-term care facilities.

HHS is also using the $175 billion fund to cover the tab for testing and treatment of the uninsured.

As of Aug. 6, HHS has paid out $167 million to cover testing costs for the uninsured and $382 million for treatment of uninsured individuals, according to data on the agency’s website.

The American Medical Association wrote to White House Chief of Staff Mark Meadows on Monday seeing help via an executive order to address issues with the Medicare Accelerated and Advance Payments Program.

RELATED: Some providers face daunting repayment deadline for Medicare advance loans

The Centers for Medicare & Medicaid Services has given out $100 billion in advance payments to providers. But the payments are essentially loans and now the bill is coming due.

Some providers must start to repay the loans beginning this month, and CMS will start to garnish 100% of a provider’s Medicare payments until the loan is repaid.

But providers need much more time to repay the loans. While patient volumes plummeted in March and April, practices have reopened but are not able to recoup the volumes before the pandemic.

“There are a series of reasons, including: spacing of patients to comply with social distancing, additional costs due to personal protective equipment and an inability or unwillingness of many patients to engage in activities outside their home, including visiting their physicians,” the letter said.

The group wants Trump to also issue an order to postpone recoupment of the Medicare funds until 365 days after the payment was issued to a physician practice. It also wants CMS to only take 25% of a provider’s Medicare payment instead of 100%

“If the administration does not act many physician practices will fail,” the letter added.

The AMA and other provider groups have been pressing CMS and Congress to make such changes, but so far nothing has materialized.

The American Hospital Association, AMA and American Nurses Association asked Congress last month to pass another $100 billion in stimulus funding for providers. This would be in addition to the $175 billion that Congress has already passed.

The HEROES Act, a $3 trillion package that passed the House more than a month ago, included $100 billion. It has stalled in the GOP-controlled Senate as Republicans charge it is too partisan.

Senate Majority Leader Mitch McConnell released a package a few weeks ago that included $25 billion and liability protection from lawsuits. 

Democrats blasted Trump’s executive orders, saying that they would not address longstanding economic issues created by the pandemic.

“Slashing unemployment benefits and forcing states to bear the burden when their budgets are already strapped is not a solution,” said House Majority Leader Steny Hoyer in a statement Saturday. “Words on paper that don’t provide rental assistance doesn’t cut it.”

The House is out until Sept. 14, but could come back if a relief deal is reached.

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