Act

health

Some Hospitals Giving Back CARES Act Funds

Several hospitals and healthcare systems have “returned” CARES Act funding, according to reports and a federal database, though it’s not clear whether those funds were repaid or given back without being spent.

An analysis by MedPage Today also revealed discrepancies in public statements and reported distributions by some of the nations’ top healthcare systems.

HCA Healthcare, the for-profit hospital system based in Nashville, Tenn., said in a press release earlier this month that it would “return, or repay early,” its entire $1.6 billion in CARES Act distributions along with $4.4 billion in Medicare accelerated payments. Leadership determined the company didn’t need the money after netting a $1.1 billion profit for the second quarter, according to the press release.

But HCA’s COVID Stimulus Watch page, produced by watchdog Good Jobs First, indicates the company actually received $1.57 billion from general distributions — loans that are often tied to Medicare accelerated payments — plus $487 million in targeted grants.

That $2.1 billion total, derived from multiple data sources including Department of Health and Human Services (HHS) data, is well short of the $6 billion HCA noted in its press release.

In addition, the HHS database has recorded only about $141.5 million accepted by HCA entities via general CARES Act distributions, as of Tuesday. An an HHS spokesperson said its dataset “only includes payment amounts formally accepted by providers.”

Researchers at Good Jobs First told MedPage Today that what public companies report publicly regarding CARES Act funds sometimes does not match HHS data. That has been the case with Tenet Healthcare and HCA, researcher director Philip Mattera said.

“HCA was not very clear in that announcement [the news release] about what exactly they are giving back or returning,” Mattera said.

An HCA spokesperson said he was unfamiliar with the COVID Stimulus Watch database and declined further comment for this story, repeatedly pointing to the news release to answer questions.

The American Hospital Association and the Federation of American Hospitals also declined to comment for this story.

The Provider Relief Fund, established under the CARES Act, involves both general distribution loans (which often include Medicare advance payments) and targeted grants for medical centers deemed to be most needy. But some Medicare funds are included in both categories and general distribution figures keep changing because they are based in part on providers completing forms, Mattera said.

“All of this makes it tough to pin down exact numbers,” Mattera said.

Similar discrepancies were seen with Kaiser Permanente. The health system said it declined most of the more than $500 million it was eligible to receive, according to a spokesperson and a news release. Both sources noted Kaiser Permanente “declined all of [the money] except for $11.8 million for Maui Health System, a nonprofit subsidiary of Kaiser Foundation Hospitals.”

But Maui Health System actually received $17.2 million, according to the HHS general distribution database.

“Bottom line: we did not accept or keep any of [the $500 million-plus] except the money for Maui Health System,” the Kaiser Permanente

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health

Affordable Care Act: Trump keeps chipping away at Obamacare with only weeks until the election — and a Supreme Court hearing

The administration this week approved Georgia’s waiver request to provide Medicaid coverage to certain low-income residents if they work or participate in other qualifying activities for at least 80 hours a month. It’s the latest state to receive permission to require work as a condition of coverage, though implementation elsewhere has been halted by federal courts or state officials.

Also, the Centers for Medicare and Medicaid Services announced it had completed its review of Georgia’s more controversial request to make fundamental changes to the state’s Affordable Care Act exchange. The agency, which opened the door for states to create alternatives to Obamacare in 2018, is still finalizing the terms for approval.

The Peach State, which has the nation’s third highest uninsured rate at 13.4%, is the first to seek this enhanced power to reshape its individual market.

Georgia and federal officials say that these efforts will make coverage more available and affordable to residents, but consumer advocates say they are the latest attempts to undercut the law.

“It’s a road map of what they would allow were the ACA to be struck down and were they to win election again,” said Judy Solomon, senior fellow at the Center on Budget and Policy Priorities.

These moves come as health care takes center stage in the 2020 presidential campaign. Former Vice President Joe Biden’s campaign has hammered Trump for trying to take down the landmark health reform law and its protections for those with pre-existing conditions. Trump has repeatedly said he has a replacement plan that would continue those safeguards but has yet to produce one.
Also, Trump’s Justice Department is backing a coalition of Republican-led attorneys general, who argue that Obamacare’s individual mandate was rendered unconstitutional after Congress reduced the penalty for not having insurance to zero as part of the 2017 tax cut law. As a result, the entire health reform law must fall, they argue. The Supreme Court will hear oral arguments in the case on November 10.
The administration has pursued multiple avenues to overturn the Affordable Care Act in its first term. After efforts to repeal the law in Congress failed in 2017, officials started undermining it from within, including shortening the annual enrollment period to obtain coverage on the exchanges and slashing the budget for outreach and assistance. It also broadened the availability of alternative plans, primarily short-term health insurance policies that typically have lower premiums but are allowed to base coverage and premiums on people’s medical histories.
Also, officials took the unprecedented step in 2018 of allowing states to institute work requirements in Medicaid, a longtime Republican goal. However, the effort has been set aside by federal courts in four states, prompting the six others that had received approval (prior to Georgia) to stop implementation. Another eight states are awaiting permission from the Centers for Medicare and Medicaid Services.

What Georgia wants to do

Georgia is not looking to expand Medicaid under the Affordable Care Act. The waiver only applies to those earning up to

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