Late Monday the Centers for Medicare and Medicaid Services approved waivers in 11 more states to improve the response to the coronavirus pandemic. The newly approved states are Alabama, Arizona, California, Illinois, Louisiana, Mississippi, New Hampshire, New Jersey, New Mexico, North Carolina, and Virginia. Florida and Washington state received the waivers last week, John Commins reports for HealthLeadersMedia. The waivers relax or remove certain requirements for Medicare, Medicaid and the Children's Health Insurance Program.

"Under the waivers, states can temporarily suspend prior authorization requirements, extend existing authorizations for services through the end of the public health emergency, suspend some nursing home pre-admission reviews, ease reimbursement for care delivered in alternative settings due to facility evacuations, and relax provider enrollment requirements to allow states to more quickly enroll out-of-state or other new providers to expand access to care," Modern Healthcare reports. The waivers are retroactive to March 1 and will end when the health emergency is declared over.

The move could help rural hospitals and health care providers struggling to cope with or prepare for the pandemic, many of which are already vulnerable to closure. Research has shown that Medicaid expansion helps rural hospitals. "Some rural communities have large senior populations and only one small hospital serving several towns. And no ventilators, the critical lifeline for patients who can’t breathe on their own," The Kansas City Star reports.

Many hospitals are canceling elective surgeries to prepare for the surge of covid-19 patients, but that means hospitals already on the edge financially are losing out on income, Edgar Walters reports for The Texas Tribune. "Meanwhile, the institutions also find themselves needing to pay higher prices for personal protective equipment such as face masks and other gear that's in short supply," Lauren Weber reports for Kaiser Health News. Last Thursday the American Hospital Association asked Congress for $100 billion for all hospitals to help with coronavirus-related expenses, citing rural hospitals' financial strain.

On Monday, a group of representatives and senators introduced coordinated bills aimed at providing financial relief for rural hospitals and other rural medical providers. The House version was sponsored by Reps. Terri Sewell, D-Ala.; Phil Roe, R-Tenn.; and Kim Schrier, D-Wash. The Senate version was introduced by Sens. Michael Bennett, D-Colo.; John Barrasso, R-Wyo.; and Doug Jones D-Ala. Barrasso, Roe, and Schrier are physicians. The bipartisan sponsorship could help parts of the bill get included in the big rescue package being finalized by House and Senate leaders. It would:
  • Provide a one-time grant to rural hospitals of $1,000 per patient day for three months.
  • Provide a one-time grant equaling the total reimbursement received for three months of services to make up for the loss of revenue.
  • Increase Medicare reimbursement 20 percent for any patient in a rural hospital using the swing bed program, to encourage larger, overcrowded hospitals to free up capacity.
  • Offer a one-time grant for all providers and ambulatory surgery centers equal to their total payroll from Jan. 1 to April 1, 2019.
  • Authorize the Small Business Administration to provide low-interest loans to physicians and other rural health care providers that would not begin accruing interest until two years after the pandemic has ended.