REGULATORY REVIEW


ASCA Advocacy in the Pandemic Quick action to tackle COVID-19 challenges bears fruit BY KARA NEWBURY


Editor’s note: This is the second part of a two-part column. Look for the first part in the November–December 2020 Reg- ulatory Review. The first part discussed the lockdown in spring 2019, and ASCA’s work with the Trump administration to make sure ASCs were represented in the conversations that defined the nation’s COVID-19 response and had access to financial relief packages; the second part focuses on financial aid for ASCs and reopening after the lockdown.


WEDNESDAY, APRIL 1 ASCA seeks to ensure ASCs are eligible for funding provided in the CARES Act.


■


ASCA sent letters to the US Depart- ment of Treasury and the Small Busi- ness Administration urging ASCs to be eligible for Paycheck Protection Program (PPP) loans, as many ASCs did not meet the affiliation rules, due to relationships with corporate man- agement companies or hospital part- ners. ASCA also sent letters to the US Department of Health & Human Ser- vices (HHS) and the Centers for Medi- care & Medicaid Services (CMS) requesting support for the PPP loans and seeking clarification that ASCs would be eligible for emergency fund allocations. There was some concern that funding would only be directed to those currently treating COVID- 19 patients, even though the stated intent of the Coronavirus Aid, Relief, and Economic Security (CARES) Act also was to provide funding for those healthcare providers who suffered rev- enue loss due to COVID-19.


FRIDAY, APRIL 10 HHS announces distribution of $30B in grants to Medicare providers,


including ASCs. ■


This was the first tranche of CARES funding and was automatically sent to


providers that received Fee-for-Ser- vice (FFS) Medicare reimbursements in 2019. ASCA staff immediately recognized there was problematic language in the terms and conditions that ASCs were being asked to sign to accept the funds. One of the stip- ulations was that the provider “cur- rently provides diagnoses, testing, or care for individuals with possible or actual cases of COVID-19.” While any healthcare facility could be car- ing for an individual with a possible case of COVID-19 without knowing it, the word “currently” was problem- atic as many facilities were shut down at this time. It also was not included in that section of the CARES Act. ASCA jumped into action, alerting its HHS contacts.


MONDAY, APRIL 13 ASCA requests HHS revise CARES Act


grant funding terms and conditions. ■


This formal request was made after discussions with HHS staff during the three days prior.


TUESDAY, APRIL 14 HHS revises terms and conditions


and removes the word “currently.” ■


This new language provided greater assurance to ASCs that they were eligible to keep these grants.


THURSDAY, APRIL 16


Trump administration releases guidelines titled “Opening Up


America Again.” ■


Among the recommendations was the resumption of elective surgery when certain gating criteria were met.


FRIDAY, APRIL 17 ASCA issues statement on resuming elective surgery. ASCA advocated that ASCs should resume elective surgeries if two conditions were met.


28 ASC FOCUS JANUARY 2021 | ascfocus.org ■


First, the prevalence of COVID-19 in the community was low or declin- ing and the community had suffi- cient bed capacity and personal pro- tective equipment (PPE) supplies to accommodate the potential needs of COVID-19 infected patients. Sec- ond, ASCs must ensure the safety of patients and the broader community.


SUNDAY, APRIL 19


CMS releases reopening guidance. ■


CMS released guidance on restart- ing non-emergent non-COVID-19 healthcare once states or regions passed the gating criteria—symp- toms, cases and hospitals—the White House announced on April 16, 2020.


TUESDAY, APRIL 21 ASCA releases reopening checklist


for ASCs. ■


While primarily meant as a resource for ASCA members to use when reopening, the ASCA Government Affairs Department also used this checklist in its advocacy efforts to promote how responsible and safe ASCs were being with reopening.


FRIDAY, APRIL 24 HHS announces an additional $20B


in CARES grants. ■


This funding was available only for providers who were eligible for the first round of funding provided beginning April 10.


ASCA advocated for additional funds to be made available to Med- icaid providers and others who were ineligible for the funds based on Medicare participation. This funding, $15B, came in Phase II which was announced in June.


Kara Newbury is ASCA’s director of Government Affairs and regulatory counsel. Write her at knewbury@ascassociation.org.


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