CMS Approves Approximately $34 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers

1/10 Hospitals and providers need support right now, but that support should be targeted and conditioned to maximize impact and protect patients.

2/10 Assistance from this pool should be thought of as a subsidy - providers should not be seeking full reimbursement.

3/10 Hospitals/providers that receive federal funding shouldn’t be able to engage in billing practices that financially harm patients particularly when we want patients to seek care and when so many people are losing their jobs and under significant financial strain.

4/10 This means that providers need to agree not to balance/surprise bill and/or engage in debt collection at least through the end of 2020 (or alternatively forever). The same taxpayer that delivered the $100b+ shouldn’t be hit again with a surprise bill and debt collection.

5/10 And just to be clear - insurers shouldn't be required to pay the balance bills either. That just passes the excessive charges on to patients through their premiums.

6/10 Pay a Medicare rate – don't pay hospitals/providers based on what they extract from commercial payers (e.g. - 300% of Medicare for some and 150% of Medicare for others). Excessive commercial rates don't reflect costs - they reflect market power.

7/10 Target safety net providers eg hospitals with high uninsured and low all payer margins (both measures available in Medicare cost reports) get more (eg 120% of Medicare) and other hospitals get less (eg 80%) - IWOs hospitals w/ stronger financials share more of the burden.

8/10 Congress needs to hold oversight hearings after the fact – and accountability organizations like @propublica should engage in the public oversight.

Any provider receiving subsidies has to transparently report on its use.

Other possible areas of oversight:

9/10 All providers' (hospitals, ER docs, SNFs, NFs labs) billing practices - including surprise bills and debt collection - are subject to review.

Reports of health systems engaged in employee gag policies should be investigated.

10/10 Supply chain disruptions and price gouging that put the hospitals and other front line providers in jeopardy (drugs, masks, etc.) should be investigated.

This oversight will help develop better payment, coverage, delivery, and supply chain systems for future disasters.