The Centers for Medicare & Medicaid Services (CMS) released new guidance on hospital reporting requirements for COVID-19 as a condition for their participation in Medicare and Medicaid. CMS established these new reporting requirements through its August 26 interim final rule with comment period (details). In brief, CMS required through this rule that hospitals and critical access hospitals (CAHs) report data in accordance with a frequency and in a standardized format to be specified by the U.S. Department of Health and Human Services (HHS).
Enforcement of these requirements begins today. Details on the guidance follows.
- Required Data Elements for Reporting: The table on p. 3-11 displays the required data elements that facilities must report to satisfy the new conditions of participation requirements. Several data elements must be reported daily and include information such as the number of hospital beds, bed occupancy, total mechanical ventilators, number of suspected or confirmed cases of COVID-19, number of COVID-19-related deaths, etc. A second set of data elements pertaining to influenza can be reported daily on an optional basis, though CMS states it intends to make these data elements mandatory as well. A final set of data must be reported once per week on Wednesdays and pertain to medical supply counts.
- Reporting Timeline: CMS states that facilities should complete reporting within one business day of the reporting period. The agency further clarifies that if a facility cannot report on weekends or holidays, it may submit data on the next business day.
- Enforcement: On p. 11, CMS states facilities that fail to comply with the reporting requirements will receive a notification from their CMS Location. Three weeks after receiving an initial notification, facilities that remain noncompliant will receive a second notice stating that failure to comply may result in termination from the Medicare program. Facilities that remain noncompliant for six weeks will then receive their first enforcement notification letter and will have one week to demonstration compliance. If providers do not comply within that week, they will receive a second and a third letter and will again have one week to demonstration compliance.
Failure to comply after that point will result in facilities receiving a fourth and final enforcement letter. Facilities will then have 30-days to demonstrate compliance. CMS states that failure to comply within this 30-day period may result in termination.
CMS further clarifies that the initial parts of the enforcement process (i.e., the steps involving the noncompliance notifications during the first three week period) are only applicable from October 7 – November 18, 2020. After this period, CMS states the enforcement process will begin at the stage where CMS delivers its first enforcement notification letter (i.e., after the first six weeks of noncompliance).
CMS also includes information on an appeals process on p. 11-12.