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July 26, 2020
MHA Asks Marylanders to Stem Rise in COVID-19 Cases
After making great strides through the spring in our fight against COVID-19, Maryland’s positive cases and hospitalizations sadly now are moving in the wrong direction .

This worrying news follows declines in new case counts, hospitalizations, and deaths since the peak two and a half months ago. That didn’t just happen. It was the result of your hard work and the discipline of our fellow Marylanders, who took measures to keep themselves and others healthy.

Yet, case counts are again climbing, and our hospitals are seeing more patients suffering from the novel coronavirus. After peaking at 1,707 COVID-19 hospitalized patients in early May, the number fell to just 386 in early July. But as of July 24, confirmed COVID-19 inpatients jumped 41%, to 545.

In conversations, you’re telling us you can handle this caseload but you’re concerned about the prospect of a more powerful resurgence, especially as fall and flu season approach. You’re already at your limits on testing, PPE inventories are thinning, and most of all, health care workers are truly fatigued.

So last week we joined the chorus urging fellow Marylanders to do their parts. There are simple things everyone can do—and must do—to stop the disease spread. MHA broadcast these tips to the public via our website , on social media and on TV news :

  • Cover your face
  • Keep your distance
  • Wash your hands
  • Cover your cough
  • Clean and disinfect 
  • Avoid large crowds

Maryland hospitals are here for everyone who needs them. We have wonderful community and specialty hospitals throughout the state and world renowned academic medical centers. We hope and we believe that working together, Maryland can stem the spread of this virus in our communities.
Bob Atlas
President & CEO
State Confirms Hospitals to Receive Remdesivir Allocations
The Department of Health and Human Services (HHS) previously announced an agreement with drug maker Gilead Sciences to allow U.S. hospitals to purchase additional treatment courses of remdesivir, which HHS and state health departments will allocate as they did the previous 120,000 treatment courses donated by the drug maker. Under the agreement, hospitals will pay no more than the wholesale acquisition price for the drug, about $3,200 per treatment course, which AmerisourceBergen likely will ship to them every two weeks. Here is the American Hospital Association summary of this opportunity.
 
While there was concern that allocations would be diverted to other states experiencing a surge of cases, MHA confirmed with the Maryland Department of Health (MDH) that the state will receive allocations that will be delivered directly to hospitals by AmerisourceBergen. MDH has been in communication with AmerisourceBergen and confirmed Maryland will not see a shipment this week; however, information about the amount and timing of a forthcoming delivery is expected and will be communicated to pharmacy leads. As with HHS' previous distributions of donated remdesivir, the amount allocated to Maryland will be determined using hospital-reported information submitted thought the TeleTracking web portal . 
U.S. Extends Public Health Emergency Declaration 90 Days
The Secretary of Health and Human Services (HHS) on Thursday renewed the federal public health emergency (PHE) declaration, which was set to expire July 25. This extension allows critical flexibilities granted by the Centers for Medicare & Medicaid Services (CMS)—especially those focused on telehealth, alternate care sites, testing, and workforce—to continue for another 90 days. MHA sought this extension in a July 7  letter to HHS and CMS. MHA remains vigilant in advocating for a continued extension of the PHE over the next several weeks and months.
 
Additionally, Maryland Medicaid confirmed that with the renewal of the federal PHE, all COVID-19 related flexibilities implemented by the Department remain in place, including the ability to offer telehealth services delivered using audio-only or non-HIPAA compliant technology. For more information, please refer to the Maryland Department of Health notice regarding the extension of the federal PHE and Maryland Medicaid COVID-19 Provider Updates .
 
For additional information, contact Maansi Raswant .
AHA Hosts Calls With HHS COVID-19 Response Team
The Department of Health & Human Services (HHS) announced significant changes to the process for hospitals to fulfill the agency’s request for daily reporting on bed capacity, utilization, personal protective equipment (PPE), and in-house laboratory testing. HHS will use this ongoing data set to allocate scarce resources, like remdesivir, and distribute provider relief funds. They will no longer ask for one-time attestations for data in TeleTracking.
 
HHS hosted two calls last week with members of the HHS COVID-19 Response Team to address data integrity concerns and other questions.
 
Here are key takeaways from the HHS COVID-19 Response Team:
 
  • Weekend reporting: HHS strongly urges daily reporting. If your hospital misses a day or lacks staff to enter in weekend data, you can submit data retroactively using the upload template
  • Difference in data elements between FAQ and TeleTracking: There are more than 100 expanded data elements in TeleTracking, but hospitals are only mandated to report on the 32 listed in the FAQ. Hospitals should always prioritize reporting the seven data elements required for remdesivir distributions
  • No penalties: No financial penalties are in place, but they have been discussed. The daily data reported in TeleTracking will be the sole source for federal resources
  • Data dictionary and technical questions: At hospitals’ request, HHS representatives agreed to future Q&A options with hospitals to answer questions on definitions
  • Reporting: Hospitals should have reported on the seven data elements for remdesivir last week. Tomorrow is the recommended deadline to report on all 32 data elements in the FAQ. Hospitals are encouraged to report to the best of their ability, as soon as possible and to coordinate questions through [email protected]
 
MHA will continue to closely monitor updates related to this reporting change. For help from MHA, please contact Katie Eckert .
MHA COVID-19 Dashboard
MHA’s COVID-19 Dashboard, updated July 22, is available . Data show that while hospitalizations are up, deaths are staying level—suggesting a higher proportion of patients are recovering.
MHA Submits Liability Letter to Congressional Delegation
MHA submitted a letter July 20 to Maryland’s congressional delegation urging their support of enhanced liability protections for health care facilities and providers in the final version of the COVID-19 Phase IV legislation. With negotiations underway and a final bill expected to pass before Congress’ August recess, MHA continues advocating at the federal level for these critically important protections. For more information, contact Nicole Stallings or Brian Frazee .
Episode Quality Improvement Program Workgroup Meets
The Episode Quality Improvement (EQIP) Workgroup met Friday for the first time since March. The group heard from the Health Services Cost Review Commission (HSCRC) on elements of the program. The presentation  included stakeholder comments to the Request for Information (RFI) published last March. HSCRC plans to further develop program design elements using the EQIP work group guidance. HSCRC staff reiterated that the launch of any new model program will be delayed until 2022 or later. CareFirst also presented their episode-based models and discussed a desire to align all episode of care model based programs regardless of payer. The group will meet again in the coming months. For more information contact Maansi Raswant or Erin Dorrien . 
Learning Community Supports Telemedicine Implementation
Registration is open for the HHS Telemedicine Hack (TM Hack), a 10-week virtual, peer-to-peer learning community to accelerate telemedicine implementation for ambulatory providers. Components of TM Hack include: Five teleECHO sessions; five virtual “office hour” discussion panels; and inter-session peer-to-peer learning facilitated via virtual discussion boards. CME/CEU credits are available. Each session will take place on Wednesdays through Sept. 23 from noon to 1 p.m. See the  HHS Telemedicine Hack Flyer  for more information. Follow this link for a list of all upcoming  HHS/ASPR COVID-19 Clinical Rounds  Project ECHO training opportunities.
Compassion Tribe: Free Virtual Forums
The Maryland Healthcare Education Institute and the Healthcare Experience Foundation (HXF) have teamed up to launch a compassion tribe for health system leaders, staff, physicians, and providers. The goal is to create a forum for support, encouragement, and problem solving during this public health emergency.
 
Compassion tribe information, including dates and times can be found  here . A video library focused on managing, working, and leading through crisis also is available, and new videos have been added. Access the full video library here . Each forum is free but registration is required. The next forum is scheduled for July 28 at 2 p.m., focused on strategies for stress and coping. Registration is open . For more information, contact  Katrina Coleman . 
Optum Administrative Service Organization Updates
On July 17, the Maryland Department of Health (MDH) and Optum, its administrative service organization for the Public Behavioral Health System, extended estimated provider payments for behavioral health services through Aug. 6. Estimated provider payments were originally set to end July 16. MDH and Optum have also begun the process to reconcile estimated payments, although leadership has indicated no recoupment will occur until October, at the earliest. Correspondingly, summary reconciliation reports were slated for release July 22. For additional information, contact Diana Hsu .
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