July 12, 2020
Maintaining Positive Momentum
Last week the number of people hospitalized in Maryland with COVID-19 fell below 400 for the first time since March.
We expect some fluctuation, yet over the last two months, trends in our state are positive—fewer hospitalizations, less death, and a lower rate of positive tests.

Meanwhile, across the country we see dramatic spikes in cases. Texas, for example, reported a record-breaking daily surge of cases—10,000 in one 24-hour period. Arizona and Florida, where 56 ICUs hit capacity, similarly are struggling to contain the virus.
MHA’s analysis of hospitalization data reported by 46 states shows an 8.9% increase in COVID-19 inpatients in the latest seven days, while Maryland saw a 3.5% decrease. Our daily COVID hospitalization rate per 100,000 population is 6.6—about half the national average of 13.1.

Our full dashboard is on the MHA website. It includes figures on statewide hospital capacity not viewable on other published reports. We update this dashboard twice weekly.
It’s alright if we all feel some relief looking at these numbers. Maryland is doing a lot of things right. YOU are doing a lot of things right. Though you know we’re not out of the woods. 
That is why it is crucial, as the American Hospital Association said, joined by associations for the country’s doctors and nurses, that we stay vigilant. We must encourage everyone to wear masks, maintain social distance, and wash their hands regularly if Maryland is to stop the spread and stay on track to beat COVID-19.
Bob Atlas
President & CEO
MHA Seeks Clarity on State Testing Directive
The Maryland Department of Health (MDH) issued a new directive July 1 significantly expanding COVID-19 testing. The state now requires all providers, excluding some specialists, to order tests for anyone who requests one. The directive specifically states, “With testing now broadly available, Marylanders who believe they should be tested for COVID-19 should contact their healthcare provider. Healthcare providers shall order a COVID-19 test for any individual who believes it necessary, regardless of symptoms.” The directive also notes Maryland Medicaid will cover the costs of testing for its beneficiaries. These changes are consistent with the Gov. Hogan and MDH focus on reopening the state and a key part of the activities they believe are needed to safely do so.

MHA shared a comment letter July 1, noting concerns and requesting amended language. MHA held a follow-up phone call with Health Secretary Robert Neall Wednesday, and is working to convene a group with MDH to take up this issue. If you have questions, contact MHA’s Nicole Stallings .
MHA: Continue Federal Public Health Emergency Declaration
MHA urged the Centers for Medicare & Medicaid Services (CMS) and the Office of Health and Human Services in a July 7 letter to extend the public health emergency beyond its current July 25 expiration date. MHA also recommended that CMS continue waivers for alternative care sites and telehealth that allowed hospitals to meet increased demand for care and foster innovative approaches to deliver care safely. For questions, contact Maansi Raswant .
CMS Releases Guidance on Visitor Policies, Infection Prevention
As hospitals consider how to balance patients’ need for support from family and friends with strict policies to control and prevent COVID-19 infection, the Centers for Medicare & Medicaid Services (CMS) released recommendations to help hospitals safely implement a phase two reopening. The recommendations focus on delivering non-emergent, non-COVID-19 care to patients when telehealth is not an option. CMS continues to urge hospitals to keep visitors to a minimum and to actively assess all visitors for COVID-19 symptoms when they enter the facility, with those who have symptoms being prevented from entering.
MHCC to Release Wear the Cost Report
The Maryland Health Care Commission (MHCC) will launch updated information on price transparency through their Wear the Cost website this week. MHCC will host a meeting July 14 from 1-2 p.m. to answer questions from hospitals. Hospitals are asked to RSVP to mahlet.nigatu@maryland.gov . MHA is working to understand how MHCC plans to promote this update and will follow up with next steps and talking points. For more information, contact Nicole Stallings .
CMS Affirms Maryland’s 2019 Model Performance, Reviews Community Benefit Report
The Centers for Medicare & Medicaid Services (CMS) validated June 12 that Maryland met or exceeded all 2019 contractual targets under the Total Cost of Care Model, Health Services Cost Review Commission (HSCRC) Executive Director Katie Wunderlich reported during Wednesday’s HSCRC meeting. In 2019, Maryland achieved $340 million of total savings—outperforming its target of $120 million. Maryland’s contract with CMS allows the state to count one-half of any actual savings above the target toward the subsequent years. As a result, Maryland can count $110 million of savings toward 2020 performance. HSCRC also reviewed hospitals’ 2019 community benefit report . Community benefits totaled $1.9 billion in fiscal year 2019—up 8% from the year before. For more on the HSCRC, see this month’s MHA Newsbreak .
State Budget Outlook Impacted by COVID-19
The Board of Public Works (BPW)—Gov. Larry Hogan, Comptroller Peter Franchot and state Treasurer Nancy Kopp—voted July 1 to reduce the fiscal year 2021 state budget by $413 million. These cuts account for two-thirds of the cuts proposed to the board by the Department of Budget and Management (DBM) to balance the budget ahead of expected revenue shortfalls stemming from the economic fallout of the COVID-19 pandemic. DBM proposed an additional $205 million in cuts to state employee benefits that were delayed by the board and will be discussed at a future BPW meeting. About half of the reductions, including a proposed $35-million increase to the Medicaid deficit assessment and cuts to provider rates, require future legislative action. In a June 30 letter , MHA advocated against cuts that would negatively impact the health care field or the most vulnerable Marylanders.
Last week the House Appropriations Committee and Senate Budget and Tax Committees were briefed by the Department of Legislative Services (DLS) and DBM. DLS emphasized that, even under a more favorable budget scenario, the state faces a $5-billion budget shortfall over fiscal years 2021 and 2022, equivalent to about 12% of planned spending over the next two years. Given this expected budget shortfall, the MHA Government Affairs team is expecting significant action around the state budget during the 2021 legislative session and will continue to advocate on behalf of the hospital field’s interest. For more information contact Erin Dorrien or Brian Frazee .
AHA, MHA Urge Hospital Members to Reach Out to Congressional Members
As Congress considers additional COVID-19 relief, we need to make sure hospital and health systems' priorities are at the top of its list and that immediate action is taken. We know Maryland hospitals are experiencing significant costs and revenue losses due to COVID-19 and preparing for the likelihood of a second surge. AHA released a report recently that estimates hospitals' financial losses from COVID-19 are expected to top $323 billion in 2020.
MHA submitted a letter to Maryland’s Congressional Delegation highlighting the importance of additional relief and key provisions including liability protections that should be passed. AHA created an easy way for all of us to take action via email, phone or Twitter—and have your community engage as well. You can share this link with your community and ask them to amplify our message as well.
Joint COVID Legislative Workgroup Update
The Joint COVID-19 Response Legislative Workgroup met on Wednesday to hear briefings and updates from Dr. Clifford Mitchell, Director of the Environmental Health Bureau at the Maryland Department of Health, Dr. Justin Lessler, Associate Professor at the Johns Hopkins Bloomberg School of Public Health, and Joe DeMattos, President & CEO of the Health Facilities Association of Maryland. The Joint Workgroup continues its interest in several COVID-related topics including, but not limited to, the state’s efforts on testing, contact tracing, and disparities. For more information, contact Brian Frazee .
Optum Maryland Reactivates Incedo Provider Portal
In consultation with the Maryland Department of Health (MDH), Optum Maryland reactivated the Incedo Provider Portal (IPP) system July 1. Updates and enhancements to the system will continue beyond the July 1 reactivation. Reactivation of the system means that starting from July 1 providers must utilize the authorization and claim features in the IPP and payments will be processed through the system. The first payment against claims made by Optum Maryland is scheduled to be July 23 and will cover the period July 13-19.

The final estimated provider payment is scheduled to be paid out on July 16 and will cover the period ending July 12. MDH and Optum have not provided official dates regarding the reconciliation process yet.

Additional information is available here:

Optum assigned Denise Eangleheart ( denise.eangleheart@optum.com ) as the designated provider relations advocate for hospitals to submit concerns. For additional questions, contact Diana Hsu .
 UMMS Let's Talk About Health - Webinar Series
Registration is open for the University of Maryland Medical System’s monthly Let’s Talk about Health webinar series . The next webinar, July 15 at noon, is focused on accessing health care. Clinical experts will take questions from families using the Ask Me 3 approach to encourage patients and families to become more active members of their health care team.
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