Despite the coronavirus emergency, TSCL is continuing its fight for you to protect your Social Security, Medicare, and Medicaid benefits. We have had to make some adjustments in the way we carry on our work, but we have not, and will not stop our work on your behalf.
One thing we are learning from the coronavirus pandemic is how much we all crave certainty in our lives. Nearly everything about the pandemic has been uncertain and so much remains that way.
Our political leaders are facing that same uncertainty, with the latest example being the decision about when Congress returns to work in Washington. The Senate returns next Monday, the 4th, but the House canceled its plans and their return remains uncertain. Visitors have been barred from the Capitol and the Congressional office buildings until May 16 but that, of course, could change.
The return to work by the Senate has not been enthusiastically received by all Senators. Almost half of all Senators are over 65, placing them in the very vulnerable category regarding the virus.
Good news regarding coronavirus testing for seniors
The Centers for Medicare and Medicaid Services (CMS) added some certainty regarding care for seniors when it announced this week that seniors covered by Medicare can get tested for the Covid-19 when told to do so by any health-care professional. This, of course, is providing that the tests are available, which they still are not in many areas.
According to a report by Bloomberg News, CMS said it is temporarily waiving more regulations to give health-care providers and hospitals greater flexibility in how they respond to the pandemic.
Some of the changes were mandated by the Coronavirus Aid, Relief and Economic Security (CARES) Act, which was signed into law on March 27. The changes take effect upon publication in the Federal Register, and some may be applied retroactively.
Pharmacists will also be allowed to perform Covid-19 tests if they are enrolled as a lab with the CMS, allowing for more use of parking lot testing sites. Hospitals will be paid if they see patients and collect samples for Covid-19 tests, even if the patient does not receive other services.
Medicaid will be required to cover lab tests during any future public health emergency due to an outbreak of a communicable disease or during a period of active surveillance after the emergency ends, under the changes. The rule defines active surveillance as “an outbreak of communicable disease during which no approved treatment or vaccine is widely available.”
Few antibody tests have been authorized by the Food and Drug Administration, but Medicare and Medicaid will cover any that are. Medicaid will also be required to cover any lab tests, including in cases of self-collection.
In addition, Medicare will also be increasing its payments for telehealth services. Rural health clinics and federally qualified health centers will be able to provide telehealth with the changes, and other types of providers, such as physical therapists, will be able to bill for the service. Hospital-based providers will also be able to provide telehealth services to Medicare patients who are registered as outpatients.
Hospitals that would normally have their Medicare payments reduced if they increase their number of beds will now be able to do so with the certainty that their payments will stay the same.
Hospitals that are expecting or facing a surge of patients will be able to send patients to inpatient rehabilitation facilities, and long-term acute care hospitals will be paid at a higher Medicare rate if they accept acute-care hospital patients. However, freestanding inpatient rehabilitation facilities will not be able to take patients from hospitals if their state is in phase two or phase three of reopening, based on the White House’s guidelines.
Some hospital outpatient departments will also be paid at the higher physician fee schedule rates even if they relocate off the hospital campus. The CMS also will pay for outpatient hospital services—such as drug administration and wound care—in temporary expansion locations designated as part of a hospital.
Under the waivers, nurse practitioners, clinical nurse specialists, and physician assistants will be able to provide home health services. Teaching hospitals also will not have their payments reduced for moving residents where needed.
The rule also calls for nursing homes to inform residents and their families of “confirmed or suspected COVID-19 cases in the facility among residents and staff.” Nursing homes also must provide weekly cumulative updates.
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Fate of prescription drug pricing and surprising billing legislation remains uncertain
When TSCL visited with Congressional offices prior to the coronavirus lock-down, we were told that the fate of legislation dealing with prescription drug prices and ending surprise health care billing for this year was tied to the fate of what they called the “health care extenders.”
“Health care extenders” refer to more than a dozen programs and other policies that have been renewed repeatedly for short periods. Those currently bundled together include mandatory funding for a range of public health, human services, Medicare, and Medicaid programs.
Those health programs remain in limbo after again being extended for a short period in the third coronavirus response law. Lawmakers pushed back until Nov. 30 a deadline, initially set for May 22, that was designed to force action on drug pricing and surprise billing legislation.
In addition, TSCL has learned that medical practices that benefit financially from surprise billing have poured tens of thousands of dollars into a lobbying effort to try and stop legislation that would halt the practice.
And now with the urgent need to find treatments and a vaccine for the coronavirus, there is mounting concern that Congress will not be willing to cut the income of the big pharmaceutical companies we are relying on to come up with those treatments and vaccine.
TSCL is closely watching this and is staying in the fight for lower prescription drug prices and ending surprise billing. What happens with the effort to fight the pandemic over the coming weeks and months will no doubt determine the fate of legislation on those issues for this year.
You can rest assured that TSCL will continue to fight for you even if the much-needed legislation is not passed this year.
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Drug Companies pour millions into stopping much-needed changes in the law
One of the painful lessons we have all learned because of the coronavirus is how vulnerable we all are because so much of our pharmaceutical manufacturing has been moved to China and India. That, along with the manufacture of protective gear for hospital personnel, has created great uncertainty as to when we will have enough for our needs in this country.
So, TSCL has been happy to see efforts now starting in Congress to bring the manufacturing of those items back to the U.S. But an article in The American Conservative magazine paints a picture of what we are up against in this effort.
Here are the first two paragraphs of the article:
“If there was any example of how colossal moneyed interests work against the health of the nation look no further than the campaign Big Pharma has launched against a measure that would redirect the manufacture of medicines back to the United States.
“According to Peter Navarro, Trump’s top trade representative, Big Pharma has been the main obstacle to getting an executive order that he crafted signed by President Trump. At a time when the country is experiencing mounting shortages of medicine and supplies and a bill has come due for all of the off-shoring of our pharmaceuticals, particularly our generic medicines, the order would endeavor to begin re-balance the supply channels by streamlining regulatory approvals for “American-made” products and encourage the U.S. government, including the Department of Defense, Department of Health and Human Services, and Department of Veterans Affairs, to only buy American-made medical products.”
You can read the entire article by clicking here: https://www.theamericanconservative.com/state-of-the-union/swamp-creatures-attack-effort-to-make-medicines-american-again/?mc_cid=af814ac02a&mc_eid=5511fc6599
Once again, it demonstrates the power of the big pharmaceutical companies and the difficulty in making changes regarding the price of drugs in this country. In addition, there are some so-called senior groups that are funded wholly or in part by the big drug companies. You can be sure they will not be in the fight to lower drug prices.
TSCL takes no money from the big drug companies or from any other company, for that matter. We rely solely on the financial support of friends like you who believe in what we do and want to help us continue to fight on your behalf.
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Seniors avoiding necessary medical care
Reports have been coming out regarding health care other than for the coronavirus for seniors that are very troubling.
According to Reuters news, “Routine medical tests critical for detecting and monitoring cancer and other conditions plummeted in the United States since mid-March, as the coronavirus spread and public officials urged residents to stay home, according to a new report by Komodo Health.
“Dr. David Tom Cooke, head of general thoracic surgery at UC-Davis Health, said his cancer patients are getting treatment. But he worries new cancers will go undetected until they are more advanced and less survivable. “'We’re not doing cancer screenings, such as mammography for breast cancer, and lung cancer screening,” he said. “There is concern that we are delaying standard of care treatment for patients with potentially curable cancers.'”
And National Public Radio has reported that, “More than half of older Americans, many with chronic conditions, put off medical treatment during the first month of social distancing. That's according to a nationwide survey funded by the SCAN Foundation and the John A. Hartford Foundation, both of which focus on improving care for older adults.
"Dr. Bruce Chernof, SCAN's President and CEO, said the survey shows that "the first month of social distancing certainly saved lives, and yet it also created a situation where many older adults are not getting the care they need to manage serious health conditions."
According to the survey, 1 in 6 older adults delayed or canceled essential medical treatment in March. Almost 40 percent put off non-essential treatment, while about a third went without preventative care.
“The respondents were all age 70 or more. Only 1 in 5 said they had had a medical appointment by phone or video chat. And their views on telehealth are divided. About half said it was much the same as a regular visit in the doctor's office, while about 40 percent said it was worse, or much worse. Ten percent liked it better.”
We at TSCL are not doctors but we strongly recommend you discuss with your health care provider whether you should see your doctor for other-than-coronavirus-related health issues, or not. Do not just put it off for some future time, especially if you have a chronic condition that needs regular treatment.
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For progress updates or for more information about these and other bills that would strengthen Social Security and Medicare programs, visit the Bill Tracking section of our website or follow TSCL on Twitter.
