Early this week, the Centers for Medicare and Medicaid Services (CMS) released a guidance document for healthcare centers on how to resume providing elective and preventive care procedures.  A little over a month ago, on March 18, 2020, CMS recommended that healthcare facilities, such as hospitals and doctors’ offices, limit “non-essential” care like elective surgery or other procedures.  CMS wanted to make sure there was enough capacity to treat patients with COVID-19 and preserve supplies, like personal protective equipment.

CMS realizes that many areas of the country have a low incidence of COVID-19 and that if these areas can meet the “gating” requirements in the White House Coronavirus Task Force guidelines to “Opening Up America,” healthcare facilities could start to provide non-coronavirus care to their patients.  The gating criteria consists of a two-week downward trajectory of influenza-like illnesses and COVID-like cases, a two-week downward trajectory of documented cases of COVID-19, and the ability that hospitals can treat all patients without crisis care and there is robust testing in place for healthcare workers.

This guidance document should be welcomed news.  Hospitals and doctors’ offices are hurting financially because millions of dollars have been spent treating COVID-19 patients, while at the same time they have not been able to treat patients for elective procedures.  This guidance will also bring great relief to patients because although a procedure may be considered elective, if someone needs heart surgery or a hip implant it is lifesaving or life changing.

The Wall Street Journal reported that as a result of the change, hospitals are “moving tentatively to resume surgeries and other procedures that were halted when the coronavirus pandemic reached the U.S.”  Some hospitals are beginning to advertise.  For example, a rural Missouri hospital has an ad, “If you stub your toe at 3 a.m. and think you broke it, yes, come in even if it’s not life-threatening.”  According to the Journal, “health care is joining other sectors of the U.S. economy making an uncertain – but urgent – push to resume business.”

Meanwhile, the Department of Health and Human Services released on April 22 how it will to distribute the rest of the $100 billion provided in the CARES Act to hospitals.  (Last week HHS announced it would distribute $30 billion immediately and as a condition of receiving the funds, hospitals could not surprise bill.)  The remaining amount will go for general funding: $20 billion going to general relief, with $10 billion targeted for COVID-19 hot spots, $10 billion for rural hospitals, $400 million for Indian Health Service facilities, and $29.6 billion to reimburse providers that treated the uninsured.

Also, the Senate passed another emergency funding bill on April 21 totaling about $500 billion, that includes roughly $75 billion more to fund hospitals and healthcare providers and more than $320 billion for the Paycheck Protection Program.  That bill is expected to pass the House on Thursday, April 22.

If these spending numbers are beginning to be frightening, you are not alone.  The Washington Examiner reported that “Republicans are losing enthusiasm for the massive bailout measures and are instead calling on local governments to develop plans to begin to reopen the economy safely as the coronavirus infection curve flattens.”

The Examiner stated that Senate Majority Leader Mitch McConnel (R-Ky.) is not inclined to “waive through” another massive spending measure and that senators need to be present before additional legislation is considered.  He said, “My view is we ought to bring everybody back to have full participation, begin thinking about the implications to the country’s future for this level of national debt, begin to see some evidence of the economy beginning to get back to normal … and take measured steps.”   McConnell said it is necessary find out “what needs less, what needs more” before the Senate starts to write another bill.  He said, “Let’s weigh this very carefully because the future of our country, in terms of the amount of debt that we are adding up, is a matter of genuine concern.”

The Senate is not scheduled to return until May 4.

It is clear many government officials are beginning to understand the importance of getting the country back to work.  The release of the White House’s three-phased plan, CMS giving the go ahead to our nation’s hospitals to begin to return to normal and getting money out the door to assist them in doing that, and many governors listening to their constituents and are allowing businesses to reopen and allow their citizens to begin normal activities.