State Update
Governor Cuomo Announces NYC Density Plan and Addresses Federal COVID-19 Response
Today (March 25th), Governor Cuomo held a press conference (available here) during which he discussed the continuing efforts to address the COVID-19 outbreak. Current projections indicate that the apex of hospital capacity need will occur in approximately 21 days and will be higher than previously anticipated, perhaps as high as 140,000 beds. To address density issues in New York City, the Governor has signed off on a plan developed by the City that would pilot closing streets, ban close contact sports, and mandate the reduction of social density in playgrounds.
Efforts to increase hospital beds, which would bring the State to a capacity of approximately 120,000 beds, include:
- Requiring all hospitals to increase capacity by 50% (with some hospitals increasing by 100%);
- Developing temporary hospitals sites with the support of the Federal Emergency Management Agency (FEMA) and the Army Corps of Engineers;
- Relieving hospitals of patients with other medical conditions by using a 1,000 bed Navy hospital ship to be stationed off the coast;
- Creating beds in downstate dormitories; and
- Converting empty hotels and nursing homes to temporary hospitals.
The Governor discussed continued efforts to obtain additional ventilators to supplement the current supply of approximately 15,000, which include approaching additional manufacturers and working with the federal government. Efforts to address shortages in the health care workforce have resulted in approximately 40,000 additional personnel who have signed up to work on reserve, including over 6,000 mental health professionals who will care for individuals requesting mental health services via a State-run hotline.
The Governor also addressed the federal legislative response, criticizing the third federal COVID-19 bill currently being developed by the Senate as insufficient to address the New York needs. The State is anticipating revenue lower than January projections by roughly $9-15 billion, while spending several billion dollars on the COVID-19 response, which the Governor compared with approximately $5 billion in direct aid to New York State and City. The Governor also restated his belief that the second federal COVID-19 bill, the Families First Coronavirus Response Act (FFCRA), which was signed into law on March 18th, needs revisions to make sure that New York is eligible for its increased Medicaid matching funds (discussed further below).
On March 24th, Governor Cuomo announced in a press release (available here) the distribution of medical supplies and equipment to hospitals and health care providers across New York City, Long Island, and Westchester, including large supplies of N-95 masks, surgical masks, gloves, gowns, and face shields. Distribution is being coordinated by the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS), who are helping to identify the hospitals with the greatest need for equipment.
Federal Update
CMS Provides State Guidance for Receiving FMAP
On March 24th, CMS issued guidance on implementation of the temporary 6.2% increase in federal medical assistance percentage (FMAP) available through the FFCRA. States will be barred from involuntarily disenrolling Medicaid enrollees (unless they move out of state), reducing benefits, or charging higher premiums. Additionally, states also must comply with the law’s requirement to cover all COVID-19 testing and treatment without any cost-sharing. The enhanced FMAP is available for qualifying expenditures incurred between January 1, 2020 and the end of the quarter in which the public health emergency ends. It will apply to Disproportionate Share Hospital (DSH) payments and waiver services, if they otherwise meet requirements. It will not apply to Medicaid administrative costs or any expenditures already reimbursed at an enhanced FMAP, such as the expansion population under the Affordable Care Act (ACA). For the purpose of qualifying for enhanced FMAP, state expenditures are considered to be incurred based on when the state makes a payment to a provider, rather than the date of service. Finally, the guidance further defined the scope of the requirement that states must not require political subdivisions of the state (i.e., counties) to pay a greater portion of the non-federal share of expenditures.
The CMS guidance is available here.