March 4, 2021

ILLINOIS HEALTH AND HOSPITAL ASSOCIATION MEMORANDUM

TO: Chief Executive Officers, Member Hospitals and Health Systems Chief Operating Officers, Chief Medical Officers, Chief Nursing Officers, Chief Quality Officers, Chief Financial Officers, Emergency Preparedness Contacts, Emergency Department Directors, Behavioral Constituency Section, Government Relations Personnel, In-House Counsel, Public Relations Directors

FROM: A.J. Wilhelmi, President & CEO Tim Nuding, Senior Vice President, Member Services & Corporate Finance Keneatha Johnson, Director, Quality, Safety and Health Policy

SUBJECT: IHA COVID-19 Update – March 4, 2021

Following is a brief recap of the most recent top developments.

Situational Awareness The Department of Public Health (IDPH) announced today 1,740 new confirmed and probable COVID-19 cases and 42 deaths. The total number of cases in the state is 1,193,260 with a total of 20,668 deaths. IDPH says that in the past 24 hours, 73,990 test specimens have been processed, with a positivity rate of 2.4%. The preliminary 7-day statewide positivity rate for cases as a percent of total tests from Feb. 25-March 3 is 2.4%, and the seven-day test positivity rate is 2.9%. Statewide COVID-19 hospitalizations in the past 24 hours decreased from 1,260 patients to 1,200 patients. Of that figure, 260 patients were in the ICU, with 128 patients on ventilators.

U.S. Senate Adds $8.5 Billion to COVID Bill for Rural Providers Late this afternoon, Democratic leaders in the U.S. Senate released an updated version of the American Rescue Plan Act of 2021, a $1.9 trillion COVID-19 relief package passed last week by the House. The updated Senate language adds $8.5 billion in relief funding for rural providers and increases COBRA premium subsidies from 85% to 100% for eligible individuals, among other changes. The legislation also includes IHA-supported provisions to expand health coverage at reduced costs, funding for vaccines, and resources to expand the healthcare workforce. Also, $350 billion is provided to state and local governments to help mitigate the fiscal effects from the pandemic, including $7.5 billion to Illinois and $5.6 billion to local governments in the state. See an IHA summary of the House version of the bill.

IHA issued an advocacy alert yesterday urging members to ask lawmakers to support additional funding for Illinois hospitals, an extension of Medicare sequestration relief and further delay of Medicare Accelerated and Advance Payment Program loan repayment. The Senate is expected to vote on the package late this week; the House will need to accept the changes before sending it to President Biden.

State Expands Vaccine Equity Effort On Wednesday, Governor J.B. Pritzker and IDPH announced a partnership with several hospitals and federally qualified health centers to administer COVID-19 vaccines to residents in underserved communities in , Metro East, , and Cook/DuPage/Lake Counties. The partnership is part of a pilot program that will be expanded in the coming weeks to include critical access hospitals across the state. Hospitals in the program include: AMITA Health Adventist Medical Center, Behavioral Hospital, SSM Health St. Mary's Hospital, and Touchette Regional Hospital.

On Tuesday, the Governor announced that two more state-supported mass vaccination sites are opening in Des Plaines and Quincy, providing a combined nearly 4,000 doses per day at full capacity. The Governor is also activating the Illinois National Guard to support Union, Johnson, Pope, Hardin, Alexander, Pulaski and Massac Counties.

United Center Vaccination Appointments Now Open As of today, Illinois seniors can schedule their first COVID-19 vaccine appointment at the United Center in Chicago, which will begin to administer a limited number of vaccines on March 9, with a full opening March 10. Following this exclusive appointment period for seniors, all Illinoisans eligible under the state's Phase 1B+ can schedule appointments starting Sunday, March 7 at 4 p.m. Illinois residents have two options for making appointments: online (Zocdoc.com/vaccine) and a call center (312-746-4835).

Chicago Vaccine Focus on Seniors Chicago is launching several new initiatives specifically for seniors to receive the COVID-19 vaccine. To date, one in three Chicagoans age 65+ has received a first dose of vaccine. Throughout March, the City will host senior community vaccine events; provide priority appointments to seniors at the United Center; offer appointments for seniors at the City’s points of dispensing sites; and offer mobile vaccination programs for homebound seniors and those residing in independent living facilities.

COVID Vaccine Administration and PRF In late January, the U.S. Department of Health and Human Services (HHS) updated the Provider Relief Fund (PRF) FAQs, reiterating that providers may not use PRF payments to pay for expenses reimbursable by other sources, including reimbursable vaccine administration. Medicare, Medicaid, the Children’s Health Insurance Program, and private payers must reimburse providers for administering COVID-19 vaccines, if reimbursement is sought. Providers should bill these payers for vaccine administration as appropriate. Providers may use PRF payments for other expenses associated with the distribution of COVID-19 vaccines, including the purchase of additional refrigerators or freezers or transportation costs not otherwise reimbursed. See the Vaccine Distribution and Administration FAQs beginning on p. 30 of HHS’ current FAQs.

Updated PRF Timeline IHA has updated the Provider Relief Fund (PRF) distribution timeline, available here. This document provides approximate general and targeted PRF distribution dates, as well as the methodologies used by the US Department of Health and Human Services (HHS) to determine payment amounts.

HHS Notice of HIPAA Enforcement Discretion on Online/Web Vaccination Appointments The U.S. Department of Health & Human Services last week released a Notice that “the HHS Office for Civil Rights will not impose penalties for noncompliance with regulatory requirements under the HIPAA Rules against covered health care providers or their business associates in connection with the good faith use of online or web-based scheduling applications” for scheduling COVID-19 vaccinations during the nationwide public health emergency. The Notice is retroactive to December 11, 2020.

Resources  IDPH COVID-19 webpage and Coronavirus.illinois.gov  CDC Homepage for Coronavirus Disease 2019 (COVID-19)  Chicago Department of Public Health COVID-19 webpage  IHA webpage on COVID-19

If you have questions or comments, please contact Tim Nuding, Senior Vice President, Member Services and Corporate Finance at 217-541-1164 or [email protected].