Draft documents obtained by NPR show that the federal government is preparing to enforce new data reporting requirements, threatening to withhold vital Medicare funding from noncompliant hospitals.

Transcript

STEVE INSKEEP, HOST:

A new Trump administration database for coronavirus has caused widespread confusion. And in response, the administration is resorting to threats. That's according to internal documents obtained by NPR News. Until July, hospitals reported coronavirus data to the Centers for Disease Control. Then the Trump administration told them to stop, changed the system and told them to report instead to a new database at the Department of Health and Human Services. NPR's learned HHS feels it's not getting enough information, so it is threatening hospital funding. NPR's Pien Huang and Selena Simmons-Duffin broke this story. And Selena is with us. Good morning.

SELENA SIMMONS-DUFFIN, BYLINE: Good morning, Steve.

INSKEEP: What information are hospitals supposed to report?

SIMMONS-DUFFIN: There are dozens of questions, everything from the number of ventilators, COVID patients in the ICU, masks and gloves, and the Trump administration is requiring hospitals to send this information to their new data reporting system operated by HHS and a contractor called TeleTracking and says the hospitals need to provide 100% of this information. Most of it is required every day, including weekends. And the administration's argument when it made the switch in July was that CDC was only getting 85% of hospitals to report this COVID data. And the president wanted 100%.

INSKEEP: OK. So the feeling was they weren't getting enough information. They were going to go way up from 85% of information coming in. What happened instead?

SIMMONS-DUFFIN: Slides from an internal CDC presentation given yesterday and obtained by NPR show that only 24% of hospitals reported all metrics every day last week.

INSKEEP: Wow. OK. So down from 85% to 24%. What's happening?

SIMMONS-DUFFIN: Well, it's hard to know for sure, but I heard some theories from people I spoke with at hospital associations. One is that the long list of questions requires input from lots of different parts of a hospital, so if someone is out sick for a day, you're noncompliant for that week. Then there are glitches. I was told if you have no pediatric COVID patients and mark that blank, you're noncompliant for the week. Regardless, the government wants to get more compliance, and it has a plan. In the presentation, it noted the government is hoping to improve that figure by threatening hospitals' federal funding.

INSKEEP: How would that work?

SIMMONS-DUFFIN: The lever they're using is Medicare. So the Centers for Medicare and Medicaid Services, or CMS, has already telegraphed that this was in the works, but now they appear to be following through. Basically, if a hospital isn't compliant after several warnings, CMS could cancel its Medicare provider agreement. And this is a big deal. For a lot of hospitals, losing this funding even temporarily could mean shutting down.

INSKEEP: So you're learning the government is getting less and less information about COVID. How are they responding to that?

SIMMONS-DUFFIN: Well, HHS referred NPR's request for comment on this to CMS. CMS did not respond by airtime. What Trump administration officials have said in the past is that 100% compliance daily is needed for close to real-time insight into the pandemic. I should note that one concern that Pien and I heard from sources is that if you demand 100% compliance and threaten Medicare funding, you could get hospitals putting in incorrect information just to have something to input so you would have more complete data, but you couldn't trust it.

INSKEEP: NPR's Selena Simmons-Duffin, thanks.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.

Tags: COVID-19 data  Centers for Medicare & Medicaid Services  Centers for Disease Control and Prevention  Series: The Coronavirus Crisis