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Medicare And Medicaid Administrator Addresses U.S. Health Care Response To COVID-19


What counts as a hospital bed? We now look to New York City, where emergency hospital beds are multiplying in tents in Central Park, on a hospital ship docked on Manhattan's West Side and 10 blocks south in the Javits Convention Center, which now houses a thousand beds. Now the federal government is relaxing rules to give the rest of the country similar flexibility. Hospitals can now operate inside dorms, gyms, schools, parking lots. That's one of a number of changes to hospital safety rules that's been announced by the Centers for Medicare and Medicaid Services, which is run by Seema Verma, who joins us now.

Seema Verma, welcome.

SEEMA VERMA: Hello. Thanks for having me today.

KELLY: So I mentioned the Javits Center, these tents we've all watched being pitched in Central Park. Can you give us a concrete example or two of what you envision this actually looking like in other American cities?

VERMA: Sure. So FEMA is doing an incredible job setting up these temporary hospitals in New York and other parts of the country, but we want to empower local communities to also be able to take action and to tap into their local resources. So a hospital that may be located close to a college university - a lot of the universities are - have gone virtual, so the dorms are empty. And they could say, you know, we're going to provide services in these dorms.

You know, right now there are surgery centers that are out there - about 5,000 of them across the country. And those surgery centers are not performing elective surgeries, so they have some capacity there. They have medical equipment. So they're allowed to kind of go beyond their four walls, and it allows them that flexibility to triage patients. They could even do that outside of the emergency room in the parking lot and...

KELLY: Yeah.

VERMA: ...Figure out where people need to go.

KELLY: This is all on an emergency basis, temporary basis. These rule changes will be rolled back once the coronavirus crisis becomes less acute.

VERMA: That's exactly it. This is under the president's emergency declaration, an emergency rulemaking. So we will be bringing some of these flexibilities back.

KELLY: Which prompts a question because those rules were in place to deter health care fraud. And the safety standards are all in place - were all in place for a reason, primarily to ensure patient care and quality care. I mean, how do you navigate that fine line when, presumably, quality care and deferring fraud remain priorities, too?

VERMA: Absolutely, and quality is top of mind. But this is an unprecedented crisis for the health care system, and we've got to make sure that we provide enough flexibility so that they can give quality care. And, you know, if they're in a surge capacity where they don't have beds available, that's a war situation. So we want to empower our hospitals and our health care workers that are on the frontlines and give them the flexibility to deal with the crisis at hand.

KELLY: So relaxing these rules - this comes as we are now three months into what's become a global pandemic. Is the administration, and your agency included - are you playing catch-up right now?

VERMA: You know, I think that we've been responsive to the health care community. Some of these waivers that we put out yesterday - we've been having conversations with different states and localities, and they had actually received these waivers already. This is a rapidly changing situation, and we are trying to be as responsive as the needs arise. I think if we had done this a month ago, I think the issues around fraud and abuse would have been more paramount. I think people have a better understanding...

KELLY: You're saying you think hospitals and states might've pushed back more had you done this a month ago.

VERMA: I think they would have been less understood. I think people would have said, why are you doing this? And now I think people understand why, and there's a lot of support. Just this morning, we've received, you know, a lot of support from the ambulance community, from the cancer community, from hospitals that really appreciate the flexibility because they're understanding that they're going to need that to be able to deal with the surge.

KELLY: I want to ask you to put on your hat as a member of the - a senior member of the White House coronavirus task force and put to you a question or two about test shortages. Here at NPR, we're interviewing governors in state after state who are telling us they do not have the tests they need even as the president insists the testing problems are over. Does the president not have accurate information?

VERMA: I think from a high level, we are seeing testing ramping up every single day. You know, we will have completed almost a million tests, over a million tests. I think that was announced yesterday. And we're also seeing incredible examples of innovation from the private sector - you know, the Abbott tests that they talked about yesterday, which is a point of care test. They can go to doctor's offices, and people can get results in a matter of minutes.

KELLY: I do have to push back, though. We had Maryland Gov. Larry Hogan on NPR this morning saying no state has enough testing, and he speaks for all of them. He's also chairman of the National Governors Association.

VERMA: Well, you know, fair to say, we need to do more testing. There is a lot of innovation that's going to help address those concerns that governors and other folks have raised.

KELLY: Why are they still so hard to come by? Why are they not getting to states that need them?

VERMA: I think you're having a lot of innovation in testing, but it's also getting it out. So you've got the Abbott test that just became available. They're going to have a half a million of those testing systems in place. So you're seeing the innovation coming, and now the next step is getting it out there.

KELLY: So I hear you drawing a distinction there between - there's actually producing an adequate number of tests, whatever that number may be, and then getting the tests to where they need to be. I do want to just circle back because the president yesterday on a conference call with governors said he hasn't heard about testing in weeks, suggesting this problem is behind us. I mean, what is your understanding of - what is the disconnect there, where you're hearing such different things from the White House and from the people leading states, from governors?

VERMA: I think the president is acknowledging all of the private sector innovation that we've seen. You know, you've seen the private sector come up with different types of tests, and it's happened very quickly. You're seeing the FDA removing regulatory barriers to allow for rapid approval. So I think from his perspective, testing is getting better. That being said, obviously, there's more work to be done. I can tell you there's a very active force that Dr. Joie (ph) from HHS is leading to increase the number of tests.

KELLY: Just a last question, and it's a big-picture one because you have so much more data about this outbreak at your fingertips than most Americans. What is your sense of how much worse this might get before it gets better?

VERMA: You know, it's hard to know, but that's why I think that all of the recommendations that the White House has made in terms of staying at home - you know, hand-washing and all of those things that they're saying, the social distancing - is so important.

KELLY: It must be chilling to you as any of us, though, as a member of the White House task force, to hear your colleagues on it - Dr. Birx, Dr. Fauci - give numbers like 100,000 Americans, 200,000 Americans might die.

VERMA: Yeah, and I think we're trying to do everything that we can to make sure that it doesn't get to those numbers, right? So all of the efforts that CMS is making to give more flexibility to the health care system to make sure that they're better prepared to deal with this surge - if we know that people can get good medical care, that's also going to help us keep down those numbers.

KELLY: Seema Verma - she's administrator of the Centers for Medicare and Medicaid Services and a member of the White House coronavirus task force.

Thank you very much for your time.

VERMA: Thank you. Transcript provided by NPR, Copyright NPR.