COVID-19
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Some insurers to no longer waive co-payments, deductibles for telehealth appointments
The New York Times (10/3, Abelson) reported, “Some people will have to start paying more out of their own pockets for telemedicine appointments, if their virtual visits with doctors are unrelated to [COVID-19] and are needed to monitor conditions like diabetes or to check out sudden knee pain.” Both Anthem and UnitedHealthcare “are no longer waiving co-payments and deductibles for some customers beginning on Oct. 1.” Patients “who have been relying on telehealth to steer clear of the emergency room or a doctor’s office during the coronavirus pandemic will need to check with their insurers to see how much they will now owe for a virtual visit.”
Click here to read more.
The New York Times (10/3, Abelson) reported, “Some people will have to start paying more out of their own pockets for telemedicine appointments, if their virtual visits with doctors are unrelated to [COVID-19] and are needed to monitor conditions like diabetes or to check out sudden knee pain.” Both Anthem and UnitedHealthcare “are no longer waiving co-payments and deductibles for some customers beginning on Oct. 1.” Patients “who have been relying on telehealth to steer clear of the emergency room or a doctor’s office during the coronavirus pandemic will need to check with their insurers to see how much they will now owe for a virtual visit.”
Click here to read more.
HHS Announced a New Round of Provider Relief Funds
Content provided by: HHS.gov
HHS announced today that it will be disbursing another $20 billion in CARES Act Provider Relief Funds. Under this Phase 3 General Distribution allocation, physicians that have already received Provider Relief Fund payments may apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Recognizing the negative impact of the COVID-19 pandemic has increased anxiety and depression in the country and behavioral health providers have continued to provide care through telehealth and other means, HHS is also announcing that the nation’s behavioral health care providers, including psychiatrists, are now eligible for funding. Previously ineligible physicians, such as those who began practicing in 2020, will also be eligible to apply. Physicians will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding.
Click here to read more.
Content provided by: HHS.gov
HHS announced today that it will be disbursing another $20 billion in CARES Act Provider Relief Funds. Under this Phase 3 General Distribution allocation, physicians that have already received Provider Relief Fund payments may apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Recognizing the negative impact of the COVID-19 pandemic has increased anxiety and depression in the country and behavioral health providers have continued to provide care through telehealth and other means, HHS is also announcing that the nation’s behavioral health care providers, including psychiatrists, are now eligible for funding. Previously ineligible physicians, such as those who began practicing in 2020, will also be eligible to apply. Physicians will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding.
Click here to read more.
AMA supports Senate bill to permanently lift Medicare’s geographic, site restrictions on telehealth
Content provided by: ASC Becker's Review
The American Medical Association highlighted its support on Sept. 18 of the Senate's "Telehealth Modernization Act of 2020," which would permanently cut many of the regulatory restrictions that were provisionally lifted at the beginning of the COVID-19 pandemic.
Three notes:
"The success of telehealth technology adoption during the COVID-19 public health emergency has made it abundantly clear that this technology should be available to all Medicare patients regardless of where they live or how they access telehealth services," AMA Executive Vice President James Madara, MD, wrote in a Sept. 2 letter to the Senate health, education, labor and pensions committee.
Click here to read more.
Content provided by: ASC Becker's Review
The American Medical Association highlighted its support on Sept. 18 of the Senate's "Telehealth Modernization Act of 2020," which would permanently cut many of the regulatory restrictions that were provisionally lifted at the beginning of the COVID-19 pandemic.
Three notes:
- The bill would permanently eliminate Medicare's previous telehealth and geographic originating site restrictions, which prevented Medicare physicians from offering most telehealth services outside of rural areas, according to the report.
- The bill would also permit the HHS secretary to grant patients access to telehealth from physical therapists, speech pathologists and other healthcare professionals as well as allow Medicare hospice and home dialysis patients to participate in a telehealth visit without having an initial in-person visit.
- Under the bill, the HHS secretary would also have the authority to give Medicare flexibility in paying for more telehealth services. At 135 services covered, Medicare more than doubled its telehealth coverage from pre-pandemic and now covers emergency department visits and physical, occupational and speech therapy services.
"The success of telehealth technology adoption during the COVID-19 public health emergency has made it abundantly clear that this technology should be available to all Medicare patients regardless of where they live or how they access telehealth services," AMA Executive Vice President James Madara, MD, wrote in a Sept. 2 letter to the Senate health, education, labor and pensions committee.
Click here to read more.
CDC Changes Coronavirus Testing Guidelines to Exclude Asymptomatic People
The New York Times (8/25, Wu) reports the CDC “quietly modified its coronavirus testing guidelines this week to exclude people who do not have symptoms of COVID-19 – even if they have been recently exposed to the virus.” Some “questioned the revision, pointing to the importance of identifying infections in the small window immediately before the onset of symptoms, when many individuals appear to be most contagious.”
Shift to Telemedicine Doesn’t Diminish Value of Team-Based Care
Content provided by: American Medical Association
As practices scrambled to implement telehealth so they could care for patients safely during the pandemic, practices that used a team-based approach to care for years suddenly found themselves defaulting back to a system where the physician did it all.
But it doesn’t have to be that way—nor should it be. That’s what team-based care experts said in a recent panel discussion hosted by AMA Chief Experience Officer Todd Unger. The AMA is providing COVID-19 video updates featuring interviews with a wide range of physicians and experts from the AMA and elsewhere who provide real-time insight on the challenge of the pandemic.
Click here to read more.
DaVita Begins Clinical Trials to Better Understand COVID-19 in Patients with ESKD
Content provided by: Healio
Through its clinical research subsidiary, DaVita Inc. has begun enrolling participants for two trials designed to investigate the ways in which COVID-19 impacts patients with end-stage kidney disease who are currently receiving dialysis.
More specifically, the trials will assess the presence of COVID-19 antibodies in these patients and determine the role genetics may play in disease severity, according to a press release.
Click here to read more.
AMA Urges FDA to Work More Closely With the Physician Community on Vaccine Transparency
Content provided by: American Medical Association
Today, the American Medical Association wrote to the U.S. Food and Drug Administration (FDA) urging them to work more closely with the physician community starting now to develop a plan for further education and transparency surrounding COVID-19 vaccine candidates. We want physicians fully informed as the vaccine development process evolves. This is particularly important to address vaccine hesitancy by patients.
Click here to read the AMA's letter to the FDA.
The New York Times (8/25, Wu) reports the CDC “quietly modified its coronavirus testing guidelines this week to exclude people who do not have symptoms of COVID-19 – even if they have been recently exposed to the virus.” Some “questioned the revision, pointing to the importance of identifying infections in the small window immediately before the onset of symptoms, when many individuals appear to be most contagious.”
Shift to Telemedicine Doesn’t Diminish Value of Team-Based Care
Content provided by: American Medical Association
As practices scrambled to implement telehealth so they could care for patients safely during the pandemic, practices that used a team-based approach to care for years suddenly found themselves defaulting back to a system where the physician did it all.
But it doesn’t have to be that way—nor should it be. That’s what team-based care experts said in a recent panel discussion hosted by AMA Chief Experience Officer Todd Unger. The AMA is providing COVID-19 video updates featuring interviews with a wide range of physicians and experts from the AMA and elsewhere who provide real-time insight on the challenge of the pandemic.
Click here to read more.
DaVita Begins Clinical Trials to Better Understand COVID-19 in Patients with ESKD
Content provided by: Healio
Through its clinical research subsidiary, DaVita Inc. has begun enrolling participants for two trials designed to investigate the ways in which COVID-19 impacts patients with end-stage kidney disease who are currently receiving dialysis.
More specifically, the trials will assess the presence of COVID-19 antibodies in these patients and determine the role genetics may play in disease severity, according to a press release.
Click here to read more.
AMA Urges FDA to Work More Closely With the Physician Community on Vaccine Transparency
Content provided by: American Medical Association
Today, the American Medical Association wrote to the U.S. Food and Drug Administration (FDA) urging them to work more closely with the physician community starting now to develop a plan for further education and transparency surrounding COVID-19 vaccine candidates. We want physicians fully informed as the vaccine development process evolves. This is particularly important to address vaccine hesitancy by patients.
Click here to read the AMA's letter to the FDA.
CMS and CDC announce provider reimbursement available for counseling patients to self-isolate at time of COVID-19 testing
Content Provided By: Centers for Medicare & Medicaid Services (CMS)
Today, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to counsel patients, at the time of coronavirus disease 2019 (COVID-19) testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms.
The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic and asymptomatic individuals emphasizing the importance of education on self-isolation as the spread of the virus can be reduced significantly by having patients isolated earlier, while waiting for test results or symptom onset. The CDC models show that when individuals who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86 percent reduction in the transmission of the virus compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.
Provider counseling to patients, at the time of their COVID-19 testing, will include the discussion of immediate need for isolation, even before results are available, the importance to inform their immediate household that they too should be tested for COVID-19, and the review of signs and symptoms and services available to them to aid in isolating at home. In addition, they will be counseled that if they test positive, to wear a mask at all times and they will be contacted by public health authorities and asked to provide information for contact tracing and to tell their immediate household and recent contacts in case it is appropriate for these individuals to be tested for the virus and to self-isolate as well.
CMS will use existing evaluation and management (E/M) payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals and community drive-thru or pharmacy testing sites.
Further information and resource links are available in the Counseling Check List PDF here.
Content Provided By: Centers for Medicare & Medicaid Services (CMS)
Today, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to counsel patients, at the time of coronavirus disease 2019 (COVID-19) testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms.
The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic and asymptomatic individuals emphasizing the importance of education on self-isolation as the spread of the virus can be reduced significantly by having patients isolated earlier, while waiting for test results or symptom onset. The CDC models show that when individuals who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86 percent reduction in the transmission of the virus compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.
Provider counseling to patients, at the time of their COVID-19 testing, will include the discussion of immediate need for isolation, even before results are available, the importance to inform their immediate household that they too should be tested for COVID-19, and the review of signs and symptoms and services available to them to aid in isolating at home. In addition, they will be counseled that if they test positive, to wear a mask at all times and they will be contacted by public health authorities and asked to provide information for contact tracing and to tell their immediate household and recent contacts in case it is appropriate for these individuals to be tested for the virus and to self-isolate as well.
CMS will use existing evaluation and management (E/M) payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals and community drive-thru or pharmacy testing sites.
Further information and resource links are available in the Counseling Check List PDF here.
Survey: Many Americans still experience lengthy wait times for coronavirus test results
The New York Times (8/4, Mervosh, Fernandez) reports that despite an increase in U.S. coronavirus testing, “many Americans are still having to wait many days for results, effectively rendering those tests useless.” Most people “do not receive results within the 24 to 48 hours recommended by public health experts to effectively stall the virus’s spread and quickly conduct contact tracing, according to a new national survey by researchers from Harvard University, Northeastern University, Northwestern University and Rutgers University.” The Times adds, “The survey – representing 19,000 people from 50 states and Washington, D.C., who responded to an online questionnaire last month – found lengthy wait times among those who had been tested for the virus, about 18% of all respondents.”
The New York Times (8/4, Mervosh, Fernandez) reports that despite an increase in U.S. coronavirus testing, “many Americans are still having to wait many days for results, effectively rendering those tests useless.” Most people “do not receive results within the 24 to 48 hours recommended by public health experts to effectively stall the virus’s spread and quickly conduct contact tracing, according to a new national survey by researchers from Harvard University, Northeastern University, Northwestern University and Rutgers University.” The Times adds, “The survey – representing 19,000 people from 50 states and Washington, D.C., who responded to an online questionnaire last month – found lengthy wait times among those who had been tested for the virus, about 18% of all respondents.”
Non-hospital docs 'instrumental' to COVID-19 response amid staffing strains — 5 key insights
Content Provided By: Becker's ASC Review
Rising numbers of COVID-19 patients in U.S. hot spots could strain availability of critical care physicians and nurses, giving non-hospital providers "an instrumental role in the pandemic response," according to a Kaiser Family Foundation report.
To gauge availability of providers who can serve in a critical care capacity, KFF consulted data from the 2020 National Plan and Provider Enumeration System National Provider Identifier Registry.
Five takeaways:
Content Provided By: Becker's ASC Review
Rising numbers of COVID-19 patients in U.S. hot spots could strain availability of critical care physicians and nurses, giving non-hospital providers "an instrumental role in the pandemic response," according to a Kaiser Family Foundation report.
To gauge availability of providers who can serve in a critical care capacity, KFF consulted data from the 2020 National Plan and Provider Enumeration System National Provider Identifier Registry.
Five takeaways:
- The report identified approximately 16,600 intensivists and 67,900 critical care nurses, as well as nearly 116,000 "second-line" hospitalists, pulmonologists and anesthesiologists who are not formally trained in critical care but could care for critically ill patients.
- California, Arizona and Texas are among several states with substantially lower per-population ratios of intensivists or critical care nurses than the national average ratios. They have also recently reported increasing COVID-19 cases.
- While the number of second-line physicians far exceeds the number of intensivists in the U.S., it's unclear how many second-line providers could feasibly be redeployed to the intensive care unit setting for COVID-19 patients. "Many hospitalists likely can be, since most practice in the hospital setting," concluded Eric Lopez, a member of KFF's ACA and Medicare Policy teams. "However, significant numbers of anesthesiologists and pulmonologists may primarily practice in non-hospital settings such as ambulatory surgery centers and outpatient physician offices, and may have little experience providing ICU-level care."
- Still, recent COVID-19 surges in several states may justify redirecting second-line providers to critical-care roles and recruiting intensivists and critical care nurses from other regions.
- Providers outside the hospital setting will "play instrumental roles in the pandemic response," Mr. Lopez said, "both by reducing strain on hospitals and by providing direct COVID-19 care." For this reason, it's vital to maintain sufficient numbers of primary and ambulatory care providers who can minimize avoidable hospitalizations and coordinate follow-up for recovering COVID-19 patients.
Senate stimulus bill introduced with COVID-19 liability protections
Content Provided By: Protect Patients Now
A second economic stimulus bill introduced in the U.S. Senate this week (S. 4317, the “Safeguarding America’s Frontline Employees To Offer Work Opportunities Required to Kickstart the Economy Act” or the “SAFE TO WORK Act”) incorporates important liability protections for frontline medical providers and facilities.
The issue has remained unresolved at the federal level since the start of the pandemic. This is of particular concern given the national nature of the crisis and the lack or inadequacy of sufficient state-level protections.
Language in the bill creates an exclusive federal cause of action for injuries resulting from the treatment, diagnosis, or care of coronavirus, or care directly affected by the coronavirus. In addition, the bill preserves state laws which provide even greater levels of protection for our frontline healthcare professionals. The HCLA has also supported a bipartisan standalone bill, H.R. 7059, that addresses the legal vulnerabilities faced by healthcare providers as a result of the pandemic.
Both H.R. 7059 and S. 4317 appropriately exclude liability protections in situations of gross negligence or willful misconduct.
Speaking in support of the bill, Senate Majority Leader Mitch McConnell stated, “Nobody should have to face an epidemic of lawsuits on the heels of the pandemic that we already have related to the coronavirus.”
The stimulus bill remains subject to continued negotiations among the Senate, the White House, and the House, with all parties expressing hope that an agreement will come quickly to address a range of needs by workers and consumers who have been faced with economic challenges in the wake of COVID-19.
For more information on the Senate stimulus measure and the SAFE TO WORK Act, click here.
Content Provided By: Protect Patients Now
A second economic stimulus bill introduced in the U.S. Senate this week (S. 4317, the “Safeguarding America’s Frontline Employees To Offer Work Opportunities Required to Kickstart the Economy Act” or the “SAFE TO WORK Act”) incorporates important liability protections for frontline medical providers and facilities.
The issue has remained unresolved at the federal level since the start of the pandemic. This is of particular concern given the national nature of the crisis and the lack or inadequacy of sufficient state-level protections.
Language in the bill creates an exclusive federal cause of action for injuries resulting from the treatment, diagnosis, or care of coronavirus, or care directly affected by the coronavirus. In addition, the bill preserves state laws which provide even greater levels of protection for our frontline healthcare professionals. The HCLA has also supported a bipartisan standalone bill, H.R. 7059, that addresses the legal vulnerabilities faced by healthcare providers as a result of the pandemic.
Both H.R. 7059 and S. 4317 appropriately exclude liability protections in situations of gross negligence or willful misconduct.
Speaking in support of the bill, Senate Majority Leader Mitch McConnell stated, “Nobody should have to face an epidemic of lawsuits on the heels of the pandemic that we already have related to the coronavirus.”
The stimulus bill remains subject to continued negotiations among the Senate, the White House, and the House, with all parties expressing hope that an agreement will come quickly to address a range of needs by workers and consumers who have been faced with economic challenges in the wake of COVID-19.
For more information on the Senate stimulus measure and the SAFE TO WORK Act, click here.
Medicaid and Children’s Health Insurance Program (CHIP) Provider Relief Fund Distribution Update
Content Provided By: Centers for Medicare & Medicaid Services (CMS)
On July 24th, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced that it will begin distributing $10 billion in a second round of high impact COVID-19 area funding to hospitals starting next week. Additionally, HHS announced that it is extending the Medicaid and CHIP Provider Relief Fund distribution provider application deadline to apply to August 3, 2020.
In June, HHS announced the opening of the application period and plans to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs who had not yet received a payment from the $50 billion General Distribution. Since the announcement on June 9, HHS has hosted a number of webinars targeted at providers and provider organizations to answer questions and assist those eligible through the application process. A fact sheet - PDF explaining the application process has also been created to address frequently asked questions.
You can read the full announcement here or below.
Full HHS Announcement:
HHS To Begin Distributing $10 Billion in Additional Funding to Hospitals in High Impact COVID-19 Areas
Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing it will begin distributing $10 billion in a second round of high impact COVID-19 area funding to hospitals starting next week. As parts of the nation confront a recent surge in positive COVID-19 cases and hospitals elsewhere continue to recover and grapple with the financial hardships caused by the pandemic, HHS recognizes the need to quickly get these funds to frontline health care providers.
“The top priority for HHS’s administration of the Provider Relief Fund has been getting support as quickly as possible to providers who have been hit hard by COVID-19,” said HHS Secretary Alex Azar. “Because we’ve carefully targeted support, we can make payments to areas most in need as the pandemic evolves, like we are doing with this round of funds.”
As COVID-19 continues to disrupt daily lives, HHS is providing support to healthcare providers fighting the pandemic through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers, including those disproportionately impacted by this pandemic.
On June 8, 2020, HHS sent communications to all hospitals about plans to distribute a second round of funding to high impact COVID-19 areas and asked them to submit data on their COVID-19 positive-inpatient admissions for the period January 1, 2020, through June 10, 2020. Their submissions were used to determine their eligibility and share of the second round of the funding being announced today to ensure hospitals are equitably supported in the battle against this pandemic. Payments from the $10 billion distribution will provide relief to more than 1,000 hospitals across the nation and begin as early as Monday of next week. In May, HHS announced the first round of high impact funding totaling $12 billion that was distributed to 395 hospitals. This means total committed payments for the two rounds of high impact area funding from the Provider Relief Fund program, to date, is over $20 billion, representing almost 12 percent of the entire $175 billion program.
Methodology
The second round of funding announced today was based on a formula for hospitals with over 161 COVID-19 admissions between January 1 and June 10, 2020, or one admission per day, or that experienced a disproportionate intensity of COVID admissions (exceeding the average ratio of COVID admissions/bed). Hospitals will be paid $50,000 per eligible admission.
The first round of funding was based on a formula that distributed funds to hospitals with 100 or more COVID-19 admissions between January 1 and April 10, 2020 and paid $76,975 per eligible admission. These previous high impact payments were also taken into account when determining each hospital’s payment in this second round distribution.
As some areas of the country face new surges of positive COVID-19 cases, HHS will continue to evaluate and provide necessary relief where possible.
View the current list of hospital recipients.
View a state-by-state breakdown on funding. - PDF
Medicaid and Children’s Health Insurance Program (CHIP) Distribution Update
In June, HHS announced the opening of the application period and plans to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs who had not yet received a payment from the $50 billion General Distribution. Since the announcement on June 9, HHS has hosted a number of webinars targeted at providers and provider organizations to answer questions and assist those eligible through the application process. A fact sheet - PDF explaining the application process has also been created to address frequently asked questions. HHS is continuing to work with provider organizations, congressional, state and local leaders to get the word out about this program. To ensure eligible Medicaid and CHIP providers, including dentists, have the opportunity to apply for a funding distribution, the deadline to apply has been extended to August 3, 2020.
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Source: U.S. Department of Health & Human Services
Content Provided By: Centers for Medicare & Medicaid Services (CMS)
On July 24th, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced that it will begin distributing $10 billion in a second round of high impact COVID-19 area funding to hospitals starting next week. Additionally, HHS announced that it is extending the Medicaid and CHIP Provider Relief Fund distribution provider application deadline to apply to August 3, 2020.
In June, HHS announced the opening of the application period and plans to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs who had not yet received a payment from the $50 billion General Distribution. Since the announcement on June 9, HHS has hosted a number of webinars targeted at providers and provider organizations to answer questions and assist those eligible through the application process. A fact sheet - PDF explaining the application process has also been created to address frequently asked questions.
You can read the full announcement here or below.
Full HHS Announcement:
HHS To Begin Distributing $10 Billion in Additional Funding to Hospitals in High Impact COVID-19 Areas
Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing it will begin distributing $10 billion in a second round of high impact COVID-19 area funding to hospitals starting next week. As parts of the nation confront a recent surge in positive COVID-19 cases and hospitals elsewhere continue to recover and grapple with the financial hardships caused by the pandemic, HHS recognizes the need to quickly get these funds to frontline health care providers.
“The top priority for HHS’s administration of the Provider Relief Fund has been getting support as quickly as possible to providers who have been hit hard by COVID-19,” said HHS Secretary Alex Azar. “Because we’ve carefully targeted support, we can make payments to areas most in need as the pandemic evolves, like we are doing with this round of funds.”
As COVID-19 continues to disrupt daily lives, HHS is providing support to healthcare providers fighting the pandemic through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers, including those disproportionately impacted by this pandemic.
On June 8, 2020, HHS sent communications to all hospitals about plans to distribute a second round of funding to high impact COVID-19 areas and asked them to submit data on their COVID-19 positive-inpatient admissions for the period January 1, 2020, through June 10, 2020. Their submissions were used to determine their eligibility and share of the second round of the funding being announced today to ensure hospitals are equitably supported in the battle against this pandemic. Payments from the $10 billion distribution will provide relief to more than 1,000 hospitals across the nation and begin as early as Monday of next week. In May, HHS announced the first round of high impact funding totaling $12 billion that was distributed to 395 hospitals. This means total committed payments for the two rounds of high impact area funding from the Provider Relief Fund program, to date, is over $20 billion, representing almost 12 percent of the entire $175 billion program.
Methodology
The second round of funding announced today was based on a formula for hospitals with over 161 COVID-19 admissions between January 1 and June 10, 2020, or one admission per day, or that experienced a disproportionate intensity of COVID admissions (exceeding the average ratio of COVID admissions/bed). Hospitals will be paid $50,000 per eligible admission.
The first round of funding was based on a formula that distributed funds to hospitals with 100 or more COVID-19 admissions between January 1 and April 10, 2020 and paid $76,975 per eligible admission. These previous high impact payments were also taken into account when determining each hospital’s payment in this second round distribution.
As some areas of the country face new surges of positive COVID-19 cases, HHS will continue to evaluate and provide necessary relief where possible.
View the current list of hospital recipients.
View a state-by-state breakdown on funding. - PDF
Medicaid and Children’s Health Insurance Program (CHIP) Distribution Update
In June, HHS announced the opening of the application period and plans to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs who had not yet received a payment from the $50 billion General Distribution. Since the announcement on June 9, HHS has hosted a number of webinars targeted at providers and provider organizations to answer questions and assist those eligible through the application process. A fact sheet - PDF explaining the application process has also been created to address frequently asked questions. HHS is continuing to work with provider organizations, congressional, state and local leaders to get the word out about this program. To ensure eligible Medicaid and CHIP providers, including dentists, have the opportunity to apply for a funding distribution, the deadline to apply has been extended to August 3, 2020.
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Source: U.S. Department of Health & Human Services
COVID-19: Correcting telehealth services billed with POS 02
During the COVID-19 public health emergency, CMS expanded the Medicare telehealth services, with instructions to bill these services. Due to the payment differential, providers can request an appeal of claims originally paid with place of service 02.
Click here to read the full article.
Temporary ASC closures wallop workers' comp cases — 3 takeaways
Content Provided By: Becker's ASC Review
Most workers' compensation surgical cases were postponed as states responded to the COVID-19 pandemic, said Frank Raneri, senior vice president of Paradigm Specialty Networks, in an article on WorkCompWire.
Three takeaways from Mr. Raneri:
- At least two-thirds of all workers' compensation surgeries involve knee or shoulder repair. While these surgeries are essential to the injured worker's recovery, they are rarely emergent.
- Surgical dates of service for orthopedic and spine patients dropped 64 percent from Jan. 1 to April 15 but rose 182 percent from April 16 to June 15, according to Paradigm Specialty Networks data.
- The recovery was "V-shaped" due to an expected backlog of surgical cases. As of July 1, ASCs were operating at 75 percent capacity or higher.
"By all accounts, the outpatient and ambulatory surgery market avoided the worst-case scenario at the time by both averting an overwhelmed health system and catastrophic economic losses," Mr. Raneri said.
Click here to read more
Provider Relief Fund Update
Content Provided By: American Medical Association
HHS extended the deadline for eligible Medicaid and CHIP physicians and organizations to submit information and apply for funding from the CARES Act Provider Relief Fund from July 20 until August 3, 2020. HHS is distributing approximately $15 billion to eligible physicians who have not previously received a payment from the Provider Relief Fund. The payment amount will be at least 2 percent of reported gross revenue from patient care, and the final amount will be determined based on submitted data, including the number of Medicaid patients served. HHS has created a fact sheet explaining the application process and answering frequently asked questions.
The American Medical Association (AMA) has made HHS aware of an issue where physicians who primarily care for patients with Medicaid and CHIP coverage received a small amount of money from the automatic Medicare allotment in April because they treated one or two patients with ESRD. They are ineligible to apply for this round of funding even if they rejected and returned the money. HHS has indicated they are working on a policy to address this issue. The AMA will continue to engage HHS to address this situation.
Telehealth Impact Study
You are invited to complete the Telehealth Impact Study Provider Questionnaire by clicking on the link below. The study has been approved by the Mayo Clinic IRB and is part of our efforts in the COVID-19 Healthcare Coalition to address the pandemic. Since COVID-19 started, we have experienced a significant shift towards telehealth. The goal of this project is to learn more about your experience with telehealth to identify the challenges and barriers, as well as the benefits.
Building on existing research, your response will help inform additional resources needed across the industry and health care community, provide insights to federal and state policymakers, and identify gaps in current research. Respondent and organization information will remain confidential and will only be reported in aggregate. The findings will be shared and made available to all on the COVID-19 Healthcare Coalition website, as well as shared by the various organizations participating in the Coalition Telehealth Workgroup*.
The COVID-19 Healthcare Coalition is focused on understanding your experience of telehealth as an individual physician, nurse practitioner, or physician assistant. Please click below to start the survey.
CLICK HERE TO TAKE THE SURVEY
The survey is expected to take up to 15-20 minutes and we ask that you complete the survey by August 13th, 2020. Please remember to press submit when you get to the end of the survey.
We want to hear from as many clinicians as possible to inform our work. If you have colleagues who use telehealth, please consider forwarding this invitation to them.
Thank you in advance for your consideration and valuable insights.
Best Regards,
Steve R. Ommen, MD
Medical Director, Center for Connected Care, Mayo Clinic
Francis X. Campion, MD, FACP
Principal Lead, Digital Health
MITRE Corporation
*COVID-19 Healthcare Coalition Telehealth Workgroup: American Medical Association (AMA) , American Telemedicine Association (ATA), Digital Medical Society (DiMe), MassChallenge Health Tech, Mayo Clinic and MITRE Corporation. The AMA, while a part of the Coalition Telehealth Workgroup, is not a formal member of the COVID-19 Healthcare Coalition.
Back to school: What Physicians Can Say to Parents Weighing the Decision
Content Provided By: American Medical Association
Should children return to school this fall? Amid the COVID-19 pandemic, it’s a question physicians—most notably pediatricians and those practicing family medicine—are likely to hear with increasing frequency in the coming months from patients. And it’s not an easy one to answer.
"Like any issue related to COVID-19, you are going to find a lot of opinions about it,” said John Andrews, MD, the AMA’s vice president for graduate medical education innovations, who has been a practicing pediatrician for three decades. “Parsing those opinions is not at all easy.”
So how should physicians address parental concerns about a return to school? Dr. Andrews offers these thoughts.
Click here to read more.
Content Provided By: American Medical Association
HHS extended the deadline for eligible Medicaid and CHIP physicians and organizations to submit information and apply for funding from the CARES Act Provider Relief Fund from July 20 until August 3, 2020. HHS is distributing approximately $15 billion to eligible physicians who have not previously received a payment from the Provider Relief Fund. The payment amount will be at least 2 percent of reported gross revenue from patient care, and the final amount will be determined based on submitted data, including the number of Medicaid patients served. HHS has created a fact sheet explaining the application process and answering frequently asked questions.
The American Medical Association (AMA) has made HHS aware of an issue where physicians who primarily care for patients with Medicaid and CHIP coverage received a small amount of money from the automatic Medicare allotment in April because they treated one or two patients with ESRD. They are ineligible to apply for this round of funding even if they rejected and returned the money. HHS has indicated they are working on a policy to address this issue. The AMA will continue to engage HHS to address this situation.
Telehealth Impact Study
You are invited to complete the Telehealth Impact Study Provider Questionnaire by clicking on the link below. The study has been approved by the Mayo Clinic IRB and is part of our efforts in the COVID-19 Healthcare Coalition to address the pandemic. Since COVID-19 started, we have experienced a significant shift towards telehealth. The goal of this project is to learn more about your experience with telehealth to identify the challenges and barriers, as well as the benefits.
Building on existing research, your response will help inform additional resources needed across the industry and health care community, provide insights to federal and state policymakers, and identify gaps in current research. Respondent and organization information will remain confidential and will only be reported in aggregate. The findings will be shared and made available to all on the COVID-19 Healthcare Coalition website, as well as shared by the various organizations participating in the Coalition Telehealth Workgroup*.
The COVID-19 Healthcare Coalition is focused on understanding your experience of telehealth as an individual physician, nurse practitioner, or physician assistant. Please click below to start the survey.
CLICK HERE TO TAKE THE SURVEY
The survey is expected to take up to 15-20 minutes and we ask that you complete the survey by August 13th, 2020. Please remember to press submit when you get to the end of the survey.
We want to hear from as many clinicians as possible to inform our work. If you have colleagues who use telehealth, please consider forwarding this invitation to them.
Thank you in advance for your consideration and valuable insights.
Best Regards,
Steve R. Ommen, MD
Medical Director, Center for Connected Care, Mayo Clinic
Francis X. Campion, MD, FACP
Principal Lead, Digital Health
MITRE Corporation
*COVID-19 Healthcare Coalition Telehealth Workgroup: American Medical Association (AMA) , American Telemedicine Association (ATA), Digital Medical Society (DiMe), MassChallenge Health Tech, Mayo Clinic and MITRE Corporation. The AMA, while a part of the Coalition Telehealth Workgroup, is not a formal member of the COVID-19 Healthcare Coalition.
Back to school: What Physicians Can Say to Parents Weighing the Decision
Content Provided By: American Medical Association
Should children return to school this fall? Amid the COVID-19 pandemic, it’s a question physicians—most notably pediatricians and those practicing family medicine—are likely to hear with increasing frequency in the coming months from patients. And it’s not an easy one to answer.
"Like any issue related to COVID-19, you are going to find a lot of opinions about it,” said John Andrews, MD, the AMA’s vice president for graduate medical education innovations, who has been a practicing pediatrician for three decades. “Parsing those opinions is not at all easy.”
So how should physicians address parental concerns about a return to school? Dr. Andrews offers these thoughts.
Click here to read more.
CDC Calls for All Americans to Wear Face Masks in Public to Combat Coronavirus
CNN (7/14, Fox) reports, “The science shows face masks work both to protect the wearer and to protect others from coronavirus, and everyone needs to wear one when around other people in public, the Centers for Disease Control and Prevention said Tuesday.” CNN adds, “Even cloth face masks help enough to be worthwhile, three top CDC officials said in a commentary published in the Journal of the American Medical Association.” In the joint-editorial, “CDC Director Dr. Robert Redfield, CDC’s chief medical officer Dr. John Brooks and Deputy Director for Infectious Diseases Dr. Jay Butler” said, “While community use of face coverings has increased substantially, particularly in jurisdictions with mandatory orders, resistance continues.”
Administration Orders Hospitals to Send COVID-19 Data Directly to HHS, not CDC
The New York Times (7/14, Stolberg) reports the administration wants “hospitals to bypass the Centers for Disease Control and Prevention and send all coronavirus patient information to a central database in Washington beginning on Wednesday.” These “new instructions were posted recently in a little-noticed document on the Department of Health and Human Services website.” Henceforth, HHS – “not the [CDC] – will collect daily reports about the patients that each hospital is treating, the number of available beds and ventilators, and other information vital to tracking the pandemic.”
CDC report indicates mask wearing may have spared nearly 140 people from catching coronavirus at Missouri hair salon
CNN (7/14, Fox) reports, “The science shows face masks work both to protect the wearer and to protect others from coronavirus, and everyone needs to wear one when around other people in public, the Centers for Disease Control and Prevention said Tuesday.” CNN adds, “Even cloth face masks help enough to be worthwhile, three top CDC officials said in a commentary published in the Journal of the American Medical Association.” In the joint-editorial, “CDC Director Dr. Robert Redfield, CDC’s chief medical officer Dr. John Brooks and Deputy Director for Infectious Diseases Dr. Jay Butler” said, “While community use of face coverings has increased substantially, particularly in jurisdictions with mandatory orders, resistance continues.”
Administration Orders Hospitals to Send COVID-19 Data Directly to HHS, not CDC
The New York Times (7/14, Stolberg) reports the administration wants “hospitals to bypass the Centers for Disease Control and Prevention and send all coronavirus patient information to a central database in Washington beginning on Wednesday.” These “new instructions were posted recently in a little-noticed document on the Department of Health and Human Services website.” Henceforth, HHS – “not the [CDC] – will collect daily reports about the patients that each hospital is treating, the number of available beds and ventilators, and other information vital to tracking the pandemic.”
CDC report indicates mask wearing may have spared nearly 140 people from catching coronavirus at Missouri hair salon
- The New York Times (7/14, Wu) reports, “Vigilant mask wearing might have spared nearly 140 people from catching the coronavirus at a hair salon in Missouri, according to a report published on Tuesday by the Centers for Disease Control and Prevention.”
- HealthDay (7/14, Foster) reports, “In May, two hairstylists at a Missouri salon who had COVID-19 but wore face masks cut the hair of 139 masked customers for roughly a week, and did not infect a single client.” Moreover, the hairstylists “did not infect any of the clients’ contacts or any of the other stylists in the salon, researchers report.” The researchers wrote, “These results support the use of face coverings in places open to the public, especially when social distancing is not possible, to reduce spread of SARS-CoV-2.”
Administration to sponsor “surge” COVID-19 testing in three cities
MedPage Today (7/7, Frieden) reports that the administration “will sponsor ‘surge’ COVID-19 testing in three cities – Jacksonville, Florida; Baton Rouge, Louisiana; and Edinburg, Texas, a suburb of McAllen in the Rio Grande valley – to try to find asymptomatic people with COVID-19 and help to dampen the spread of the illness, the Department of Health and Human Services (HHS) announced Tuesday.” In a press release, HHS said the tests will become available for “individuals 5 years and older – including those experiencing symptoms; those who believe they may have been exposed to someone with COVID-19 coronavirus; and anyone who is worried about possibly having the virus. Individuals seeking testing do not need to be a resident of the community where these testing sites are located.”
Personal protective gear supply said to be running low again as coronavirus continues to spread across U.S.
PPP Application Deadline Extended to Aug. 8.
Content Provided by: Katz, Sapper & Miller
With nearly $130 billion of funding remaining in the Paycheck Protection Program (PPP), last week Congress unanimously approved an extension of the application deadline. The extension was signed into law by President Trump over the weekend and gives borrowers until Aug. 8 to apply for the loan.
Introduced as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the PPP is a lifeline for small businesses, providing capital during the economic crisis brought on by COVID-19. The program offers federally guaranteed loans, which can be partially or fully forgivable, provided certain criteria are satisfied.
Click here for the full article.
Governor’s COVID Executive Order Seeks To Address Concerns Of Workers And Employers
Content Provided by: Workers Compensation Institute (WCI360.com)
Little Rock, AR (WorkersCompensation.com) – Gov. Asa Hutchinson’s latest executive order regarding COVID-19 does not create a presumption for workers. But it does, according to some, make it easier for workers who contract the virus to obtain workers’ compensation benefits. It also protects employers from lawsuits for requiring employees to work in an atmosphere that potentially exposes them to the virus.
“It basically says that COVID-19 is an infectious disease, not an ordinary disease of life, and that really all [employees] have to do is prove a causal connection,” said R. Scott Zuerker, a member at Ledbetter, Cogbill, Arnold & Harrison, Llp. “They have the burden of proof, there are no presumptions; although I suspect that it is going to be liberally construed.”
The order expanded the state’s allowed coverage for ‘infectious disease,’ which previously included only employees working in hospitals or sanitoriums where a specific disease was being treated. ‘Ordinary diseases of life” are not compensable under Arkansas’s law.
Click here for the full article.
MedPage Today (7/7, Frieden) reports that the administration “will sponsor ‘surge’ COVID-19 testing in three cities – Jacksonville, Florida; Baton Rouge, Louisiana; and Edinburg, Texas, a suburb of McAllen in the Rio Grande valley – to try to find asymptomatic people with COVID-19 and help to dampen the spread of the illness, the Department of Health and Human Services (HHS) announced Tuesday.” In a press release, HHS said the tests will become available for “individuals 5 years and older – including those experiencing symptoms; those who believe they may have been exposed to someone with COVID-19 coronavirus; and anyone who is worried about possibly having the virus. Individuals seeking testing do not need to be a resident of the community where these testing sites are located.”
Personal protective gear supply said to be running low again as coronavirus continues to spread across U.S.
- The AP (7/7, Mulvihill, Fassett) reports that “the personal protective gear that was in dangerously short supply during the early weeks of the coronavirus crisis in the U.S. is running low again as the virus resumes its rapid spread and the number of hospitalized patients climbs.” Overall, protective gear supplies “are more robust now, and many states and major hospital chains say they are in better shape. But medical professionals and some lawmakers have cast doubt on those improvements as shortages begin to reappear.” Meanwhile, “the American Medical Association wrote to the Federal Emergency Management Agency, Vice President Mike Pence and members of Congress calling for a coordinated national strategy to buy and allocate gear.”
- Citing the AP report, Forbes (7/7, Robinson-Jacobs) says that “Deborah Burger, president of National Nurses United, cited results from a union survey showing that five months after the pandemic began in the U.S., ‘there are still shortages of gowns, hair covers, shoe covers, masks, N95 masks…and we’re still being told to reuse them.’”
PPP Application Deadline Extended to Aug. 8.
Content Provided by: Katz, Sapper & Miller
With nearly $130 billion of funding remaining in the Paycheck Protection Program (PPP), last week Congress unanimously approved an extension of the application deadline. The extension was signed into law by President Trump over the weekend and gives borrowers until Aug. 8 to apply for the loan.
Introduced as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the PPP is a lifeline for small businesses, providing capital during the economic crisis brought on by COVID-19. The program offers federally guaranteed loans, which can be partially or fully forgivable, provided certain criteria are satisfied.
Click here for the full article.
Governor’s COVID Executive Order Seeks To Address Concerns Of Workers And Employers
Content Provided by: Workers Compensation Institute (WCI360.com)
Little Rock, AR (WorkersCompensation.com) – Gov. Asa Hutchinson’s latest executive order regarding COVID-19 does not create a presumption for workers. But it does, according to some, make it easier for workers who contract the virus to obtain workers’ compensation benefits. It also protects employers from lawsuits for requiring employees to work in an atmosphere that potentially exposes them to the virus.
“It basically says that COVID-19 is an infectious disease, not an ordinary disease of life, and that really all [employees] have to do is prove a causal connection,” said R. Scott Zuerker, a member at Ledbetter, Cogbill, Arnold & Harrison, Llp. “They have the burden of proof, there are no presumptions; although I suspect that it is going to be liberally construed.”
The order expanded the state’s allowed coverage for ‘infectious disease,’ which previously included only employees working in hospitals or sanitoriums where a specific disease was being treated. ‘Ordinary diseases of life” are not compensable under Arkansas’s law.
Click here for the full article.
AMA Requests Administration to Act on PPE Shortages in Ambulatory Settings
Content Provided by: American Medical Association
In the American Medical Association’s (AMA) continuing efforts to address personal protective equipment (PPE) shortages, we wrote letters to Vice President Pence and the Federal Emergency Management Agency (FEMA) today urging immediate action to address ongoing PPE shortage and access issues in ambulatory settings. In the letter to the vice president, the AMA asked the administration to activate the Defense Production Act as a matter of patient safety. Physicians are telling the AMA that the biggest challenge to reopening their practices is the ongoing shortages of PPE, especially N95 masks and gowns. In the letter to FEMA, we highlighted the difficulty in solving the PPE problem in physician practices, citing a lack of data to determine whether the central problem is in the availability of raw materials, production backlogs, gaps in the distribution systems, or some combination of all three. We also recommended that FEMA work with us to provide additional assistance to these non-hospital physicians in securing PPE, disinfectants, and sanitizers.
CDC Guidance on Healthcare Personnel Return to Work
Content Provided by: Centers for Disease Control and Prevention
With confirmed cases of COVID continuing to increase, we are hearing from more medical practices that are experiencing staff members or clinicians being exposed to the virus. It is important that the practice follows CDC recommendations for the return of healthcare personnel to the office or clinic. Below is the latest recommendations from the CDC.
Decisions about return to work for HCP with confirmed or suspected COVID-19 should be made in the context of local circumstances. Options include a symptom-based (i.e., time-since-illness-onset and time-since-recovery strategy) or time-based strategy or a test-based strategy. Of note, there have been reports of prolonged detection of RNA without direct correlation to viral culture.
Click here to read the CDC Guidance.
CMS Announces Physician Opt-Out for 2020 MIPS Program
Content Provided by: Renal Physicians Association
On June 24, CMS announced that physician practices can opt out of the 2020 MIPS program using the Extreme and Uncontrollable Circumstances Application "if the COVID19 pandemic is preventing you from collecting data for an extended period of time, or could impact your performance on cost measures. Approved applications will reweight performance categories to 0%." CMS offers physicians the following options on the hardship exemption application: a practice can indicate that they do not want to be scored on Cost and Quality and have their score calculated based on just Promoting Interoperability and Improvement Activities. Alternatively, practices can opt-out of all four performance categories and be held harmless from a 2022 payment adjustment. Submitting any MIPS data to CMS will override the hardship exception application and physicians will be scored on their submission.
Content Provided by: American Medical Association
In the American Medical Association’s (AMA) continuing efforts to address personal protective equipment (PPE) shortages, we wrote letters to Vice President Pence and the Federal Emergency Management Agency (FEMA) today urging immediate action to address ongoing PPE shortage and access issues in ambulatory settings. In the letter to the vice president, the AMA asked the administration to activate the Defense Production Act as a matter of patient safety. Physicians are telling the AMA that the biggest challenge to reopening their practices is the ongoing shortages of PPE, especially N95 masks and gowns. In the letter to FEMA, we highlighted the difficulty in solving the PPE problem in physician practices, citing a lack of data to determine whether the central problem is in the availability of raw materials, production backlogs, gaps in the distribution systems, or some combination of all three. We also recommended that FEMA work with us to provide additional assistance to these non-hospital physicians in securing PPE, disinfectants, and sanitizers.
CDC Guidance on Healthcare Personnel Return to Work
Content Provided by: Centers for Disease Control and Prevention
With confirmed cases of COVID continuing to increase, we are hearing from more medical practices that are experiencing staff members or clinicians being exposed to the virus. It is important that the practice follows CDC recommendations for the return of healthcare personnel to the office or clinic. Below is the latest recommendations from the CDC.
Decisions about return to work for HCP with confirmed or suspected COVID-19 should be made in the context of local circumstances. Options include a symptom-based (i.e., time-since-illness-onset and time-since-recovery strategy) or time-based strategy or a test-based strategy. Of note, there have been reports of prolonged detection of RNA without direct correlation to viral culture.
Click here to read the CDC Guidance.
CMS Announces Physician Opt-Out for 2020 MIPS Program
Content Provided by: Renal Physicians Association
On June 24, CMS announced that physician practices can opt out of the 2020 MIPS program using the Extreme and Uncontrollable Circumstances Application "if the COVID19 pandemic is preventing you from collecting data for an extended period of time, or could impact your performance on cost measures. Approved applications will reweight performance categories to 0%." CMS offers physicians the following options on the hardship exemption application: a practice can indicate that they do not want to be scored on Cost and Quality and have their score calculated based on just Promoting Interoperability and Improvement Activities. Alternatively, practices can opt-out of all four performance categories and be held harmless from a 2022 payment adjustment. Submitting any MIPS data to CMS will override the hardship exception application and physicians will be scored on their submission.
SBA Releases New EZ PPP Loan-Forgiveness Application
Content Provided by: Entrepreneur
Needless to say, it’s been a roller coaster ride for business owners over the past couple of months understanding how to navigate the CARES Act, but there are now signs the ride may be coming to an end.
On Wednesday of this week, the Small Business Administration (SBA) released a revised, and hopefully a final, forgiveness application for the Paycheck Protection Program (PPP), including a new EZ application that appears many business owners may qualify for.
Also, just the day before, the SBA issued a new Final Interim Rule with guidance for determining payroll costs and owner compensation forgiveness under the new 24-week covered period.
These new rules and procedures were in response to the Paycheck Protection Flexibility Act of 2020 that became law on June 5. The biggest changes in that law being the extension of the eight weeks to a new 24-week covered period, and a reduction of payroll costs from 75 percent to 60 percent. For a more in-depth analysis see “New PPP Law Extends 8-Week Period and Reduces Percent Payroll Cost Rule.”
If you feel daring enough to dive straight into the Applications and Instructions before a little summary of the notable items, they are available at the following links:
Read the full article.
Medicare Coverage of COVID-19 Testing for Nursing Home Residents and Patients
Content Provided by: Centers for Medicare & Medicaid Services
On Monday the Centers for Medicare & Medicaid Services (CMS) instructed Medicare Administrative Contactors and notified Medicare Advantage plans to cover coronavirus disease 2019 (COVID-19) laboratory tests for nursing home residents and patients. This instruction follows the Centers for Disease Control and Prevention’s (CDC) recent update of COVID-19 testing guidelines for nursing homes that provides recommendations for testing of nursing home residents and patients with symptoms consistent with COVID-19 as well as for asymptomatic residents and patients who have been exposed to COVID like in an outbreak. Original Medicare and Medicare Advantage plans will cover COVID-19 lab tests consistent with CDC guidance.
Medicare Advantage plans must continue not to charge cost sharing (including deductibles, copayments, and coinsurance) or apply prior authorization or other utilization management requirements for COVID-19 tests and testing-related services.
CDC says fewer Americans were admitted to EDs for heart attacks, strokes, hyperglycemic crisis 10 weeks after the national emergency declaration than 10 weeks before
Reuters (6/22, Mishra) reports researchers at the CDC found “fewer Americans were admitted to emergency departments with life-threatening conditions such as heart attacks during the initial months of the COVID-19 pandemic.” According to the CDC report, when comparing ED visits 10 weeks after the national emergency declaration to 10 weeks before, ED visits for heart attacks decreased 23%, ED visits for strokes decreased 20%, and ED visits for hyperglycemic crisis decreased 10%.
The Hill (6/22, Hellmann) reports the CDC report said, “The substantial reduction in [emergency department] visits for these life-threatening conditions might be explained by many pandemic-related factors including fear of exposure to COVID-19, unintended consequences of public health recommendations to minimize non-urgent health care, stay-at-home orders, or other reasons.” The CDC report added, “The finding suggests that patients with these conditions either could not access care or were delaying or avoiding seeking care during the early pandemic period.”
Black Medicare Patients With COVID-19 Nearly 4 Times As Likely To End Up In Hospital
Content Provided by: Health News Florida
New federal data reinforces the stark racial disparities that have appeared with COVID-19: According to the Centers for Medicare and Medicaid Services, Black Americans enrolled in Medicare were hospitalized with the disease at rates nearly four times higher than their white counterparts.
Disparities were also striking among Hispanics and Asian Americans. Hispanics were more than twice as likely to be hospitalized as whites, while Asian Americans were about 50% more likely. Black and Hispanic beneficiaries were more likely to test positive for the coronavirus as well, CMS Administrator Seema Verma said.
The data "confirms long understood and stubbornly persistent disparities in health outcomes for racial and ethnic minority groups," Verma said in a press briefing Monday. Read the full article.
Report indicates many furloughed workers are still holding onto employer health coverage
Bloomberg Law (6/23, Hansard, Subscription Publication) reports, “More people are uninsured as a result of [COVID-19], but many furloughed workers are still holding on to employer coverage – for now.” A report by the Commonwealth Fund “found that of the 2,271 adults surveyed from May 13 through June 2, 21% said they or their partner had lost a job or were furloughed as a result of the pandemic,” however, “53% still had health coverage through the job.” Moreover, nearly “three in 10 respondents with no coverage through a job affected by the pandemic are uninsured.”
Content Provided by: Entrepreneur
Needless to say, it’s been a roller coaster ride for business owners over the past couple of months understanding how to navigate the CARES Act, but there are now signs the ride may be coming to an end.
On Wednesday of this week, the Small Business Administration (SBA) released a revised, and hopefully a final, forgiveness application for the Paycheck Protection Program (PPP), including a new EZ application that appears many business owners may qualify for.
Also, just the day before, the SBA issued a new Final Interim Rule with guidance for determining payroll costs and owner compensation forgiveness under the new 24-week covered period.
These new rules and procedures were in response to the Paycheck Protection Flexibility Act of 2020 that became law on June 5. The biggest changes in that law being the extension of the eight weeks to a new 24-week covered period, and a reduction of payroll costs from 75 percent to 60 percent. For a more in-depth analysis see “New PPP Law Extends 8-Week Period and Reduces Percent Payroll Cost Rule.”
If you feel daring enough to dive straight into the Applications and Instructions before a little summary of the notable items, they are available at the following links:
- Revised PPP Loan Forgiveness Application and Instructions
- EZ PPP Loan Forgiveness Application and Instructions
Read the full article.
Medicare Coverage of COVID-19 Testing for Nursing Home Residents and Patients
Content Provided by: Centers for Medicare & Medicaid Services
On Monday the Centers for Medicare & Medicaid Services (CMS) instructed Medicare Administrative Contactors and notified Medicare Advantage plans to cover coronavirus disease 2019 (COVID-19) laboratory tests for nursing home residents and patients. This instruction follows the Centers for Disease Control and Prevention’s (CDC) recent update of COVID-19 testing guidelines for nursing homes that provides recommendations for testing of nursing home residents and patients with symptoms consistent with COVID-19 as well as for asymptomatic residents and patients who have been exposed to COVID like in an outbreak. Original Medicare and Medicare Advantage plans will cover COVID-19 lab tests consistent with CDC guidance.
Medicare Advantage plans must continue not to charge cost sharing (including deductibles, copayments, and coinsurance) or apply prior authorization or other utilization management requirements for COVID-19 tests and testing-related services.
- Read the Medicare Learning Network article https://www.cms.gov/files/document/se20011.pdf.
- Read the memo to Medicare Advantage plans: https://cms.gov/files/document/hpms-memo-diagnostic-testing-nursing-home-residents-and-patients-coronavirus-disease-2019.pdf.
- More information about Medicare coverage of COVID-19 tests is available at: https://www.medicare.gov/coverage/coronavirus-disease-2019-covid-19-tests.
CDC says fewer Americans were admitted to EDs for heart attacks, strokes, hyperglycemic crisis 10 weeks after the national emergency declaration than 10 weeks before
Reuters (6/22, Mishra) reports researchers at the CDC found “fewer Americans were admitted to emergency departments with life-threatening conditions such as heart attacks during the initial months of the COVID-19 pandemic.” According to the CDC report, when comparing ED visits 10 weeks after the national emergency declaration to 10 weeks before, ED visits for heart attacks decreased 23%, ED visits for strokes decreased 20%, and ED visits for hyperglycemic crisis decreased 10%.
The Hill (6/22, Hellmann) reports the CDC report said, “The substantial reduction in [emergency department] visits for these life-threatening conditions might be explained by many pandemic-related factors including fear of exposure to COVID-19, unintended consequences of public health recommendations to minimize non-urgent health care, stay-at-home orders, or other reasons.” The CDC report added, “The finding suggests that patients with these conditions either could not access care or were delaying or avoiding seeking care during the early pandemic period.”
Black Medicare Patients With COVID-19 Nearly 4 Times As Likely To End Up In Hospital
Content Provided by: Health News Florida
New federal data reinforces the stark racial disparities that have appeared with COVID-19: According to the Centers for Medicare and Medicaid Services, Black Americans enrolled in Medicare were hospitalized with the disease at rates nearly four times higher than their white counterparts.
Disparities were also striking among Hispanics and Asian Americans. Hispanics were more than twice as likely to be hospitalized as whites, while Asian Americans were about 50% more likely. Black and Hispanic beneficiaries were more likely to test positive for the coronavirus as well, CMS Administrator Seema Verma said.
The data "confirms long understood and stubbornly persistent disparities in health outcomes for racial and ethnic minority groups," Verma said in a press briefing Monday. Read the full article.
Report indicates many furloughed workers are still holding onto employer health coverage
Bloomberg Law (6/23, Hansard, Subscription Publication) reports, “More people are uninsured as a result of [COVID-19], but many furloughed workers are still holding on to employer coverage – for now.” A report by the Commonwealth Fund “found that of the 2,271 adults surveyed from May 13 through June 2, 21% said they or their partner had lost a job or were furloughed as a result of the pandemic,” however, “53% still had health coverage through the job.” Moreover, nearly “three in 10 respondents with no coverage through a job affected by the pandemic are uninsured.”
AAOS Issues Position Statement on Access to Care During COVID-19
The AAOS recently released a new position statement on preserving access to care during the COVID-19 pandemic. It notes that as the pandemic moves from a short-term crisis to extending for a longer-term horizon, medically indicated care once deemed elective becomes more urgent. These unprecedented circumstances should not impede access to health care coverage—including specialty care—for the many patients requiring treatment and management of their health conditions, diseases and illnesses. Therefore addressing these needs becomes even more important, and the AAOS believes that the responsibility of financing appropriate services must be a shared public-private cooperative effort that advances a patient-centered model for choosing affordable health care options. It also urges the Administration and respective federal, state, and local health care programs to take action to protect access to care for all Americans, particularly at-risk individuals. Read the full position statement.
High Unemployment Has Reportedly Made Health Care Unaffordable to Many Content Provided by: American Medical Association
The New York Times (6/16, Abelson) reports many people are still avoiding visiting a physician with their health care concerns in part because of ongoing fears of becoming infected with SARS-CoV-2, but also because financial losses have made health care unaffordable for many. According to the New York Times, “While hospitals and doctors across the country say many patients are still shunning their services out of fear of contagion – especially with new cases spiking – Americans who lost their jobs or have a significant drop in income during the pandemic are now citing costs as the overriding reason they do not seek the health care they need.”
NIH Launches Centralized Nationwide Platform for Data on Patients with Coronavirus Content Provided by: American Medical Association
Fox News (6/16, Rivas) reports the National Institutes of Health (NIH) “announced Monday a new ‘centralized, secure enclave’ of medical record data from coronavirus patients diagnosed nationwide.” The analytics platform “is part of a new effort called the National COVID Cohort Collaborative (N3C), to help scientists analyze data to understand the disease and develop treatments, according to a press release.” The new platform “will systematically collect clinical, laboratory and diagnostic data from health care provider organizations across the country.”
The AAOS recently released a new position statement on preserving access to care during the COVID-19 pandemic. It notes that as the pandemic moves from a short-term crisis to extending for a longer-term horizon, medically indicated care once deemed elective becomes more urgent. These unprecedented circumstances should not impede access to health care coverage—including specialty care—for the many patients requiring treatment and management of their health conditions, diseases and illnesses. Therefore addressing these needs becomes even more important, and the AAOS believes that the responsibility of financing appropriate services must be a shared public-private cooperative effort that advances a patient-centered model for choosing affordable health care options. It also urges the Administration and respective federal, state, and local health care programs to take action to protect access to care for all Americans, particularly at-risk individuals. Read the full position statement.
High Unemployment Has Reportedly Made Health Care Unaffordable to Many Content Provided by: American Medical Association
The New York Times (6/16, Abelson) reports many people are still avoiding visiting a physician with their health care concerns in part because of ongoing fears of becoming infected with SARS-CoV-2, but also because financial losses have made health care unaffordable for many. According to the New York Times, “While hospitals and doctors across the country say many patients are still shunning their services out of fear of contagion – especially with new cases spiking – Americans who lost their jobs or have a significant drop in income during the pandemic are now citing costs as the overriding reason they do not seek the health care they need.”
NIH Launches Centralized Nationwide Platform for Data on Patients with Coronavirus Content Provided by: American Medical Association
Fox News (6/16, Rivas) reports the National Institutes of Health (NIH) “announced Monday a new ‘centralized, secure enclave’ of medical record data from coronavirus patients diagnosed nationwide.” The analytics platform “is part of a new effort called the National COVID Cohort Collaborative (N3C), to help scientists analyze data to understand the disease and develop treatments, according to a press release.” The new platform “will systematically collect clinical, laboratory and diagnostic data from health care provider organizations across the country.”
Trump Administration Unveils Enhanced Enforcement Actions Based on Nursing Home COVID-19 Data and Inspection Results
Content Provided by: Centers for Medicare & Medicaid Services
Under the leadership of President Trump, the Centers for Medicare & Medicaid Services (CMS) unveiled enhanced enforcement for nursing homes with violations of longstanding infection control practices. This announcement builds on the previous actions CMS has taken to ensure the safety and security of America’s nursing homes as the nation battles coronavirus disease 2019 (COVID-19), and is a key step in the Trump Administration’s Guidelines for Opening Up America Again.
Click here to read the full article.
Content Provided by: Centers for Medicare & Medicaid Services
Under the leadership of President Trump, the Centers for Medicare & Medicaid Services (CMS) unveiled enhanced enforcement for nursing homes with violations of longstanding infection control practices. This announcement builds on the previous actions CMS has taken to ensure the safety and security of America’s nursing homes as the nation battles coronavirus disease 2019 (COVID-19), and is a key step in the Trump Administration’s Guidelines for Opening Up America Again.
Click here to read the full article.
NIH says Researchers Have Confirmed There are Ways to Decontaminate N95 Masks so They Can be Reused
The New York Times (4/16, Gorman) reports the NIH announced that “researchers have confirmed that there are several effective methods for decontaminating the N95 masks worn by health professionals so that they can be used more than once.” The NIH publicized the research, which was posted on medRxiv.
The New York Times (4/16, Gorman) reports the NIH announced that “researchers have confirmed that there are several effective methods for decontaminating the N95 masks worn by health professionals so that they can be used more than once.” The NIH publicized the research, which was posted on medRxiv.
Paycheck Protection Program Runs Out of Money
On Thursday, Health News Florida ran a story about the Paycheck Protection Program running out of the initial allocation of funds from Congress. It is anticipated that Congress will take up this issue next week and many in the business and health care sector are pushing for immediate action. A large number of physician practices either have not received confirmation that their application has been approved or if approved have not yet received loan documents or funding. Employers are encouraged to check with their financial institution to see if they are still accepting applications. Some banks are still encouraging applications to be submitted while some have temporarily closed the application process. The hope is that once Congress provides additional funding, that applications already submitted will be processed in the order received by the various institutions.
Click here to read more.
On Thursday, Health News Florida ran a story about the Paycheck Protection Program running out of the initial allocation of funds from Congress. It is anticipated that Congress will take up this issue next week and many in the business and health care sector are pushing for immediate action. A large number of physician practices either have not received confirmation that their application has been approved or if approved have not yet received loan documents or funding. Employers are encouraged to check with their financial institution to see if they are still accepting applications. Some banks are still encouraging applications to be submitted while some have temporarily closed the application process. The hope is that once Congress provides additional funding, that applications already submitted will be processed in the order received by the various institutions.
Click here to read more.
White House Releases Guidelines for Opening Up America Again
Yesterday, the White House released the guidelines for States and Regions to consider as they weigh opening up portions of their local economies. The guidelines provide phases based on documented reductions in symptoms and positive cases and tests over 14-day periods. In relation to healthcare services, elective surgeries in the outpatient setting would be allowed under Phase One. And additional elective surgeries would come on line in Phase 2.
Click here to view the Federal Guidelines.
Yesterday, the White House released the guidelines for States and Regions to consider as they weigh opening up portions of their local economies. The guidelines provide phases based on documented reductions in symptoms and positive cases and tests over 14-day periods. In relation to healthcare services, elective surgeries in the outpatient setting would be allowed under Phase One. And additional elective surgeries would come on line in Phase 2.
Click here to view the Federal Guidelines.
FDA authorizes saliva test for COVID-19
The AP (4/13, Perrone) reports Rutgers University researchers “have received U.S. government clearance for the first saliva test to help diagnose COVID-19, a new approach that could help expand testing options and reduce risks of infection for health care workers.” The FDA “authorized the test under its emergency powers to quickly clear new tests and therapies to fight the outbreak.” The university “tested the accuracy of its method by taking both saliva and swab samples from 60 patients” and found “patients’ saliva samples had a 100% match with results from the swabs.” In its authorization letter, the FDA “said the test should only be performed ‘in a health care setting under the supervision of a trained health care provider."
The Hill (4/13, Coleman) reports that with this test, patients “will spit in a tube several times and give it to the health professional for testing, making it less risky for them to get infected, Andrew Brooks, the chief operating officer and director of technology development at the Rutgers’ lab, said in the university’s release.” Brooks said, “Saliva testing will help with the global shortage of swabs for sampling and increase testing of patients, and it will not require health care professionals to be put at risk to collect samples. ... Saliva testing will also be important for people who are in quarantine because they don’t know how long it will be until they are no longer infectious.”
The AP (4/13, Perrone) reports Rutgers University researchers “have received U.S. government clearance for the first saliva test to help diagnose COVID-19, a new approach that could help expand testing options and reduce risks of infection for health care workers.” The FDA “authorized the test under its emergency powers to quickly clear new tests and therapies to fight the outbreak.” The university “tested the accuracy of its method by taking both saliva and swab samples from 60 patients” and found “patients’ saliva samples had a 100% match with results from the swabs.” In its authorization letter, the FDA “said the test should only be performed ‘in a health care setting under the supervision of a trained health care provider."
The Hill (4/13, Coleman) reports that with this test, patients “will spit in a tube several times and give it to the health professional for testing, making it less risky for them to get infected, Andrew Brooks, the chief operating officer and director of technology development at the Rutgers’ lab, said in the university’s release.” Brooks said, “Saliva testing will help with the global shortage of swabs for sampling and increase testing of patients, and it will not require health care professionals to be put at risk to collect samples. ... Saliva testing will also be important for people who are in quarantine because they don’t know how long it will be until they are no longer infectious.”
Private insurers required to provide free COVID-19 antibody tests
Politico (4/11, Ravindranath) reported that the Administration said “it will require health insurers to provide free antibody tests that could provide better insight into the scale of the U.S. coronavirus outbreak.” Congress has “required that all Americans, including people without health insurance, receive free diagnostic tests to determine whether they are sick with coronavirus.” The Administration “said it had authority from recent emergency rescue packages to mandate private insurers also provide antibody testing without out-of-pocket costs.”
Politico (4/11, Ravindranath) reported that the Administration said “it will require health insurers to provide free antibody tests that could provide better insight into the scale of the U.S. coronavirus outbreak.” Congress has “required that all Americans, including people without health insurance, receive free diagnostic tests to determine whether they are sick with coronavirus.” The Administration “said it had authority from recent emergency rescue packages to mandate private insurers also provide antibody testing without out-of-pocket costs.”
Billions Going To Hospitals Based On Medicare Billings, Not COVID-19
Content Provided by: Health News Florida
Probably few hospital systems need the emergency federal grants announced this week to handle the coronavirus crisis as badly as Florida’s Jackson Health does.
Miami, its base of operations, is the worst COVID-19 hot spot in one of the most severely hit states. Even in normal years, the system sometimes barely makes money. At least two of its staff members have died of the virus.
But in a scathing letter to policymakers, system CEO Carlos Migoya said the way Washington has handled the bailout “could jeopardize the very existence” of Jackson, one of the nation’s largest public health systems, and similar hospital groups.
“We are here for you right now,” Migoya, who has tested positive for COVID-19 himself, said in a Thursday letter to Alex Azar, secretary of Health and Human Services. “Please, be here for us right now.”
Migoya and executives at other beleaguered systems are blasting the government’s decision to take a one-size-fits-all approach to distributing the first $30 billion in emergency grants. HHS confirmed Friday it would give hospitals and doctors money according to their historical share of revenue from the Medicare program for seniors — not according to their coronavirus burden.
That method is “woefully insufficient to address the financial challenges facing hospitals at this time, especially those located in ‘hot spot’ areas such as the New York City region,” Kenneth Raske, CEO of the Greater New York Hospital Association, said in a memo to association members.
Read more here.
Content Provided by: Health News Florida
Probably few hospital systems need the emergency federal grants announced this week to handle the coronavirus crisis as badly as Florida’s Jackson Health does.
Miami, its base of operations, is the worst COVID-19 hot spot in one of the most severely hit states. Even in normal years, the system sometimes barely makes money. At least two of its staff members have died of the virus.
But in a scathing letter to policymakers, system CEO Carlos Migoya said the way Washington has handled the bailout “could jeopardize the very existence” of Jackson, one of the nation’s largest public health systems, and similar hospital groups.
“We are here for you right now,” Migoya, who has tested positive for COVID-19 himself, said in a Thursday letter to Alex Azar, secretary of Health and Human Services. “Please, be here for us right now.”
Migoya and executives at other beleaguered systems are blasting the government’s decision to take a one-size-fits-all approach to distributing the first $30 billion in emergency grants. HHS confirmed Friday it would give hospitals and doctors money according to their historical share of revenue from the Medicare program for seniors — not according to their coronavirus burden.
That method is “woefully insufficient to address the financial challenges facing hospitals at this time, especially those located in ‘hot spot’ areas such as the New York City region,” Kenneth Raske, CEO of the Greater New York Hospital Association, said in a memo to association members.
Read more here.
How doctors can keep their families safe after providing COVID-19 care
One of the nation’s most distinguished infection-control experts advises physicians on how to minimize the risk for their loved ones.
The rise in COVID-19 cases creates anxiety among physicians and other health professionals who worry they might carry the virus home to their families. This remains top of mind for many people in the medical field, leaving them wondering: How do I keep my family safe after caring for patients during the COVID-19 pandemic?
Read more from the AMA.
One of the nation’s most distinguished infection-control experts advises physicians on how to minimize the risk for their loved ones.
The rise in COVID-19 cases creates anxiety among physicians and other health professionals who worry they might carry the virus home to their families. This remains top of mind for many people in the medical field, leaving them wondering: How do I keep my family safe after caring for patients during the COVID-19 pandemic?
Read more from the AMA.
Lasting Impacts on Health Insurance Market Projected Due to the Coronavirus Crisis
More than seven million Americans expected to lose insurance during coronavirus pandemic, study predicts
Large Hikes in Health Insurance Premiums Projected: Will Self Funded Insurance Plans Become More Attractive as Costs of Covid Crisis Wash Through the Fully Insured Market
More than seven million Americans expected to lose insurance during coronavirus pandemic, study predicts
- Newsweek (4/8, Lemon) reports “more than 7 million Americans are expected to lose their health insurance during the coronavirus pandemic, while more than 1.5 million are already estimated to have lost coverage, according to a new study.” The study authors wrote, “Coverage losses are likely to be steepest in states that have turned down the Patient Protection and Affordable Care Act’s Medicaid expansion. In expansion states, the share of persons who have lost or left a job who lacked coverage was 22.1% versus 8.3% for employed persons – a difference of 13.8 percentage points.” The analysis was published in the Annals of Internal Medicine. Read more here.
Large Hikes in Health Insurance Premiums Projected: Will Self Funded Insurance Plans Become More Attractive as Costs of Covid Crisis Wash Through the Fully Insured Market
- Over the past year our organizations launched a Self-Funded Captive Health Insurance Program through our partners with FBMC and Danna-Gracey. We have leaned on our partners to track the impact of the crisis on employee health insurance programs to see if evidence emerges to assist our members in dealing with future crisis. We will periodically share information they discover through this forum. Below is an article that discusses projections of 40% increases in premiums due to the crisis unless the government provides assistance to stabilize premiums. Could your business budget for and sustain such an increase in your employee benefits? Will this drive more to consider a captive program or something like it as an essential component of their business plan? Read more here.
CMS Approves Approximately $34 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers in One Week
The Centers for Medicare & Medicaid Services (CMS) has delivered near $34 billion in the past week to the healthcare providers on the frontlines battling the 2019 Novel Coronavirus (COVID-19). The funds have been provided through the expansion of the Accelerated and Advance Payment Program to ensure providers and suppliers have the resources needed to combat the pandemic.
“Healthcare providers are making massive financial sacrifices to care for the influx of coronavirus patients,” said CMS Administrator Seema Verma. “Many are rightly complying with federal recommendations to delay non-essential elective surgeries to preserve capacity and personal protective equipment. They shouldn’t be penalized for doing the right thing. Amid a public health storm of unprecedented fury, these payments are helping providers and suppliers – so critical to defeating this terrible virus – stay afloat.”
Read the full article here.
The Centers for Medicare & Medicaid Services (CMS) has delivered near $34 billion in the past week to the healthcare providers on the frontlines battling the 2019 Novel Coronavirus (COVID-19). The funds have been provided through the expansion of the Accelerated and Advance Payment Program to ensure providers and suppliers have the resources needed to combat the pandemic.
“Healthcare providers are making massive financial sacrifices to care for the influx of coronavirus patients,” said CMS Administrator Seema Verma. “Many are rightly complying with federal recommendations to delay non-essential elective surgeries to preserve capacity and personal protective equipment. They shouldn’t be penalized for doing the right thing. Amid a public health storm of unprecedented fury, these payments are helping providers and suppliers – so critical to defeating this terrible virus – stay afloat.”
Read the full article here.
