COVID-19 Update: May 4, 2020

COVID-19 update for Monday, May 4 as of 2:30 p.m.

Pennsylvania Update

Department of Health

The Department of Health has issued an advisory on the criteria for the discontinuation of transmission-based precautions for patients with COVID-19.

The department has issued an update on its criteria for health care personnel returning to work after confirmed or suspected COVID-19. The advisory includes extending the amount of time such personnel need to be excluded from work after the first symptoms arise.

The department has posted an alert reminding health care providers that only labs with CLIA certification can perform COVID-19 tests, that only molecular and serology tests have been authorized by the FDA, and providing additional clarifications. It also offers a graphic depiction of COVID-19 testing requirements.

Department of Health Daily Briefing

With 825 new cases yesterday, Pennsylvania has surpassed 50,000 people diagnosed with COVID-19. 2500 of them have passed away.
Of the 50,000 cases, 3100 are health care workers and more than 9300 reside in long-term-care facilities.
2689 people are currently hospitalized with COVID-19; among them, 553 are on ventilators.
46 percent of the state’s acute-care beds and 40 percent of its ICU beds are currently unoccupied and nearly 75 percent of its ventilators are now idle.
The process of reviewing counties and regions for eligibility to reopen will be conducted on a continual basis as new data becomes available.
Secretary Levine believes that if mitigation measures are reduced that case counts will rise.
She believes the strategy the state has been employing has been appropriate.
She said the state is still not getting the data on race that it needs to perform a more complete analysis of the impact of COVID-19.
The Department of Health is working on guidance for dental practices and hopes to have that guidance by the end of the week.
State officials are still discussing whether to share data with the public on cases and deaths in individual long-term-care facilities.
The death counts Philadelphia announces and those the state announces for Philadelphia continue to disagree. The two jurisdictions use different data systems and are working to reconcile the differences between those systems.
With another outbreak predicted for later this year, Secretary Levine said that one of the major lessons the state has learned, and that it should apply in the future, is to seek to be able to do more testing, especially at the point of care and with a faster turnaround time for results.

Department of Human Services

DHS has issued a Medical Assistance Bulletin adding COVID-19 lab test codes to the Medicaid program fee schedule.

DHS has issued a Medical Assistance Bulletin adding the multi-function ventilator to the Medicaid program fee schedule.

DHS has issued a Medical Assistance Bulletin on COVID-19 testing and related treatments that are exempt from Medicaid copayment requirements.

DHS has issued a Medical Assistance Bulletin to advise providers that certain non-physician practitioners may prescribe home health services and medical supplies, equipment, and appliances effective March 1.

DHS’s Office of Long-Term Living has posted a notice presenting a new way to certify people to administer insulin injections in long-term-care facilities that may have a shortage of qualified staff to perform this task.

Federal Update

Department of Health and Human Services

Last Friday HHS began processing $22 billion in payments from the CARES Act’s provider relief fund to hospitals with large numbers of COVID-19 admissions through April 10 and to rural providers in support of the national response to COVID-19. See HHS’s announcement of the distribution of this money, including a breakdown by state of grant recipients.

Centers for Medicare & Medicaid Services

CMS has posted a presentation that elaborates on the regulatory changes the agency introduced last week. It includes explanations of how to interpret the new regulation’s flexibilities and offers examples of how health systems can expand services.
In response to the increased need for providing telehealth due to COVID-19, CMS has given additional consideration to telehealth services in HHS-operated risk adjustment for issuers in the individual and small group health insurance markets inside and outside the marketplaces. In new guidance, CMS clarifies which telehealth services are valid for HHS-operated risk adjustment data submission in light of the COVID-19 pandemic.
CMS has published CARES Act financial guidance to state survey agencies for the award and administration of supplemental funding for the cost of survey and certification efforts with a focus on areas where there is community spread of COVID-19. This funding is expected to be used to complete focused infection control surveys for nursing homes, to increase complaint surveys, and to perform reopening surveys of facilities with previous COVID-19 outbreaks.
CMS has updated its COVID-19 FAQ on Medicare fee-for-service billing.

CMS Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information about the agency’s response to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer participants an opportunity to ask questions of CMS and other subject matter experts. Conference lines are limited so CMS encourages interested parties to join via audio webcast. Call recordings and transcripts are posted on the CMS podcast page at https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Call

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and health care systems to increase hospital capacity, expand the health care work force, and promote greater use of telehealth in Medicare. This week’s first of two Office Hours Calls will be held on Tuesday, May 5 at 5:00 p.m. (eastern). The toll-free dial-in number is 833-614-0820 and the access passcode is 3996146. Interested parties also can join the audio webcast here.

This week’s second Office Hours Call will be held on Thursday, May 7 at 5:00 p.m. (eastern). The toll-free dial-in number is 833-614-0820 and the access passcode is 1181167. Interested parties also can join the audio webcast here.

Lessons from the Front Lines

Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters. This week’s Lessons From the Front Lines call will be held on Friday, May 8 at 12:30 p.m. (eastern). The toll-free dial-in number is 877-251-0301 and the access code is 9146779. Interested parties also can join the meeting via audio webcast here.

Home Health and Hospice

This week’s home health and hospice call will be held on Tuesday, May 5 at 3:00 p.m. (eastern). The toll-free dial-in number is 833-614-0820 and the access passcode is 7844154. Interested parties also can join the meeting via audio webcast here.

Nursing Homes

This week’s nursing homes call will be held on Wednesday, May 6 at 4:30 p.m. (eastern). The toll-free dial-in number is 833-614-0820 and the access passcode is 8899983. Interested parties also can join the meeting via audio webcast here.

Dialysis Organizations

This week’s call for dialysis organizations will be held on Wednesday, May 6 at 5:30 p.m. (eastern). The toll-free dial-in number is 833-614-0820 and the access passcode is 8278522. Interested parties also can join the meeting via audio webcast here.

Nurses

This week’s call for nurses will be held on Thursday, May 7 at 3:00 p.m. (eastern). The toll-free dial-in number is 833-614-0820 and the access passcode is 5486361. Interested parties also can join the meeting via audio webcast here.

Centers for Disease Control and Prevention

The CDC has updated its FAQ on COVID-19 testing at laboratories.
The CDC has updated information about its Coronavirus Disease-Associated Hospitalization Surveillance Network, a population-based surveillance system that collects data on laboratory-confirmed COVID-19-associated hospitalizations among children and adults through a network of over 250 acute-care hospitals in 14 states.
The CDC has updated its interim guidance on health care workers returning to work after confirmed or suspected COVID-19.
The CDC has issued a lab advisory with additional guidance on COVID-19 laboratory testing.
The CDC has updated its guidance on COVID-19 evaluation and testing.
The CDC has updated its clinical care guidance for health care professionals about COVID-19.
The CDC has updated its interim guidance on the discontinuation of home isolation for persons with COVID-19, including increasing the length of recommended time for home isolation.
The CDC has updated its guidance on the care of children with COVID-19.
The CDC has launched a national viral genomics consortium to better map COVID-19 transmission.
The CDC has updated its page collecting contact tracing training guidance and resources.
The CDC has updated its interim guidance for the collection and submission of post-mortem specimens from deceased persons under investigation for COVID-19.

Food and Drug Administration

The FDA has approved an emergency use authorization (EUA) for the use of the investigational anti-viral drug remdesivir for the treatment of suspected or confirmed COVID-19.
The FDA has issued guidance to provide recommendations to health care providers and investigators on the administration and study of investigational convalescent plasma collected from individuals who have recovered from COVID-19 during the public health emergency. The guidance also provides recommendations to blood establishments on the collection of COVID-19 convalescent plasma.
The FDA has approved EUAs for four new COVID-19 tests (here, here, here, and here ) and three new COVID-19 serology tests (here, here, and here).
The FDA has issued an EUA for a specific commercial respiratory muscle ventilator to be used to reduce atrophy of the abdominal walls among COVID-19 patients who require mechanical ventilation.
The FDA has sent a letter to manufacturers of protective barrier enclosures, health care providers, and other stakeholders outlining the characteristics it will be looking for when considering issuing EUAs for protective barrier enclosures to help protect health care personnel caring for confirmed or suspected COVID-19 patients.
The FDA has issued an EUA for a specific commercial product used to provide continuous renal replacement therapy to treat patients in an acute-care environment during the COVID-19 crisis.

Department of Labor

The Department of Labor has issued additional guidance about 100 percent federal reimbursement of certain state short-term compensation payments and other changes in short-term compensation programs. The guidance seeks to address “…how states can take advantage of this program as they look to re-open their businesses.” For further information see the department’s news release and its official unemployment insurance program letter.