COVID-19 Update: Friday, September 4
The following is the latest coronavirus information from the state and federal governments as of 1:30 p.m. on Friday, September 4.
Pennsylvania Update
Independent Fiscal Office
The Independent Fiscal Office reports that Pennsylvania collected $2.55 billion in General Fund revenue for August, an increase of $355.5 million (16.2 percent) over August 2019 collections. The IFO estimates that roughly $235 million of the $355.5 million increase was associated with extended tax due dates related to the COVID-19 pandemic. Personal income tax revenue, sales, use, and hotel occupancy revenue, and corporate net income tax revenue all exceeded estimates. See the IFO’s full August report here.
Department of Health
The Department of Health has revised its guidance for skilled nursing facilities with a recommended testing plan for facilities not experiencing a COVID-19 outbreak, safe access for compassionate care, access to the facility for resident advocates, and a revised timeline for lifting restrictions after a mitigated outbreak. See a news release describing the new guidance and go here to see the guidance itself.
Department of Health – by the numbers
- In the past three days the number of COVID-19 cases in Pennsylvania surpassed 135,000 and the number of COVID-19 deaths rose past 7700.
- Thursday marked the first time since late July that the state registered more than 1000 new cases in a single day.
- Despite this, the number of Pennsylvanians currently hospitalized with COVID-19 is, with one exception, lower than it has been since before June.
- Fewer of these patients are on ventilators today than at any time in the past three months.
- More than 9800 health care workers in the state have contracted COVID-19.
- More than 21,300 residents of long-term-care facilities and 4600 people who work in those facilities have contracted COVID-19 in 942 such facilities in 61 of the state’s 67 counties.
- 26 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 22 percent of adult ICU beds, 15 percent of pediatric ICU beds, 38 percent of pediatric beds, and 41 percent of airborne isolation rooms.
Department of State
Because of the challenges of finding continuing education opportunities to fulfill professional requirements during the COVID-19 emergency, the Department of State has authorized the granting of continuing education credits for nursing home administrators, physical therapists, social workers, marriage and family therapists, professional counselors, speech language pathologists, and audiologists who serve as poll workers in this November’s election. See the Department of State notice here.
Federal Update
Provider Relief Fund
Reminder: Applications are currently open for Phase 2 general distribution funding for Medicaid, Medicaid managed care, the Children’s Health Insurance Program (CHIP), dental providers, certain Medicare providers, and assisted living facilities. All groups have until September 13, 2020 to submit their tax identification number for validation and apply for funding from the phase 2 general distribution. Go here for more information.- HHS announced that assisted living facilities may apply for funding under the Provider Relief Fund phase 2 general distribution allocation. Go here to see HHS’s announcement.
- HHS has announced some of the details of an upcoming $2 billion Provider Relief Fund performance-based incentive payment distribution to nursing homes. HHS will measure nursing homes against a baseline level of infection in the community where individual facilities are located. Learn more from HHS’s announcement of this distribution.
- HHS has updated its Provider Relief Fund FAQ with new and modified questions.
- Changes marked 9/1/2020 can be found on pages 22, 23, 29, and 32. The new information focuses largely on the newly announced distribution for assisted living facilities, criteria for eligibility, and applying to participate in the distribution.
- One change, marked 9/2/2020 and on page 23, describes how HHS identified assisted living facilities that are eligible to receive distributions from the Provider Relief Fund.
- Five changes, marked 9/3/2020 and found on pages 2, 9, and 17, address HHS requests for additional financial information, how to report Provider Relief Fund grants on Medicare cost reports, and the responsibility of parent organizations to send to their subsidiaries grants intended for those subsidiaries.
Find all of these changes in the Provider Relief Fund FAQ.
American Medical Association
The American Medical Association has updated codes and guidelines for office and other outpatient evaluation and management (E/M) services. Some of the changes were introduced earlier this year in response to the COVID-19 emergency. The AMA has recommended to CMS that it implement these changes on January 1, 2021. Learn more in this AMA news release.
Centers for Medicare & Medicaid Services
CMS has updated the article “Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment” in its online publication MLN Matters to reflect an update that includes additional COVID-19 codes. Some of those codes took effect on August 10 and others take effect on October 1.
- CMS has updated the article “Update to the International Classification of Diseases, Tenth Revision (ICD-10) Diagnosis Codes for Vaping Related Disorder and Diagnosis and Procedure Codes for the 2019 Novel Coronavirus (COVID-19)” in its online publication MLN Matters to include new procedure codes.
Department of Health and Human Services
- HHS has extended coverage under the Public Readiness and Emergency Preparedness Act to licensed health-care practitioners prescribing or administering point-of-care COVID-19 tests for screening in congregate facilities.
- HHS, the Federal Communications Commission, and the Department of Agriculture have signed a Memorandum of Understanding to work together on the Rural Telehealth Initiative, a joint effort to collaborate and share information to address health disparities, resolve service provider challenges, and promote broadband services and technology to rural areas in America, noting that the ongoing COVID-19 pandemic has highlighted the critical importance of telehealth in delivering care to rural Americans. Go here to see the agencies’ announcement and read their Memorandum of Understanding.
- HHS’s Office of the Inspector General has updated its guidance on the application of its administrative enforcement authorities to arrangements directly connected to the COVID-19 public health emergencywith new guidance on the appropriateness of home health agency staff performing blood draws free of charge and the appropriateness of federally qualified health centers (FHQCs) that have received private grant money to provide emergency assistance to the financially needy distributing that assistance with gift cards instead of cash.
Centers for Disease Control and Prevention
In three documents the CDC has advised states to be ready to begin distributing COVID-19 vaccines as early as late October or early November.
- One document addresses shipments, storage, allocations, provider outreach and education, data reporting, administering vaccines, and vaccine safety.
- The second document addresses different scenarios for when vaccines will be available and in what quantities and covers storage, distribution, handling, and the administration of the vaccines.
- The third document addresses the organizational structure of the cities and states receiving vaccines, the gaps in their preparedness, capacity and information systems issues, identification of critical populations, provider enrollment and education, communication planning, and preparation for early vaccine administration.
Food and Drug Administration
The FDA has issued guidance to health care providers on the use of convalescent plasma for treating patients with COVID-19.
Resources to Consult
Pennsylvania Department of Human Services
Pennsylvania Department of Health
Centers for Disease Control and Prevention
(To receive this daily update directly, sign up for our mailing list at info@pasafetynet.org.)
Governor Wolf has signed a second renewal of his 90-day disaster declaration for the COVID-19 pandemic. This declaration provides for increased support for state agencies involved in the continued response to the virus and recovery during reopening, including expediting supply procurement and lifting certain regulations to allow for efficient and effective mitigation. The disaster declaration also has facilitated waivers and extensions to support Pennsylvanians, Pennsylvania businesses, and Pennsylvania caregivers during the pandemic. Learn more from 
The 
In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date, CMS will enforce its own interpretation of the policy.
Governor Wolf has presented his fall legislative agenda. Among his proposals, he called for $225 million for hazard pay for frontline workers; $10 million for a personal protective equipment reimbursement program for small businesses; and $250 million for child care for families with school-age children in need of care because of blended or remote in-person instruction models. Learn more about these and other aspects of the governor’s proposal 
The Department of Health has unveiled “CATE” (Community-Accessible Testing and Education”), a recreational vehicle that has been equipped as a mobile COVID-19 testing and education unit that will travel the state offering free COVID-19 tests and education in medically underserved communities in 16 counties. Established and operated by the organization Latino Connection, staffed by the Welsh Mountain Health Centers, and funded in part by the state, Highmark, and Independence Blue Cross, CATE has more than 30 stops scheduled during September, the first half of them in the Philadelphia area and then moving westward across the state. Appointments are not needed and CATE’s tests will be performed by the state’s lab in Exton, which is producing results in 24 to 48 hours. Learn more about CATE, its origins, and its scheduled stops in this Department of Health 
The Wolf administration’s 
HHS announced that it will distribute $1.4 billion in CARES Act Provider Relief Fund grants to nearly 80 free-standing children’s hospitals. Qualifying children’s hospitals must be either an exempt hospital under CMS’s Medicare inpatient prospective payment system or be a HRSA-defined Children’s Hospital Graduate Medical Education facility. Eligible hospitals will receive 2.5 percent of their net revenue from patient care. Qualifying free-standing children’s hospitals will begin receiving grants next week. Learn more from this 
In a message to families in anticipation of a new school year, the Wolf administration stressed the importance of children receiving their required childhood vaccinations but reminded Pennsylvanians that the Department of Health has temporarily suspended its requirements for children’s immunizations for two months after the beginning of the school year or the beginning of enrollment in an early childhood education program. See the Wolf administration’s news release on this subject 
HHS’s Office of the Assistant Secretary for Preparedness and Response held a webinar in late July on the use of telemedicine in alternative care sites. Now available from that webinar are the 
The FDA has issued guidance on