The following is the latest information from Pennsylvania’s state government as of 4:00 p.m. on Wednesday, June 24.

Department of Human Services

• DHS has issued four CHIP policy clarifications:  They cover:
  • billing guidance for alternative sites developed in response to the COVID-19 emergency;
  • directions on how to bypass prior authorization requirements for CT scans of the chest for COVID-19 patients;
  • guidance on how pharmacies may override early refill alerts for medications; and
  • guidance for providers on accepting self-attestation on applications and renewals and enrolling children prior to initial premium payments during the COVID-19 emergency.
• DHS’s Office of Developmental Programs has posted an announcement that provides information about diagnoses and conditions associated with elevated risk for severe illness when an individual is infected with COVID-19.

Department of Health

Secretary Levine sent a letter to providers seeking to ensure that critical COVID-19 patient data on sexual orientation and gender identity is being collected at the point of care.

Department of Health – by the numbers

• The number of Pennsylvanians newly diagnosed with COVID-19 remains higher than it was a week ago, as does the daily number of people who have passed away from the disease.
• But the number of people hospitalized with COVID-19, and the number on ventilators, continues to decline.  Yesterday, only six COVID-19 patients in the state were on ventilators.
• The number of available hospital beds, ICU beds, and isolation rooms remains as it has been for the past several weeks.

Insurance Department

Yesterday, Insurance Commissioner Jessica Altman announced that the Insurance Department has  submitted a notice  to the Pennsylvania Bulletin outlining guidance for insurers that encounter providers engaging in inappropriate billing practices during the COVID-19 pandemic.  On June 12, DHS published a Medical Assistance Bulletin advising providers that they may not charge Medical Assistance beneficiaries for personal protective equipment used in connection with medical or dental services.  According to an Insurance Department press release, the notice is in response to reports that “providers, particularly dental providers, are charging patients outside of the insurer-provider contracts.”

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

Coronavirus update for Monday, June 22 as of 4:30 p.m.

The following is the latest information from the state and federal government as of 4:30 p.m. on Monday, June 22.

State Update

PA House Republican Leadership Elections

Following the retirement of House Speaker Mike Turzai earlier this month, the House met today and elected former Majority Leader Bryan Cutler (Lancaster County) as Speaker.  The House Republican caucus also elected as majority leader Kerry Benninghoff (Centre County), who previously was majority whip, and chose Donna Oberlander (Armstrong, Clarion, and Forest counties), previously chair of the caucus’s policy committee, as their new majority whip.  As of this writing, the role of policy committee chair is vacant.

Department of Health

The Department of Health has updated its report on its mitigation activities for long-term-care facilities.

Department of Health – by the numbers

• New case counts have been higher during the past four days.  The average number of new cases in the past four days was more than 35 percent greater than the average number for the five days before that.  Death totals, on the other hand, have declined significantly.
• 746 Pennsylvanians are currently hospitalized with COVID-19, with 153 of them on ventilators.  Both of these figures have generally decreased in recent weeks although the hospitalization figure has risen slightly in recent days.
• 40 percent of Pennsylvania hospitals’ acute-care beds are currently unoccupied, as are 39 percent of their ICU beds, 30 percent of their pediatric ICU beds, and 17 percent of their isolation rooms.  These figures have remained virtually unchanged in recent weeks.

Federal Update

Department of Health and Human Services

HHS has added new questions and answers and modified others in its CARES Act Provider Relief Fund FAQ. Providers should review these changes carefully; they are marked 6/19/2020 and 6/21/2020.

CARES Act Provider Relief Fund – Medicaid and SCHIP-Only Distribution Webcasts

On its Provider Relief Fund web page, HHS has posted the following notice:

HHS expects to distribute $15 billion to eligible Medicaid and CHIP providers through the Provider Relief Fund.  Join our webcast to learn more about the application process.  Please pre-register to reserve a spot on your preferred date:

Tuesday, June 23, 2020 at 2 PM ET

Thursday, June 25, 2020 at 2 PM ET

Centers for Medicare & Medicaid Services

• CMS has added new questions and modified others in its compendium document “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing.” Providers should review these changes carefully.
• CMS has updated its instructions to Medicare Administrative Contractors (MACs) and Medicare Advantage Plans to cover COVID-19 laboratory tests for nursing home residents and patients. See an announcement about the new instructions here.
• CMS has posted a new FAQ on COVID-19 surveillance testing. This informed is intended for laboratories.
• Last week CMS issued eight section 1135 waivers to give states greater flexibility to serve their Medicaid beneficiaries during the COVID-19 public health emergency.  It issued waivers to Alaska, Connecticut, Colorado, Massachusetts, New Jersey, New York, South Carolina, and Washington.

CMS Stakeholder Calls

CMS hosts varied recurring stakeholder engagement sessions to share information related to 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 attendees an opportunity to ask questions of CMS and other subject matter experts.  Call details are below.  Conference lines are limited so CMS encourages interested parties to join via audio webcast, either on your computer or smartphone web browser. Calls recordings and transcripts are posted on the CMS podcast page, which you can find here.

CMS COVID-19 Office Hours Calls

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 their health care workforce, and make greater use of telehealth in Medicare.

Tuesday, June 23 at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In:  833-614-0820;

Access Passcode:  5775248

Audio Webcast link:  go here.

Home Health and Hospice

Tuesday, June 23 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820;

Access Passcode:  3676539

Audio Webcast Link:  go here.

Nursing Homes

Wednesday, June 24 at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820;

Access Passcode:  3089577

Audio Webcast Link:  go here.

Dialysis Organizations

Wednesday, June 24 at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820;

Access Passcode:  6494855

Audio Webcast Link:  go here.

Nurses

Thursday, June 25 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820;

Access Passcode:  9496814

Audio Webcast Link: go here.

Food and Drug Administration

• On Tuesday, June 23 at 12 noon (eastern) the FDA, along with the CDC’s National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA), will host a seminar on importing respirators during the COVID-19 pandemic.
• The FDA has issued emergency use authorizations (EUAs) for four new commercial COVID-19 diagnostic tests. Find them here, here, here, and here.
• The FDA has issued an EUA for a new commercial COVID-19 serology test. Find it here.

Centers for Disease Control & Prevention

The CDC has updated its guidance for nursing homes and other long-term-care facilities to take steps to assess and improve their preparedness for responding to COVID-19.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

Coronavirus update for Friday, June 19 as of 3:00 p.m.

A Note About SNAP’s COVID-19 Updates

Beginning the week of June 15, SNAP will prepare COVID-19 updates on Mondays, Wednesdays, and Fridays, with additional updates as needed on subjects that are especially timely or important.  SNAP members and update subscribers will continue to receive their updates near the close of the business day and those updates will continue to be posted in this space the morning of the following business day.

Pennsylvania Update

The Wolf Administration

• On Thursday Governor Wolf issued a news release reminding Pennsylvanians that mask-wearing is required when entering any business in all counties in the state in both the yellow and green phases of reopening.  The mask requirement is part of Secretary of Health Levine’s order “Directing Public Health Safety Measures for Businesses Permitted to Maintain In-person Operations.”  See the governor’s new release here and Secretary Levine’s order here.
• On Thursday Governor Wolf and Secretary of Health Levine signed orders for eight counties to move to the green phase at 12:01 a.m. on Friday, June 19.  The affected counties are Dauphin, Franklin, Huntingdon, Luzerne, Monroe, Perry, Pike, and Schuylkill.  With these orders, on Friday there will be 54 counties in green and 13 counties in yellow.  See the governor’s news release here, the governor’s amended order here, and Secretary Levine’s amended order here.
• On Friday Governor Wolf announced that 12 more counties will move to the green phase of reopening from the COVID-19 pandemic at 12:01 a.m. on Friday, June 26.  The affected counties are Berks, Bucks, Chester, Delaware, Erie, Lackawanna, Lancaster, Lehigh, Montgomery, Northampton, Philadelphia, and Susquehanna.  See the governor’s news release about this announcement here.

Department of Health

• The Department of Health distributed 4788 doses of remdesivir to hospitals to treat patients hospitalized with COVID-19.  Go here to see the department’s announcement about this shipment and here to see a list of the 82 hospitals.
• The department announced that more than 4000 close contacts of COVID-19 cases have been identified and monitored to date through the contact tracing efforts of 500 trained contact tracers throughout the state, including 130 state health nurses.  These efforts include support from six county health departments and four municipal health departments that have primary responsibility for all efforts inside their jurisdiction.  Go here for a news release about the contact tracing effort.
• The department’s message board on Friday, June 19 included the following notice:

The Pennsylvania Department of Health and Pennsylvania Emergency Management Agency are pleased to announce a partnership with CVS Health to offer COVID-19 testing services to skilled nursing facilities to assist with compliance to the Secretary’s Order related to universal testing issued June 9, 2020. Using a number of data sources including current outbreak status, historic outbreak status, geography, and facility-reported testing data, the Department is providing a three-tiered priority list to CVS Health to begin making contacts to offer testing services free of charge to the facility (residents and employees).

The CVS Health Onsite Swab & Send solution includes:

• All necessary logistic services, including scheduling, records administration, test orders, and communication of results
• All specimen collection and Personal Protective Equipment (PPE) for CVS Health clinician testers
• Transmission to an FDA-approved reference laboratory for testing
• Responsibility for communication of test results back to skilled nursing administration

CVS Health is currently onboard to conduct 50,000 individual tests for skilled nursing residents and staff members. Testing is anticipated to begin the week of June 29 with CVS Health beginning outreach calls as early as June 22.  Please anticipate an email outreach and phone call from CVS Health, and they will confirm the necessary steps to schedule your onsite testing clinic.

If you have questions regarding this initiative, universal testing in general, or to request assistance, please contact RA-DHCOVIDTESTING@pa.gov.     

Department of Health – by the numbers

• Case counts and death totals remain generally down but the new case count for Thursday was the highest in the past week.  On Thursday the total number of Pennsylvanians who have contracted COVID-19 rose above the 80,000 mark.  Ninety-seven percent of those cases were confirmed by tests and the rest are considered “probable.”
• 728 Pennsylvanians are currently hospitalized with COVID-19, with 162 of them on ventilators.  Both of these figures have been declining in recent weeks.
• 40 percent of Pennsylvania hospitals’ acute-care beds are currently unoccupied, as are 39 percent of their ICU beds, 30 percent of their pediatric ICU beds, and 17 percent of their isolation rooms.  These figures have remained virtually unchanged in recent weeks.

Department of Human Services

• DHS’s COVID-19 update, published on Wednesday, includes the following notice about its Regional Response Health Collaboration Program.
• In last week’s written update, we mentioned that a Request for Applications was posted for the Regional Response Health Collaboration Program (RRHCP). The RRHCP will assume the Education Support and Clinical Coaching Program’s role in providing operational, managerial, administrative, and clinical support for long-term care facilities as they protect their residents and staff from COVID-19. Responses to this RFA are due by June 25, and the RFA is posted on eMarketplace.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

Coronavirus update for Wednesday, June 17 as of 4:00 p.m.

A Note About SNAP’s COVID-19 Updates

Beginning the week of June 15, SNAP will prepare COVID-19 updates on Mondays, Wednesdays, and Fridays, with additional updates as needed on subjects that are especially timely or important.  SNAP members and update subscribers will continue to receive their updates near the close of the business day and those updates will continue to be posted in this space the following morning.

Pennsylvania Update

The Courts

The Pennsylvania Supreme Court agreed today to hear a lawsuit filed by Senate Republicans against  Governor Wolf seeking to enforce a resolution adopted by the General Assembly last week requiring the governor to end the COVID-19 disaster emergency proclamation that he enacted in March and extended for another ninety days on June 1.  The suit was originally filed in Commonwealth Court.

Department of Health

In communication circulated via message board but not posted on any department web site, the Department of Health explained the following:

The Department has received questions and is concerned that there are laboratories marketing their ability to run tests who are not certified in Pennsylvania.

Per the Order of the Secretary of the Pennsylvania Department of Health Directing Testing at Skilled Nursing Facilities, issued June 8, 2020, Skilled Nursing Facilities (SNFs) are required to complete a baseline universal test for SARS-CoV-2 of all residents and staff no later than July 24, 2020. In order to be compliant with this Order, a facility needs to enter into a contract with a commercial laboratory to meet testing needs of the facility. A laboratory must have a current Pennsylvania laboratory permit and be approved to perform COVID-19 testing.

A list of laboratories that have a CLIA permit in Pennsylvania can be found here.

Department of Health – by the numbers

• Case counts and death totals remain generally down and declining
• 788 Pennsylvanians are currently hospitalized with COVID-19, with 169 of them on ventilators.
• 40 percent of Pennsylvania hospitals’ acute-care beds are currently unoccupied, as are 39 percent of their ICU beds, 30 percent of their pediatric ICU beds, and 17 percent of their isolation rooms.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

Coronavirus update for Friday, June 12 as of 4:00 p.m.

A Note About SNAP’s COVID-19 Updates

Beginning the week of June 15, SNAP will prepare COVID-19 updates on Mondays, Wednesdays, and Fridays, with additional updates as needed on subjects that are especially timely or important.  SNAP members and update subscribers will continue to receive their updates near the close of the business day and those updates will continue to be posted in this space the following morning.

Pennsylvania Update

The Wolf Administration

Governor Wolf and Secretary of Health Levine signed amended green phase orders for 12 counties to move to the green phase of reopening at 12:01 a.m. on June 12.  With these orders taking effect, there will be 46 counties in green and 21 counties in yellow.

In addition, eight more counties will move to the green phase of reopening at 12:01 a.m. on Friday, June 19.

Department of Human Services

DHS has published a Medical Assistance Bulletin advising providers that they may not charge Medical Assistance beneficiaries for personal protective equipment used in connection with medical or dental services.

Department of Health – by the numbers

• Today’s COVID-19 death count is comparable to what it has been in recent days but the new case count is up slightly.
• 901 Pennsylvanians are currently hospitalized for COVID-19 and 195 of them are on ventilators – both figures much lower than yesterday’s.
• 40 percent of state hospitals’ acute-care beds, 40 percent of their ICU beds, 57 percent of their pediatric beds, and 30 percent of their pediatric ICU beds are currently unoccupied.

State Legislature

The Senate has canceled its session for next week.  The House is scheduled to return to session on June 22.

Federal Update

Department of Health and Human Services

• As we reported previously, HHS will be distributing $10 billion in CARES Act Provider Relief Fund grants to hospitals that have served especially large numbers of COVID-19 patients. To apply for these grants, hospitals must submit data to HHS via its teletracking web site.  See below for:
  • information about the Provider Relief Fund and the grants to high-impact hospitals;
  • an FAQ about the grants and the data to be submitted; and
  • where to submit the data.

Hospitals must submit their data no later than 9:00 pm (eastern) on Monday, June 15.

• HHS’s Office for Civil Rights (OCR) issued guidance on how the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy rule permits covered health care providers to contact their patients who have recovered from COVID-19 to inform them about how they can donate their blood and plasma containing antibodies to help other patients with COVID-19. See the announcement here and the guidance here.

Centers for Medicare & Medicaid Services

In the past week CMS issued five section 1135 waivers to give states greater flexibility to serve their Medicaid beneficiaries during the COVID-19 public health emergency.  It issued waivers to Delaware, Oklahoma, Pennsylvania, Tennessee, and Wisconsin.

Food and Drug Administration

• The FDA posted FAQs to address questions about the design, evaluation, labeling, and marketing of hospital beds, stretchers, and mattresses during the COVID-19 public health emergency.
• The FDA issued emergency use authorizations (EUAs) for four new commercial diagnostic tests for COVID-19. Find them here, here, here, and here.
• The FDA issued an EUA for a new serology test for COVID-19. Find it here.

National Institutes of Health

NIH’s National Institute on Minority Health and Health Disparities is accepting applications for research to evaluate interventions that might lessen the impact of COVID-19 on populations that suffer from health disparities or other vulnerabilities to the virus.  Learn more here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

Coronavirus update for Wednesday, June 10 as of 3:00 p.m.

Pennsylvania Update

General Assembly

This week the General Assembly passed a concurrent resolution that seeks to end the governor’s COVID-19 emergency disaster declaration; on June 4 the governor extended that declaration for an additional 90 days.  During a press conference today, Governor Wolf said he will defend in court his right to veto the resolution.  The measure’s proponents believe the resolution, having passed both chambers, is effective and does not require the governor’s consideration.

Department of Health

The Department of Health has issued an order requiring hospitals to implement measures to protect their staff and patients.  The policies and procedures must, at a minimum, include distribution of respirators to hospital staff providing direct patient care to COVID-19-positive and suspected cases and hospital staff assigned to provide direct patient care in COVID-19 units.  Respirator distribution must occur prior to the beginning of the hospital staff member’s shift and respirators must be replaced as soon as practical if the hospital is notified by a staff member that their mask has become soiled, damaged, or otherwise ineffective.  The policies and procedures also must include access to testing upon request for staff members who have been exposed to patients with or suspected of having COVID-19, measures for notifying staff members who have been in contact with such patients, and a requirement that all hospital visitors over the age of two wear masks.  See a news release summarizing the order here.

Department of Health – by the numbers

• Today’s new COVID-19 case and death counts are comparable to what they have been in recent days.
• More than 5800 Pennsylvania health care workers have contracted COVID-19.
• 986 Pennsylvanians are currently hospitalized for COVID-19 and 206 of them are on ventilators.
• 40 percent of state hospitals’ acute-care beds, 39 percent of their ICU beds, 57 percent of their pediatric beds, and 30 percent of their pediatric ICU beds are currently unoccupied.

Department of Human Services

CMS has approved a section 1135 waiver request from DHS’s Office of Medical Assistance Programs.  The waiver permits the state to temporarily allow payments for section 1905(a) personal care services to be rendered by legally responsible individuals and gives the state the ability to modify deadlines for face-to-face encounters required for home health services.  These waivers will remain in effect until the official end of the current public health emergency.

DHS’s Office of Medical Assistance Programs has written to local education agencies participating in its School-Based ACCESS Program to inform them of temporary flexibilities in the program’s usual practices and requirements that it has authorized in response to the COVID-19 emergency.

DHS’s Office of Developmental Programs has published an announcement that provides additional guidance to individual support planning teams on the criteria for requesting a cap exception for the Person/Family Directed Support and Community Living Waivers.  It also has posted a  template for applying for such waivers.

Federal Update

Department of Health and Human Services

On Tuesday HHS announced that it will be distributing $15 billion to clinicians and facilities that participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations that have not yet received any general distribution grants from the Provider Relief Fund.

This funding is intended to supply relief to Medicaid and CHIP providers experiencing lost revenues or increased expenses due to COVID-19.  Examples of providers serving Medicaid/CHIP beneficiaries that may be eligible for this funding include pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities, and other home and community-based services providers.

Providers that believe they may be eligible for this funding may submit their annual patient revenue information to a new provider relief portal to seek a distribution equal to at least two percent of their reported gross revenues from patient care; that portal is supposed to be established today but was not up at the time this update was written.

Learn more from:

• HHS’s news release announcing this distribution;
• its Provider Relief Fund web page;
• its Provider Relief Fund general information page; and
• its CARES Act Provider Relief Fund FAQ, which has been updated more than two dozen times in the past 48 hours to reflect changes related to yesterday’s announced distributions (additions and modifications are marked within this FAQ).

Centers for Medicare & Medicaid Services

• CMS has published recommendations for health care providers reopening facilities to provide non-emergency non-COVID-19 services.
• CMS has published a guide with information about what patients should know about seeking health care as health care providers begin restoring services.

Food and Drug Administration

• The FDA approved an abbreviated new drug application for succinylcholine chloride injection USP 200 mg/10 mL, which is indicated in addition to general anesthesia to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.
• The FDA has issued an emergency use authorization (EUA) for the first COVID-19 diagnostic test using next generation sequence technology.
• The FDA has issued an EUA for a new commercial diagnostic test for COVID-19.

Centers for Disease Control and Prevention

• The CDC has updated its brochure on the use of personal protective equipment when caring for patients with confirmed or suspected COVID-19.
• The CDC has updated its resources for laboratories.
• The CDC has updated its FAQ about COVID-19 for laboratories.
• The CDC has updated its guidance for health care facilities with recommendations and resources.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)