PA Safety Net Admin, Author at Safety-Net Association of Pennsylvania

COVID-19 Update: March 23, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of March 23, 2020 at 4:00 p.m.

Pennsylvania Legislature

The governor and General Assembly agreed to postpone the Pennsylvania primary from April 28 until June 2. We anticipate this agreement to be formalized within the coming week. The House met to consider this issue today in non-voting session and are scheduled for voting session tomorrow. The Senate remains at a twelve-hour call of the President Pro Tempore.

Pennsylvania Administration

Department of Health Daily Update

Governor Wolf announced stay at home orders for residents in Philadelphia, Allegheny, Bucks, Chester, Delaware, Montgomery, and Monroe counties, urging residents in those areas to shelter in place and only leave home for something that is life sustaining, such as grocery shopping or health care needs.

Department of Health Secretary Levine discussed ongoing conversations with hospitals and health systems about capacity and supply needs, noting that about 40 percent of the state’s 3,400 intensive care beds are still available. Levine is working with providers to examine the entire care continuum’s capacity to continuing serving patients, exploring options like repurposing ambulatory surgical center beds or hotel rooms for post-acute services.

Pennsylvania has not gone as far as asking hospitals to increase bed capacity by 50 percent, as Governor Cuomo of New York recently ordered in that state. Instead, the three pillars of Pennsylvania’s COVID response at this time are: 1) prevention/mitigation 2) testing availability, and 3) preparing hospitals and health systems for surge (PPE, beds, ventilators, etc.)

Secretary Levine and Governor Wolf’s biggest concerns at the moment are, respectively, the continued exponential rise in new confirmed COVID-19 cases and the need to buy time to increase the capacity of the health care system to respond to this crisis so we’re not overwhelmed.

Department of Human Services

Since Friday, the Department of Human Services (DHS) has issued the following two new guidance documents on its provider resources web page:

DHS also shared a response to stakeholder questions regarding its overall responses to the COVID-19 outbreak so far. One point of interest to health care providers is that DHS plans to submit an 1135 waiver within the coming week.

The Office of Long Term Living released a Long-Term Care Facility Toolkit. The suite of documents comprising the kit can be downloaded from the announcement page here.

DHS shared a document describing temporary changes to the 1915(c) waiver under which the Community HealthChoices program operates. A copy of the document describing the changes can be downloaded here.

Supply Chain

As providers continue to use necessary supplies and procurement of additional supplies is disrupted, we want to remind you of the supply chain protocol as described by HAP:

Confirm that your facility has exhausted its normal procurement channels.
If the item is not available, confirm the availability of the item through the health care coalitions’ mutual aid component.
If the item is not available via mutual aid through the health care coalitions, your facility may be eligible to consider use of county, state or strategic national stockpile resources.
Facility sends unmet needs request to county emergency manager—following normal resource tracking.
Pennsylvania Emergency Management Agency forwards to department operation center.
Section chief will coordinate with incident commander to identify the overall risk.
Operations section will approve/decline based on crisis clinical need.

Licensure Guidelines

Several DHS program offices have relaxed requirements related to licensure. The details of the temporary alterations are available here.

The Pennsylvania Department of State has also issued notices of suspension of several license requirements. Details of the suspensions are available here.

Federal Update

Congress

The Senate on Sunday evening rejected a COVID-19 stimulus bill negotiated between Senate Republicans and the White House. While Treasury Secretary Steve Mnuchin continues to negotiate this bill with Senate minority leader Chuck Schumer, House Speaker Nancy Pelosi is expected to introduce an alternative proposal later today. This House proposal is rumored to be more generous to hospitals than the Senate bill. As of this writing, however, the House proposal is not yet available.

HHS Office of Civil Rights

The Department of Health and Human Services’ Office of Civil Rights has published a six-page telehealth fact sheet that addresses what patients can be served by telehealth, where HIPAA fits in the delivery of telehealth, locations where providers can deliver telehealth services, and the communications products and software that are acceptable for the delivery of care via telehealth. Find that fact sheet here.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) explains that no modifier is needed to bill for telehealth under the nation-wide waiver. This is a clarification of past information issued by CMS and can be found in the agency’s MLN Matters publication, which is here.
CMS has announced relief for clinicians, providers, hospitals, and facilities participating in quality reporting programs. It is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs for upcoming measure reporting and data submission for those programs. Read CMS’s news release announcing the policy change here and look for more specific guidance soon.
On Sunday CMS released COVID-19 checklists and tools for use by state Medicaid and CHIP programs. These four tools will enable states to seek emergency administrative relief, make temporary modifications to Medicaid eligibility and benefit requirements, relax rules to ensure that individuals with disabilities and the elderly can be served in their homes, and modify payment rules to support health care providers affected by the outbreak. In addition, the president has called on states to permit Medicaid beneficiaries to receive services through telehealth. See the news release announcing it here. This package of tools includes 1115 Waiver Opportunity and Application Checklist, 1135 Waiver Checklist, 1915(c) Appendix K Template, Medicaid Disaster State Plan Amendment Template. Further information about all of these tools can be found here.
While not directed at providers, CMS has published information about state Medicaid plan flexibilities. See it here.
In the face of this crisis, hospitals and others are interested in finding faster ways to enroll Medicare providers. Find a CMS FAQ on this subject here.

CMS publishes a running list of its guidance, regulatory changes, and more associated with COVID-19 on its “current emergencies” web page. That page is updated daily, or as needed, and you can find it here.

Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) published guidance in two areas over the weekend.

The CDC maintains a web page with general resources about COVID-19. That page is here.

Food and Drug Administration

The Food and Drug Administration (FDA) published six updates over the weekend. New updates from Friday through today:

And the FDA’s general COVID-19 resources page can be found here.

Resources to Consult

Pennsylvania Department of Human Services

Pennsylvania Department of Health

Centers for Disease Control and Prevention

Main COVID-19 Page FAQ

PA Safety Net Admin2020-03-24T06:00:21+00:00March 24th, 2020|Coronavirus, COVID-19, Federal Medicaid issues|Comments Off

SNAP to PA Delegation: Help Us Fight Coronavirus

Pennsylvania safety-net hospitals need help fighting COVID-19, the Safety-Net Association of Pennsylvania declared in a letter to members of the state’s congressional delegation.

In addition to the resources sought by hospitals everywhere – equipment, supplies, funding for expanded capacity to accommodate patients suffering from COVID-19 – SNAP emphasized three specific types of assistance in its letter to the delegation:

Help with cash flow. As requested by the federal government and others, SNAP hospitals have limited or suspended elective surgery so they can focus their resources on COVID-19 patients. This will create a cash-flow problem for them: while they will be doing everything they can to care for their patients and will be expending considerable resources doing so, their revenue will decline. These hospitals need up-front funding to replace the revenue they will lose and to help compensate them for the considerable costs they are incurring to prepare for the surge of patients they have been told to expect so they can keep the lights on, patient rooms and supply closets adequately stocked, and staff paid.
The elimination of Affordable Care Act-mandated reductions of Medicaid DSH allotments to the states. Congress has already delayed these reductions on numerous occasions and late last year there was every indication that Congress would do so again. At a time when hospitals are facing the gravest threat to the public health that they have seen in many years they should not be forced to waste valuable time planning the reductions in staffing and spending they would need to make if the cuts are implemented as scheduled on May 23.
No new programs or requirements in future COVID-19-related legislation that would increase hospitals’ regulatory burden. In recent weeks Congress and the administration have appropriately reduced certain regulatory requirements on a temporary basis and it would be counterproductive to offset this much-needed regulatory relief by introducing new regulations and requirements.

See SNAP’s letter to the Pennsylvania congressional delegation here.

PA Safety Net Admin2020-03-23T13:00:25+00:00March 23rd, 2020|Coronavirus, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

COVID-19 Update: March 20, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania today as of 5:30 p.m. on March 20, 2020.

Pennsylvania Administration

Since yesterday, the Department of Human Services has issued the following four new guidance documents:

We notified you last night that the governor issued an order to close all “non-life-sustaining businesses.” Below please find two resources for additional information.

Any business that would like to seek a waiver to the mandate to close can send a request to this email address: RA-dcexemption@pa.gov
In addition, questions about whether or not your specific business needs to close can be directed to: ra-dcedcs@pa.gov

At the Secretary of Health’s daily update she noted that the number of diagnosed COVID-19 cases in the state doubled in the past two days.

Federal

Administration

CMS approved Washington state’s 1135 waiver request. The approval letter can be found here.

In addition, CMS released two telehealth toolkits: one for general practitioners that is available here and another for end-stage renal disease providers available here.

Congress

Congress is preparing a combination bill to both combat the spread of the coronavirus and also provide economic stimulus to counteract the negative effects of the state of emergency. As Congress deliberates, SNAP weighed in today with Pennsylvania’s congressional delegation, asking for immediate financial support for hospitals, the elimination of the Affordable Care Act Medicaid DSH cuts, and a moratorium on new regulatory requirements on hospitals. Find a summary of the bill here and SNAP’s letter to the delegation 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

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

PA Safety Net Admin2020-03-23T06:00:11+00:00March 23rd, 2020|Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Uncategorized|Comments Off

SNAP Rallies PA Delegation to Oppose Proposed Medicaid Fiscal Accountability Regulation (Letter)

SNAP asks members of Pennsylvania’s congressional delegation to sign onto a bipartisan letter written by delegation members Brendan Boyle (D) and Mike Kelly (R) asking the Centers for Medicare & Medicaid Services Administration to reconsider a proposed regulation that could limit the state’s ability to finance its share of its Medicaid spending and appropriately reimburse providers of high volumes of Medicaid-covered services.

PA Safety Net Admin2020-09-01T17:58:14+00:00March 20th, 2020|Advocacy|Comments Off

COVID-19 Update: March 19, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania for March 19, 2020 as of 6:30 p.m.

Pennsylvania Administration

Governor’s Order Closing State Businesses

Early in the evening, Governor Tom Wolf announced that he was ordering the immediate closing of what he called “non-life-sustaining businesses in Pennsylvania.” See his news release on the order here, the order itself here, and a list of types of businesses and whether they are or are not “life-sustaining” here.

Pennsylvania Department of State Licensure Exceptions and Fast Track

The Pennsylvania Department of State Bureau of Professional and Occupational Affairs, in conjunction with Governor Wolf, issued a press release announcing that the governor had granted the department’s request for a suspension to permit licensed practitioners in other states to provide services to Pennsylvanians without obtaining a Pennsylvania license during the emergency. The announcement also makes clear that “no Pennsylvania law prohibits the practice of telemedicine.” Under the exception, out-of-state practitioners must:

Be licensed and in good standing in their home state, territory or country.
Provide the Pennsylvania board from which they would normally seek licensure with the following information prior to practicing telemedicine with Pennsylvanians:
their full name, home or work mailing address, telephone number, and email address; and
their license type, license number or other identifying information that is unique to that practitioner’s license, and the state or other governmental body that issued the license.

The full text of the document can be found here.

Pennsylvania Department of Drug and Alcohol Programs Authorizing Additional Take-home Opioid Treatment Medicine

On March 16, the federal Substance Abuse and Mental Health Services Administration provided additional guidance to Opioid Treatment Programs. Today, Pennsylvania’s Department of Drug and Alcohol Programs issued a licensing alert taking advantage of that guidance to suspend the prohibition on patients receiving a greater-than-two-week supply of medication to take home. The full text of the document can be found here.

Pennsylvania Department of Human Services Shares COVID Response Overview

On Tuesday, March 17 Pennsylvania’s Department of Human Services (DHS) hosted an invitation-only call to provider DHS stakeholders with an overview of its actions related to COVID-19. Last night DHS issued a summary of that presentation. Please find that summary attached.

Pennsylvania Department of Health Daily Update

The Secretary stated that the Department of Health (DOH) is working with hospitals to evaluate whether elective procedures are necessary and to delay them as appropriate.
DOH has directed hospitals to update their emergency plans to include COVID-19 and to implement those plans as of 11:59 tonight.
Although the number of diagnoses continues to rise, hospitalizations in Pennsylvania are on par with nationwide statistics at roughly 10 percent of the diagnosed population.
The Secretary is urging small businesses to comply with the social distancing protocols and called on small business owners to contact the Department of Community and Economic Development to identify financial resources to assist them through this period.
She reminded citizens that limiting individual exposure does not require a mask, stating that the limited personal protective equipment supplies are best used by frontline responders.

Pennsylvania Legislature

House Chamber of the State House The following summary of PA legislative actions was compiled by Cynthia Fernandez of Spotlight PA and Gillian McGoldrick of Lancaster Online.

Limiting Disaster Powers

When Gov. Tom Wolf declared a disaster emergency on March 6, he was able to claim expansive powers. Rep. Russ Diamond (R., Lebanon) plans to issue a resolution to terminate Wolf’s COVID-19 emergency declaration “if the need arises.”

Privacy

Sen. Doug Mastriano (R., Franklin) is drafting a resolution that would call on the federal government to suspend privacy regulations for people who have tested positive for COVID-19. There should be “full disclosure of anyone who came within immediate contact of any contaminated citizen,” Mastriano said in a statement, “until the COVID-19 crisis passes.”

Pa. Coronavirus Cases

As of March 18, 2020, the Pa. Department of Health reports that there are 133 positive cases of COVID-19 in Pennsylvania.

Total cases/Deaths

VIEW THE INTERACTIVE MAP HERE: https://www.pennlive.com/news/2020/03/evictions-student-loans-pssas-and-more-what-pa-lawmakers-are-proposing-in-response-to-the-coronavirus.html

Rent

Lawmakers are drafting a bill to limit landlords’ right to evict tenants when a governor declares a state of emergency. The measure, from Rep. Mary Isaacson (D., Philadelphia) and Rep. Summer Lee (D., Allegheny), would “provide an exemption from eviction for workers who are unemployed, separated from their employment, or unable to find employment.”

Schools

Sen. Andy Dinniman (D., Chester) and Sen. Scott Martin (R., Lancaster) are drafting a bill that would cancel the state PSSA and Keystone exams for the remainder of this school year. The measure would also require the state Department of Education to waive federal testing requirements.

Dinniman is also drafting a measure that would give school districts authority to deliver online instruction until the end of the academic year.

Martin has proposed a bill that would require colleges and universities closed because of COVID-19 to refund all fees paid in advance, including room and board. The prorated refund would only apply from the date the institution shuttered through the end of the semester.

Sick Leave

Rep. Joe Hohenstein (D., Philadelphia) and Sen. Larry Farnese (D., Philadelphia) want to require paid sick leave for any workers left out by a federal bill on its way to President Donald Trump’s desk, which is limited to workers who need to care for their children. The legislation could leave 19.3 million workers without any sick pay, the Washington Post reported.

The state legislation would also require employers to reinstate workers when they return from leave.

Small Businesses

To lessen the impact on small businesses, Sen. Tom Killion (R., Chester) plans to introduce legislation that would direct table game revenue to the Department of Community and Economic Development to create zero-interest loans.

Reps. Valerie Gaydos (R., Allegheny) and Jared Solomon (D., Philadelphia) also plan to introduce legislation to create low-to-no interest loans to help small businesses survive. The bill will outline two types of loans: one will be short-term funding to meet payroll and overhead expenses; the other will be for “long-term resiliency” to help businesses recover over time.

Student Loans

A measure by Rep. Malcolm Kenyatta (D., Philadelphia) would allow a 60-day grace period for repayment of student loans issued by the Pennsylvania Higher Education Assistance Agency.

READ MORE: U.S. courthouse in Harrisburg closed after agent assigned there tests positive for coronavirus

Taxes and Filing

Rep. David Rowe (R., Union) and Rep. Frank Ryan (R., Lebanon) are writing a measure that would suspend sales and personal income tax collection until the disaster declaration is lifted.

The IRS will keep its tax-filing deadline as April 15, but the U.S. Treasury announced Tuesday it will waive interest and penalties for 90 days after that date. Rep. Joe Ciresi (D., Montgomery) plans to introduce legislation that would apply a 60-day extension for Pennsylvanians to file state income taxes when the state is under a disaster declaration.

Voting

All Pennsylvanians are now eligible to vote by mail. Rep. Kevin Boyle (D., Philadelphia) wants to encourage that by mailing all voters that kind of ballot ahead of the April 28 primary.

Rep. Dan Williams (D., Chester) plans to introduce legislation to allow elections officials to open votes submitted by mail before the polls close. House Majority Leader Bryan Cutler (R., Lancaster) previously said this is a part of discussions with Gov. Tom Wolf to “clean-up” a comprehensive voting reform bill passed last year.

Workers’ Rights

A proposed state Senate bill would support workers while quarantined or in isolation during a public health emergency. Sen. Steve Santarsiero (D., Bucks) said in a memo to his colleagues that Pennsylvania does not have a law that addresses whether an employer can fire a worker under these conditions during a state of emergency.

A measure by Rep. Ed Neilson (D., Philadelphia) would provide unemployment compensation for people who have been ordered to quarantine or isolate because of the coronavirus. His bill would not offer extended benefits to people who used paid time off or paid sick days during quarantine or isolation.

Federal

CMS Catastrophic Plan Coverage Guidance

Catastrophic coverage plans are generally prohibited from covering essential health benefits until a covered individual has met its deductible. The U.S. Department of Health and Human Services has issued a notice informing plans that it will not enforce this provision as it relates to insurers amending their plans to provide pre-deductible coverage for services related to the diagnosis and treatment of COVID-19. The full notice is available here.

CMS Medicaid and CHIP FAQ Released

The guidance describes the authority states have generally to respond to emergencies but has also been updated as of March 18 to include additional guidance specific to the response to COVID-19. The updates generally provide additional clarity around telehealth.

There are also new sections on managed care flexibilities and 1115 waiver flexibilities, again generally focused on limiting the spread of person-to-person contact through the use of telehealth, remote monitoring, etc. It is worth mentioning that this is federal guidance for state Medicaid programs so it describes what is possible but does not describe the actual conditions in any particular state.

The FAQ document is available here.

CMS Elective Surgery Guidance

CMS released guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures, in an effort to conserve critical resources such as ventilators and Personal Protective Equipment (PPE). Decisions remain the responsibility of local health care delivery systems, including state and local health officials, and those surgeons who have direct responsibility to their patients. To help with that decision-making, CMS offered a tiered framework of procedures that should be considered for postponement, taking into account the location (outpatient department, ambulatory surgery center, or hospital), the hospital’s COVID-19 patient census, the patient’s acuity, and more. Click here to read the full guidance. Click here to read the CMS press release.

HRSA Data Collection Activities

The Health Resources and Services Administration (HRSA) will not be going through notice and comment periods for data collection activities for the remainder of the emergency. Under this authority, HRSA launched an information collection effort to support the Trump administration’s response to the COVID-19 pandemic, surveying HRSA-funded health centers on their involvement in the COVID-19 response, including whether they are offering diagnostic tests. The agency will have to comply with relevant provisions within 30 days of the end of the emergency declaration. The announcement is available here.

CDC Alters Timeline to Implement New ICD-10 Code for Coronavirus (see attached)

The Centers for Disease Prevention and Control (CDC) is taking the unprecedented step of invoking the National Emergencies Act to supersede the schedule for updating the ICD coding set defined within HIPAA. Under this authority, CDC is establishing an effective date of April 1, 2020 for the new code as opposed October 1 date that would have been required under the normal statutory update schedule. The full text of the announcement is available 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

Pennsylvania Emergency Preparedness Guide

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

PA Safety Net Admin2020-03-20T09:54:40+00:00March 20th, 2020|Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19|Comments Off

COVID-19 Update: March 18, 2020

The following is a summary of today’s major COVID-19-related developments.

Pennsylvania Updates

PACE Prescription Drug Program

Department of Health Secretary Rachel Levine announced that for individuals who participate in the state’s PACE program, which provides financial assistance on prescription drugs for low-income seniors, the state is waiving the current requirement that participants must use at least 75 percent of their supply of an individual drug before being eligible to renew their prescription. This does not apply to opioids and other controlled substances but participants who use those drugs can apply for a waiver from the 75 percent requirement.

In addition, PACE participants will not have to pay the cost of home delivery of their prescriptions.

COVID-19 Testing

Secretary Levine said that her department is working with hospitals on testing sites. The state is working with the county health departments in Philadelphia and Montgomery counties and the federal government to develop mass testing sites in those counties. Meanwhile, Quest and Labcorp are now doing COVID-19 testing and other commercial labs should be coming online soon. Hospitals, too, are developing their own testing capacity, and she specifically mentioned the Children’s Hospital of Philadelphia, Penn Medicine, UPMC, and the Allegheny Health Network as now having FDA-approved testing programs.

Ventilators

Secretary Levine announced that the state has its own stock of extra ventilators and is hoping to acquire more of them.

Hospital Beds

The state, Secretary Levine said, is waiving the requirement that hospitals notify the state before they increase their bed complement.

Unemployment Compensation

With unemployment claims in Pennsylvania up sharply, the state is streamlining its process for applying for benefits, waiving a one-week waiting period while it verifies unemployment and proof of a job search while also encouraging people to apply online. Read an account of the changes in this Pittsburgh Business Times article and find the official state notice here on the state’s unemployment compensation web page.

PA General Assembly Update

Today the Senate met briefly at the Capitol to pass temporary rules to allow its members to work and vote remotely should the need arise in the coming weeks/months. This is similar to the temporary rules adopted by the House earlier this week. In his floor remarks, Majority Leader Corman (R-Centre) committed to being as transparent as possible throughout this process with the public, press, administration, and House. He also committed to only move legislation forward during this remote time that is directly related to the pandemic. He noted that the time may come in the months ahead that the primary election or state budget could require the Senate’s attention in accordance with this remote voting authority.

Federal Updates

Senate Passes Emergency COVID-19 Aid Bill

Late this afternoon the Senate passed the COVID-19 aid bill that had already passed the House. President Trump is expected to sign it.

Elective Surgery

Today Vice President Pence urged hospitals to delay elective procedures. Centers for Medicare & Medicaid Services (CMS) administrator Verma said her agency will issue recommendations on such limits.

Practicing Medicine Across State Lines

The Department of Health and Human Services (HHS) is expected to issue regulations later today addressing the practice of medicine across state lines by doctors and medical professionals to meet the demands of caring for COVID-19 patients.

Section 1135 Waivers

The declaration of a national emergency included an invitation to states to apply for waivers of some federal regulations to facilitate caring for COVID-10 patients. As we wrote to you yesterday, Florida already has received such a waiver. Yesterday the California Hospital Association applied for such a waiver on behalf of the state’s hospitals and a published report suggests that almost every state is expected to apply for a section 1135 waiver.

Infection Control

The Centers for Disease Control and Prevention (CDC) has issued new infection prevention and control recommendations for patents with suspected or confirmed COVID-19. See those recommendations here.

The CDC also has issued guidelines that address health care workers returning to work after suffering from COVID-19 or who were suspected of suffering from or being exposed to it. Find those guidelines here.

HIPAA

Late yesterday HHS released a bulletin detailing the provisions of HIPAA that it will not be enforcing for covered hospitals that have implemented a disaster protocol. The waiver became effective on March 15, 2020. Find it here.

Telehealth

Yesterday the HHS Office of the Inspector General issued a policy statement regarding physicians and other practitioners that reduce or waive amounts owed by federal health care program beneficiaries for telehealth during the COVID-10 outbreak. Find that policy statement here and an accompanying fact sheet here.

On the same subject, the HHS Office of Civil Rights issued a notification of enforcement discretion for telehealth remote communications during the COVID-19 emergency. Find that document here.

JCAHO

Yesterday the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) announced that it has suspended its surveying activities at least until the end of April.

PA Safety Net Admin2020-03-19T15:44:02+00:00March 19th, 2020|Coronavirus, COVID-19|Comments Off

COVID-19 Update: March 17, 2020

Safety-Net Association of Pennsylvania logo The following is a summary of the major COVID-19-related developments in Pennsylvania today.

Telemedicine

The Office of Medical Assistance Programs has issued guidance for providers on the use of telemedicine services for Medicaid patients – those covered both by managed care plans and on a fee-for-service basis. Learn more from the newly posted telemedicine guidelines and a separate memo to the HealthChoices managed care plans from the state.

In addition, CMS issued a waiver for certain restrictions on the provision of telemedicine services under the Medicare program. The details of the wavier are described in a Fact Sheet and FAQ.

New Guidance From the State

Today the state published a number of COVID-19-related resources:

Letter from Department of Health Secretary

Attached to this memo, please find a letter and its attachment issued by the PA Department of Health providing additional hospital guidance on implementing your emergency preparedness plans.

PA Insurance Department Public Notice

You can find a preview copy of a pending public notice from the insurance department related to COVID-19 at this link.

PA General Assembly Update

Both the House and Senate are currently in recess with a 12-hour call of their respective chairs. Neither chamber is expected to be in Harrisburg through the remainder of this week and we will likely receive an update on next week’s session schedule over the weekend.

The House passed temporary rules during session yesterday to allow its members to work and vote remotely should the need arise in the coming weeks/months. This temporary rule still requires majority and minority leadership to be at the Capitol for bill movement and to tally votes. The same is required of Committee Chairs should they call voting meetings during this time away from Harrisburg.

Daily State Briefing

Department of Health Secretary Levine reported that the state is now receiving more COVID-19 test results from commercial and hospital laboratories, which are now doing most of the testing. As that number rises, the ability of officials to trace the origin of the disease is expected to decrease.
Mass testing sites for Philadelphia and Montgomery County are still being explored. They would perform drive-through testing and would only be for people showing symptoms.
With state liquor stores about to close, state officials are planning to meet later today to discuss possible resources for alcohol-dependent individuals who suffer withdrawal problems.
The state will be providing guidance to dentists, who are considered very high risk, later this week.
No hospitals are reporting to the state that they are overtaxed by COVID-19 patients at this time.

Secretary Miller’s Briefing

DHS Secretary Teresa Miller is holding an invitation-only briefing later today. If anything urgent arises we will let you know immediately. Otherwise, we will report on it tomorrow.

Resources to Consult

Pennsylvania Department of Human Services

Pennsylvania Department of Health

Centers for Disease Control and Prevention Main COVID-19 Page FAQ

Conclusion

Please let us know if you have any questions or need additional information or resources.

PA Safety Net Admin2020-03-18T16:53:47+00:00March 18th, 2020|Coronavirus, COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

CMS Posts COVID-19 FAQ for State Medicaid and CHIP Agencies

State Medicaid agencies and CHIP programs have received new guidance on the federal resources available to them to fight the COVID-19 national health emergency through a new FAQ published by the Centers for Medicare & Medicaid Services last week.

Among the issues addressed in the FAQ are eligibility, enrollment, benefits, cost sharing, workforce issues, telehealth, and more. Health care providers may find this information useful when serving their patients.

See CMS’s news release describing the FAQ here and the FAQ itself here.

PA Safety Net Admin2020-03-17T06:00:50+00:00March 17th, 2020|Federal Medicaid issues|Comments Off

Largest PA Health Insurers to Underwrite Members’ Coronavirus Testing

Some of Pennsylvania’s largest health insurers will waive co-pays for coronavirus testing for their members.

The insurers – Aetna, Capital Blue Cross, Cigna, Geisinger, Highmark, Independence Blue Cross, Pennsylvania Health & Wellness, United Healthcare, and UPMC Health Plan – will cover such tests when they are medically ordered and performed by approved medical labs.

Not all insurers serving Pennsylvanians will do the same. Among those that may not are short-term and limited duration plans.

Learn more about the role some Pennsylvania health insurers will play in coronavirus testing in the Philadelphia Business Journal article “Wolf: Major Pennsylvania health insurers to cover coronavirus testing.”

PA Safety Net Admin2020-03-10T10:13:39+00:00March 10th, 2020|Uncategorized|Comments Off

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The February 2020 MACPAC meeting opened with a continuation of MACPAC’s examination of Medicaid’s role in maternal health, when Medicaid officials from Michigan, New Jersey, and North Carolina joined the Commission to discuss how their states are addressing maternal morbidity and mortality.^* The Commission plans to include a chapter on maternal health in its June 2020 report to Congress. Commissioners later turned their attention to policy options for improving enrollment in the Medicare Savings Program.

The Commission later took a deep dive into value-based payment in Medicaid managed care. This three-part session began with findings from a series of interviews with state officials, managed care organizations, and other stakeholders aimed at understanding how states use managed care to promote payment reform, conducted by MACPAC contractor Bailit Health. Then, representatives from three of these organizations shared their reactions to the findings and talked about how value-based payment models are working in practice.^* The session concluded with Commissioners’ perspectives on the study’s findings and the panelists’ reactions to them, and possible next steps.

The final session of the afternoon continued a line of inquiry begun at the October 2019 meeting: third-party liability coordination between Medicaid and TRICARE. MACPAC estimates that almost 1 million Medicaid enrollees have primary coverage through TRICARE, which provides health benefits for military personnel, military retirees, and their dependents. Commissioners explored making recommendations in the June report to improve coordination between the two programs.

On Friday, the Commission returned to the theme of improving care for dually eligible beneficiaries, looking more closely at the rise of so-called dual-eligible special needs plan (D-SNP) look-alikes and how changes in the Medicare Advantage market are affecting efforts to integrate care. Commissioners also reviewed a rule proposed in February that would, among other things, restrict the growth of look-alikes.

Following that session, the Commission discussed draft recommendations to improve integration of Medicare and Medicaid benefits for dually eligible beneficiaries. The February meeting wrapped up with a discussion of a forthcoming rule expected to affect the Medicaid eligibility determination process.

Supporting the discussion were the following briefing papers:

Because they serve so many Medicaid and CHIP patients – more than the typical hospital – MACPAC’s deliberations are especially important to Pennsylvania safety-net hospitals.

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide variety of issues affecting Medicaid and the State Children’s Health Insurance Program. Find its web site here.

PA Safety Net Admin2020-03-06T06:00:04+00:00March 6th, 2020|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

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