COVID-19 Update: April 22, 2020
COVID-19 update for April 22 as of 5:00 p.m.
Pennsylvania Update
Governor Wolf
Last night Governor Wolf presented his plan for a phased reopening of Pennsylvania over the coming weeks and months. See an outline of that plan here.
Department of Human Services
DHS’s Office of Long-Term Living has published a brief FAQ addressing the question of how economic stimulus payments recently distributed by the federal government may affect eligibility for its Community HealthChoices, Living Independence for the Elderly (LIFE), OBRA waiver, and Act 150 programs.
Department of Health
- The Department of Health has issued an order requiring skilled nursing care facilities to make daily reports of specific data regarding supplies and equipment, including staffing and infection control supply stores. Technical assistance documents to help facilities submit that information can be found here and here.
- The department has issued guidance for making decisions about returning to work for health care personnel with confirmed COVID-19 or who have had suspected COVID-19 but were not tested. This replaces previous guidance on the same subject.
- The department did not conduct a COVID-19 news conference today. In lieu of this update, see this Department of Health news release.
Federal Update
Distribution of Additional CARES Act Funding
Today the Department of Health and Human Services announced how it will distribute the remaining $70 billion of the $100 billion designated in the CARES Act for health care providers. See a news release describing that plan here.
Centers for Medicare & Medicaid Services
- CMS has posted a new toolkit to help state and local health care decision-makers maximize workforce flexibilities when confronting COVID-19 in their communities. The toolkit is a curated set of previously released resources and tools for decision-makers managing health care workforce challenges in response to the COVID-19 emergency.
- CMS and the Office of the National Coordinator for Health IT have announced a policy of enforcement discretion to allow compliance flexibilities regarding the implementation of the operability rules announced in March in response to the COVID-19 crisis. See the CMS announcement here and the National Coordinator for Health IT statement here.
- CMS has issued guidance permitting independent freestanding emergency departments to provide care to Medicare and Medicaid beneficiaries during the COVID-19 emergency.
- CMS has issued its first COVID-19-specific section 1115 Medicaid waiver to the state of Washington. The waiver permits self-attestation or alternative verification of individuals’ eligibility (income/assets) and level of care to qualify for Medicaid-covered long-term services and supports (LTSS) and for selected aspects of payments for LTSS.
- CMS has issued new blanket waivers addressing care for patients in long-term care hospitals (LTCHs), temporary expansion locations of Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), staffing and training modifications in Intermediate Care Facilities for individuals with Intellectual disabilities, and the limit for substitute billing arrangements. They are included in CMS’s updated compendium of COVID-19 emergency declaration blanket waivers for health care providers.
- CMS is easing the burden on Qualified Health Plans (QHPs) during the COVID-19 crisis by directing plans that are eligible to report for the Quality Rating System and the Quality Improvement Strategy programs to discontinue collecting clinical quality measure data. Eligible QHPs can discontinue reporting in June 2020 for display on exchange websites for the 2021 open enrollment period.
Department of Health and Human Services
- HHS has launched a new web site to serve as a telehealth resource for health care providers and patients. The site offers information about telemedicine, including an overview of telehealth, technology issues, COVID-19-related policy changes, and links to tools and resources for practitioners.
- HHS and its Health Resources and Services Administration (HRSA) have awarded nearly $165 million to combat the COVID-19 pandemic in rural communities. These investments will support 1779 small rural hospitals and provide additional funding to 14 HRSA-funded Telehealth Resource Centers to provide technical assistance on telehealth to help rural and underserved areas combat COVID-19.
Food and Drug Administration
The FDA will participate in a webinar that addresses the current landscape of COVID-19 treatment trial designs and best practices for quickly launching trials that ensure both patient safety and reliable results. The webinar will be held on Thursday, April 23 at 9:30 a.m. (eastern).- The FDA has approved an abbreviated new drug application for Albuterol sulfate inhalation solution for the relief of bronchospasm in patients two to 12 years of age with asthma in recognition of the increased demand for Albuterol products during the COVID-19 pandemic.
- The FDA has issued an emergency use authorization (EUA) for the use of a specific commercial device for use in decontaminating compatible N95 or N95-equivalent respirators for single-user reuse when there are insufficient supplies of face-filtering respirators.
- The FDA has authorized the first diagnostic test with a home collection option for COVID-19 by re-issuing the EUA for the LabCorp COVID-19 RT-PCR test to permit testing of samples self-collected by patients at home using LabCorp’s Pixel by LabCorp COVID-19 Test home collection kit.
- The FDA has issued two MUAs for specific commercial laboratory tests for COVID-19. See them here and here.
- The FDA has published guidance about its temporary policy on repackaging or combining propofol drug products during the COVID-19 emergency.
Centers for Disease Control and Prevention
- The CDC has developed a spreadsheet-based tool to estimate the surge in demand for hospital-based services during the COVID-19 pandemic.
National Institutes of Health
- Working under the aegis of the NIH, a panel of U.S. physicians, statisticians, and other experts has developed treatment guidelines for COVID-19 based on published and preliminary data and the clinical expertise of the panelists.
Resources to Consult
Pennsylvania Department of Human Services
Pennsylvania Department of Health
Centers for Disease Control and Prevention
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Today SNAP wrote to members of Pennsylvania’s congressional delegation to ask them to support new COVID-19 and economic relief legislation that was expected to include $75 billion for hospitals. See SNAP’s letter
The Department of Health new daily case counts are now the sum of two figures: “confirmed” cases that have been determined by testing plus cases that have been ruled “probable” because of an individual’s symptoms and recent contact with someone who has a confirmed case of COVID-19.
DHS has published its answers to the questions asked by stakeholders and interested parties during its April 15 COVID-19 webinar. Find that document
Congressional leaders and the Trump administration have agreed to provide $75 billion for hospitals as part of a $484 billion COVID-19 and economic relief package. This $75 billion would be addition to the money from the CARES Act and would have the same parameters as the CARES Act money.
The CDC has
Governor Wolf today announced that he was extending his stay-at-home order through May 8, at which time the state may, depending on the status of spread of COVID-19, begin permitting some industries and businesses to resume operations while still observing social distancing guidelines. Pennsylvania’s liquor stores have begun curbside pick-up and online auto sales will be permitted to resume, with notaries doing their work online. Construction projects would be permitted to resume on May 8. The administration is exploring permitting some retailers to engage in curbside pick-ups but the governor acknowledged that this presented different challenges in different places. He said the reopening of the state’s economy would be regional rather than state-wide, that some things that may be realistic in Cameron County may not be feasible in Philadelphia, and that all reopening efforts would be contingent on the progress of the COVID-19 pandemic between now and May 8. He did not speak about anything involving health care other than to note that social distancing appears to have been effective in preventing the health care system from becoming overwhelmed at the height of the crisis.
The department has issued an
FEMA has published a
National Health Services Corps
Department of Health and Human Services
Governor Wolf
Yesterday President Trump announced the creation of the
Department of State
CMS has posted a
The DEA has published a letter that grants to the satellite hospitals and clinics of DEA-registered hospitals, under certain conditions, the
Over the weekend, House Speaker Michael Turzai changed the House of Representatives’ session schedule to hold a non-voting session day today and a voting session day tomorrow in an effort to enable Republicans to move forward with relief efforts for businesses related to the COVID-19 crisis. There has been speculation that if a quorum is present the Speaker may seek to suspend temporary House rules permitting remote voting to ease the passage of Republican-sponsored relief measures for businesses affected by limits on their ability to operate during the COVID-19 emergency. The House also has canceled its session for Wednesday and Thursday of this week.
Children’s Health Insurance Program
MACPAC has written to CMS administrator Seema Verma to express its concern that the manner in which CMS has chosen to distribute $30 billion of the $100 billion designated in the CARES Act for hospitals and health care providers “…does not account for the real and pressing concerns of safety-net providers that are on the frontlines of serving the nation’s poorest and most vulnerable people…” MACPAC also asks Ms. Verma to “…ensure that safety-net providers, including hospitals considered deemed disproportionate share hospitals (DSH) for the purpose of Medicaid payment…children’s hospitals, and other providers serving Medicaid and other low-income patients have access to federal funds made available through the CARES Act without delay.” See the MACPAC letter
The FDA has issued guidance on best