The following is the latest coronavirus information from Pennsylvania’s state government as of 3:30 p.m. on Tuesday, August 18.

Wolf Administration

The Wolf Administration has awarded $50 million in hazard pay grants for front-line workers in life-sustaining industries.  The program, funded through CARES Act money appropriated to the Department of Community and Economic Development, was announced in mid-July in an effort to keep front-line workers working across the commonwealth.  Click here to read the full press release and here to view a list of grant recipients.

 Department of Health 

• The Secretary of the Department of Health has ordered all skilled nursing facilities, personal care homes, assisted living residences, and private intermediate care facilities to develop, implement, and adhere to policies and procedures that provide for the procurement and distribution of personal protective equipment to all staff by August 27, 2020.  The policies and procedures must at a minimum include distribution of respirators to staff providing direct patient care to COVID-19 positive and suspected cases and staff assigned to provide direct patient care in COVID-19 units.  The respirators distributed by each facility must be National Institute for Occupational Safety and Health-approved or FDA-approved.  Respirator distribution must occur prior to the beginning of the staff member’s shift and the respirator must be replaced as soon as practical if the facility is notified by a staff member that a mask has become soiled, damaged, or otherwise ineffective.
• The administration provided an update on its efforts to improve and expand COVID-19 contact tracing efforts through the Department of Health.

Department of Health – by the numbers 

• The number of new COVID-19 cases has remained relatively steady for the past two weeks:  fewer than late July and more like the beginning of last month.
• The department continues to report that the number of cases among people between the ages of 19 and 24 exceeds those among people between the ages of 50 and 64 and those 65 years of age and older.  The number of cases among those between 19 and 24 is rising in every part of the state.
• More than 8,997 health care workers in the state have contracted COVID-19.
• The number of COVID-19-caused deaths in Pennsylvania is nearing 7,500.
• The number of long-term-care facility residents and staff who have contracted COVID-19 now exceeds 24,700.  These cases have occurred in 899 such facilities in 61 of the state’s 67 counties. 

Department of Human Services 

The Department of Human Services has temporarily suspended certain regulatory requirements for the continued and uninterrupted delivery of behavioral health services during the COVID-19 pandemic. Go here for a complete list of the regulatory suspensions issued by the Office of Mental Health and Substance Abuse Services to date.

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.)

The following is the latest COVID-19 information from the state and federal governments as of 2:30 p.m. on Tuesday, August 11.

Pennsylvania Update

Wolf Administration

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 here and Department of Health notice about the temporary policy suspension here.

Department of Health

• The Department of Health addressed a provider question about direct care worker exposure to a COVID-19-positive patient in last week’s weekly wrap-up document, stating that anyone who has had prolonged close contact (within six feet for at least 15 minutes) with an individual who tests positive should be considered potentially exposed regardless of the personal protective equipment worn by either the worker or the patient.
• A posting on the department’s message board provided guidance for hospitals on how to comply with the requirement for an annual public meeting of the governing body in 28 Pa. Code §103.3(10)(iii) during the public health emergency.  That posting explained that

For purposes of a compliance with 28 Pa. Code §103.3(10)(iii), the Department has interpreted the term “attend” to include virtual attendance by the general public and the governing body through the use of audio-video technology.  A hospital choosing to conduct its annual public meeting virtually must still publicize the meeting information well in advance of the meeting and establish a mechanism to document attendance at the meeting.  A hospital does not need approval from the Department to conduct a virtual meeting under 28 Pa. Code §103.3(10)(iii) but must be able to provide documentation of the advance notice and attendance upon request.

Department of Health – by the numbers

• The number of new COVID-19 cases has remained relatively steady for the past week:  fewer than late July and more like the beginning of last month.  Today’s new cases brought the state-wide count to more than 120,000 since the beginning of the pandemic.
• The number of COVID-19-caused deaths has generally been down except for two days in the past week that had the highest death totals since July 1.  Yesterday the state’s total death count from COVID-19 surpassed 7300.
• A report issued jointly by Governor Wolf and the Department of Health late last week noted that the state-wide positive COVID-19 test rate declined to 4.1 percent from 4.6 percent last week.  Counties with concerning positive test rates include Union (11.8 percent), Indiana (7.9 percent), Fayette (7.7 percent), Fulton (7.4 percent), Huntingdon (6.7 percent), Erie (6.2 percent), Mercer (6.2 percent), Lawrence (6.0 percent), Northumberland (6.0 percent), York (5.8 percent), Clearfield (5.7 percent), Luzerne (5.4 percent), Juniata (5.3 percent), Lancaster (5.3 percent), Beaver (5.2 percent), Delaware (5.2 percent), and Mifflin (5.0 percent).
• The number of long-term-care facility residents and staff who have contracted COVID-19 recently rose past the 24,000 mark.
• As has been the case for more than two months, 68 percent of the state’s COVID-19 deaths have been among elderly residents of long-term-care facilities.
• The number of Pennsylvanians hospitalized with COVID-19 and breathing with the help of mechanical assistance continues to decline slowly.
• 22 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  24 percent of adult ICU beds, 15 percent of pediatric ICU beds, 41 percent of pediatric beds, and 43 percent of airborne isolation rooms.

Federal Update

Provider Relief Fund

• Eligible providers may now apply for Provider Relief Fund phase 2 general distributions. These are providers that are being given another opportunity to receive Provider Relief Fund payments after missing the June 3, 2020 deadline to apply for funding equal to two percent of their total patient care revenue from the $20 billion portion of the $50 billion phase 1 general distribution; this group also includes Medicaid, Children’s Health Insurance Program (CHIP), dental providers with low Medicare revenues, and hospitals that received payments in the phase 1 distribution but returned them.  In addition, providers that experienced a change in ownership, making them ineligible for phase 1 funding, also may apply.
  • Providers can go here to learn more about this phase 2 distribution and eligibility.
  • Providers can submit the required financial data on the Provider Relief Fund application and attestation portal. The deadline for submitting data is August 28.
  • Providers can go here to register for a webinar on this distribution to be held on Thursday, August 13 at 3:00 (eastern).
• HHS has shared information about its next CARES Act-authorized nursing home Provider Relief Fund distribution. This $5 billion distribution will include approximately $2.5 billion to support increased testing, staffing, and personal protective equipment needs and to establish COVID-19 isolation facilities, with the balance to be linked to nursing home performance.  HHS expects to make the first $2.5 billion distribution in mid-August and the performance-based distributions throughout the fall.  Learn more from this HHS news release.
• HHS has updated its Provider Relief Fund FAQ with 16 new questions, 15 of which address eligibility for phase 2 general distributions from the Provider Relief Fund and how to apply for those distributions. These questions can be found on pages 22, 23, 24, 29, and 31 of the FAQ; these and other new questions are all dated 8/10/2020.  Another question about eligibility, dated 8/7/2020, can be found on page 2.

Department of Health and Human Services

• HHS has posted the July through December COVID-19 testing plans of all states, territories, and localities. Find those testing plans here.

Centers for Medicare & Medicaid Services

• CMS announced a new Community Health Access and Rural Transformation Model (CHART) that will seek to improve the quality, accessibility, and value of care in rural areas. The agency intends to invest up to $75 million in seed money to enable up to 15 rural communities to participate in the program, which will involve tools such as an accountable care organization (AC) transformational track, the extension of COVID-19-inspired telemedicine waivers after the pandemic is over, a reduction of the minimum required supervision level for hospital outpatient therapeutic services, and an increase in wage indexes for low-wage hospitals, including many rural hospitals.  Learn more here.
• CMS has updated its “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing” document with a new question about the broader impact of its waiving of certain Medicare and Medicaid utilization review requirements. See page 22, question 23 for further details.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to its 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.

Lessons from the Front Lines: COVID-19

Friday, August 21 at 12:30 – 2:00 PM eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5956858

Audio Webcast Link:  go here.

CMS COVID-19 Office Hours Call

Tuesday, August 25 at 5:00 – 6:00 PM eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 8579003

Audio Webcast link:  go here.

Home Health and Hospice Call

Tuesday, August 25 at 3:00 – 3:30 PM eastern

Toll Free Attendee Dial-In: 833-614-0820 Access Passcode: 6782346
Audio Webcast Link:  go here.

Nursing Homes Call

Wednesday, August 12 at 4:30 – 5:00 PM eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7857618

Audio Webcast Link:  go here.

Wednesday, August 26 at 4:30 – 5:00 PM eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5718509
Audio Webcast Link:  go here.

Dialysis Organizations Call

Wednesday, August 12 at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1027088

Audio Webcast Link:  go here.

Wednesday, August 26 at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1834329
Audio Webcast Link:  go here.

Nurses Call

Thursday, August 13 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7844289

Audio Webcast Link: go here.

Thursday, August 27 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1556623
Audio Webcast Link:  go here.

Conference lines are limited, so CMS encourages interested parties to join via audio webcast.  To listen to the audio files and read the transcripts for these and past COVID-19 Stakeholder calls, visit CMS’s Podcast and Transcripts page.

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.)

The following is the latest COVID-19 information from the state and federal governments as of 2:30 p.m. on Friday, August 7.

Pennsylvania Update

News Conference

Governor Wolf and Health Secretary Levine held a joint news conference on Thursday, August 6.  Among the issues they highlighted:

• Pennsylvania now has 445 testing sites.
• The state’s testing capacity, about 8000 tests a day in April, is now more than 22,000 tests a day.
• The state is now testing about four percent of its population a month.  It would like to exceed five percent.
• The positivity rate on those tests is less than five percent.  More than five percent is considered a problem.
• One of the biggest challenges is the turnaround time for test results.  Hospital and small commercial labs are often turning tests around in 24-48 hours but the major labs are struggling under their workload.  With many cases and often lacking reagents needed for testing, they are averaging a turnaround time of seven days.  State officials have spoken to them about this and to the federal Department of Health and Human Services about the lack of testing reagents that is a major part of the problem.
• The national labs also often need to focus on states in the midst of serious outbreaks.
• The number of Pennsylvanians hospitalized daily for COVID-19 has fallen from an average of 1028 in June to 700 at the end of July and the number of patients on ventilators daily has fallen from an average of 222 in June to 94 at the end of July.
• With mandatory nursing home testing now completed, the state will turn its attention to continued testing at nursing homes based on what the first round of testing revealed and testing at the more than 1200 assisted living and personal care facilities.
• At this point, everyone who needs a test can get one.  The challenge remains getting the results of such tests in a timely manner.
• The state laboratory has expanded its testing capacity.  In addition, it can prioritize tests taken in areas where there appear to be outbreaks, to ensure more timely results.
• The state lab and the county labs have enough reagents and testing materials for their own use but they do not have any to share.
• Governor Wolf expressed a desire for a simpler point-of-care test that is less uncomfortable to administer.  He revealed that he has not yet been tested.

Department of Health

The Department of Health has revised a previous health alert on infection prevention and control in health care settings to reorganize the information and add new recommendations about protective eye wear.  This advises personnel working in health care facilities located in areas with moderate to substantial community transmission to wear eye protection in addition to a face mask for all patient care encounters.

Department of Health – by the numbers

• The number of new COVID-19 cases has declined from the higher totals of late July.  With occasional exceptions, daily death totals also are generally down.
• 22 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  26 percent of adult ICU beds, six percent of pediatric ICU beds, 38 percent of pediatric beds, and 44 percent of airborne isolation rooms.
• The number of health care workers who have contracted COVID-19 now exceeds 8500.
• Pennsylvania has seen 40 confirmed cases of multisystem inflammatory syndrome in children (MIS-C).  twelve suspected cases were found not to be MIS-C and another 16 are currently being investigated.

Department of Human Services

• DHS has updated its interim guidance for personal care homes, assisted living residences, and private intermediate-care facilities during the COVID-19 emergency.
• DHS has developed a suggested tool for personal care homes, assisted living residences, and private intermediate-care facilities to use when developing their implementation plan for reopening.  It is designed not as a tool to submit to DHS but as a means of facilitating compliance with the interim guidance noted above.  Find it here.

State Legislature

The Senate Republican Policy Committee held an informational meeting to discuss the challenges facing the state’s rural hospitals, and in particular, the challenges those hospitals have faced during the COVID-19 emergency.  Go here to see a video of what the committee billed as a “workshop.”

Federal Update

White House:  Executive Order

The White House issued an executive order directing the Department of Health and Human Services to extend permanently some of the Medicare telehealth waivers initiated during the COVID-19 public health emergency; to simplify Medicare billing codes and propose a payment model to improve health care in rural areas; and to encourage the Department of Agriculture and Federal Communications Commission to invest in technology that enhances access to telehealth services.

The administration’s plans for following through on this executive order are described in an HHS news release that summarizes the policy changes the administration seeks and a CMS news release that addresses several proposed regulations that would facilitate achieving these objectives.

Department of Health and Human Services

• 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 presentation around which that webinar was conducted and an FAQ about the use of telemedicine in alternative sites.
• The Office of the Assistant Secretary for Preparedness has created a new rural health information hub web page with current and key resources for rural health care systems preparing for and responding to a COVID-19 surge.  The page includes links to resources by audience and topic.
• 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 emergency with new guidance on the ability of clinical laboratories to offer free COVID-19 antibody testing to federal health care program beneficiaries who are contemporaneously receiving other medically necessary blood tests.

Centers for Medicare & Medicaid Services

• CMS has posted three-year average hourly wages used for 2022 Medicare area wage index reclassifications.  CMS usually publishes this data with its final inpatient prospective payment system regulation but is posting it separately this year.
• CMS has updated its FAQs about COVID-19 testing in skilled nursing facilities.
• CMS has posted a database detailing which nursing homes will receive point-of-care tests in its first wave of such shipments.

Food and Drug Administration

• The FDA has issued guidance on the use of drugs frequently used to treat COVID-19 patients when those drugs go beyond their labeled “in-use time” limits.
• The FDA has issued emergency use authorization (EUA) for a commercial device intended to provide temporary left ventricular support when treating critically ill COVID-19 patients who are undergoing ECMO treatment and suffer complications during that treatment.
• The FDA has issued an EUA for a commercial device that is a patient interface intended for helmet-based non-invasive positive pressure ventilation used to treat acute respiratory distress symptoms among COVID-19 patients being treated in hospital intensive care units.
• The FDA has issued an EUA for a commercial device that is a valve intended for use to deliver emergency, short term, constant-flow pressure-cycled ventilator support for COVID-19 with patients who weigh 10kg or more.
• The FDA has issued an EUA for a commercial device that provides bi-level positive air pressure to support respiratory therapy of spontaneously breathing adults who weigh more than 30kg and who suffer from COVID-19.
• The FDA has issued a surgical masks umbrella EUA in response to concerns about insufficient supply and availability of disposable, single-use surgical masks.  Under this EUA, surgical masks that meet specific performance requirements are authorized for use in health care settings by health care personnel as personal protective equipment during surgical mask shortages resulting from the COVID-19 pandemic.
• The FDA will host a virtual town hall for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for COVID-19.  The purpose of this town hall is to help answer technical questions about the development and validation of tests for COVID-19.  This event will be held on Wednesday, August 12 at 12:15 p.m. (eastern).  Go here for call-in information.  Similar town hall meetings will be held on August 19 and August 26.

Centers for Disease Control and Prevention

• The CDC has updated its FAQs on COVID-19 clinical issues.
• The CDC has updated its guidance for shared and congregate housing.
• The CDC has updated information about its own two COVID-19 diagnostic tests.

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.)

The following is the latest information from the state and federal governments as of 3:00 p.m. on Monday, August 3.

Pennsylvania Update

The Wolf Administration

Late last week the Wolf administration released a weekly status update on the COVID-19 pandemic in Pennsylvania.  It showed that:

• The state-wide rate of positive COVID-19 tests declined from 4.7 percent during the week of July 17-23 to 4.6 percent during the week of July 24-30.
• The seven-day new case count rose from 6010 to 6228.
• Counties with the highest positive test rates were Lawrence (7.4 percent), Franklin (7.2 percent), Indiana (7.2 percent), Fayette (7.1 percent), Armstrong (7.0 percent), Beaver (6.5 percent), Delaware (6.5 percent), Allegheny (6.4 percent), Lancaster (5.8 percent), Berks (5.6 percent), Philadelphia (5.4 percent), and Chester (5.3 percent).

Department of Health

• The department announced that it will hire and employ 1000 new COVID-19 contact tracing workers. Currently, 654 people across the state are working on contact tracing.
• The department has released an overview of point-of-care testing, including information on available training, Pennsylvania’s electronic disease surveillance system (PA-NEDSS) reporting, and CLIA waiver requirements.
• The Department of Health announced that it will open new COVID-19 testing sites later this week at nine Walmart stores across the state. See this department news release for locations, hours, and registration information.
• The department also has introduced an updated Word template for skilled nursing facilities to use in creating their own reopening plan. It has been updated to reflect the department’s latest reopening guidance, which was revised on July 20.

Department of Health – by the numbers

• The number of new COVID-19 cases fell significantly the past two days, as did the death count. For the first time since the early days of the pandemic, no new deaths were reported today.
• 25 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 29 percent of adult ICU beds, 18 percent of pediatric ICU beds, 42 percent of pediatric beds, and 44 percent of airborne isolation rooms.

Department of Human Services

DHS reminded personal care homes, assisted living residents, and intermediate care facilities that they must complete a baseline universal test for COVID-19 of all residents and staff no later than August 31, 2020.  Those subject to this universal testing requirement, as mandated by the Secretary of Health, include any resident or staff person who has never been tested and any resident or staff person who was tested prior to June 12, 2020 and whose test result was negative.  Learn more about the requirement here.

DHS has updated its guidance that placed certain restrictions on personal care homes, assisted living residences, and private intermediate care facilities.

Independent Fiscal Office

For July, General Fund collections were $4.10 billion, which is $1.77 billion (76.2 percent) above collections for July 2019.  Roughly $1.62 billion of this increase is associated with extended tax due dates related to the COVID-19 pandemic.  Excluding this shift, July monthly collections exceeded the prior year total by $154.8 million, or 6.6 percent.  Personal income tax collections for July were $2.31 billion, an increase of $1.29 billion (126.1 percent) above the prior year, with this growth attributed to the virus-related extension of final (tax year 2019) and estimated (tax year 2020) payments from April and June to July.  Withholding declined $22.7 million from the prior year, or 4.3 percent.  Monthly sales and use tax revenues increased $330.3 million (35.7 percent) from July 2019.  Corporate net income tax collections for the month totaled $236.7 million, or $143.6 million (154.3 percent) above the prior year.  Learn more here.

Federal Update

Department of Health and Human Services

• HHS has issued a news alert titled “HHS Extends Application Deadline for Medicaid Providers and Plans to Reopen Portal to Certain Medicare Providers.” This means some providers will have new opportunities to pursue grants from the CARES Act’s Provider Relief Fund.  The major subjects of this news release are:
  • HHS is extending the deadline for applying for the phase 2 general distribution to Medicaid, Medicaid managed care, CHIP, and dental providers to August 28. The web portal for applying is here.
  • Starting the week of August 10, HHS will permit Medicare providers that missed the first opportunity to apply for funding from the $20 billion portion of the $50 billion phase 1 Medicare general distribution. Applications for this funding, which can amount to up to two percent of annual patient revenue, are now due August 28.
  • Some providers that have undergone a change in ownership did not receive the automatic payments for the pool of $30 billion from the $50 billion phase 1 Medicare general distribution. Starting August 10, those providers may submit documentation for consideration of a Provider Relief Fund payment.  These applications, too, are due August 28.

For more information, find HHS’s CARES Act Provider Relief Fund page here and its CARES Act Provider Relief Fund FAQ here.  (Please note that the FAQ is updated frequently.)

• HHS has updated its Provider Relief Fund FAQ with additions and modifications on the following subjects:
  • Sharing targeted distribution money received on behalf of subsidiaries (p. 2).
  • Time limits for expending Provider Relief Fund payments (p. 6).
  • Whether Provider Relief Fund payments are subject to Single Audit (two questions, one on pp. 10-11 and another on p.11).
  • Extensions for submitting data for audits (p. 11).
  • Identifying providers on lists to receive payments from the Medicaid, CHIP, and dental providers distribution (p. 30).
  • Information about dental providers and the Medicaid, CHIP, and dental providers distribution (p. 30).
  • Eligibility of providers for payments from the Medicaid, CHIP, and dental providers distribution if they have received aid from certain other COVID-19-related payment programs (two questions on p. 31).
  • Use of the applicant portal (three questions: on p. 37, pp. 37-38, p. 38).
  • Application issues for home and community-based services providers (two questions on  p. 38).
  • Applications from fiscal management services organizations for the Medicaid, CHIP, and dental providers distribution (two questions on p. 38).
  • Issues involving tax identification numbers (TINs) (two questions, one on pp. 38-39 and the other on p. 39).

Centers for Medicare & Medicaid Services

• On Thursday, CMS announced new hospital procedure codes for COVID-19 treatments. Go here to see the new codes and their descriptions.
• CMS has updated the MLN Matters article “Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) with a new section titled “Counseling and COVID-19 Testing.” The article includes information about how to bill Medicare for newly authorized counseling services.
• CMS has updated its fact sheets on waivers and flexibilities for hospitals and for teaching hospitals, teaching physicians, and medical residents. Both reflect the extension of the deadline for submitting occupational mix survey data from the current deadline to September 3.
• The latest CMS online publication MLN Matters features a brief article that addresses billing codes for physician telehealth services provided to residents of skilled nursing facilities.

CMS COVID-19 Stakeholder Calls

CMS hosts 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.

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.

Friday, August 7 at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 4695240

Audio Webcast Link:  go 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 the health care workforce, and promote the use of telehealth in Medicare.

Tuesday, August 4 at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820, Access Passcode: 3296947

Audio Webcast link:  go here

Tuesday, August 11 at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 3498643

Audio Webcast link:  go here.

Home Health and Hospice

Tuesday, August 11 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode: 5097566

Audio Webcast Link:  go here.

Nursing Homes

Wednesday, August 12 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode: 7857618

Audio Webcast Link:  go here.

Dialysis Organizations

Wednesday, August 12 at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode: 1027088

Audio Webcast Link:  go here.

Nurses

Thursday, August 13 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  7844289

Audio Webcast Link:  go here.

Food and Drug Administration

• The FDA updated its FAQ on the emergency use authorization for the use of remdesivir for treating COVID-19 patients and notes changes in the remdesivir fact sheet for health care providers and a changes in a separate fact sheet for patients and caregivers.
• On Tuesday, August 4 at noon (eastern), the FDA will host a webinar on its regulation of face masks and surgical masks during the COVID-19 pandemic. Interested parties can go here for call-in information for the webinar and for access to transcripts of past webinars and the presentations offered during those events.  The FDA will hold a similar webinar on August 18, also at 12:15.
• The FDA will host a virtual town hall on August 5 at 12:15 (eastern) for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for COVID-19. The purpose of this town hall is to help answer technical questions about the development and validation of tests for COVID-19.  Go here for call-in information for the town hall and for access to transcripts of past town halls and the presentations offered during those events.  The FDA will hold similar town halls on August 12, 19, and 26, also at 12:15.

Centers for Disease Control and Prevention

• The CDC has updated its key considerations for transferring COVID-19 patients to relief health care facilities.
• The CDC has updated its guidance to inform providers about the diagnosis, evaluation, infection prevention and control practices, and disposition of neonates with suspected or confirmed COVID-19 infection or known COVID-19 exposure, including birth to a mother with suspected or confirmed COVID-19.
• The CDC has updated several guidance documents for laboratories that perform COVID-19 diagnostic tests. Those guidance documents address:
• performing COVID-19 diagnostic tests
• reporting COVID-19 laboratory data
• pooling procedures in COVID-19 diagnostic, screening, and surveillance testing.
• COVID-19 antibody testing

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.)

The following is the latest information from the state and federal governments as of 2:30 p.m. on Thursday, July 30.

Pennsylvania Update

The Wolf Administration

The Wolf administration issued a news release reminding Pennsylvanians about the importance of wearing masks, the circumstances under which masks must be worn, exceptions to those requirements, and the roles various state and local agencies play in enforcing mask guidelines and requirements.  It invites Pennsylvanians to report violations of these standards and presents the statutory foundation for the state’s actions.

Department of Community and Economic Development

Friday, July 31 is the deadline for businesses, including health care organizations, to apply for grants to support hazard pay for workers in life-sustaining occupations during the COVID-19 pandemic.  See this overview of the hazard pay program, the program guidelines, and an FAQ about the program.

Department of Health

The Secretary of the Department of Health signed an order requiring hospital emergency departments to offer to collect specimens for COVID-19 viral testing from all symptomatic persons who seek treatment or testing in the emergency department.  See the order here and an accompanying letter to providers here in which the Secretary assures hospitals that her order is not meant to position hospital emergency departments as the new universal COVID-19 testing hub for Pennsylvanians.

Department of Health – by the numbers

• The number of new COVID-19 cases reported today remains in line with the numbers of recent days, as does the number of new reported deaths.
• The number of patients hospitalized with COVID-19 and those requiring mechanical assistance to breathe remains unchanged since yesterday.
• 37 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 37 percent of adult ICU beds, 26 percent of pediatric ICU beds, 50 percent of pediatric beds, and 68 percent of airborne isolation rooms.
• More than 23,000 residents and employees of 846 long-term-care facilities in 61 of Pennsylvania’s 67 counties have been diagnosed with COVID-19.

Department of Human Services

The federal Centers for Medicare & Medicaid Services has granted Pennsylvania a section 1135 waiver – an authority granted under the federal declaration of a public health emergency designed to facilitate the delivery of care during a time of crisis – to temporarily permit services provided under various state waivers and programs to be provided in settings that have not been determined to meet Medicaid’s home and community-based settings criteria.  The waiver also gives the state authority to temporarily waive written consent required under some home and community-based service programs and states that to the extent applicable, these waivers also apply to the state’s CHIP program.  See the waiver authorization here.

Department of State

In response to the COVID-19 emergency, the Department of State has extended for 30 days the deadline for renewal of certain licenses administered by the State Board of Nursing: for registered nurses, clinical nurse specialists, certified registered nurse practitioners, and for prescriptive authority.  This deadline was already extended once and the department warns that it will not be extended again past this new deadline of August 28, 2020.  See its notice here.

Federal Update

Department of Health and Human Services

• HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) has published three new resources for providers:
  • “COVID-19 and Urgent Care Centers: Lessons Learned for the Future”
  • information on clinical presentation, disease progression, and related information from clinicians in the field treating COVID-19 patients
  • a presentation on the use of telemedicine in alternative care settings

• HHS’s Office of the Inspector General has updated its FAQs on its administrative authorities on arrangements directly connected to the COVID-19 emergency with new guidance for providers.
• HHS has issued a report documenting trends in the use of telehealth by Medicare beneficiaries during the COVID-19 emergency. Find HHS’s announcement about the report and its summary here and go here to see the report itself.

Centers for Medicare & Medicaid Services

• CMS has announced that it is introducing new procedure codes to enable Medicare and other insurers to identify the use of remdesivir and convalescent plasma for treating hospital inpatients with COVID-19. These new codes go into effect on August 1.
• CMS has updated its FAQ for providers on Medicare fee-for-service billing The changes address:
  • Use of the cost-sharing modifier for pre-surgery exams that include COVID-19 testing (pp. 10-11).
  • Billing for COVID-19 testing provided in an outpatient department prior to an inpatient admission (pp. 21-22).
  • Billing for diabetes self-management training services delivered via telehealth (two questions, one on p. 74 and one on pp. 74-75).
  • Billing for telehealth services furnished by a provider located outside the U.S. (p. 75).
  • Billing involving episodes of care for patients participating in a Medicare Shared Savings Program (five questions: 96-97, 97, 97-98, and two on p. 98).
  • Billing when serving patients with the assistance of drugs or supplies from the Strategic National Stockpile or other government source (pp. 111-112).
  • Billing for telehealth services (five questions: 126-127, 127, 127-128, 128, and 128-129).
  • Billing for therapy provided via telehealth (pp. 131-132).

• CMS and the CDC announced that payment is available to physicians and health care providers to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to the onset of symptoms. CMS will use existing evaluation and management (E/M) payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals, and community drive-through or pharmacy testing sites.
• See the CMS news release announcing the new policy and a new CMS counseling checklist.
  • As part of this effort, CMS also has developed new talking points for providers,
  • a guide for patients as they await the results of their COVID-19 test, and
  • an overview of contact tracing for those who have just taken a COVID-19 diagnostic test.
• CMS has added certain COVID-19 diagnostic tests to its lists of tests that do not need to be ordered by authorized practitioners during the current public health emergency and for which Medicare will pay. Read about this addition here and find a list of other tests similarly authorized here.
• CMS has updated its “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers” with two changes:
• it extended the deadline for hospitals to submit their occupational mix surveys with supporting documentation to their MACs to no later than September 3 (it had previously been extended from July 1 to August 3) (see page 14) and
• it terminated its previous waiver of the requirement that long-term-care facilities submit staffing data through the payroll-based journal system (see page 15).

National Academies of Science, Engineering, and Medicine

• The National Academies of Science, Engineering, and Medicine’s standing committee on emerging infectious diseases and 21^st century health threats has outlined considerations for clinical staffing needs during the implementation of crisis standards of care. It has produced a consultation document on this subject and will host webinars to brief stakeholders on Friday, July 31; Tuesday, August 4; and Wednesday, August 5.  Find the document here and go here to register for one of the webinars.

Food and Drug Administration

• The FDA has posted a new template for commercial developers to help them develop and submit emergency use authorization (EUA) requests for COVID-19 diagnostic tests that can be performed entirely at home or in other settings besides a lab, such as offices or schools, and that could be available without a prescription. See the FDA’s announcement here.
• The FDA has updated its guidance for laboratories performing COVID-19 diagnostic testing.

Centers for Disease Control and Prevention

• The CDC has updated its list of underlying medical conditions that increase a person’s risk of severe illness from COVID-19.
• The CDC has updated its preparedness tools for health care professionals and facilities 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

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The following is the latest information from the Pennsylvania state government as of 3:00 p.m. on Wednesday, July 29.

The Wolf Administration

The Wolf Administration announced the availability of 24/7 call centers to provide clinical and operational support to long-term-care facilities as they seek to protect residents and staff from COVID-19.  The call centers are run and staffed by health systems participating in the Regional Response Health Collaboration Program (RRHCP), an education and clinical support network launched for long-term-care providers earlier this month.  The announcement, found here, includes contact information for long-term-care facilities seeking assistance.

Department of Health

The department announced that all 693 nursing homes in the state have completed testing all residents and staff for COVID-19 at least once, in accordance with Secretary of Health Dr. Rachel Levine’s universal testing order issued June 8.

Department of Health – by the numbers

• The number of new COVID-19 cases reported the past two days has been high; the number reported on Tuesday was the second highest since late May.
• The number of new deaths remains low but is up slightly the past two days.
• The number of patients hospitalized with COVID-19 is higher than at any time since June 17.
• The number of COVID-19 patients requiring mechanical assistance to breathe is higher than it has been at any time since July 2.
• More than 8100 health care workers in the state have tested positive for COVID-19.
• 37 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 37 percent of adult ICU beds, 26 percent of pediatric ICU beds, 50 percent of pediatric beds, and 68 percent of airborne isolation rooms.

Other Numbers

• The Pittsburgh Tribune-Review reported yesterday that “Tuesday’s near-record number of new reported hospitalizations come days after the record high, 22, was announced Friday.”
• The Tribune-Review noted that “After two consecutive days of reporting no covid-19 deaths, the county saw its second highest reported increase in deaths this month, bringing the death total to 229” and that “The new covid-19 cases reported Tuesday come from 1,804 test results and have a positivity rate of 6.59%.” [Note:  During a press briefing last week, Secretary of Health Levine said she starts to worry when positivity rates exceed five percent.]
• Today the Tribune-Review reports that “Allegheny County recorded new coronavirus cases in triple digits for the seventh straight day on Wednesday.  The Allegheny County Health Department reported 125 new cases, along with five additional deaths and 10 new hospitalizations.”
• Across the state, the Philadelphia Inquirer reported that “New daily case numbers and averages keep rising in Philadelphia and its four neighboring counties, in many cases making a fairly steady climb in July, state data shows.  That means progress made in May and June in flattening the curve of infections appears to be eroding.”
• In addition, the Inquirer reported that “Two weeks ago, Philadelphia’s weekly average of new cases per day was 111; in the last week, the average reached 164…. The positivity rate reported Tuesday was about 5.2%.”
• Increased case counts in southeastern Pennsylvania go beyond Philadelphia, the Inquirer added, noting that “The average number of new daily cases has at least doubled in Bucks, Chester, and Montgomery Counties in the last month, and more than quadrupled in Delaware County, according to state data.”
  

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

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The following is the latest information from the Pennsylvania state government as of 3:30 p.m. on Monday, July 27.

Department of Health

The Department of Health updated the Frequently Asked Questions for COVID-19 and Treatment Drugs issued on May 11, 2020.  Changes are shown in red.

The department shared contact information for the Regional Response Health Collaboration Program call centers.  Long-term-care facilities may reach out for direct support and assistance 24/7 from the program that covers the county in which the facility is located.

Department of State

The Department of State has extended the registration deadlines for charitable organizations whose deadlines fall between July 15 and September 20 by three months, with new renewals required to be postmarked by the 15th day of the 14th month following the close of the organization’s fiscal year.  Many health care entities have charitable organizations registered with the state.  Go here to read the department’s notice and see the new registration deadlines.

Department of Health – by the numbers

• The number of new COVID-19 cases reported today and over the weekend remains high.
• Together, Allegheny and Philadelphia have been accounting for approximately 30 percent of new cases.
• The number of new deaths reported remains very low.
• As does the number of patients hospitalized for COVID-19, which declined over the weekend and is at its lowest level in a week.
• The number of COVID-19 patients requiring mechanical assistance to breathe is not rising.
• Nearly 8000 health care workers in the state have tested positive for COVID-19.
• 39 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 41 percent of adult ICU beds, 29 percent of pediatric ICU beds, 59 percent of pediatric beds, and 69 percent of airborne 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

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The following is the latest information from Pennsylvania’s state government as of 2:45 p.m. on Friday, July 24.

Department of Health

With much Department of Health staff working remotely with limited access to mail, the department has requested that all communications to its Division of Acute and Ambulatory Care be made electronically to RA-DAAC@pa.gov with no additional copies sent via regular mail.

Department of Health – by the numbers

• The number of new COVID-19 cases reported today is the highest in more than two months.
• Philadelphia and Allegheny County together account for 35 percent of those new cases but the number of non-Philadelphia, non-Allegheny County cases remains very high.
• The number of new deaths reported remains in line with recent figures.
• As does the number of patients hospitalized for COVID-19, which is higher than it was more than three weeks ago but the same as it has been for the past three days.
• The number of COVID-19 patients requiring mechanical assistance to breathe is not rising at all.
• Nearly 19,000 residents and staff members in 813 long-term-care facilities in 60 counties have tested positive for COVID-19.
• Residents of those facilities continue to account for 68 percent of all COVID-19 deaths in the state.
• More than 7800 health care workers in the state have tested positive for COVID-19.
• 34 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 36 percent of adult ICU beds, 27 percent of pediatric ICU beds, and 66 percent of airborne isolation rooms.
• More than 151,000 COVID-19 tests were administered in Pennsylvania during the past seven days.
• 639 Pennsylvanians have now tested positive for COVID-19 antibodies.
• Pennsylvania now has 36 confirmed cases of multisystem inflammatory syndrome in children (MIS-C), up just one case in the past week, with another 16 possible cases under investigation.

Department of Human Services

• DHS has posted an FAQ on the allowable uses of Pennsylvania Emergency Coronavirus Relief Funds (federal CARES Act money allocated to the state and directed to health care providers by the state through Pennsylvania Act 24 of 2020) and the manner in which fund recipients will be required to account for their use of this money.  The purpose of this funding is to pay for necessary expenses, lost revenue from COVID-19 business interruption for non-public entities, and COVID-19-related hazard or incentive pay incurred between March 1, 2020, and November 30, 2020.  DHS has not yet released the COVID-19 cost reporting form it will use to capture costs incurred by entities that received these payments.  Find the FAQ here.
• DHS announced that it has resumed annual on-site inspections of its licensed settings but may apply alternative techniques such as videoconferencing for annual inspections that do not require an on-site presence.
• DHS will host a COVID-19 update call for stakeholders on Wednesday, July 29 at 4:00 PM.  Interested parties can register for the call 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

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The following is the latest information from Pennsylvania’s state government as of 3:00 p.m. on Tuesday, July 22.

Department of Health

• The Department of Health issued a news release describing its recent efforts to develop the state’s capacity to perform contact tracing for individuals diagnosed with COVID-19.
• In the face of COVID-19-related challenges to making routine visits to doctors’ offices, the department has suspended for two months its regulation that children have certain vaccinations before they can attend public school or participate in early childhood education programs. See the department’s notice here.
• The department has issued updated guidance on the discontinuation of isolation for persons with COVID-19 not in health care settings.

Department of Health – by the numbers

• The number of new COVID-19 cases reported in Pennsylvania yesterday remains on par with the past week except for Monday’s major spike.
• The number of new deaths reported today was the highest in the past week.
• Over last weekend Pennsylvania quietly climbed above 100,000 total COVID-19 cases and 7000 deaths from the virus.
• The state’s current seven-day average of 871 new cases is more than twice what it was in mid-June and higher than it has been at any time in the past two months.
• For more perspective, the state has experienced:
  • June 25-July 1: 4,051 new cases, an average of 578 per day
  • July 2-8: 4,906 new cases, an average of 700 per day
  • July 9-15: 5,517 new cases, an average of 788 per day
  • July 16-22: 5,731 new cases, an average of 818 per day
• The rising numbers are led by growing numbers of cases in southwestern Pennsylvania and the Philadelphia area.
• The number of new cases in Allegheny County has been rising lately and is 1535 percent greater than it was this time a month ago.
• Philadelphia’s seven-day average of 138 new cases a day is up from its seven-day average of 110 new cases a day the previous week.
• The number of Pennsylvanians hospitalized with COVID-19 has risen above the 700 mark for the first time in nearly a month.
• But the number requiring mechanical assistance to breathe is not rising at all.
• 37 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are 40 percent of adult ICU beds, 57 percent of pediatric beds, 26 percent of pediatric ICU beds, and 66 percent of airborne isolation rooms.

Regional Response Health Collaboration Program

The Department of Health and Department of Human Services are holding an informational webinar on Friday, July 24^th from 9:00-10:00am EST to present an overview of the Regional Response Health Collaboration Program (RRHCP) available for long-term care providers state-wide.  Interested parties can log into the webinar here or call in at 844-621-3956.  The event password is DHS2020 and the event number and access code is 145 274 9024.

This new resource will give nursing homes and personal care and assisted-living facilities direct access to local support by health systems.  The health systems that are part of the RRHCP will have regional call centers with 24/7 access for providers to have direct access to clinical consultation and technical assistance, assistance with universal testing, access to expertise in infection control, and the ability to deploy rapid response teams in case of emergency in conjunction with the Department of Health, Department of Human Services, and Pennsylvania Emergency Response Management.

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.)