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COVID-19 Update: April 27, 2020

COVID-19 update for Monday, April 27 as of 3:30 p.m.

Pennsylvania Update

Department of Health

Hospital buildingThe Department of Health has issued guidance on the terms under which hospitals can begin performing elective procedures again and under which ambulatory surgical facilities may begin performing elective procedures again.

Department of Health Daily Briefing

  • The number of newly reported cases has declined for the third consecutive day.
  • 2394 positive tests have been among health care workers and 7037 have been among residents of 441 long-term-care facilities.
  • 2799 people are currently hospitalized for COVID-19 and 615 of them are on ventilators.
  • 47 percent of the state’s hospital beds and 40 percent of its ICU beds are currently unoccupied and nearly 70 percent of its ventilators are not in use.
  • Secretary Levine discussed the criteria for the state to reopen regions.  She cautioned against too great a focus on the number of cases per 100,000 population and explained that to reopen, regions also would need a certain level of testing capacity, enough personal protective equipment, have enough hospital staff to handle any surge in cases, and not be operating under crisis standards of care.
  • The state is doing well in finding more testing materials for the state lab and Secretary Levine said more needs to be done to make this supply chain more reliable and to do the same for others that perform tests as well.

Governor Wolf

The Wolf administration has issued a news release elaborating on the data-driven and qualitative measures that will be used to determine when individual regions of the state will be permitted to reopen.

Federal Update

Department of Health and Human Services

  • Last Friday HHS deposited its second tranche of CARES Act funding in hospitals’ bank accounts.  We have contacted HHS to inquire about the specifics of the funding formula, whether there are additional future attestation requirements, the timing for the next round of payments, and more.

In the meantime, providers that received Provider Relief Payments in either round of funding should visit the CARES Act General Distribution Portal, where you will be able to provide data that HHS may use to calculate payment distributions from the Provider Relief Fund.  (Other useful resources:  the CARES Act Provider Relief Fund web page and an FAQ on the General Distribution Portal.  Also, please note: the General Distribution Portal is not the same as the Attestation Portal.)

Specifically, the portal is collecting the following four pieces of information:

  1. a provider’s “Gross Receipts or Sales” or “Program Service Revenue” as submitted on its federal income tax return;
  2. the provider’s estimated revenue losses in March 2020 and April 2020 due to COVID;
  3. a copy of the provider’s most recently filed federal income tax return; and
  4. a listing of the tax identification numbers any of the provider’s subsidiary organizations that have received relief funds but that DO NOT file separate tax returns.

In addition, providers can submit separate applications for CARES Act funding for any additional entities that received Provider Relief Fund payments and that also filed a separate tax return for 2017, 2018, or 2019.  See the provider relief fund page and FAQ for further details.

Health care providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 can request claims reimbursement through the program electronically and will be reimbursed generally at Medicare rates, subject to available funding. Steps will involve: enrolling as a provider participant, checking patient eligibility, submitting patient information, submitting claims, and receiving payment via direct deposit.

To participate, providers must attest to the following at registration:

  • You have checked for health care coverage eligibility and confirmed that the patient is uninsured. You have verified that the patient does not have coverage such as individual, employer-sponsored, Medicare or Medicaid coverage, and no other payer will reimburse you for COVID-19 testing and/or care for that patient
  • You will accept defined program reimbursement as payment in full.
  • You agree not to balance bill the patient.
  • You agree to program terms and conditions and may be subject to post-reimbursement audit review.

The new web page also includes information about covered services, claims submission, and claims reimbursement.

Centers for Medicare & Medicaid Services

  • CMS has announced that it is re-evaluating the amounts it will have available for Part A providers with new and pending applications under its Accelerated Payment Program and is suspending its Advance Payment Program for Medicare Part B suppliers effective immediately.  Now that Congress has appropriated $175 billion for the grant-style “Provider Relief Fund,” CMS is shifting away from the cash advance approach of the Advance and Accelerated Payment Programs.  Part B suppliers will no longer be able to apply for the Advance Payment Program and CMS will be re-evaluating the amounts available for Part A providers with new and pending applications under the Accelerated Payment Program.  Previously, Part A and Part B providers were able to request an advance on Medicare fee-for-service payments up to a maximum value of six months’ worth of payments.  See CMS’s news release explaining its shift in approach and an updated fact sheet on the Accelerated and Advance Payment Programs.
  • CMS has updated its FAQ on Medicare fee-for-service billing.  In particular, the updated FAQ provided more specific information about use of the condition code “DR” and the modifier “CR” for claims for which Medicare payment is conditioned on the premise of a formal waiver.
  • CMS has informed state governments that it will hold constant the inspection domain of the Nursing Home Compare site due to the prioritization and suspension of certain surveys during the COVID-19 emergency to ensure that the rating system provides fair information for consumers.

Centers for Disease Control and Prevention

Food and Drug Administration

Occupational Safety and Health Administration

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.)

 

2020-04-28T09:04:56+00:00April 28th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: April 27, 2020

COVID-19 Update: April 24, 2020

COVID-19 update for Friday, April 23 as of 4:00 p.m.

Attention:  Health Care Providers

HHS has extended until 3:00 p.m. (eastern) on Saturday, April 25 the deadline for providers to submit data that will be used to determine how it will allocate the $10 billion it will be distributing to providers hit especially hard by COVID-19Providers that have been targeted for possible assistance from this pool have already been notified of the need to submit data, although such notice does not assure funding.

State Update

Department of Health Daily Briefing

  • After a week of declines in the number of new COVID-19 cases, the daily case count has returned to its higher levels of one to two weeks ago.
  • More than 6000 residents of 418 long-term-care facilities located in 40 of the state’s counties have tested positive for COVID-19, as have more than 700 people who work at those facilities.
  • More than 2000 of the Pennsylvanians who have tested positive for COVID-19 are health care workers.
  • 2746 people are currently hospitalized with COVID-19 and 662 of them are on ventilators.
  • 47 percent of the state’s acute-care beds and 40 percent of its ICU beds are currently unoccupied and nearly 70 percent of its ventilators are not in use at this time.

Department of Health

The Department of Health has issued a notice to hospitals reminding them that they are required to promptly notify any first responder agency that is known to have transported a patient determined to be positive for COVID-19 and that they must do so as soon possible and no later than 48 hours after the determination.  This requirement is the same as that called for in the Ryan White HIV/AIDS Treatment Extension Act of 2009.

Insurance Department

The state Insurance Department has published COVID-19 guidance regarding volunteer physicians, podiatrists, and certified nurse midwives practicing under a reactivated license.  The notice addresses the medical malpractice insurance obligations of such volunteers depending on where they practice during the COVID-19 pandemic.

Pennsylvania Health Law Center

The Pennsylvania Health Law Center has launched a “COVID-19 Resource Center.”  While it has useful information, its primary target audiences appears to be consumers and those who work with consumers.

Federal Update

Centers for Medicare & Medicaid Services

Centers for Disease Control and Prevention

Food and Drug Administration

National Institutes of Health

The White House

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.)

2020-04-25T07:21:45+00:00April 25th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: April 24, 2020

COVID-19 Update: April 23, 2020

COVID-19 update for Thursday, April 23 as of 5:00 p.m.

Pennsylvania Update

Governor Wolf

On Wednesday night Governor Wolf addressed the state about his plan to gradually reopen Pennsylvania and its economy.  While the governor had previously announced some reopenings, he outlined general parameters for authorizing additional steps and further business activity.

Reopening the state, he said, would be based on a three-phase approach and guidelines for attempting to maintain control of COVID-19:  to make sure that case counts are under control and that the population of the regions identified for possible reopening have fewer than 50 cases per 100,000 residents over 14 days before people can return to work.  Target dates for some reopenings may change, he said, if conditions and case counts change, but the goal is to begin on May 8.

Governor Wolf emphasized that continued social distancing and use of masks is imperative and that reopening would not be state-wide but would be on a regional basis, depending on their conditions.  He will be making the decisions about regional reopenings, he said, and not local or county officials, and those decisions will be data-driven.  Based on current conditions, he said, reopening is most likely to start in northern central Pennsylvania and the northwestern part of the state, but that has not yet been decided.

The governor also said the Department of Health has been talking to hospital industry representatives about resuming non-urgent elective procedures.

Learn more about Governor Wolf’s plan here.

Department of Human Services

  • DHS has written to the federal Centers for Medicare & Medicaid Services to request Medicaid state plan amendments in response to the COVID-19 emergency.  The amendments include suspension of co-payments for screening, diagnosis, and treatment for COVID-19; benefit flexibility to authorize the use of additional cough and cold suppressant products; suspension of prior authorization requirements for certain services and for the permitted supply of covered outpatient drugs; and more.
  • DHS has also written to CMS to request approval of its disaster relief state plan amendment to seek flexibilities in how the state operates its Children’s Health Insurance Program (CHIP).  These flexibilities include:
  • allowing enrollees to receive services beyond their certification period by extending CHIP renewal deadlines;
  • temporarily delaying acting on certain changes in circumstances;
  • accepting self-attestation and conduct post-enrollment verification;
  • allowing individuals to provide a reasonable explanation of inconsistencies in lieu of requiring paper documentation;
  • extending deadlines for submitting verification at renewal;
  • temporarily suspending application of co-payments related to COVID-19 testing, screening, and treatment services; and
  • temporarily delaying payment of premiums (and/or delay payment of premium balance).
  • DHS has published an announcement listing the functions managed by its Office of Developmental Programs that it is suspending state-wide until further notice.  Previously, these functions had been suspended for a limited period of time.

Department of Health Daily Briefing

  • Secretary Levine explained the difference between confirmed cases of COVID-19 and probable cases and between confirmed deaths from COVID-19 and probable deaths from COVID-19.  She said that in both situations, “probable” means the cases are under investigation.
  • “Probable” classifications account for only about two percent of cases.
  • Investigation of probable deaths has led the state to reduce its COVID-19 death count by 201 from yesterday.
  • Secretary Levine responded to numerous questions about Governor Wolf’s plan for reopening Pennsylvania.
  • When making decisions about regional reopenings the state will be using confirmed data, not probable data.
  • She stressed that reopening parts of Pennsylvania will be on a regional basis and not a county-by-county basis.  The state has not yet completely defined the regions it will use for this purpose.
  • When determining whether regions meet the cases per 100,000 population criterion for reopening, cases in long-term-care facilities will be counted because employees enter and exit those facilities.
  • The Department of Health is currently formulating its plan for future contact tracing.
  • When deciding whether to reopen regions, factors such as the availability of testing, an adequate supply of hospital beds, contact tracing capabilities, and other considerations will figure in the governor’s decisions.
  • Those regions will need to have enough testing capacity to accommodate a loosening of the current, strict criteria for who can be tested for COVID-19.
  • Amid concern about how many COVID-19 patients end up needing dialysis, the Department of Health will be exploring the adequacy of the current supply of dialysis machines.

Department of Health

With long-term-care facilities now accounting for approximately 50 percent of COVID-19 deaths in Pennsylvania. The Department of Health’s web site now tracks cases and deaths associated with nursing homes and personal care homes.  Go here and scroll about two-thirds of the way down the page.

Department of Community and Economic Development

The Department of Community and Economic Development has established a business-to-business exchange through which health care organizations seeking N95 masks, fabric and other masks, surgical and procedure masks, and thermometers can identify and do business with Pennsylvania companies that sell such supplies.

Pennsylvania Emergency Management Agency

The Wolf administration has launched an online portal for individuals, corporations, and community organizations to inform others about critical medical supplies available for donation during the COVID-19 pandemic.

Federal Update

Congress

The House has passed H.R. 266, the $384 billion COVID-19 relief/economic stimulus bill  that includes $75 billion for health care providers and $25 billion for testing.

Department of Health and Human Services

  • Providers that received an email from CMS on Sunday night informing them that they are in a COVID-19 hotspot were directed to register their information through https://www.teletracking.com/ by noon on Saturday, April 25.  Doing so does not guarantee eligibility for a share of the $10 billion that CMS announced yesterday that it would be distributing among providers that have been hit hard by COVID-19 but failing to provide the requested information will exclude providers from eligibility.  Only providers that received the Sunday night email from CMS can submit the information to the site.
  • The Department of Health and Human Services has updated its CARES Act Provider Relief Fund web page to include new information about how it intends to distribute the final $70 billion of the $100 billion designated for hospitals in the CARES Act.  It also describes its distribution methodology and timetable for distribution in this news release.
  • HHS’s Office of the Inspector General has updated its FAQ addressing the application of its administrative enforcement authority to arrangements directly connected to the COVID-19 emergency.

Centers for Medicare & Medicaid Services

Centers for Disease Control and Prevention

Food and Drug Administration

National Governors Association

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.)

2020-04-24T08:40:42+00:00April 24th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: April 23, 2020

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

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

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

Centers for Disease Control and Prevention

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

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.)

2020-04-23T06:00:17+00:00April 23rd, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: April 22, 2020

COVID-19 Update: April 21, 2020

COVID-19 update for April 21 as of 5:00 p.m.

Pennsylvania Update

SNAP Advocacy

Safety-Net Association of Pennsylvania logoToday 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 here.  The Senate has voted to approve the legislation and the house is expected to take it up on Thursday.  More detail about the bill’s contents is included in the federal update.

General Assembly

Today the House and Senate met to consider bills related to COVID-19 and to position legislation for FY 2020-21 budget negotiations.  Most notable of the votes today was final passage of S.B. 857, which would authorize health care providers to use telemedicine and require insurers to provide coverage and reimbursement for these services.  Over the last several months this bill stalled in the Senate due to controversial amendments added by House Republicans to restrict the use of telemedicine for certain abortion-related services.  Circumstances related to the COVID-19 pandemic have elevated the importance of ensuring access to telemedicine services, and today the Senate voted to concur in those controversial House amendments, along a party-line vote, and send the legislation to the governor.  The governor is expected to veto the bill.

Daily COVID-19 Briefing

  • 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.
  • Death counts are now being presented in a similar fashion:  “confirmed” deaths of patients who tested positive for COVID-19 plus “probable” cases for which a patient’s death certificate lists COVID-19 as a cause contributing to death but for which no COVID-19 test was administered.
  • As a result, the death figures are rising significantly.  They do not, however, reflect a sudden increase in daily deaths; instead, they are the result of after-the-fact reconciliation of case data.
  • More than half of all deaths have been residents of long-term-care facilities.
  • The state is working to get antibody testing materials but is first evaluating the array of test products, which appear to be of varying quality.
  • Antibody testing is now available through Quest.
  • Secretary Levine said she would like to do much more testing across the state, including through more mass testing sites and other sources.
  • Rite Aid, she noted, is now doing COVID-19 testing.
  • 40 percent of ICU beds across the state are currently unoccupied.
  • On the whole, the state’s hospitals are doing well.  Some are more challenged, especially in Philadelphia and the surrounding counties.
  • As a result of this challenge, an alternate site of care at Temple University has now opened to serve COVID-19 patients who are on the road to recovery but need to remain hospitalized.  This is being done to free hospital beds for more seriously ill COVID-19 patients.
  • Secretary Levine discussed the process of permitting hospitals to resume non-urgent procedures, explaining that this reflects a need to balance the desire to limit patients’ exposure to COVID-19 with the medical needs of patients who need procedures that are essential to their health.  Decisions about when and how to begin resuming non-urgent procedures will be made in consultation with the hospital industry.

Department of Human Services

DHS has published its answers to the questions asked by stakeholders and interested parties during its April 15 COVID-19 webinar.  Find that document here.

Two things are especially noteworthy in the information DHS provided.

First, DHS is still evaluating whether to take advantage of the CARES Act provision enabling states to temporarily expand Medicaid coverage to cover COVID-19 testing for uninsured individuals at 100 percent federal match.

Second, DHS is internally finalizing its request to CMS to alter its Medicaid State Plan to respond to the public health emergency.  The so-called Disaster SPA will include the following:

The Medicaid Disaster SPA is currently under internal review and will be submitted in the near future. When the Disaster SPA is submitted, DHS will be requesting the following:

  • Flexibilities related to eligibility determinations by CAOs;
  • Suspension of copayments for screening, diagnostic and treatment services related to COVID-19;
  • Coverage for certain cough and cold medications for adults;
  • Expansion of the outpatient drug day supply limit from 34 day/100 unit to 90 days;
  • Suspension of annual reassessments related to targeted support management for Individuals with an intellectual disability or autism;
  • Suspension of the prior authorization requirements for certain services, including:
    • Automated utilization reviews for emergency and urgent inpatient admissions;
    • First 28 of days of Home Health Services;
    • First 30 days of the following medical supplies:
      • Feeding supplies;
      • Respiratory supplies;
      • Urinary catheters;
      • Ostomy supplies; and,
      • Infusion supplies.
    • Appliances or equipment that costs more than $600; and,
    • Initial prescriptions of oxygen and related equipment.
  • A 90-day extension of the timeframe to complete cost reconciliation activities for Pennsylvania’s School-Based ACCESS Program (SBAP); and,
  • Waiver of Public notice requirements related to State Plan submission.

Department of Corrections

In our April 13 update we reported that Pennsylvania Correctional Industries, a business operated by Pennsylvania’s Corrections Department, was taking orders from non-profit organizations for masks and hand sanitizer.  Today the department announced that it is no longer fulfilling such orders at this time.

Federal Update

Congress and Administration Agree on Next Aid Package

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 bill also includes $25 billion to research, develop, validate, manufacture, purchase, administer, and expand capacity for COVID-19 tests.  Among others, this $25 billion would be distributed as follows:

  • $11 billion for states, localities, and territories to develop, purchase, administer, process, and analyze COVID-19 tests, increase laboratory capacity, trace contacts, and support employee testing.
  • $1 billion to the Centers for Disease Control and Prevention for surveillance, epidemiology, lab capacity expansion, contact tracing, public health data surveillance, and the modernization of analytics infrastructure.
  • $1.8 billion to the National Institutes of health to develop, validate, improve, and implement testing and associated technologies, accelerate research and development of point-of-care testing, and partnerships with other entities.
  • $1 billion for the Biomedical Advanced Research and Development Authority (BARDA) for advanced research, development, manufacture, production, and purchase of diagnostic, serologic, and other COVID-19 tests and supplies.
  • $825 million for Community Health Centers and rural health clinics.
  • Up to $1 billion to pay for testing for the uninsured.

Other major components of the bill include $310 billion to replenish the Paycheck Protection Program and $60 billion for the Small Business Administration’s disaster relief fund.

The Senate has already passed the bill and the House will vote on it on Thursday.

Department of Health and Human Services

Centers for Medicare & Medicaid Services

Centers for Disease Control and Prevention

Food and Drug Administration

Accreditation Association for Ambulatory Health Care

In the wake of CMS’s announcement earlier this month that ambulatory surgery centers would temporarily be permitted to operate as hospitals to increase the capacity of the health care system during the COVID-19 emergency, the Accreditation Association for Ambulatory Health has posted resources for use in facilitating those temporary transitions.

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.)

2020-04-22T08:23:40+00:00April 22nd, 2020|Coronavirus, COVID-19, Safety-Net Association of Pennsylvania|Comments Off on COVID-19 Update: April 21, 2020

COVID-19 Update: April 20, 2020

The following is the latest information from state and federal regulators and others as of 4:30 p.m. on Monday, April 20.

Pennsylvania Update

Governor Wolf

Pennsylvania State MapGovernor 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.

In addition, today Governor Wolf signed S.B. 841 into law, providing flexibilities for businesses.  The bill reauthorizes the Health Care Cost Containment Council (PHC4) and requires that it study the impact of COVID-19 on hospitals and health systems.  It also:

  • permits local governments to conduct remote public meetings;
  • provides property tax relief by permitting taxing districts to waive late fees and penalties for property taxes paid by December 31, 2020;
  • permits school districts to renegotiate contracts with service providers to ensure payment of personnel and fixed costs during the school closure; and
  • permits remote notarization of documents.

Governor Wolf vetoed S.B. 613, which would have immediately reopened the state and ended the governor’s stay-in-place orders.

Daily COVID-19 Briefing

  • With a one-day exception, the number of new cases reported daily has continued to decline in recent days and fell into three figures yesterday for the first time this month.
  • Despite this, the death count continues to rise, although this rise can be attributed in part to a more careful analysis of death reports and decisions to link some deaths to COVID-19 that were not previously categorized that way. The overall state death toll from COVID-19 now exceeds 1200, all of them adults.
  • Data on COVID-19 cases in Pennsylvania is now available on the department’s web site at the county level and at the zip code level.
  • 3057 Pennsylvanians are currently hospitalized with COVID-19 and 645 of them are now on ventilators.
  • 42 percent of acute-care hospital beds and 36 percent of ICU beds are currently unoccupied and nearly 70 percent of ventilators are currently available for use.
  • Secretary Levine reported that the state’s hospitals are doing well and are not overwhelmed with COVID-19 patients although she noted that hospitals in the southeastern part of the state have higher-than-usual daily censuses but are still doing well.

Department of Health

  • The department posted an FAQ on staffing resources for nursing care facilities during the COVID-19 crisis in response to requests for guidance on what staffing measures can be implemented or contemplated during the crisis. In addition, guidance is now available for facilities that wish to expand their number of beds or convert closed wings or entire facilities to support COVID-19 patients or residents. Because this latter guidance is available only through a subscription-only department message board and cannot be reached through a direct link, it is presented in its entirety below:

If a facility wishes to expand the number of beds or convert closed wings or entire facilities to support COVID-19 patients or residents, first review PA-HAN 496, Universal Message Regarding Cohorting of Residents in Skilled Nursing Facilities. If the facility’s planned strategy appears to conform with PA-HAN 496, submit a request to the Department of Health’s (Department) field office (list below). Each request will be considered on a case-by-case basis, and dialogue with the facility will occur to acquire all details needed to render a decision. To ensure the Department has the necessary information to enter into that dialogue, include at a minimum the following (if applicable) with the request:

Number of beds and/or residents impacted, including whether residents will be moved initially

Whether the beds are Medicare or Medicaid (including proof of approval from the Department of Human Services to expand the number of MA beds, if applicable)

Location and square footage (with floor plan and pictures, if appropriate)

Available equipment

Staffing levels and plan for having adequate staffing for the duration

Plan for locating residents (including care of vulnerable residents (such as dementia residents)

Description of how residents with COVID-19 will be handled (e.g., moving within the facility, admitted from other facilities, admitted from the hospital)

Plan for discontinuing use of any new, altered or renovated space upon the expiration of the Governor’s Proclamation of Disaster Emergency issued on March 6, 2020

Upon submission of the request, a representative from the Department will reach out to the facility’s contact person to discuss next steps. Questions regarding this process can be directed to the appropriate field office.

Field Office Contacts:

Michele Gresko MGRESKO@pa.gov – Scranton Field Office
Traci Duncan tduncan@pa.gov – Williamsport Field Office
Rose Martin ROMARTIN@pa.gov – Lehigh Valley Field Office
Ellen Fuller elfuller@pa.gov – Lionville Field Office
Jennifer Lyons jelyons@pa.gov – Jackson Field Office
Mary Anne Bennis mbennis@pa.gov – Norristown Field Office
Heidi McKay hmckay@pa.gov – Norristown Field Office
Kiera Price kieprice@pa.gov – Harrisburg Field Office
Renee Bergamaschi rbergamasc@pa.gov – Johnstown Field Office
Denise Scolieri dscolieri@pa.gov – Pittsburgh Field Office
Lil Agostinella – LAGOSTINEL@pa.gov – Pittsburgh Field Office

Department of Human Services

Department of State

The Department of State has extended the expiration dates of temporary permits for more health care licenses during the COVID-19 emergency.  The boards and professions to which this temporary waiver applies are:

  • State Board of Massage Therapy
  • State Board of Physical Therapy – physical therapists, physical therapy assistants
  • State Board of Medicine – graduate physician assistants, respiratory therapists, athletic trainers, orthotic fitters, pedorthists, graduate orthotist, provisional orthotist, prosthetist graduate permits, and genetic counselor provisional licenses
  • State Board of Osteopathic Medicine – respiratory therapist temporary licenses, athletic trainer temporary licenses, genetic counselor temporary provisional licenses.

Federal Update

Centers for Medicare & Medicaid Services

  • CMS has issued guidance on providing non-essential non-COVID-19 care to patients without symptoms of COVID-19 in regions with low and stable incidence of COVID-19. It views this guidance as part of phase one of the administration’s plan to reopen the U.S. economy.  See CMS’s news release on this guidance here and the guidance itself here.  Under this guidance, individual states will determine for themselves when it is appropriate to begin the “reopening” process.  As a practical matter, only Oklahoma, Texas, and Alaska, to our knowledge, have identified concrete dates for commencing the delivery of the described non-essential care.
  • To ensure appropriate tracking, response, and mitigation of COVID-19 in nursing homes, CMS is reinforcing an existing requirement that nursing homes must report communicable diseases, health care-associated infections, and potential outbreaks to state and local health departments. In rulemaking that will follow, CMS is requiring facilities to report this data to the Centers for Disease Control and Prevention and Control (CDC) in a standardized format and frequency defined by CMS and CDC.  See CMS’s announcement of its intentions; a memo CMS has sent to state Medicaid agencies; and additional CDC guidance.
  • In February, CMS published a rule that would change certain requirements for pre-admission screening and resident review (PASRR) to reflect updates in diagnostic criteria for mental illness and intellectual disability. Because of the COVID-19 emergency, the agency is extending the deadline for stakeholder comment from the current April 20 – today – to May 20.

Department of Health and Human Services

Food and Drug Administration

Federal Emergency Management Agency

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.)

2020-04-21T06:00:36+00:00April 21st, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: April 20, 2020

COVID-19 Update: April 17, 2020

The following is the latest COVID-19 information from the state and federal governments as of 4:30 p.m. on Friday, April 17.

Pennsylvania Update

Daily COVID-19 Briefing

During today’s COVID-19 briefing, Governor Wolf addressed the subject of “reopening” Pennsylvania following the limits he has placed on the state’s residents and its businesses, community life, and social interactions in response to the COVID-19 crisis.  He emphasized the need to continue social distancing, said his administration has been working for weeks to develop plans for reopening the state, and explained that any such effort would be data-driven and local and regional, as opposed to state-wide.  He mentioned the importance of doing more to support the health care system and said that any reopening must ensure the state’s continued ability to respond to COVID-19 challenges if they re-emerge.  What he described today, he said, was a framework for future action, and he said he would provide more details next week.

In the meantime, his office released three documents in support of his plans:  one on relief, reopening, and recovery; one on businesses; and one on health care.

From the Department of Health’s daily update news release on the COVID-19 crisis:

  • After several days of more modest numbers, new COVID-19 cases rose considerably yesterday and deaths remain high.
  • More than half of all COVID-19 deaths in Pennsylvania to date have been among residents of 321 different long-term-care facilities.

Department of Health

The department has updated its March 24 interim infection prevention and control recommendations for patients in health care settings who have COVID-19 or are under investigation for COVID-19.  The new guidance explains that “As community transmission intensifies within a region, healthcare facilities may consider foregoing contact tracing for exposures in a healthcare setting in favor of universal source control for HCP and screening for fever and symptoms before every shift, as well as the end of every work shift…”

The Department of Health sent a letter to hospitals reminding them that the CARES Act requires each provider of a diagnostic test for COVID-19 to publicize the cash price of the test on a public internet website of the provider.

Department of Human Services

DHS has updated its March 20 guidance to reflect that it will not be conducting any annual licensing inspections for entities licensed by its Office of Developmental Programs, Office of Child Development and Early Learning, Office of Long-Term Living/Bureau of Human Services Licensing, and Office of Children, Youth and Families until Governor Wolf lifts his current disaster emergency proclamation or until such other time determined by DHS.

DHS has issued a memorandum to HealthChoices physical health managed care organizations about telemedicine guidelines related to COVID-19.  This memo clarifies issues related to HIPAA compliance in the use of communication technology and the use of out-of-state practitioners and supersedes a similar memo DHS sent to the HealthChoices plans last month.

Department of State

The Department of State has waived certain administrative requirements for graduate medical trainees during the COVID-19 emergency.  Until this waiver was implemented, medical residents with graduate medical trainee licenses who wished to work elsewhere, in addition to where they were serving as residents, needed to provide to the state a detailed written statement of the medical services they would be providing beyond the parameters of the graduate medical trainee program and receive a board evaluation of their training and education.  This required statement has now been temporarily waived.

Pennsylvania Congressional Delegation

Ten Democratic members of Pennsylvania’s congressional delegation have written to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma to complain that the manner in which they have allocated the first $30 billion of the $100 billion designated for hospital and health care providers in the federal CARES Act “…disadvantages Pennsylvania and many of our key providers in several ways.”  Go here for a link to the letter.

Federal Update

The White House

  • President Trump has unveiled “Guidelines for Opening Up America Again,” a three-phase approach to reopening the economy.  Find that plan here.
  • President Trump has signed a memorandum authorizing the use of the National Guard by governors in five more states to help with their response to the COVID-19 emergency, with the cost of National Guard assistance to be assumed 100 percent by the federal government.  The five states are Iowa, Kansas, Maine, Nebraska, Oklahoma, and Vermont.

Centers for Medicare & Medicaid Services

Food and Drug Administration

Centers for Disease Control and Prevention

National Institutes of Health

National Health Services Corps

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.)

2020-04-20T06:00:18+00:00April 20th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: April 17, 2020

SNAP Covid-19 Update: April 16, 2020

The following is the latest COVID-19 information from the Pennsylvania and federal governments and others as of 4:00 p.m. on Thursday, April 16.

Pennsylvania Update

Daily COVID-19 Briefing

  • The number of new COVID-19 cases has remained relatively steady for the past four days and well below where it was a week ago.
  • But the death toll remains higher than it has been in Pennsylvania for most of the past month.
  • 1401 people with COVID-19 are health care workers.
  • 2503 COVID-19 patients are currently in hospitals, 664 of them on ventilators.
  • As of today, 41 percent of the state’s acute-care hospital beds and 37 percent of its ICU beds are unoccupied and nearly 70 percent of its ventilators are not currently in use.
  • The state is now providing negative test result numbers on a county-by-county basis; included in those figures are gender breakdowns.
  • While race and ethnicity data remains elusive, the Department of Health is working on this providers and is now presenting data on positive test results and deaths by race (scroll down about halfway).
  • The state will not give retailers more time to comply with the new requirement that employees and customers all wear masks.
  • The Department of Health recommends that people riding public transportation wear masks but is not requiring it.
  • When asked, Secretary Levine would not reject the possibility of some form of stay-at-home requirement extending into the fall but reiterated her past explanation that the disease will determine the time line.

Department of Human Services

DHS has updated its guidance on the use of the CR modifier and the DR condition code for COVID-19 disaster/emergency-related claims.

Department of Health

The federal Department of Health and Human Services Office of Civil Rights has resolved a civil rights complaint against Pennsylvania over complaints that the state’s interim Pennsylvania Crisis Standards of Care for Pandemic Guidelines would discriminate against the disabled if the state needed to begin triaging access to critical care and ventilators.  Pennsylvania has revised those standards to the Office of Civil Rights’ satisfaction.

Department of State

The Department of State has expanded “clinical clerk” services during the COVID-19 emergency.  Under ordinary circumstances, clinical clerks may serve only patients in hospital settings.  Under this waiver, clinical clerks will be assigned to work in hospitals but may provide services by phone to other health care settings.  The objective of this change is to facilitate the use of medical students as clinical clerks with the understanding that they will work under the supervision of MDs and DOs.

Federal Update

Department of Health and Human Services

Centers for Medicare & Medicaid Services

  • CMS has updated its list of blanket waivers for health care providers. CMS updates this document regularly, with the latest update including changes in Medicare reimbursement for acute-care hospitals, long-term care hospitals, and inpatient rehabilitation facilities required by the CARES Act.

Federal Emergency Management Agency

Food and Drug Administration

Centers for Disease Control and Prevention

National Institutes of Health

Industry Groups

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.)

 

2020-04-17T06:00:33+00:00April 17th, 2020|Coronavirus, COVID-19|Comments Off on SNAP Covid-19 Update: April 16, 2020

COVID-19 Update: April 15, 2020

The following is the latest COVID-19 information from Pennsylvania state and federal officials as of 4:00 p.m. on Wednesday, April 15.

Pennsylvania Update

Governor Wolf

  • The governor’s office issued a news release today in which it announced that it is “…offering taxpayers increased flexibility, additional time to meet their tax obligations, and a pause on several of its standard enforcement actions.”  Go here to see the news release with more details about the specific changes.
  • Governor Wolf has established a COVID-19 Response Task Force for Health Disparity to look into and address how COVID-10 affects minorities.  Lieutenant Governor John Fetterman will serve as its chairman.

Daily COVID-19 Briefing

  • The number of new COVID-19 cases has declined for the third consecutive day.
  • But yesterday’s death toll was among the highest since the pandemic began.
  • 1327 health care workers have tested positive for COVID-19.
  • Health Department staff took a “deep dive” on the data on the status of COVID-19 in long-term-care facilities and has significantly increased both the case and the death totals in those facilities to 3316 residents of such facilities with COVID-19 and 324 deaths attributed to the disease.  The latter figure accounts for nearly one-half of all COVID-19 deaths state-wide.
  • 2392 people are currently hospitalized with COVID-19 and 662 are on ventilators.
  • 41 percent of the state’s acute-care beds and 39 percent of its ICU beds are currently unoccupied and nearly 70 percent of its ventilators are currently not in use.
  • Both Secretary Levine and Governor Wolf said that Pennsylvania is “bending the curve.”
  • Governor Wolf expressed opposition to the bill passed by the state House that would give county governments greater authority over which businesses can remain open during the COVID-19 emergency but when asked did not say he would veto the bill.
  • A new mass testing site will open on the premises of the Mohegan Sun casino in Wilkes-Barre.
  • The Montgomery County mass testing site has relocated and opened.
  • Secretary Levine said she did not know why hospital uncompensated care rose in 2019, as reported today by the Pennsylvania Health Care Cost Containment Council, but she said she is not worried about the impact of COVID-19 on this year’s total because the federal government has said it will pay for care for uninsured people suffering from COVID-19.

Department of Health

Department of Human Services

DHS’s Office of Long-Term Living has issued clarification guidance for Pennsylvania’s pre-admission screening resident review (PASRR) process for nursing homes.  This clarification comes in the wake of guidance from the CMS Center for Clinical Standards and Quality that addresses a blanket waiver CMS has issued indicating that nursing facilities will not be cited for non-compliance with federal PASRR requirements.   While Pennsylvania requested and received approval from CMS that would permit the state to suspend the PASSR assessment process for 30 days, the state has decided to continue performing PASRR activities through remote means and will only invoke the blanket waiver on a case-by-case basis.  See the clarification guidance for further details.

General Assembly

The Senate met to consider S.B. 613 on concurrence in amendments passed in the House yesterday.  During debate, Senate Republicans pointed to the bill’s requirement that businesses comply with CDC guidance for mitigating exposure to COVID-19 before reopening while Senate Democrats argued that the timing of this legislation would detract from the mitigation efforts of the governor and Secretary of Health.  The bill was passed by the Senate along party lines and now goes to the governor for action.

S.B. 327 was also considered on concurrence in amendments from the House.  The bill was amended in the Senate today to delegate authority to counties to develop emergency mitigation plans for businesses.  Senate Democrats expressed concern about this amendment not establishing a statewide, uniform approach to addressing the pandemic.  The bill was adopted along party lines and will return to the House for its concurrence with the Senate’s additional amendments.

The House has added tomorrow, April 16, as a non-voting session day and April 20 and 21 as voting session days.  The Senate stands in recess until the call of the President Pro Tempore.

Federal Update

The White House

Centers for Medicare & Medicaid Services

Health Resources and Services Administration

HRSA is temporarily waiving fees for skilled health care practitioner license queries of the National Practitioner Data Bank to facilitate the deployment of workforce resources.

Food and Drug Administration

Centers for Disease Control and Prevention

Medicare Payment Advisory Commission

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

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

New resource:

PA Health Alert Network

The health alerts published on this page include emergency-related information the Department of Health wishes to communicate to public health agencies, health care providers, hospitals, and emergency management officials.

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

 

2020-04-16T06:00:55+00:00April 16th, 2020|Coronavirus, COVID-19|Comments Off on COVID-19 Update: April 15, 2020

COVID-19 Update: April 14, 2020

The following is the latest COVID-19 information from Pennsylvania state regulators, the Pennsylvania legislature, and federal regulators and others as of 4:00 p.m. on Tuesday, April 14.

Pennsylvania Update

Governor Wolf

Governor Wolf today announced that businesses that collect Pennsylvania sales tax will not have to make accelerated sales tax pre-payments over the next three months.  That means businesses that normally have a monthly prepayment requirement will not be charged penalties for missing the prepayment deadline during this three-month period.

Daily COVID-19 Briefing

  • For the fourth time in the last five days, the number of newly reported cases fell. Today’s total was the lowest in nearly two weeks.
  • But the death count was the third highest single-day total since the pandemic began. Secretary Levine warned that this could be because of reports still coming in from the weekend.
  • 1250 health care workers have tested positive for COVID-19, as have 1869 residents of 232 long-term-care facilities.
  • 42 percent of acute-care beds and 37 percent of ICU beds remain unoccupied and nearly 70 percent of ventilators are still available for use.
  • To date, about one percent of the state’s population has been tested for COVID-19, with nearly 20 percent testing positive.
  • 2306 COVID-19 patients are currently in the hospital, 666 of them on ventilators.
  • Demographic data on race and ethnicity is still proving elusive. (See the paragraph below about the department’s alert on this subject.)
  • A mass testing site should be opening in East Stroudsburg later this week or next week. It will focus on testing health care workers and seniors.  There are not enough testing materials to test those without symptoms.
  • An alternative care facility in East Stroudsburg will serve patients who are on the road to recovery from COVID-19, to free hospital beds for more seriously ill patients.
  • In no part of the state are hospitals overwhelmed at this time. The state is keeping a close eye on this.
  • Yesterday the state shipped a “large push-out” of personal protective equipment to providers.
  • The secretary attributed the decline in the number of daily tests administered to the closing of the mass testing site in Philadelphia and the temporary closing of the mass testing site in Montgomery County.

Department of Health

  • The Department of Health, working with the Hospital and Healthsystem Association of Pennsylvania, has published a revised Interim Pennsylvania Crisis Standards of Care for Pandemic Guidelines Work on this document started last fall and not in response to the COVID-19 public health emergency and is viewed by the Department of Health as a work in progress that will resume once the current pandemic ends.  The purpose of the document, it states, “…is to help guide the allocation of patient care resources during an overwhelming public health emergency of any kind when demand for services dramatically exceeds the supply of resources needed.”
  • The department has issued an alert to laboratories after identifying a large number of laboratory test results submitted without key variables such as patient date of birth, address, and telephone number. In addition, the alert notes that race and ethnicity data is missing from more than 60 percent of reports submitted.  In the alert, the department directs laboratories to include all of this data in the reports they submit to the Department of Health.  Recipients of this alert included hospitals, EMS councils, local health jurisdictions, professional organizations, and long-term-care facilities.

Department of Human Services

Department of State

Department of Labor

The state’s Department of Labor has established a new hiring portal on which employers in life-sustaining businesses can advertise job openings.  Employers may advertise on the site if they are formally considered life-sustaining businesses and have at least 10 jobs to offer.  The process begins with completing an employer intake form.  A number of health care entities already list jobs on the site.

General Assembly

Today the House of Representatives met to continue considering legislation that would create a pathway for businesses to reopen despite the governor’s executive order mandating the closure of non-essential businesses.  Arguments on the floor and in committee meetings fell along party lines, with Republicans advocating the reopening of businesses and Democrats wanting to continue following the governor’s orders.  Ultimately the House passed along party lines SB 613, which primarily provides for the creation of a COVID-19 emergency mitigation plan for businesses.

The House is also expected to pass, in concurrence with Senate amendments, SB 841, which reauthorizes the Pennsylvania Health Care Cost Containment Council (PHC4) Act by adding data collection requirements and other measures in response to the COVID-19 emergency.

The Senate announced today that it will return to session this week to “consider legislation that will provide a safe path for re-opening the state’s economy.”  This came in response to Governor Wolf’s announcement yesterday that he is participating in a multi-state effort to begin planning for next steps beyond stay-at-home orders and for re-opening the state’s economy.

Federal Update

Centers for Medicare & Medicaid Services

Department of Health and Human Services

Drug Enforcement Administration

Occupational Safety and Health Administration

Food and Drug Administration

American Medical Association

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

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.)

2020-04-15T06:00:22+00:00April 15th, 2020|Coronavirus, COVID-19, Uncategorized|Comments Off on COVID-19 Update: April 14, 2020
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