COVID-19 Update: Thursday, July 30

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:

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.