The following is the latest COVID-19 information from the state and federal governments as 2:30 p.m. on Tuesday, December 8.

Pennsylvania Update

Governor Wolf

At a press briefing on Monday, Governor Wolf expressed concern about the alarming rate at which new COVID-19 cases are being diagnosed in Pennsylvania, asked Pennsylvanians to wear masks, engage in recommended social distancing, and avoid mass gatherings, and warned that while he was not calling for any new mitigation requirements at this time, he and other state officials are reviewing their options and may recommend new measures later this week.

Department of Health

The Department of Health announced that beginning on Thursday, December 10, regional drive-through and indoor walk-in COVID-19 testing clinics will be held in Clinton, Delaware, Greene, Warren, and Wyoming counties.  Counties with new, temporary state-sponsored testing sites will change each week over the next 11 weeks so that 61 counties will eventually be reached by these pop-up testing sites.  Go here to learn more, including the testing schedule and site addresses.

Department of Health – by the numbers

• Pennsylvania’s number of COVID-19 cases today surpassed 345,000.
• In three of the past six days Pennsylvania has set a new single-day high for the number of new cases.
• More than 11,500 Pennsylvanians have now died from COVID-19.
• More than 40,000 residents of long-term-care facilities and more than 7000 people who work in those facilities have contracted COVID-19.  Those figures encompass 1349 facilities in 66 of Pennsylvania’s 67 counties.
• More than 18,000 health care workers in the state have contracted COVID-19.
• The number of people currently hospitalized with COVID-19 has doubled in the past two weeks.
• The number of COVID-19 patients currently breathing with the help of a ventilator has risen 50 percent in the past two weeks.
• More than 1000 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19; that is a 40 percent increase in the past two weeks.
• 14 percent of hospital adult ICU beds are currently unoccupied, as are 14 percent of medical/surgical beds, 37 percent of pediatric beds, 16 percent of pediatric ICU beds, and 34 percent of airborne isolation unit beds.
• The state-wide positivity rate on COVID-19 tests rose from 11.7 percent two weeks ago to 14.4 percent last week, according to the early warning dashboard released weekly by the governor and Department of Health.
• A positivity rate greater than five percent is considered “concerning,” Department of Health Secretary Levine has explained in the past.

Around the State

• The web site northcentralpa.com reported late last week that “The 15-day average test positivity rate in Lycoming County is 43%, Pa. Department of Health data show.  By comparison, the statewide 7-day average is 11%.  A percent positivity rate of 5% is considered ‘too high’ by some experts.”
• Westmoreland County has experienced an especially high rate of new COVID-19 cases in recent weeks.  The Pittsburgh Tribune-Review reports that in response to increases in the number of hospitalized patients, Excela Health will convert a procedure room into a new space for about 12 new, temporary beds in one of its Westmoreland County hospitals.  The newspaper notes that “On Monday, there were 133 patients hospitalized in the county with covid-19 – a 24% increase in a week and more than 138% since Nov. 1, according to state data.  On Sunday, there were 137 patients — the highest since the pandemic started in March.”
• One of that county’s commissioners has tested positive for COVID-19, the Tribune-Review reports.
• And after being exposed to someone who tested positive for COVID-19, Philadelphia’s mayor has just entered into a quarantine period – for the second time, according to the Philadelphia Inquirer.
• The Inquirer also reports that according to Philadelphia’s health commissioner, the city’s recent spike in COVID-19 cases was “likely caused by social gatherings that happened over Thanksgiving on top of already high case counts.”  The Inquirer added that “The city on Tuesday reported 1,408 newly confirmed cases, for a total of 75,458 since the pandemic began.  During the week that ended Saturday, the city reported about 910 new cases per day, with a positive rate of 12.7%.”

Department of State

• To provide a greater number of people with convenient, limited-contact access to flu shots, the Department of State has suspended the age restriction that limits intern-administered flu shots to those ages nine and older.  Instead, pharmacy interns may temporarily administer any age-appropriate influenza vaccination to children three years of age and older.  Also, to increase access to COVID-19 vaccines as they become available, this waiver authorizes pharmacy interns to administer COVID-19 vaccinations to persons who are at least 18 years of age but only under the direct, immediate, and personal supervision of a licensed pharmacist who holds an active authorization to administer injectable medications.  See the notice of this new, temporary policy.
• The Department of State has extended previous waivers related to CPR training for massage therapists and CPR and basic life support training for dentists, dental hygienists, and expanded function dental assistants.  See the notice of this new, temporary policy.
• The Department of State has extended a waiver of the periodontal portion of the dental clinical exam because that exam involves a live patient.  It also has extended the current waiver of the live patient aspect of the restorative exam and for its temporary replacement by a non-patient-based restorative dentistry examination administered by the Commission on Dental Competency Assessments and the Council of Interstate Testing Agencies Inc.  See the notice describing these waivers.

Federal Update

Provider Relief Fund

• HHS announced that the Provider Relief Fund will distribute $523 million in second-round performance payments to 9248 nursing homes as rewards for successfully reducing COVID-19-related infections and deaths between September and October.  HHS concluded that between September and October, 69 percent of 13,251 eligible nursing homes met the incentive program’s infection control criteria.  See HHS’s announcement of the nursing home distribution and a list of how much of this money HHS distributed to nursing homes in individual states.
• HHS has updated its CARES Act Provider Relief Fund FAQ with nine new or modified questions and answers.  Find the new items, all labeled “12/4/2020,” on pages 2, 6, 14, 15, 16-17, 25, 34, 47, and 55.  Fund recipients should review this new information carefully, and in particular, the question on page 6 about erroneous payments, which reverses previous policy, and questions on audit terms and extensions on pages 14 and 15.

Centers for Medicare & Medicaid Services

• CMS has posted information about how providers should code monoclonal antibody treatments and vaccine administration for Medicare beneficiaries and how much Medicare will pay for those activities.
• CMS has sent a letter to the nation’s governors about steps they can take to ensure that their hospitals have sufficient capacity to handle the current surge in COVID-19 cases and their other patients as well.  The letter stresses three steps states can take to maximize hospital capacity:  ensure that no state-level licensure or scope of practice restrictions would impede health systems from leveraging flexibilities already granted by the federal government; ensure that state Medicaid agencies adapt payment and coverage policies appropriately; and foster coordination within their health care systems to create the partnerships necessary for effective community surge plans.  See CMS’s letter to state governors.
• CMS has updated its statement on how it will exercise its enforcement discretion for laboratories that perform COVID-19 molecular and antigen point-of-care tests.
• CMS has posted new nursing home COVID-19 testing FAQs.

CMS COVID-19 Stakeholder Calls 

CMS hosts recurring stakeholder engagement sessions to share information about 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 participants an opportunity to ask questions of CMS and other subject matter experts.

COVID-19 Office Hours Call

Tuesday, December 22 at 5:00 (eastern)

Toll Free Dial In:  833-614-0820; Access Passcode:  3968359

Audio Webcast link:  go here.

Hospitals Without Walls Call

On November 25, CMS announced the expansion of its Hospitals Without Walls program by introducing its Acute Hospital Care At Home program, giving eligible hospitals unprecedented regulatory flexibilities to treat eligible patients in their homes.  This program was developed to support models of at-home hospital care that have succeeded in several hospitals and networks.  A CMS Hospitals Without Walls stakeholder call will feature two organizations walking through their programs and a question and answer session.  Slides/resources will be posted on CMS.gov prior to the call.

Wednesday, December 9 at 4:00-5:00 PM (eastern)

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  1235939

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 past stakeholder calls, go here.

Department of Health and Human Services

• HHS has released new hospital COVID-19 capacity data at the facility level.  Previously released data about hospital capacity that had been released was aggregated at the state level but this new, more granular data release aggregates daily hospital reports into a “week at a time” picture while providing a view of how COVID-19 is affecting hospitals and communities.  See HHS’s announcement about the new data and an FAQ about the data and go here for access to the data itself.

Food and Drug Administration

• The FDA has authorized the first diagnostic test for at-home collection of patient samples to detect both COVID-19 and influenza A and B (flu).

Centers for Disease Control and Prevention

• The CDC has announced ICD-10-CM codes for hospital cases involving COVID-19.  The new codes are for encounters for screening for COVID-19; contact with and expected and (suspected) exposure to COVID-19; personal history of COVID-19; multisystem inflammatory syndrome (MIS); other specified systemic involvement of connective tissue; and pneumonia due to COVID-19.  See the CDC’s announcement about the new codes, which take effect on January 1, 2021.
• CMS has updated its general information about COVID-19 for health care workers, its information about therapeutic options for treating patients with COVID-19, and its guidance for the clinical care of patients with COVID-19.
• The CDC has updated its guidance for administering and analyzing COVID-19 antigen tests.
• The CDC has updated its information for health care workers about COVID-19 vaccines.

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

The following is the latest COVID-19 information from the state and federal governments as of 3:45 p.m. on Monday, October 26.

Pennsylvania Update

Governor Wolf

Governor Wolf has written to President Trump asking him to work with Congress to provide funding to enable the state to continue its Regional Response Healthcare Collaborative Program (RRHCP) for which current funding expires on December 31.  The RRHCP is a partnership between the state’s departments of Human Services and Health and the Pennsylvania Emergency Managemental Agency through which selected Pennsylvania health systems work with long-term-care facilities that are vulnerable to the COVID-19 pandemic by providing assistance with preparation, prevention, response, and education.

Department of Health

• The Department of Health has published an executive summary of the state’s plan to distribute and administer COVID-19 vaccines in Pennsylvania once such vaccines become available.  Among other matters, the plan identifies critical populations and addresses vaccine provider enrollment, storage and handling, communication, and safety concerns.
• The Department of Health has issued a training PowerPoint to assist skilled nursing facilities with capacity and testing reporting requirements.
• The Department of Health has updated its FAQ on drugs for treating COVID-19.
• The Department of Health has issued a health advisory titled “Additional Factors to Determine Close Contacts of Persons with COVID-19” with recommendations for implementing new guidance from the CDC on the identification and quarantine of close contacts.
• The state has begun distributing its second allotment of COVID-19 antigen test kits provided by the federal government to Clinical Laboratory Improvement Amendments (CLIA)-certified institutions in Berks, Huntingdon, Union, and Westmoreland counties.
• During a Monday news conference, Secretary Levine called for an extension of the authorization for the Pennsylvania National Guard to help with the state’s COVID-19 response.

Department of Health – by the numbers

• Pennsylvania’s COVID-19 case count has now surpassed 195,000.  The daily total has been in four figures every day this month except for one, which has not happened since the early months of the pandemic.  This includes the three highest single-day new case counts since the pandemic began.
• With today’s latest figures, the death count now nears 8700.  Daily death counts are now generally lower than they were in the spring.
• Overall, more than 30,000 residents and employees of long-term-care facilities have contracted COVID-19.  Those figures encompass 1049 facilities in 63 of Pennsylvania’s 67 counties.
• More than 12,000 health care workers in the state have contracted COVID-19.
• The state-wide positivity rate for COVID-19 tests is now five percent, up from 4.2 percent last week; 30 counties are currently above five percent.  Counties with what the state calls “concerning” positivity rates including Huntingdon (12 percent), Bradford (11.2 percent), Lawrence (9.0 percent), Lebanon (8.7 percent), and Westmoreland (8.4 percent).
• According to the state’s weekly data dashboard, Berks, Bradford, Centre, Elk, Huntingdon, Lackawanna, Lawrence, Lebanon, Luzerne, Mifflin, Montour, Northumberland, Philadelphia, Schuylkill, and Westmoreland counties are in a “substantial” level of community transmission.  Allegheny County is now in a low level of community transmission.
• The rate of response to contact tracing efforts is not very good, but Secretary Levine reports that among those who have recently been diagnosed with COVID-19 and who responded to inquiries about their recent whereabouts, 55 percent said they had visited a restaurant in the past two weeks and 13 percent said they had visited a bar.
• Over the past two weeks more than 2000 cases have been diagnosed among school-aged children.  This reflects a change in the nature of who is contracting COVID-19:  while the numbers are up in all age groups, such cases are more common in people under the age of 50 than they were in the spring and early summer.
• Labs are reporting an average of 34,000-35,000 test results a day.
• The number of people currently hospitalized with COVID-19 is more than twice what it was on October 1.
• Secretary Levine said that the number of hospitalized COVID-19 patients generally lags behind case count trends by about two weeks and can therefore be expected to continue rising in the coming weeks.
• The number of COVID-19 patients currently breathing with the help of a ventilator also is up significantly this month.
• But Secretary Levine explained that far fewer hospitalized COVID-19 patients are assisted by ventilators now than they were during the pandemic’s early days.  Back in the spring, roughly 30 percent of hospitalized COVID-19 patients in Pennsylvania were assisted by ventilators; now, only about 10 percent are.
• She attributed this decline to how much providers have learned over the past few months about how to care for COVID-19 patients.  Both treatment and therapeutics have improved since the spring.  Patients continue to get very sick but the health care delivery system is better equipped to treat them.
• 25 percent of hospital adult ICU beds are currently unoccupied, as are 22 percent of medical/surgical beds, 36 percent of pediatric beds, 13 percent of pediatric ICU beds, and 40 percent of airborne isolation unit beds.  These figures are similar to what they were a week ago.

Department of Human Services

DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) published a memorandum in August informing behavioral health managed care organizations, county mental health/intellectual disability offices, and behavioral health providers that specified state regulatory provisions have been temporarily suspended during the COVID-19 disaster emergency declaration period.  OMHSAS has now re-issued this memorandum to update signature requirements for treatment and service plans.  The notice applies to inpatient psychiatric services, outpatient psychiatric services, intensive behavioral health services, outpatient drug and alcohol services, mental health procedures, partial hospitalization, intensive case management, psychiatric rehabilitation services, community residential rehabilitation services, and long-term structured residences.

Federal Update

Provider Relief Fund:  Webcast on Phase 3 General Distribution

• Applications for the Provider Relief Fund Phase 3 general distribution are now being accepted by HHS.  HHS will hold a webcast on Monday, November 2 at 3:00 p.m. (eastern) for interested parties.  Go here to register for the webcast and to submit questions.  Providers considering applying for Phase 3 general distribution funds that did not view the previous webcast should participate in this one in anticipation of the November 6 application deadline.  Also available are a fact sheet and a presentation about the Phase 3 general distribution.

Provider Relief Fund:  Financial Reporting

Last week we reported on HHS’s updating of its most recent Provider Relief Fund financial reporting instructions that broadened how fund recipients may use those funds.  That report was accompanied by an HHS policy memorandum and amended reporting requirements.  For providers interested in how HHS is defining parent entities in this update, the amended reporting requirements document includes the following explanation:

Reporting Entity: Entity (at the Tax Identification Number (TIN) level) that received one or more PRF [Provider Relief Fund] payments, or an entity that meets the following three criteria: 1) is the parent of one or more subsidiary billing TINs that received General Distribution payments, 2) has providers associated with it that were providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31, 2020, and 3) is an entity that can otherwise attest to the Terms and Conditions. If the entity has subsidiary TINs that received General Distribution payments, regardless of whether the subsidiary or Reporting Entity formally attested to accepting the payment within the provider portal, the Reporting Entity may report on and direct the use of General Distribution payments. However, if a subsidiary TIN received a Targeted Distribution payment, 1 the subsidiary TIN must report use of funds for that payment, and the parent organization that reports on a subsidiary’s General Distribution payment cannot also report on (or transfer) the subsidiary’s Targeted Distribution payment.

Department of Health and Human Services

• Four weeks after HHS announced that it would distribute 150 million state-of-the-art Abbott BinaxNOW COVID-19 tests nationally to assist with states’ reopening efforts, states have begun to report back to HHS about how they are choosing to distribute the rapid, point-of-care tests.  Of the states that have provided preliminary reports, the BinaxNOW allocations are largely being sent to local health departments, K-12 schools and institutes of higher education, nursing homes, hospitals, and correctional facilities.  Learn more from this HHS announcement about the status of the distribution and states’ responses to it.
• HHS’s Office of the Inspector General has updated its work plan for COVID-19-related audits, evaluations, and inspections.

CMS COVID-19 Stakeholder Calls 

CMS hosts recurring stakeholder engagement sessions to share information about 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 participants an opportunity to ask questions of CMS and other subject matter experts.  Two such calls remain this month.

CMS COVID-19 Office Hours Call

Tuesday, October 27 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2394789

Audio Webcast link:  go here to register for the call

Nursing Homes Call

Wednesday, October 28 at 4:30 – 5:00 PM (eastern)

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  5587022
Audio Webcast Link:  go here to register for the call

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 other COVID-19 stakeholder calls, visit CMS’s podcast and transcripts page.

Food and Drug Administration

• The FDA has approved the antiviral drug Veklury (remdesivir) for treatment of COVID-19 requiring hospitalization for use in adult and pediatric patients 12 years of age and older and weighing at least 40 kilograms (about 88 pounds).
• The FDA has consolidated its existing resources for stakeholders to easily find information about drug and biologics development and manufacturing, including for products to diagnose, cure, mitigate, treat, or prevent COVID-19 and for other critically needed products to treat symptoms of COVID-19 or to provide supportive care to those with COVID-19.  Go here to find the consolidated guide to these resources.

Centers for Disease Control and Prevention

• The CDC has updated its flow chart for the management of health care workers who have been exposed to an individual with COVID-19.
• The CDC has updated its summary of considerations for the use COVID-19 testing in nursing homes.
• The CDC has updated its guidance on the diagnosis, evaluation, and infection prevention and control practices for 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 its recommended strategies for optimizing provider supplies of disposable medical gloves.
• The CDC’s weekly morbidity and mortality weekly report offers new Veterans Health Administration research on the risk for in-hospital complications associated with COVID-19 and influenza from October 1, 2018 to May 31, 2020.
• The CDC’s weekly morbidity and mortality report offers new research on COVID-19-related hospitalizations of health care workers in 13 states between March 1 and May 31.

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

The following is the latest COVID-19 information from the state and federal governments as of 2:30 p.m. on Tuesday, October 20.

Pennsylvania Update

Department of Health

• The Department of Health has issued its weekly news release updating its COVID-19 contact tracing efforts.
• In its weekly guidance wrap-up document, the Department of Health addressed a skilled nursing facility’s question about how to protect respirators from surface contamination to prolong their use.
• COVID-19 testing sites have been launched in faith-based settings in communities in Allegheny and Dauphin counties.  For more information, including a list of testing sites and when they will be operating, see this Department of Health announcement.

Department of Health – by the numbers

• Pennsylvania’s COVID-19 case count so far is just short of 185,000.  The daily total has been in four figures every day this month except for one, which has not happened since the early months of the pandemic.
• With today’s latest figures, the death count now exceeds 8500.
• Of that number, 61 percent were residents of long-term-care facilities.
• Overall, more than 24,700 residents of long-term-care facilities and more than 5400 people who work in those facilities have contracted COVID-19.  Those figures encompass 1028 facilities in 62 of Pennsylvania’s 67 counties.
• More than 11,700 health care workers in the state have contracted COVID-19.
• The number of people currently hospitalized with COVID-19 is up 65 percent since October 1.
• The number of COVID-19 patients currently breathing with the help of a ventilator is up 57 percent since October 1 and is at its highest level since August 20.
• 21 percent of hospital adult ICU beds are currently unoccupied, as are 19 percent of medical/surgical beds, 36 percent of pediatric beds, 20 percent of pediatric ICU beds, and 39 percent of airborne isolation unit beds.  These figures are similar to what they were a week ago.
• The weekly news release from the office of the governor and the Department of Health reported that during the week of October 9-15, the number of COVID-19 cases rose 17.9 percent over the previous week and the state-wide positivity rate for COVID-19 tests rose from 3.9 percent to 4.3 percent during the same period.
• The highest positivity rates were in Huntingdon (9.9 percent), Westmoreland (8.9 percent), Bradford (8.3 percent), and Lackawanna, Lebanon, and Perry (8.2 percent) counties.
• Counties found to have substantial levels of community transmission were Berks, Blair, Bradford, Centre, Huntingdon, Lackawanna, Montour, Schuylkill, Union, and Westmoreland.
• Allegheny and Philadelphia counties are considered to have “moderate” rates of community transmission.
• Despite this, Philadelphia’s health commissioner reports that every zip code in the city is experiencing an increase in its number of cases, the Philadelphia Inquirer reports.
• Eight percent of all cases to date in the 8-15 years-old age group occurred during the week of October 9-15.

Department of Human Services

DHS’s Office of Developmental Programs has updated operational guidance to implement services through Appendix K flexibilities approved for the Community Living, Consolidated and Person/Family Directed Support (P/FDS) Waivers during the COVID-19 pandemic.

Federal Update

Provider Relief Fund

HHS has updated its Provider Relief Fund FAQ with a new question that appears on page 46 and is marked “Added 10/15/2020.”  The new question is “An organization has prescription sales as part of its revenue.  Can these sales be captured in the data submitted as a part of revenue from patient care?”  The answer is “Generally no, prescriptions sale revenue may not be captured as part of revenue from patient care.  Only patient care revenues from providing health care, services, and supports, as provided in a medical setting, at home, or in the community may be included.  Patient care revenues do include savings obtained by providers through enrollment in the 340B Program.”

Centers for Medicare & Medicaid Services

• CMS announced that starting January 1, 2021, Medicare will pay $100 for COVID-19 laboratory tests only to laboratories that complete high-throughput COVID-19 diagnostic tests within two calendar days of the specimen being collected.  Also effective January 1, 2021, Medicare will pay only $75 for laboratories that take longer than two days to complete these tests.
• CMS has updated the document “COVID-19 Frequently Asked Questions on Medicare Fee-for-Service (FFS) Billing” with new questions on pages 12-16 about the creation of new HCPCS codes and add-on payments for laboratory tests using high-throughput technologies.
• CMS has updated the article “Medicare Fee-for-Service Response to the Public Health Emergency on the Coronavirus (COVID-19)” in its online publication MLN Matters to clarify the HCPCS codes that critical access hospitals should use in the “Families First Coronavirus Response Act Waives Coinsurance and Deductibles for Additional COVID-19 Related Services” section.  It also has clarified the “Skilled Nursing Facility (SNF) Benefit Period Waiver – Provider Information” section of that article to show that the skilled nursing facility waiver applies to swing-bed services in rural hospitals and critical access hospitals.  All other information remains the same.
• CMS has published the results of its survey on how COVID-19 has affected Medicare beneficiaries’ daily lives and experiences, including the degree to which they have chosen to forego receiving health care, the steps they have taken to avoid contracting COVID-19, their experiences with telemedicine, and more.  Learn more from the CMS announcement about the survey, view its data infographic on the survey’s results, and find a public use file detailing the survey results.
• CMS has published a list of all recipients of money through its Accelerated and Advance Payments Program, including how much money they received through this program.  See the Medicare COVID Accelerated & Advanced Payment Data  (ZIP).

Department of Health and Human Services

• HHS and the Department of Defense have announced agreements with CVS and Walgreens to provide and administer COVID-19 vaccines to residents of long-term-care facilities nation-wide with no out-of-pocket costs.
• Starting October 19, long-term-care facilities may opt into this program and indicate which pharmacy partner their facility prefers to have on-site.  Long-term-care facilities are not required to participate in this program and can request to use their current pharmacy contracts to support COVID-19 vaccination.  Nursing homes can sign up via the National Healthcare Safety Network and assisted living facilities can sign up via an online survey they will receive.
• In support of this action, CMS has posted a document outlining how it will exercise its enforcement discretion to permit pharmacists to bill Medicare directly when they administer COVID-19 vaccines at skilled nursing facilities.
• Communities that are part of the federal surge testing effort for COVID-19 now have a new option:  a test that uses samples of saliva collected by spitting into a sterile container.  The first place where the saliva test will be used is Waco, Texas.  See HHS’s announcement of this new option.
• HHS’s Office of the Assistant Secretary for Planning and Evaluation has developed a “PPE Preservation Planning Toolkit.”
• HHS’s Office of the Assistant Secretary for Planning and Evaluation, in cooperation with the National Emerging Special Pathogen Training and Education Center and Project Echo, holds weekly COVID-19 clinical rounds peer-to-peer virtual communities of practice webinars:  EMS – patient care and operations on Mondays at noon (eastern); critical care:  life-saving treatment and clinical operations on Tuesdays at noon (eastern); and emergency department:  patient care and clinical operations on Thursdays at noon (eastern).  Go here to sign up for information on upcoming webinars.

Centers for Disease Control and Prevention

• The CDC has updated its information about how providers should report COVID-19-related laboratory data.
• The CDC has updated its interim guidance for providing home care to patients with COVID-19 who do not need hospitalization.
• The CDC has updated its information about resources for laboratories that perform COVID-19 diagnostic tests.
• The CDC’s morbidity and mortality weekly report includes its new research on race, ethnicity, and age trends in persons who died from COVID-19 from May through August.
• The CDC’s morbidity and mortality weekly report includes its new research on excess deaths in the U.S. associated with COVID-19 by age, and race and ethnicity from January 26 through October 3, 2020.

Food and Drug Administration

• The FDA has re-issued emergency use authorization (EUA) for certain filtering facepiece respirators that are not approved by the Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and Health.
• The FDA has removed epinephrine from the list of drugs that it has authorized for temporary compounding during the COVID-19 emergency.  Find the updated list of authorized drugs here.
• The FDA will host a virtual town hall for COVID-19 test developers on October 28, 2020 from 12:15 pm – 1:15 pm (eastern).  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 information on how to join the event.

Department of Labor

The Department of Labor’s Occupational Safety and Health Administration (OSHA) has published an FAQ on how N95 respirators protect wearers from COVID-19 exposure.

 Federal Reserve System

The Federal Reserve System will hold a webinar for its Main Street Lending Program on Wednesday, October 21 at 2:00 (eastern).  That program supports lending to small and medium-sized for-profit businesses and non-profit organizations that were in sound financial condition before the COVID-19 pandemic but lack access to credit on reasonable terms.  Go here to learn more about the program, sign up for the webinar, and submit questions about the program.

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

Main COVID-19 Page

FAQ

The following is the latest COVID-19 information from the state and federal governments as of 3:00 p.m. on Thursday, October 15.

 Pennsylvania Update

Department of Human Services

DHS’s Office of Developmental Programs has issued an FAQ on modifications to medication administration course requirements as a result of the COVID-19 emergency.  The audience for this FAQ is Office of Developmental Programs providers whose staff, contractors, or consultants are required by state law to take medication administration training.  Due to the COVID-19 pandemic, the Office of Developmental Programs has temporarily permitted staff required to undergo such training to take a modified medication administration course.  The FAQ addresses the current state of the training requirement.

Department of Health

• The Department of Health has issued new guidance for skilled nursing facilities that replaces guidance issued on September 3 and brings the agency’s guidance in line with recent CMS memoranda.  This document is a compendium of all COVID-19-related guidance and recommendations in areas such as testing, visitation, cohorting, and reporting.
• The Department of Health announced that the state has begun distributing the first allotment of 250,000 COVID-19 rapid antigen test cards provided by the federal government.
• Distribution is beginning with Bradford, Centre, Lebanon, Montour, Northumberland, Schuylkill, and Snyder counties because of the recent high COVID-19 incidence rates in those areas.
• The tests are being distributed to Clinical Laboratory Improvement Amendments (CLIA)-certified organizations, including long-term-care facilities, personal care homes and assisted living/intermediate-care facilities, higher education institutions, drug and alcohol and behavioral health treatment centers, state and county correctional facilities, and health care providers such as FQHCs, urgent care centers, pharmacies, and primary care doctors.
• Populations targeted for testing with these materials include individuals in congregate care settings, day care workers and clients, K-12 students and adults who work in K-12 settings, college and university students, individuals without permanent housing, food distribution facility employees, food workers, and first responders.
• These test kits are separate from and in addition to the tests being provided by the federal government directly to skilled nursing facilities, personal care homes, and historically black colleges and universities.
• The Secretary of Health issued an order to laboratories, health care practitioners, health care providers, and facilities reinforcing that all antigen test results, both positive and negative, must be reported to the Department of Health via its reporting system, PA-NEDSS.

Department of Health – by the numbers

• The weekly news release from the office of the governor and the Department of Health cited 14 counties as concerns because of their high rate of positive test results:  Northumberland (8.6 percent), Centre (7.6 percent), Bradford (7.4 percent), Lebanon (7.4 percent), Lawrence (6.9 percent), Potter (6.3 percent), Westmoreland (6.3 percent), Fulton (6.2 percent), Montour (6.0 percent), Berks (5.9 percent), Indiana (5.9 percent), Huntingdon (5.8 percent), Lackawanna (5.4 percent), and Schuylkill (5.0 percent).  It also noted that “Each of these counties bears watching as the state continues to monitor all available data.”
• With the increase in cases in Northumberland County, the Department of Health has arranged for an outdoor testing site from October 16-20.  The tests are free and appointments are not needed.
• The number of new COVID-19 cases has been in four digits in 14 of the 15 days of October – the first time that has happened in more than four months.  Today’s new case count is the highest single day figure since at least May.
• The number of people currently hospitalized with COVID-19 is up 43 percent since October 1.
• The number of COVID-19 patients currently breathing with the help of a ventilator is up 57 percent since October 1 and is at its highest level since August 20.
• 22 percent of hospital adult ICU beds are currently unoccupied, as are 18 percent of medical/surgical beds, 33 percent of pediatric beds, 13 percent of pediatric ICU beds, and 38 percent of airborne isolation unit beds.  These figures are almost identical to what they were a week ago.
• More than 11,500 health care workers in the state have contracted COVID-19.

Federal Update

Provider Relief Fund

• Yesterday HHS held a webinar to provide more detailed information to health care providers about its planned $20 billion CARES Act Provider Relief Fund Phase 3 general distribution. It used this toolkit during the webinar.  The deadline for applying for a Phase 3 general distribution is November 6.
• During the webinar, providers that have received Provider Relief Fund general distributions in the past were advised that they need to submit an entirely new application to participate in Phase 3 and be eligible to receive any add-on payment that HHS distributes from the funding pool that remains after all applicants have received payments equal to two percent of patient care revenue.  There are no details available on how these potential add-on payments might be calculated.
• During the webinar HHS offered a point of contact for stakeholders with questions about the Provider Relief Fund and payments for testing and treatment for the uninsured: its Provider Support Line at 866-569-3522 (for TYY, dial 711).

Centers for Medicare & Medicaid Services

• CMS has expanded the list of telehealth services that Medicare fee-for-service will pay for during the COVID-19 public health emergency, adding 11 new services to the Medicare telehealth services list. Medicare will begin paying for these services immediately and for the duration of the COVID-19 emergency.  These new telehealth services include certain neurostimulator analysis and programming services and cardiac and pulmonary rehabilitation services.  Go here to see CMS’s announcement of the newly authorized telehealth services and here for a link to the list of the new services and their billing codes.
• CMS has published the document “State Medicaid and CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth” and subtitled it “COVID-19 Version.”  The document explains that “This guide is intended to help states identify which aspects of their statutory and regulatory infrastructure may impede the rapid deployment of telehealth capabilities in their Medicaid program.  As such, this guide will describe each of these policy areas and the challenges they present below.  The toolkit concludes with a list of questions state policymakers can use to ensure they have explored and/or addressed potential obstacles.”  It also notes that “CMS encourages states to consider telehealth options as a flexibility in combatting the COVID-19 pandemic and increasing access to care.  States are encouraged to facilitate clinically appropriate care within the Medicaid program using telehealth technology to deliver services covered by the state.”  CMS also has published a supplement to this guide, “State Medicaid & CHIP Telehealth Toolkit:  Policy Considerations for States Expanding Use of Telehealth,” and subtitled it “COVID-19 Version:  Supplement #1.”  This document is dated October 14, 2020.

Centers for Disease Control and Prevention

• The CDC has updated its guidance on point-of-care COVID-19 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