The following is the latest information from the state and federal government as of 2:45 p.m. on Monday, July 13.

Pennsylvania Update

Governor Wolf

Governor Wolf has signed an executive order authorizing state agencies to conduct administrative proceedings remotely.  Several state agencies conduct administrative proceedings, including meetings and disciplinary hearings of the 29 occupational licensing boards and commissions under the Department of State.  The order took effect immediately.

Department of Health

The Department of Health has revised its guidance for hospitals responding to COVID-19.

Department of Health – by the numbers

• After a week of continued large numbers of new COVID-19 cases in Pennsylvania, the new case count announced today was less than half of each of the three previous days. Secretary Levine warned, however, that slow data reporting tends to make Monday figures low and that today’s number includes no new cases from Philadelphia.
• The number of Pennsylvanians hospitalized with COVID-19 has now risen daily for the past week after more than a month of nearly daily declines.
• The number of Pennsylvanians on breathing machines also is down and has fallen below 100 in recent days – lower than it has been since the start of the pandemic.
• The number of new COVID-19-related deaths remains down significantly compared to recent weeks.
• The recovery rate for Pennsylvanians who contract COVID-19 is now 77 percent.
• Overall, case counts are up in 43 of Pennsylvania’s 67 counties over the past week.
• In a news release issued late last week, the Wolf administration noted that “While the statewide percent-positivity rate is at 4.4%, counties with concerning percent-positivity rates include Allegheny (7.9%), Beaver (6.3%), Butler (5.5%), Clarion (14.6%), Fayette (5.2%), Greene (5.4%), Lawrence (5.8%), Lebanon (5.6%), Philadelphia (5.1%), Washington (7.2%), Westmoreland (5.4%) and York (6.3%).”
• The state-wide rate of positive cases, though, is down – currently, 4.4 percent. Secretary Levine said she would worry if it reached five percent.
• To date, residents and staff of 750 long-term-care facilities in 55 counties have accounted for more than 21,700 cases of COVID-19 in the state.
• Universal testing in such facilities is identifying many new cases but many of those new cases are residents and employees who are asymptomatic.
• 300 long-term-care facilities have now completed the universal testing mandated by the Department of Health last month.
• Overall, the proportion of Pennsylvanians over the age of 65 who test positive for COVID-19 is now declining.
• More than 7100 health care workers have contracted COVID-19.
• In the past seven days, 135,000 Pennsylvanians have been tested for COVID-19.
• In the state, an average of 15,800 tests have been performed daily over the past 30 days.
• From March 3 to date, 1,148,174 Pennsylvanians have been tested – about nine percent of the state’s population.
• When tests are performed by hospitals and local labs, results are usually available in a day or two. The national companies, such as Labcorp and Quest, are struggling under their current workload, with some results taking as long as a week.  The Department of Health has scheduled calls with the nation-wide labs to discuss this.
• The state still does not have the capacity to engage in population-wide testing. The kind of simple, nearly instant-result test needed to do such widespread testing, Secretary Levine explained, does not yet exist.
• Currently unoccupied are 40 percent of state hospitals’ acute-care beds, 42 percent of their ICU beds, 59 percent of their pediatric beds, 37 percent of their pediatric ICU beds, and 65 percent of their airborne isolation rooms.

Federal Update

Department of Health and Human Services

• HHS has announced that it will distribute another $4 billion in CARES Act Provider Relief Fund money. Of that sum, approximately $3 billion will be distributed to safety-net providers, with the agency expanding its criteria since its June distribution of safety-net provider funding to encompass some safety-net hospitals that did not meet the previous criterion that addressed hospital profitability.  Another $1 billion will be distributed to specialty rural hospitals, urban hospitals with certain rural Medicare designations, and hospitals in small metropolitan areas.  Hospitals are expected to see deposits as soon as Wednesday.
• As part of these newest distributions of CARES Act money, HHS has added extensive updates to its CARES Act Provider Relief Fund FAQ. Most of the new questions involve these latest distributions and are all marked “7/10/2020.”
• HHS also has updated its CARES Act Provider Relief Fund FAQ with new information about finding the status of applications or payments; the impact of changes on ownership in eligibility for payments; the eligibility of Programs of All-Inclusive Care (PACE) for payments; accounting for full-time employees by applicants for the Medicaid and CHIP distribution; and the ability of providers with tax identification numbers that have not yet been validated to apply for funds. All changes are marked “7/8/2020.”
• HHS has posted a video titled “Five Things About Nursing Homes During COVID-19” that presents five things the agency is doing to stop the spread of COVID-19 in nursing homes.
• HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA) announced the adoption of a revised Confidentiality of Substance Use Disorder Patient Records regulation that seeks to advance “…the integration of healthcare for individuals with substance use disorders while maintaining critical privacy and confidentiality protections. Under Part 2, a federally assisted substance use disorder program may only disclose patient identifying information with the individual’s written consent, as part of a court order, or under a few limited exceptions.”  Under the new rule, however, “Health care providers, with patients’ consent, will be able to more easily conduct such activities as quality improvement, claims management, patient safety, training, and program integrity efforts.”  Go here to see HHS’s announcement and go here to see HHS’s fact sheet about the new regulation.

Centers for Medicare & Medicaid Services

• CMS has updated its fact sheets describing the administrative flexibilities it has extended to different types of providers during the COVID-19 emergency. All of the updated fact sheets linked below describe extended deadlines for filing Medicare cost reports.
  • hospitals
  • teaching hospitals, teaching physicians, and medical residents
  • inpatient rehabilitation facilities
  • long-term-care hospitals and extended neoplastic disease care hospitals
  • long-term care facilities (skilled nursing facilities and/or nursing facilities)
  • rural health clinics and federally qualified health centers
  • end-stage renal disease facilities
  • home health agencies
  • hospices
• CMS announced that it will deploy Quality Improvement Organizations (QIOs) to provide immediate assistance to nursing homes in hotspot areas identified by the White House Coronavirus Task Force.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Home Health and Hospice Calls

Tuesday, July 21st at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  6080197

Audio Webcast Link:  go here.

CMS COVID-19 Office Hours Calls

Tuesday, July 14th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2550919

Audio Webcast link:  go here.

Tuesday, July 21st at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  7477995

Audio Webcast link:  go here.

Tuesday, July 28th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  1492795

Audio Webcast link:  go here.

Nursing Homes Call

Wednesday, July 22nd at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  1143564

Audio Webcast Link:  go here.

Dialysis Organizations Call

Wednesday, July 22nd at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  7692208

Audio Webcast Link: go here.

Nurses Call

Thursday, July 23rd at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  7971869

Audio Webcast Link: go here.

Lessons from the Front Lines

Friday, July 17th at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Code: 3096434

Web Link:  go here.

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

Food and Drug Administration

• The FDA has issued emergency use authorizations (EUAs) for seven new commercial diagnostic tests for COVID-19. Find them here, here, here, here, here, here, and here.
• The FDA has issued an EUA for a new commercial serology test for COVID-19. Find it here.
• The FDA has issued an EUA for the emergency use of a device intended for acute use at home or in a health care setting to treat adult patients with known or suspected COVID-19 who are experiencing exacerbation of asthma-related dyspnea and reduced airflow.

Centers for Disease Control and Prevention

• The CDC has updated its interim infection prevention and control recommendations for health care personnel during the COVID-19 pandemic.
• The CDC has updated its interim guidelines for collecting, handling, and testing clinical specimens from persons with COVID-19.
• The CDC has updated its information about transferring patients to relief health care facilities when responding to community transmission of COVID-19.
• The CDC has updated its guidance for health care facilities for COVID-19-related issues.
• The CDC has updated its FAQ on laboratory testing for COVID-19.
• The CDC has updated its strategies for optimizing supplies of personal protective equipment.
• The CDC has updated its toolkit on shared and congregate housing.

Department of Labor

• The Department of Labor announced the launch of a public awareness campaign to remind workers that it is committed to ensuring their workplace rights during the coronavirus pandemic and to ensure that employers know their responsibilities. The campaign will include public service announcements to provide employers and employees information about the new paid sick leave and expanded family and medical leave benefits available under the Families First Coronavirus Response Act.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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The following is the latest information from Pennsylvania’s state government and the federal government as of 3:00 p.m. on Friday, July 10.

Governor Wolf

Governor Wolf has signed an executive order that protects homeowners and renters from evictions or foreclosure until August 31 if they have not received assistance from a new program administered by the Pennsylvania Housing Finance Agency or are not already receiving relief through one of several federal foreclosure moratorium programs or judicial orders.  While the first order of this kind in early May extended protections to businesses, it is unclear whether the provisions protecting businesses will be permitted to expire or whether they were also extended under this new order.  See a news release explaining the administration’s actions here and find the executive order itself here.

Department of Health – by the numbers

• The number of newly reported COVID-19 cases has been up sharply in the past week while the number of newly reported deaths remains mostly where it has been for the past month.  Today the number of new cases rose above 1000 for the first time in about two months.
• In a news release today the department noted that it “… is seeing significant increases in the number of COVID-19 cases among younger age groups, particularly 19 to 24-year-olds.  An alert was sent to healthcare providers over the weekend about the changing COVID-19 case demographics, as there are more cases in younger age groups than in those 50-64 and 65+.”
• To date, residents and staff of 737 long-term-care facilities in 55 counties have accounted for more than 21,500 cases of COVID-19 in the state, which amounts to 23 percent of the state’s overall cases.
• Long-term-care facility residents now account for 68 percent of the 6880 COVID-19 deaths in the state.
• More than 7000 health care workers have contracted COVID-19.
• 635 Pennsylvanians have tested positive on COVID-19 serology tests.
• After more than a month of steadily declining numbers, the number of Pennsylvanians hospitalized with COVID-19 has now risen for four consecutive days.
• Currently unoccupied are 36 percent of state hospitals’ acute-care beds, 40 percent of their ICU beds, 54 percent of their pediatric beds, 27 percent of their pediatric ICU beds, and 65 percent of their airborne isolation rooms.
• To date, Pennsylvania has experienced 34 confirmed cases of multisystem inflammatory syndrome in children (MIS-C).  Another seven suspected cases of MIS-C were determined not to be that condition and another 17 possible cases are currently being investigated.

Department of Human Services

DHS has updated its interim guidance for certified child care facilities during the COVID-19 pandemic.

Department of State

The Department of State has authorized licensed pharmacists who are authorized to administer injectables to administer influenza immunizations by injectable or needle-free delivery methods to persons three years of age or older.  This authority suspends the current minimum age for pharmacist-administered immunizations of nine years but only does so for influenza vaccinations and does not apply to COVID-19 vaccines.  See the announcement of this policy and rationale here.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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The following is the latest information from Pennsylvania’s state government and the federal government as of 3:45 p.m. on Wedneday, July 8.

Pennsylvania Update

Department of Health

The Department of Health has updated its FAQ on universal testing requirements for skilled nursing facilities.  It includes new guidance on the definition of “all staff” and how to treat staff who refuse testing.

Department of Health – by the numbers

The number of newly reported COVID-19 cases in the state has risen significantly in the past two days.  The Department of Health attributed the first day’s increase to delayed reporting from some counties, especially Philadelphia.

Department of Human Services

Act 20, recently passed by the legislature and signed by the governor, allocates money from the federal CARES Act.  Included in that funding is $457 million for providers of long-term living programs.  DHS has posted a statement explaining how it will distribute $8 million of that sum among qualified providers of ventilator or tracheostomy nursing facility services.

Federal Update

Department of Health and Human Services

HHS has updated its CARES Act Provider Relief Fund web page to remind providers that to be considered for its next distribution of CARES Act money to Medicaid and CHIP providers, interested parties must submit their gross revenues from patient care for CY 2017, 2018, or 2019 by July 20, 2020.  Applications submitted after this deadline will not be considered for funding.  To learn more about this process, interested parties can read the Medicaid and CHIP provider distribution fact sheet.

Centers for Medicare & Medicaid Services

• CMS has published an FAQ addressing matters involving provider burden relief.
• In March, CMS published a memo “…granting exceptions under certain Medicare quality reporting and value-based purchasing programs for acute care hospitals, Prospective Payment System (PPS)-exempt cancer hospitals, inpatient psychiatric facilities, skilled nursing facilities, home health agencies, hospices, inpatient rehabilitation facilities, long-term care hospitals, ambulatory surgical centers, renal dialysis facilities, and Merit-based Incentive Payment System (MIPS) eligible clinicians for all providers and suppliers…” participating in certain CMS quality data reporting programs.  Those exceptions have now expired.  Providers may request exceptions to the restored quality data reporting requirements using this form.
• In its online publication MLN Matters, CMS has revised past guidance with a new point-of-origin code for the transfer of patients from a designated disaster alternate care site.  The article introduces a new Point of Origin (PoO) Code “G” to indicate a “Transfer from a Designated Disaster Alternative Care Site (ACS)” due to changes related to the COVID-19 public health emergency.
• CMS has updated the MLN Matters article “New and Expanded Flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) During the COVID-19 Public Health Emergency (PHE)” to clarify how Rural Health Clinics and Federally Qualified Health Centers can apply the Cost Sharing (CS) modifier to preventive services furnished via telehealth.
• CMS has published its proposed end-stage renal disease prospective payment system for calendar year 2021.  In it the agency proposes, at least in part in response to the COVID-19 emergency, “…that certain new and innovative equipment and supplies used for dialysis treatment of patients with ESRD in the home would qualify for an additional Medicare payment.  These proposed changes would encourage the development of certain new and innovative home dialysis machines that would give beneficiaries more dialysis treatment options in the home…”  The changes include rate increases and add-on payments.  See CMS’s news release about the proposed rule here and a CMS fact sheet here and go here to see the rule itself.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Home Health and Hospice Calls

Tuesday, July 21st at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  6080197

Audio Webcast Link:  go here.

CMS COVID-19 Office Hours Calls

Tuesday, July 14th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2550919

Audio Webcast link:  go here.

Tuesday, July 21st at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  7477995

Audio Webcast link:  go here.

Tuesday, July 28th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In:833-614-0820; Access Passcode:1492795

Audio Webcast link:  go here.

Nursing Homes Call

Wednesday, July 22nd at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  1143564

Audio Webcast Link:  go here.

Dialysis Organizations Call

Wednesday, July 22nd at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  7692208

Audio Webcast Link: go here.

Nurses Call

Thursday, July 9th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  9386539

Audio Webcast Link:  go here.

Thursday, July 23rd at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820; Access Passcode:  7971869

Audio Webcast Link: go here.

Lessons from the Front Lines

Friday, July 17th at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Code: 3096434

Web Link:  go here.

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

Food and Drug Administration

• The FDA has issued to the Centers for Disease Control and Prevention an emergency use authorization (EUA) for a new test that can simultaneously diagnose COVID-19 and the flu.
• The FDA has issued EUAs for three new commercial tests for the diagnosis of COVID-19.  Find them here, here, and here.
• The FDA has issued an EUA for a new commercial serology test for COVID-19.  Find it here.

Centers for Disease Control and Prevention

• The CDC has updated its interim guidance on testing health care personnel for COVID-19.
• The CDC has updated its FAQs about COVID-19 clinical issues.
• The CDC has updated its COVID-19 FAQ for laboratories.
• The CDC has updated its guidance on safe laboratory practices during the COVID-19 pandemic.
• The CDC has updated its information about how to get the CDC’s COVID-19 diagnostic test and supplies.
• The CDC has updated its resources for laboratories working on COVID-19.
• The CDC has updated its information for laboratories about COVID-19.

Environmental Protection Agency

For the first time, the EPA has approved surface disinfectant products for use against the COVID-19 virus.  The EPA expects to approve similar products in the coming weeks.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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The following is the latest information from Pennsylvania’s state government as of 3:45 p.m. on Monday, July 6.

Department of Health

• The Department of Health issued a health alert regarding the changing epidemiology of COVID-19 case demographics as increasing numbers of COVID-19 cases are associated with travel and social gatherings.  The alert advises clinicians to inquire about patients’ recent travel and ask them to develop a list of people with whom they were in close contact from the period 48 hours before the onset of COVID-19 symptoms.
• Perhaps with this in mind, the department has issued a warning for travelers stating that “If you have traveled, or plan to travel, to an area where there are high amounts of COVID-19 cases, it is recommended that you stay at home for 14 days upon return to Pennsylvania.”  The warning lists 15 such states with high numbers of COVID-19 cases.  This is a warning, however, and not a requirement.
• Last week Secretary Levine signed an order that Pennsylvanians must wear masks whenever they leave home; find that order here.  The department has now followed up that effort with an FAQ about the mask order; find that FAQ here.
• The Department of Health has issued guidance on how provider surveys will be conducted in counties that have moved to the yellow and green phases of the governor’s reopening plan. Find guidance for hospitals, ambulatory surgical facilities, and abortion facilities here and guidance for home care and home health agencies, hospices, birth centers, and pediatric extended care centers here.

Department of Health – by the numbers

• After an alarming increase last week in the number of new COVID-19 cases in the state, those numbers have now stabilized and declined.  Despite this overall positive news comes one troubling item:  according to a department news release, “The number of new cases in Allegheny County increased by 218 overnight.”
• The number of new deaths has fallen dramatically.
• Despite the still-higher number of new cases, the number of Pennsylvanians hospitalized with the disease continues to decline and today is lower than at any time in June.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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The following is the latest information from Pennsylvania’s state government as of 4:45 p.m. on Wednesday, July 1.  There will be no update on Friday because of the 4^th of July holiday.

Pennsylvania Supreme Court

The Pennsylvania Supreme Court ruled unconstitutional legislation passed by the General Assembly to limit or terminate Governor Wolf’s exercise of emergency authority when he issued a “Proclamation of Disaster Emergency” in response to the COVID-19 pandemic.  The decision stresses that the court addressed only the constitutional question and not whether either the exercise of emergency authority or its termination constituted sound public policy.

Department of Health

• Department of Health Secretary Levine signed an order that masks must be worn whenever anyone in Pennsylvania leaves home. The order, which the Secretary is authorized to issue under the state’s Disease Prevention and Control Act, takes effect immediately.  Go here to see Governor Wolf’s announcement about the new order and here to see the order itself.
• The Department of Health distributed 3162 doses of the drug remdesivir to 80 Pennsylvania hospitals; remdesivir is used to treat patients in the hospital with COVID-19. The state received the drug today from the federal government.  See an announcement about the shipment here.
• The department has introduced an online form for long-term-care facilities to report the results of the required baseline universal testing of residents and staff. Testing must be completed by July 24 and results should be submitted within 48 hours of completing the baseline testing.
• The department has introduced an online early warning monitoring dashboard that provides information on state-wide and county COVID-19 prevalence to track increases in the disease on a weekly basis. Data included in the dashboard will include, on a county-by-county basis:
  • difference in confirmed cases (last seven days vs. previous seven days);
  • incidence rate (last seven days and previous seven days) per 100,000 residents;
  • COVID-19 test positivity rate (last seven days and previous seven days);
  • difference in the average daily number of COVID-19 hospitalizations in the last seven days and the previous seven days;
  • difference in the average daily number of COVID-19 patients on ventilators in the last seven days and previous seven days; and
  • percent of hospital emergency department visits in the last seven days and previous seven days due to COVID-like-illness.

Go here to see the department’s announcement about the new dashboard and here to see the dashboard itself.

Department of Health – by the numbers

• The number of new COVID-19 cases reported today was greater than for all but one day in June and the number of newly reported deaths is the highest in six days.
• Despite the increase in the number of new cases, the number of Pennsylvanians hospitalized with the disease continues to decline and today is lower than at any time in June and is less than half of what it was a month ago (634 people hospitalized today, 1302 hospitalized on June 1).
• More than 21,000 residents and employees of 699 long-term-care facilities in 52 of the state’s 67 counties have tested positive for COVID-19.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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The following is the latest information from Pennsylvania’s state government as of 3:30 p.m. on Monday, June 29.

Pennsylvania Update

Governor Wolf

Governor Wolf issued a statement expressing support for mitigation efforts launched by Allegheny County in the wake of a recent increase in the number of COVID-19 cases in that county.

The governor announced that Lebanon County will move to the green reopening phase on July 3 – the last Pennsylvania county to do so.

Department of Human Services

DHS has updated its interim reopening guidance for personal care homes, assisted living residences, and private intermediate-care facilities during the COVID-19 crisis.  See a Wolf administration news release announcing the updated policies.

Department of Health

Secretary Levine has issued an order that every long-term-care facility in the state must test residents and staff for COVID-19 at least once by August 31.  The order requires that such testing be performed by laboratories approved by the Department of Health and that facilities report all of their results in a timely manner through a system to be designated by the Department of Human Services.  For further information see the order, an FAQ about the order, a list of CLIA-approved labs that are authorized to perform such testing, and the Department of Health’s testing guidelines.

Department of Health – by the numbers

• The number of new COVID-19 cases remains higher than it was in the middle of the month but declined slightly in the past two days.  The number of newly reported deaths has decreases significantly in recent days.
• The number of health care workers who have tested positive for COVID-19 now exceeds 6500.
• Nearly 21,000 residents and employees of 689 long-term-care facilities in 52 of the state’s 67 counties have tested positive for COVID-19.
• To date, 69 percent of all COVID-19-related deaths in Pennsylvania have been among residents of long-term-care facilities.
• 634 Pennsylvanians are currently hospitalized with COVID-19.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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The following is the latest information from Pennsylvania’s state government as of 3:30 p.m. on Friday, June 26.

Pennsylvania Update

The Wolf Administration

Governor Wolf and Secretary of Health Levine signed amended green phase orders for 12 counties to move to the green phase of reopening at 12:01 a.m. this morning, June 26.  The counties are Berks, Bucks, Chester, Delaware, Erie, Lackawanna, Lancaster, Lehigh, Montgomery, Northampton, Philadelphia, and Susquehanna.  Learn more from the Wolf administration’s news release on this change and see the governor’s amended order authorizing the change and the Secretary of Health’s amended executive order to the same effect.

Department of Human Services

As a result of increased federal matching funds from the COVID-19 response, DHS anticipates ending the fiscal year with excess state share funds from the collection of the quality care assessment and it is statutorily required to return all but $10 million of those funds to the participating hospitals by either reducing the assessment rate used in the following year or proportionately refunding the hospitals.  To reconcile these excess funds, DHS has published a notice in the Pennsylvania Bulletin explaining that it will assess hospitals in FY 2020-2021 at 3.05 percent of net inpatient revenue and 1.59 percent of net outpatient revenue instead of the planned rates of 3.23 percent and 1.73 percent, respectively.

Department of Human Services/Office of Long-Term Living

On April 30, DHS’s Office of Long-Term Living published the document “Temporary Changes to the Community HealthChoices 1915 (c) Waiver-Revised,” which provided flexibilities for service coordinators and providers as they worked with participants who may have been facing disruption in services due to COVID-19.  This week, OLTL published “Transition Plan to Phase Out Temporary Changes to the Community HealthChoices 1915(c) Waiver,” which addresses the phasing out of the earlier temporary changes when program participants can be safely served and providers and service coordinators are taking proper precautions.  The latter document includes a spreadsheet describing how DHS intends to phase out Community HealthChoices waiver provisions based on a county’s red, yellow, green, or resurgence phase of the reopening plan.  This guidance is intended to be implemented at the county level.

OLTL has posted notices about CARES Act funding for various types of programs and providers that it regulates.  Individual notices have been posted for:

• home and community-based services providers;
• Community HealthChoices managed care organizations and Living Independence for the Elderly (LIFE) organizations;
• nursing facility providers; and
• licensed personal care home and licensed assisted living residences.

The notices identify the types of providers eligible for funding and address what, if anything, eligible providers need to do to receive payments and how and when these payments will be made.

Department of Health

The Department of Health and Pennsylvania Emergency Management Agency (PEMA) are partnering with CVS Health to offer COVID-19 testing services to skilled nursing facilities statewide, free of charge.  Learn more in this Department of Health news release.

Department of Health – by the numbers

• The last two days have seen the highest new case count in the past two weeks while new deaths remain slightly lower than for much of the past two weeks.
• Nearly 6400 health care workers have contracted COVID-19.
• 661 people are currently hospitalized with COVID-19 and 126 of them are on ventilators; both are the lowest totals this month.
• The state has seen 27 confirmed cases of multisystem inflammatory syndrome in children (MIS-C). Another 17 possible cases are currently being investigated.
• 632 Pennsylvanians have tested positive on COVID-19 serology tests.

Federal Update

Department of Health and Human Services

HHS updated its CARES Act Provider Relief Fund FAQ. The latest changes are marked “6/22/2020.”  Most refer to the planned Provider Relief Fund distribution of $15 billion to Medicaid and CHIP providers.

Centers for Medicare & Medicaid Services

• CMS has posted an FAQ on implementation of the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
• CMS has issued guidance to hospitals on visits to patients who are COVID-19 negative.
• CMS has clarified previous guidance that Medicare Administrative Contractors (MACs) will not calculate the average length of stay for long-term-care hospitals (LTCHs) for purposes of applying the LTCH 25-day length-of-stay requirement for the duration of the COVID-19 emergency.
• CMS has updated its emergency declarations blanket waivers for health care providers. See CMS’s emergency blanket waiver document here, its announcement about its changes here, and its memo to state Medicaid officials and nursing home stakeholders here.
• CMS has published a fact sheet for qualifying clinicians and groups to apply for exceptions to meeting merit-based incentive payment system (MIPS) program requirements based on circumstances out of their control, such as the COVID-19 emergency. See CMS’s quality payment program web page for further information.
• CMS has revised its billing instructions under its skilled nursing facility benefit period waiver.
• CMS has issued an FAQ on nursing home visitation.
• CMS issued a proposed rule that calls for routine updates to the home health payment rates for calendar year (CY) 2021. It also includes a proposal to make permanent the regulatory changes related to telecommunications technologies in providing care under the Medicare home health benefit beyond the expiration of the COVID-19 public health emergency.  See CMS’s announcement and the proposed rule itself.
• In the past week CMS issued two section 1135 waiversto give states greater flexibility to serve their Medicaid beneficiaries during the COVID-19 public health emergency.  It issued waivers to Montana and New York.

Food and Drug Administration

• The FDA has issued emergency use authorizations (EUAs) for seven new commercial diagnostic tests for COVID-19. Find them here, here, here, here, here, here, and here.
• The FDA has issued an EUA for a new commercial serology tests for COVID-19. Find it here.
• The FDA has updated its list of EUAs for ventilators and ventilator accessories.

Centers for Disease Control & Prevention

The CDC has updated and expanded its list of who is at increased risk for getting severely ill from COVID-19.

Department of Labor

The Labor Department has posted an online tool to help workers determine whether they are eligible for paid sick leave due to COVID-19.

Government Accountability Office

The GAO has issued a new report, COVID-19: Opportunities to Improve Federal Response and Recovery Efforts, that describes the federal response to the pandemic, reaches conclusions about that response, and offers recommendations for improving the government response to such crises.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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

The following is the latest information from Pennsylvania’s state government as of 4:00 p.m. on Wednesday, June 24.

Department of Human Services

• DHS has issued four CHIP policy clarifications:  They cover:
  • billing guidance for alternative sites developed in response to the COVID-19 emergency;
  • directions on how to bypass prior authorization requirements for CT scans of the chest for COVID-19 patients;
  • guidance on how pharmacies may override early refill alerts for medications; and
  • guidance for providers on accepting self-attestation on applications and renewals and enrolling children prior to initial premium payments during the COVID-19 emergency.
• DHS’s Office of Developmental Programs has posted an announcement that provides information about diagnoses and conditions associated with elevated risk for severe illness when an individual is infected with COVID-19.

Department of Health

Secretary Levine sent a letter to providers seeking to ensure that critical COVID-19 patient data on sexual orientation and gender identity is being collected at the point of care.

Department of Health – by the numbers

• The number of Pennsylvanians newly diagnosed with COVID-19 remains higher than it was a week ago, as does the daily number of people who have passed away from the disease.
• But the number of people hospitalized with COVID-19, and the number on ventilators, continues to decline.  Yesterday, only six COVID-19 patients in the state were on ventilators.
• The number of available hospital beds, ICU beds, and isolation rooms remains as it has been for the past several weeks.

Insurance Department

Yesterday, Insurance Commissioner Jessica Altman announced that the Insurance Department has  submitted a notice  to the Pennsylvania Bulletin outlining guidance for insurers that encounter providers engaging in inappropriate billing practices during the COVID-19 pandemic.  On June 12, DHS published a Medical Assistance Bulletin advising providers that they may not charge Medical Assistance beneficiaries for personal protective equipment used in connection with medical or dental services.  According to an Insurance Department press release, the notice is in response to reports that “providers, particularly dental providers, are charging patients outside of the insurer-provider contracts.”

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.)

Coronavirus update for Monday, June 22 as of 4:30 p.m.

The following is the latest information from the state and federal government as of 4:30 p.m. on Monday, June 22.

State Update

PA House Republican Leadership Elections

Following the retirement of House Speaker Mike Turzai earlier this month, the House met today and elected former Majority Leader Bryan Cutler (Lancaster County) as Speaker.  The House Republican caucus also elected as majority leader Kerry Benninghoff (Centre County), who previously was majority whip, and chose Donna Oberlander (Armstrong, Clarion, and Forest counties), previously chair of the caucus’s policy committee, as their new majority whip.  As of this writing, the role of policy committee chair is vacant.

Department of Health

The Department of Health has updated its report on its mitigation activities for long-term-care facilities.

Department of Health – by the numbers

• New case counts have been higher during the past four days.  The average number of new cases in the past four days was more than 35 percent greater than the average number for the five days before that.  Death totals, on the other hand, have declined significantly.
• 746 Pennsylvanians are currently hospitalized with COVID-19, with 153 of them on ventilators.  Both of these figures have generally decreased in recent weeks although the hospitalization figure has risen slightly in recent days.
• 40 percent of Pennsylvania hospitals’ acute-care beds are currently unoccupied, as are 39 percent of their ICU beds, 30 percent of their pediatric ICU beds, and 17 percent of their isolation rooms.  These figures have remained virtually unchanged in recent weeks.

Federal Update

Department of Health and Human Services

HHS has added new questions and answers and modified others in its CARES Act Provider Relief Fund FAQ. Providers should review these changes carefully; they are marked 6/19/2020 and 6/21/2020.

CARES Act Provider Relief Fund – Medicaid and SCHIP-Only Distribution Webcasts

On its Provider Relief Fund web page, HHS has posted the following notice:

HHS expects to distribute $15 billion to eligible Medicaid and CHIP providers through the Provider Relief Fund.  Join our webcast to learn more about the application process.  Please pre-register to reserve a spot on your preferred date:

Tuesday, June 23, 2020 at 2 PM ET

Thursday, June 25, 2020 at 2 PM ET

Centers for Medicare & Medicaid Services

• CMS has added new questions and modified others in its compendium document “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing.” Providers should review these changes carefully.
• CMS has updated its instructions to Medicare Administrative Contractors (MACs) and Medicare Advantage Plans to cover COVID-19 laboratory tests for nursing home residents and patients. See an announcement about the new instructions here.
• CMS has posted a new FAQ on COVID-19 surveillance testing. This informed is intended for laboratories.
• Last week CMS issued eight section 1135 waivers to give states greater flexibility to serve their Medicaid beneficiaries during the COVID-19 public health emergency.  It issued waivers to Alaska, Connecticut, Colorado, Massachusetts, New Jersey, New York, South Carolina, and Washington.

CMS Stakeholder Calls

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.  Call details are below.  Conference lines are limited so CMS encourages interested parties to join via audio webcast, either on your computer or smartphone web browser. Calls recordings and transcripts are posted on the CMS podcast page, which you can find here.

CMS COVID-19 Office Hours Calls

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and health care systems to increase hospital capacity, expand their health care workforce, and make greater use of telehealth in Medicare.

Tuesday, June 23 at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In:  833-614-0820;

Access Passcode:  5775248

Audio Webcast link:  go here.

Home Health and Hospice

Tuesday, June 23 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820;

Access Passcode:  3676539

Audio Webcast Link:  go here.

Nursing Homes

Wednesday, June 24 at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820;

Access Passcode:  3089577

Audio Webcast Link:  go here.

Dialysis Organizations

Wednesday, June 24 at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820;

Access Passcode:  6494855

Audio Webcast Link:  go here.

Nurses

Thursday, June 25 at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In:  833-614-0820;

Access Passcode:  9496814

Audio Webcast Link: go here.

Food and Drug Administration

• On Tuesday, June 23 at 12 noon (eastern) the FDA, along with the CDC’s National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA), will host a seminar on importing respirators during the COVID-19 pandemic.
• The FDA has issued emergency use authorizations (EUAs) for four new commercial COVID-19 diagnostic tests. Find them here, here, here, and here.
• The FDA has issued an EUA for a new commercial COVID-19 serology test. Find it here.

Centers for Disease Control & Prevention

The CDC has updated its guidance for nursing homes and other long-term-care facilities to take steps to assess and improve their preparedness for responding to COVID-19.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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

Coronavirus update for Friday, June 19 as of 3:00 p.m.

A Note About SNAP’s COVID-19 Updates

Beginning the week of June 15, SNAP will prepare COVID-19 updates on Mondays, Wednesdays, and Fridays, with additional updates as needed on subjects that are especially timely or important.  SNAP members and update subscribers will continue to receive their updates near the close of the business day and those updates will continue to be posted in this space the morning of the following business day.

Pennsylvania Update

The Wolf Administration

• On Thursday Governor Wolf issued a news release reminding Pennsylvanians that mask-wearing is required when entering any business in all counties in the state in both the yellow and green phases of reopening.  The mask requirement is part of Secretary of Health Levine’s order “Directing Public Health Safety Measures for Businesses Permitted to Maintain In-person Operations.”  See the governor’s new release here and Secretary Levine’s order here.
• On Thursday Governor Wolf and Secretary of Health Levine signed orders for eight counties to move to the green phase at 12:01 a.m. on Friday, June 19.  The affected counties are Dauphin, Franklin, Huntingdon, Luzerne, Monroe, Perry, Pike, and Schuylkill.  With these orders, on Friday there will be 54 counties in green and 13 counties in yellow.  See the governor’s news release here, the governor’s amended order here, and Secretary Levine’s amended order here.
• On Friday Governor Wolf announced that 12 more counties will move to the green phase of reopening from the COVID-19 pandemic at 12:01 a.m. on Friday, June 26.  The affected counties are Berks, Bucks, Chester, Delaware, Erie, Lackawanna, Lancaster, Lehigh, Montgomery, Northampton, Philadelphia, and Susquehanna.  See the governor’s news release about this announcement here.

Department of Health

• The Department of Health distributed 4788 doses of remdesivir to hospitals to treat patients hospitalized with COVID-19.  Go here to see the department’s announcement about this shipment and here to see a list of the 82 hospitals.
• The department announced that more than 4000 close contacts of COVID-19 cases have been identified and monitored to date through the contact tracing efforts of 500 trained contact tracers throughout the state, including 130 state health nurses.  These efforts include support from six county health departments and four municipal health departments that have primary responsibility for all efforts inside their jurisdiction.  Go here for a news release about the contact tracing effort.
• The department’s message board on Friday, June 19 included the following notice:

The Pennsylvania Department of Health and Pennsylvania Emergency Management Agency are pleased to announce a partnership with CVS Health to offer COVID-19 testing services to skilled nursing facilities to assist with compliance to the Secretary’s Order related to universal testing issued June 9, 2020. Using a number of data sources including current outbreak status, historic outbreak status, geography, and facility-reported testing data, the Department is providing a three-tiered priority list to CVS Health to begin making contacts to offer testing services free of charge to the facility (residents and employees).

The CVS Health Onsite Swab & Send solution includes:

• All necessary logistic services, including scheduling, records administration, test orders, and communication of results
• All specimen collection and Personal Protective Equipment (PPE) for CVS Health clinician testers
• Transmission to an FDA-approved reference laboratory for testing
• Responsibility for communication of test results back to skilled nursing administration

CVS Health is currently onboard to conduct 50,000 individual tests for skilled nursing residents and staff members. Testing is anticipated to begin the week of June 29 with CVS Health beginning outreach calls as early as June 22.  Please anticipate an email outreach and phone call from CVS Health, and they will confirm the necessary steps to schedule your onsite testing clinic.

If you have questions regarding this initiative, universal testing in general, or to request assistance, please contact RA-DHCOVIDTESTING@pa.gov.     

Department of Health – by the numbers

• Case counts and death totals remain generally down but the new case count for Thursday was the highest in the past week.  On Thursday the total number of Pennsylvanians who have contracted COVID-19 rose above the 80,000 mark.  Ninety-seven percent of those cases were confirmed by tests and the rest are considered “probable.”
• 728 Pennsylvanians are currently hospitalized with COVID-19, with 162 of them on ventilators.  Both of these figures have been declining in recent weeks.
• 40 percent of Pennsylvania hospitals’ acute-care beds are currently unoccupied, as are 39 percent of their ICU beds, 30 percent of their pediatric ICU beds, and 17 percent of their isolation rooms.  These figures have remained virtually unchanged in recent weeks.

Department of Human Services

• DHS’s COVID-19 update, published on Wednesday, includes the following notice about its Regional Response Health Collaboration Program.
• In last week’s written update, we mentioned that a Request for Applications was posted for the Regional Response Health Collaboration Program (RRHCP). The RRHCP will assume the Education Support and Clinical Coaching Program’s role in providing operational, managerial, administrative, and clinical support for long-term care facilities as they protect their residents and staff from COVID-19. Responses to this RFA are due by June 25, and the RFA is posted on eMarketplace.

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.)