Coronavirus update for Wednesday, June 3 as of 12:00 p.m.

Pennsylvania Update

Department of Health

The Department of Health has announced that nursing homes located in green counties will continue operating under restrictions for 28 days after the beginning of the green phase in those counties. Those facilities should continue to follow the department’s operations guidance updated on May 12.

The Department of Health issued an update to its dental health care guidance removing the prohibition on non-urgent and non-emergent dental procedures.

Department of Health – by the numbers

• Yesterday’s new case and death figures were slightly lower than those of the previous day.
• More than 18,300 long-term-care residents and workers have contracted COVID-19.
• As have more than 5500 health care workers.
• 1302 Pennsylvanians are currently hospitalized for COVID-19, with 257 of them on ventilators.
• 45 percent of state hospitals’ acute-care beds, 38 percent of their ICU beds, and 24 percent of their pediatric ICU beds are currently unoccupied, as are 53 percent of their isolation rooms.

Federal Update

Centers for Medicare & Medicaid Services

• CMS has updated its FAQ on Medicare COVID-19 fee-for-service billing.  All of the changes address national coverage determinations and are clearly marked within the document.  Providers should review them carefully.
• In response to COVID-19, CMS is providing new flexibilities and adjustments to current and future CMMI models to address the emergency.  It has released a chart that outlines the models and the new changes.  CMS also has written a blog post describing additional CMMI model flexibilities.
• CMS has released guidance to states supporting implementation of the Optional COVID-19 Testing (XXIII) Group­­­ established by the Families First Coronavirus Response Act (FFCRA) for uninsured individuals for COVID-19 testing and testing-related services.  This guidance identifies the different requirements associated with implementing the new group (including eligibility and enrollment, claiming, and data reporting) and provides guidance on strategies that states may employ to meet these requirements.

Department of Health and Human Services

• HHS has updated its CARES Act Provider Relief Fund FAQ.  See additions on pages 5, 14, and 20.  Providers should review these additions carefully.
• HHS announced that the next deadline for submitting data to inform the agency’s distribution of its supply of remdesivir is Monday, June 8 at 8 p.m. (eastern).  HHS is requesting the same data as last month’s remdesivir request:  the number of currently hospitalized COVID-19 patients, and of those hospitalized, the number requiring placement in ICUs.  Hospitals should submit the data using the HHS TeleTracking web portal. ​
• HHS has provided $250 million to help health care systems treating patients and responding to the COVID-19 pandemic.  According to an HHS news release, the money will support hospitals and other health care entities to train workers, expand telemedicine and the use of virtual health care, procure supplies and equipment, and coordinate across jurisdictions and facilities.  Most of this money is going to state hospital associations for distribution.

Centers for Disease Control and Prevention

• The CDC has established a new web page with a data set of health care entities that have received federal claims reimbursement for COVID-19 testing of uninsured individuals and/or treatment for uninsured individuals with a COVID-19 diagnosis as of May 26, 2020.
• The CDC has updated its interim clinical guidance for managing patients with COVID-19.
• The CDC has updated its FAQ about COVID-19 and children.

Food and Drug Administration

• The FDA has published guidance, titled Institutional Review Board (IRB) Review of Individual Patient Expanded Access Requests for Investigational Drugs and Biological Products During the COVID-19 Public Health Emergency Guidance for IRBs and Clinical Investigators, that includes recommendations regarding procedures for single IRB member review.  This is in response to physician requests for a waiver from the requirement for full IRB review.
• The FDA has added a second ventilator to its list of authorized ventilators, ventilator tubing connectors, and ventilator accessories that was issued in response to concerns relating to insufficient supply and availability of FDA-cleared ventilators for use in health care settings to treat patients during the COVID-19 pandemic. This new ventilator is tailored to provide respiratory support for COVID-19 patients who are experiencing respiratory failure or insufficiency.
• The FDA has added an emergency resuscitator to its list of authorized ventilators, ventilator tubing connectors, and ventilator accessories.  This commercial resuscitator is a continuous respiratory support system that includes an FDA-cleared manual resuscitator and its design is intended for use in treating patients with COVID-19.
• The FDA and the European Medicines Agency have published procedural assistance for sponsors and applicants that anticipate submitting pediatric product development plans for the treatment and prevention of COVID-19.

Department of Labor

The Department of Labor has issued an alert with information about how to keep stockroom and loading dock workers safe during the COVID-19 pandemic.  See an announcement about the alert and the alert itself.

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 2 as of 2:45 p.m.

The following is the latest information from the state and federal governments as of 3:00 p.m. on Tuesday, June 2.

Pennsylvania Update

Department of Health

The Department of Health has updated its guidance on risk assessment and work restrictions for health care personnel that it originally issued in early March.  This update simplifies the determination of risk exposures warranting work restriction.

Department of Health – by the numbers

• Yesterday’s new case count was higher than the previous day and the death count soared.
• More than 18,300 long-term-care residents and workers have contracted COVID-19.
• As have more than 5500 health care workers.
• 1302 Pennsylvanians are currently hospitalized for COVID-19, with 270 of them on ventilators.
• 45 percent of state hospitals’ acute-care beds, 38 percent of their ICU beds, and 24 percent of their pediatric ICU beds are currently unoccupied, as are 53 percent of their isolation rooms.

Federal Update

Centers for Medicare & Medicaid Services

• The Quality, Safety & Oversight Group of CMS’s Center for Clinical Standards and Quality has written to state Medicaid agencies about COVID-19 survey activities, CARES Act funding, and enhanced enforcement for infection control deficiencies and quality improvement activities in nursing homes. The memo calls on states to do a more complete job of inspecting nursing homes for their infection control efforts, proposes penalties for states that fail to do so, and explains that CMS will allocate CARES Act funding based on performance-based metrics.  See CMS’s detailed news release about this new policy.
• CMS has updated its toolkit to help states mitigate the prevalence of COVID-19 in nursing homes.

Food and Drug Administration

• On Wednesday, June 3, the FDA will host a virtual town hall for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for COVID-19. The purpose of this town hall is to help answer technical questions about the development and validation of COVID-19 tests.  For more information about the town hall, go here.
• The FDA has issued emergency use authorization for a specific commercial device for use in hospitals to provide temporary right ventricular support for up to 14 days for critical care patients suffering from acute right heart failure or decompensation caused by complications related to COVID-19.

The Joint Commission

The Joint Commission has announced that it will resume regular surveys and reviews in this month, with its methodology modified in some respects to reflect the need to practice social distancing.

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 1 as of 3:00 p.m.

Pennsylvania Update

Department of Health

The Department of Health issued updated guidance on testing in long-term-care facilities, including nursing homes, assisted living, and personal care homes. This guidance supersedes the universal testing guidance released on May 12, which applied only to nursing homes.

The department released frequently asked questions about reporting requirements for skilled nursing facilities.

Department of Health – by the numbers

• Yesterday’s new COVID-19 case count was the state’s lowest since March 24 and the death count remains low for the third day in a row.
• More than 18,000 residents and employees of long-term-care facilities have tested positive for COVID-19 and the number of facilities with infected residents or staff has increased by four, to 608, since last Friday.
• More than 5400 health care workers have tested positive for COVID-19.
• 1302 Pennsylvanians are currently hospitalized with COVID-19.
• 277 of them are on ventilators.
• 38 percent of state hospitals’ acute-care beds, 45 percent of their ICU beds, and 24 percent of their pediatric ICU beds are currently unoccupied, as are 53 percent of their isolation beds.

Department of Education

The Department of Education has offered guidance for medical, nursing, and allied health training programs on when and how to resume training for health care practitioners and allied health practitioners as the state reopens.

Independent Fiscal Office

The state’s Independent Fiscal Office published its May 2020 revenue update, which reports a $502.6 million revenue shortfall in collections compared to August projections.  The report attributes 100 percent of the shortfall to fallout from the COVID-19 outbreak.

Federal Update

Department of Health and Human Services

HHS has added to and modified its CARES Act Provider Relief Fund FAQ.  Find additions on pages 2, 4, 5, 8, 23, 24, and 25 and modifications on pages 8, 9, and 19.  The latest changes are identified as added or modified on 5/26 or 5/29.  Providers should review these changes carefully.

Centers for Medicare & Medicaid Services

CMS has issued new guidance to clarify when providers must use modifier CR (catastrophe/disaster-related) and/or condition code DR (disaster-related) when submitting claims to Medicare.  The guidance applies to short-term hospitals, long-term hospitals, inpatient rehabilitation facilities, and others.

Centers for Medicare & Medicaid Services – 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.  Call details are below.  Conference lines are limited so CMS encourages interested parties to join via audio webcast.  Calls recordings and transcripts also are posted on the CMS podcast page here.

CMS COVID-19 Office Hours Calls (Tuesdays at 5:00 – 6:00 PM eastern)

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 healthcare systems to increase hospital capacity, expand their health care workforce, and promote greater use of telehealth in Medicare.

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 4474407

Audio Webcast link:  go here.

Lessons from the Front Lines: COVID-19 (Fridays at 12:30 – 2:00 PM eastern)

Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force.  Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.

Toll Free Attendee Dial-In: 833-614-0820; Access Code: 6583696

Web Link:  go here.

Centers for Disease Control and Prevention

• The CDC has updated its FAQ on infection prevention and control in health care settings.

• The CDC has posted an illustrated guide on the use of personal protective equipment when caring for patients with confirmed or suspected COVID-19.
• The CDC has published interim guidance on discontinuing isolation for people with COVID-19 who are not in health care settings.
• The CDC has published guidance to assist with the assessment of risk, monitoring, and work restriction decisions for health care providers with potential exposure to COVID-19.
• The CDC has updated its web page on ways for institutions of higher education to protect students and employees from COVID-19.

Food and Drug Administration

• The FDA is making its previously developed FDA MyStudies app available to investigators as a free platform to securely obtain patients’ informed consent for eligible clinical trials when face-to-face contact is not possible or practical due to COVID-19 control measures. FDA MyStudies is now referred to as COVID MyStudies in the Apple App store and in the Google Play store.
• The FDA has approved emergency use authorization for a new commercial home diagnostic test for COVID-19.
• The FDA has approved emergency use authorizations for three new commercial laboratory serology tests for COVID-19. Find those authorizations here, here, and 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

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

Coronavirus update for Friday, May 29 as of 2:30 p.m.

Pennsylvania Update

Wolf Administration

• The Wolf administration announced that 16 more counties will move to the green phase next Friday, June 5. This includes Allegheny County.
• Today, eight counties moved from red to yellow, joining 49 others already in the yellow phase, and 18 went from yellow to green.
• All counties currently in the red phase are still scheduled to move to the yellow phase next Friday.

Department of Health – by the numbers

• Friday’s new COVID-19 case and death counts are similar to Thursday’s.
• Three more long-term-care facilities now report cases of COVID-19 among patients or staff.
• Nearly 5300 health care workers have tested positive for COVID-19.
• 604 people have now tested positive on serology tests.
• 1445 Pennsylvanians are hospitalized because of COVID-19.
• 298 of them are on ventilators.
• 45 percent of acute-care beds, 38 percent of adult ICU beds, and 24 percent of pediatric beds are currently unoccupied, as are 53 percent of Pennsylvania hospitals’ isolation rooms.

Friday’s Daily Briefing

• Governor Wolf and Secretary Levine took questions from reporters.
• Governor Wolf said Pennsylvania has more testing sites (318) than any other state.
• But the state still does not have enough testing materials.
• Secretary Levine said Pennsylvania’s testing sites are now performing up to 13,000 tests a day.
• She noted that the numbers decline significantly on weekends.
• And the state is still working to expand its testing capacity.
• She said she hoped there might eventually be point-of-care tests that can be administered by non-health care professionals and provide accurate results in 15-20 minutes.
• She explained that the value of antibody testing is still not known.
• Governor Wolf observed that the state is nowhere near being able to perform surveillance testing and that is far off in the future.
• He explained that as the state gets more data and learns more about COVID-19, the standard of no more than 50 cases per 100,000 population over 14 days has become less relevant to decisions about counties moving from one phase to another.
• He said schools will reopen in September but did not commit to all children returning to the classroom in the traditional manner.
• He said he wants to do everything possible to avoid another shelter-in-place situation if the pandemic surges again in the fall or winter.
• Secretary Levine said the state hopes to have several thousand people across Pennsylvania working on contact tracing.

Federal Update

Centers for Medicare & Medicaid Services

In the past week CMS issued five section 1135 waiversto give states greater flexibility to serve their Medicaid beneficiaries during the COVID-19 public health emergency.  It issued waivers to Alaska, Maine, New Hampshire, Ohio, and Vermont.

Centers for Disease Control and Prevention

• The CDC has issued emergency use authorizations (EUAs) for two specific commercial diagnostic tests for COVID-19 intended for self-collection in the home or in health care settings. Find them here and here.
• The CDC has published information on considerations when preparing for COVID-19 in assisted living facilities.

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 Wednesday, May 27 as of 2:30 p.m.

Pennsylvania Update

State Budget

The General Assembly is working on a five-month stop-gap budget bill to fund the state’s government through November.  This proposal, HB 2387, uses the enacted state FY 2020 budget as its foundation and makes a 58 percent cut across the board, funding most budget line-items at 42 percent of their enacted FY 2020 level.  The exceptions to this cut are education and the state’s pension obligations, which would be funded in full.  The legislature would need to return to Harrisburg in the fall to fund the remainder of the 2021 fiscal year.  HB 2387 passed in the House on Tuesday evening and is moving through the Senate, where it is expected to pass on Thursday and head to the governor.

The legislature also continues to discuss the distribution of federal and state funding in response to the COVID-19 pandemic.  Thus far, legislative efforts focus on using federal funds for long-term care.  This funding is being outlined in a fiscal code bill that would distribute federal CARES money to various health care providers and programs.  The bill’s sponsor, House Speaker Mike Turzai, proposes creating regional collaboratives to support efforts to address COVID-19 in long-term living facilities.  SNAP expects a second fiscal code bill to focus on the distribution of state funds.

The Wolf Administration

The Wolf administration has added information to its “Plan for Pennsylvania” for the phased reopening of the state with new information about recovery steps for the state, for businesses, and for the health care industry.

Late this afternoon, Governor Wolf issued a news release elaborating on the reopening process for green phase counties and providing guidance on outdoor dining in yellow counties, dining in green counties, and professional sports in yellow counties.  See the news release here.

Department of Health – by the numbers

• Both the COVID-19 new case and new death counts were up yesterday, the latter significantly so.
• More than 17,500 residents and employees of long-term-care facilities have tested positive for COVID-19.
• As have more than 5200 health care workers.
• 1493 Pennsylvanians are currently hospitalized because they have COVID-19.
• 334 of them are on ventilators.
• As of today, 45 percent of state hospitals’ acute-care beds, 38 percent of their ICU beds, and 24 percent of their pediatric ICU beds are unoccupied, as are 53 percent of their isolation rooms.
• The state currently has 11 children who have been diagnosed with multisystem inflammatory syndrome in children (MIS–C), a condition associated with COVID-19 in children. Ten more possible cases are under investigation.
• As of today, the state has sent to various health care providers and other entities five million N95 masks, 300,000 hospital gowns, 1.6 million masks, two million sets of gloves, 180,000 face shields, and 300 bottles of hand sanitizers.

Department of Human Services

DHS has issued a Medical Assistance Bulletin to advise providers of changes it has made to Medicaid pharmacy services to ensure that beneficiaries maintain access to needed services during the COVID-19 emergency.  It applies to all licensed pharmacies and prescribers enrolled in the state’s Medicaid program (fee for service, Physical health HealthChoices, and Community HealthChoices).

DHS has posted a memo to all Medicaid physical health HealthChoices managed care organizations notifying them that prescriptions for Sublocade (buprenorphine extended release) injections to treat opioid dependence no longer require prior authorization if they do not exceed the quantity limit.

Federal Update

Centers for Medicare & Medicaid Services

CMS has published a fact sheet for state and local governments on how to seek payments from CMS programs such as Medicare, Medicaid, and CHIP for outpatient services and acute inpatient care provided at alternative care sites established in response to the COVID-19 crisis.

Department of Health and Human Services

ASPR TRACIE, sponsored by HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) to provide Technical Resources, Assistance Center, and Information Exchange (TRACIE) services, in collaboration with the HHS/FEMA COVID-19 Healthcare Resilience Task Force, is hosting the webinar “Ensuring Healthcare Safety Throughout the COVID-19 Pandemic” to share experiences and lessons learned from innovators in the field. Learn more here.

Centers for Disease Control and Prevention

• The CDC has posted interim guidance with suggested goals and strategies for outpatient and ambulatory care settings in response to the COVID-19 emergency.
• The CDC has updated a number of its contact tracing web pages, including one on contact tracing for COVID-19 and another on investigating COVID-19 cases.

Food and Drug Administration

• The FDA has issued an emergency use authorization for a specific commercial software product for use in intensive care units for the computation of proprietary patient status indices that assist with the early identification of patients who are likely to be diagnosed with respiratory failure or hemodynamic instability as complications from 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 Tuesday, May 26 as of 2:30 p.m.

Pennsylvania Update

The Wolf Administration

Last Friday Governor Wolf announced that eight more counties would move to the yellow phase of reopening on May 29; 17 counties that were already in the yellow phase would move to green that same day; and the remaining counties still in the red phase would move to yellow on June 5.  That latter group includes Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

Department of Health

• Late last Friday the department announced that on the previous day it shipped 8928 doses of remdesivir to 81 Pennsylvania hospitals. This news release is the announcement and it includes a link to a list of the recipient hospitals.
• The department updated its guidance for hospitals to clarify that the requirement to test patients for COVID-19 infection prior to discharge to a long-term-care facility applies only to inpatients of the hospital. In addition, hospitals’ visitor policies cannot deny access to an attendant, caregiver, or family member of a patient who has an intellectual, developmental, or cognitive disability, communication barrier, or behavioral concerns.
• The department updated its guidance for ambulatory surgical facilities to reflect the requirement that ambulatory surgical facilities with their own COVID-19 laboratory testing report those test results, whether positive or negative, through PA-NEDSS.

Department of Health – by the numbers

• The department reported that the number of new COVID-19 cases over the holiday weekend remained modest by the standard of recent weeks and fell under 500 a day for the past two days.
• The new daily death totals fell significantly over the holiday weekend, from more than 100 a day for several days last week to just 56 over the last three days combined.
• 551 Pennsylvanians have now tested positive on serology tests.
• More than 17,000 residents and employees of 594 long-term-care facilities have now tested positive for COVID-19.
• As have more than 5100 health care workers.
• As of today, 1628 Pennsylvanians are hospitalized for COVID-19.
• 320 of them are on ventilators and 16 are undergoing extracorporeal membrane oxygenation (ECMO).
• 45 percent of state hospitals’ acute-care beds, 38 percent of its adult ICU beds, and 24 percent of its pediatric ICU beds are currently unoccupied, as are 53 percent of their isolation rooms.

Department of Human Services

DHS’s Office of Children, Youth and Families has issued guidance regarding the suspension of regulatory requirements for its licensees during the COVID-19 pandemic.  Recipients of the guidance include county children and youth agencies, private children and youth social services agencies, family foster care agencies, adoption services agencies, child residential and day treatment facilities, and child welfare service providers.

Federal Update

Department of Health and Human Services

• HHS has submitted its required report to Congress detailing its COVID-19 strategic testing plan.
• HHS announced a 45-day extension for providers that are receiving grants from the CARES Act’s Provider Relief Fund to accept the terms and conditions for those payments. This means providers have now been granted 90 days from the date they received a payment to accept the terms and conditions or return the money.
• ASPR TRACIE, sponsored by HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) to provide Technical Resources, Assistance Center, and Information Exchange (TRACIE) services, has announced that a presentation from and a recording of its webcast on “Funding Sources for the Establishment and Operationalization of Alternate Care Sites” are now available. Find them here.
• HHS announced $400 million in payments from the CARES Act’s Provider Relief Fund to Indian Health Services and tribal hospitals, clinics, and urban health centers to support the tribal response to COVID-19.

Department of Health and Human Services/Office of the Inspector General

HHS’s Office of the Inspector General has announced the release of its strategic plan for oversight of the COVID-19 response and recovery. Go here for the announcement and here to see the plan itself.

Centers for Disease Control and Prevention

• The CDC has updated its COVID-19 transmission web page to clarify information about the different types of spread of the virus.
• The CDC has updated its web page on evaluating and reporting persons under investigation for COVID-19.
• The CDC has posted information about a new laboratory test kit it has developed for use in testing patients for COVID-19.
• The CDC has updated its FAQ on COVID-19 and children.
• The CDC has updated its web page about serology testing for COVID-19.
• The CDC has updated its interim guidelines for COVID-19 antibody testing in clinical and public health settings.
• The CDC has posted information about steps health care facilities can take now to prepare for COVID-19.

Food and Drug Administration

• The FDA has updated its FAQ on testing for COVID-19.
• The FDA has approved emergency use authorizations for three new commercial diagnostic tests for COVID-19. Find them here, here, and here.
• The FDA has posted a notice to manufacturers of gowns and other apparel, health care personnel, hospital purchasing departments and distributors, and other stakeholders listing currently authorized equipment, requirements it is waiving when considering issuing emergency use authorizations, and outlining the standards it considers when determining whether to issue such authorizations for new gowns and apparel.

National Institutes of Health

The NIH has issued a media advisory sharing the preliminary results of peer-reviewed data from clinical trials to test the effectiveness of remdesivir for treating COVID-19. A more detailed preliminary report also can be found in the New England Journal of Medicine.

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, May 22 as of 3:30 p.m.

Pennsylvania Update

Budget Update

The House and Senate will return next Tuesday to begin the FY 2020-2021 budget process.  Their current plan is to enact a budget that funds the first five months of the fiscal year and then return in the fall after the November elections to fund the remainder of the fiscal year.  SNAP understands that the General Assembly will use the current fiscal year funding amounts as a baseline and fund most line-items at 42 percent of their current levels (a 58 percent cut).  Some areas, such as education, will be funded at or close to 100 percent.  We will provide updates as developments warrant when they reconvene next week.

The Wolf Administration

Twelve more counties moved from the red to the yellow phase today.  See the governor’s executive order on this change here.

The Wolf administration announced that it will close its COVID-19 drive-through public testing site in Wilkes-Barre next Friday, May 29.  Since April 20 it tested more than 2000 people, seven percent of whom tested positive for COVID-19.  The state plans to shift these resources elsewhere.

Department of Health

On Friday the Department of Health reported:

• A new case count in line with recent days and more than 100 new deaths.
• More than 16,600 residents and employees of 578 long-term-care facilities in 44 counties have contracted COVID-19 to date.
• As have nearly 5000 health care workers.
• 1602 Pennsylvanians are currently hospitalized with COVID-19.
• 350 of them are on ventilators.
• 14 are undergoing extracorporeal membrane oxygenation (ECMO).
• 45 percent of the state’s acute-care beds, 38 percent of its adult ICU beds, 24 percent of its pediatric ICU beds, and 53 percent of its isolation beds are currently unoccupied.

Federal Update

Department of Health and Human Services

• HHS has updated its CARES Act Provider Relief Fund page, adding a new section on allocations for skilled nursing facilities.
• That new section is the foundation for HHS’s announcement that it has begun distributing nearly $4.9 billion in relief funds to skilled nursing facilities to help them respond to the effects of COVID-19. Each SNF will receive a fixed distribution of $50,000 plus $2500 per bed.  All certified SNFs with six or more certified beds are eligible for this targeted distribution.
• HHS has updated its CARES Act Provider Relief Fund FAQ, adding several new questions and answers about reporting for related entities (see pages 11 and 12).

Centers for Medicare & Medicaid Services

In the past week CMS issued seven section 1135 waivers to give states greater flexibility to serve their Medicaid beneficiaries during the COVID-19 public health emergency.  It issued three such waivers to Rhode Island, two to Texas, and one each to North Dakota and Virginia.

CMS Weekly Stakeholder Calls

COVID-19: Lessons from the Front Lines Calls — May 29

Friday, May 29 from 12:30 to 2 pm ET

These weekly calls are a joint effort between CMS Administrator Seema Verma, Food and Drug Administration (FDA) Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians share their experiences, ideas, strategies, and insights related to their COVID-19 responses.  There is an opportunity to ask questions.

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 877-251-0301; Access Code: 6350189

COVID-19: Home Health and Hospice Call — May 26

3 to 3:30 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 833-614-0820; Access Passcode: 4666966

COVID-19: Office Hours Call — May 26

Tuesdays from 5 to 6 pm ET

Hospitals, health systems, and providers: Ask CMS questions about its temporary actions that enable providers to increase hospital capacity, expand the health care workforce, and promote telehealth.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 833-614-0820; Access Passcode: 8977438

Target Audience: Hospitals, health systems, and providers.

COVID-19: Nursing Home Call — May 27

Wednesdays from 4:30 to 5 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or, call 833-614-0820; Access Passcode: 1243649

Target Audience: Nursing home providers.

COVID-19: Dialysis Organization Call — May 27

Wednesdays from 5:30 to 6 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 833-614-0820; Access Passcode: 6152699

Target Audience: Dialysis organizations.

COVID-19: Nurses Call — May 28

Thursdays from 3 to 3:30 pm ET

These calls provide targeted updates on the agency’s latest COVID-19 guidance.  Leaders in the field also share best practices.  There is an opportunity to ask questions if time allows.

To Participate:

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 833-614-0820; Access Passcode: 2988422

Target Audience: Nurses.

Prior Authorization Process and Requirements for Certain Outpatient Hospital Department Services Special Open Door Forum — May 28

Thursday, May 28 from 1:30 to 3 pm ET

CMS invites hospitals, physicians, practitioners, and other Medicare stakeholders to discuss the prior authorization of certain outpatient hospital department services from the following categories: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation.

For More Information:

• Final rule
• Prior Authorization webpage: Presentation materials posted prior to the call
• Find more information here

Participation Instructions:

• Participant Dial-In Number: 888-455-1397
• Conference ID #: 9375124

COVID-19: Lessons from the Front Lines Calls — May 29

Friday, May 29 from 12:30 to 2 pm ET

These weekly calls are a joint effort between CMS Administrator Seema Verma, Food and Drug Administration (FDA) Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians share their experiences, ideas, strategies, and insights related to their COVID-19 responses.  There is an opportunity to ask questions.

• Conference lines are limited; CMS encourages interested parties to join via audio webcast
• Or call 877-251-0301; Access Code: 6350189

Centers for Disease Control and Prevention

• The CDC has updated its guidance about the diagnosis, evaluation, infection prevention and control practices, and disposition of neonates with confirmed or suspected COVID-19 or known COVID-19 exposure, including birth to a mother with confirmed or suspected COVID-19.
• The CDC has updated its web page on serology testing.

Food and Drug Administration

• The FDA has updated its temporary policy for the compounding of certain drugs for hospitalized patients by outsourcing facilities during the COVID-19 emergency.
• The FDA has approved the use of dexmedetomidine hydrochloride for treating initially intubated and mechanically ventilated patients during treatment in an intensive care setting and sedation of non-intubated patients prior to and/or during surgical and other procedures.
• The FDA has issued an emergency use authorization (EUA) for the use of a sterilizer to decontaminate compatible N95 respirators for single-user reuse by health care personnel.
• The FDA has issued EUAs for four additional commercial diagnostic tests for COVID-19. Find those EUAs here, here, here, and here.

Congressional Research Service

The Congressional Research Service has published a brief paper on COVID-19 and federal employment protections for work refusals.

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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Coronavirus update for Thursday, May 21 as of 3:30 p.m.

Pennsylvania Update

Department of Health

The Department of Health has issued revised guidance for home care agencies, home health agencies, and hospices during the COVID-19 emergency.

Department of Health – Daily Briefing

• Pennsylvania’s new COVID-19 case count remains under 1000 a day but its death count remains more than 100 a day.
• More than 14,000 residents of long-term-care facilities and more than 2300 employees of such facilities have contracted COVID-19 and such facilities account for two-thirds of all COVID-19 deaths in the state.
• Nearly 5000 health care workers have been diagnosed with COVID-19.
• Secretary Levine reported that the state now has about 300 testing sites that performed more than 13,000 tests yesterday. Testing capacity continues to improve.
• The state now has two confirmed cases of multisystem inflammatory syndrome in children (MIS-C) and several other unconfirmed cases. The one pediatric COVID-19 death the state has experienced did not involve MIS-C.
• Secretary Levine reported that the counties in southwestern Pennsylvania that are now in the yellow phase are doing well.

Federal Update

Department of Health and Human Services

• HHS has again updated its CARES Act Provider Relief Fund FAQ.
• HHS has announced that it is collaborating with Astra Zeneca to make available at least 300 million doses of a COVID-19 vaccine called AZD1222, with the first doses delivered as early as October of this year.
• HHS has notified skilled nursing facilities of its intent to distribute additional Provider Relief Fund grants to them.  According to email communication directly from HHS to those providers, “Each SNF will receive a fixed distribution of $50,000, plus a variable distribution ranging between $2,000 per bed for the smallest SNFs (between 5 and 25 beds) and $1,800 per bed for the largest SNFs (more than 200 beds).”
• HHS has issued an advisory opinion stating that the Public Readiness and Emergency Preparedness Act preempts state licensing laws that restrict the ability of pharmacists to order and administer COVID-19 diagnostic tests where HHS has authorized pharmacists to order and administer such tests.
• HHS’s Office of the Assistant Secretary for Preparedness and Response has established a new web page featuring its portfolio of COVID-19 medical countermeasures under investigation.
• HHS’s Office of the Assistant Secretary for Preparedness and Response also has created a new web page that specifically addresses remdesivir.
• ASPR TRACIE, sponsored by HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) to provide Technical Resources, Assistance Center, and Information Exchange (TRACIE) services, will hold a webinar on ensuring health care safety throughout the COVID-19 pandemic on June 2.
• ASPR TRACIE has posted a health care facility onboarding checklist to help hospitals and other faculties streamline staff acquisition and onboarding in times of need.
• ASPR TRACIE has introduced behavioral health guidance and resources for preventing and addressing moral injury affecting health care workers during the COVID-19 pandemic.

Centers for Disease Control and Prevention

• The CDC updated its instructions to laboratories on how to report their COVID-19 lab data.
• The CDC updated its FAQ for laboratories on COVID-19.
• The CDC updated its web page with resources for laboratories working on COVID-19.
• The CDC has updated its interim clinical guidance for management of patients with confirmed COVID-19.
• The CDC has updated its FAQ on COVID-19 infection and prevention control in health care settings.
• The CDC has updated its interim considerations for infection prevention and control of COVID-19 in inpatient obstetric care settings.
• The CDC has updated its COVID-19 contact tracing training guidance and resources.
• The CDC has updated its web page with strategies for long-term-care facilities.

Food and Drug Administration

• The FDA issued an emergency use authorization (EUA) for an airway management isolation chamber to be used by military health care providers as an extra layer of barrier protection to prevent exposure to pathogenic biological airborne particulates during transport of patients at the time of definitive airway management or when performing medical procedures on such patients during the COVID-19 pandemic.
• The FDA has issued an EUA for use of a continuous renal replacement therapy to treat patients with renal failure, fluid overload, or both in an acute-care environment during the COVID-19 pandemic.
• The FDA issued an EUA for a specific commercial COVID-19 diagnostic test.
• The FDA has removed from its list of available serology tests 27 individual tests because their sponsors did not meet additional filing requirements or problems arose with the tests.  (Scroll down to the question about removed serology tests).

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

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

Coronavirus update for Wednesday, May 20 as of 3:00 p.m.

Pennsylvania Update

Department of Human Services

DHS has published a Medical Assistance Bulletin advising providers of the diagnosis coding guidance issued by the CDC for health care encounters related to COVID-19.

DHS has updated its FAQ on CHIP program coverage of COVID-19 testing and related services.

Department of Health

The Department of Health has published an FAQ on its strategy for universal COVID-19 testing in long-term-care facilities.

As of 4:15 on Wednesday afternoon the department had not published its usual news release with a summary of new case and death statistics and other matters and did not provide a daily briefing.

Federal Update

Department of Health and Human Services

• HHS has updated its FAQ for the distribution of CARES Act money through the Provider Relief Fund on four occasions in the past two weeks, including new updates dated yesterday.  Updates from yesterday include instructions on attestation and questions about change in ownership.  Go here to see the changes, which are identified within the document.
• HHS announced that its Health Resources and Services Administration provided $225 million to rural health clinics for COVID-19 testing and shared a state-by-state breakdown of the funding.

Centers for Medicare & Medicaid Services

• For COVID-19 tests that do not use high throughput technology, CMS has announced that Medicare Administrative Contractors have developed payment amounts for claims in their jurisdictions that will be used until CMS establishes national payment rates though the annual laboratory meeting process. The same notice includes reminders about other payment policies implemented in response to the COVID-19 crisis.
• CMS has published a therapy codes update that includes the addition of codes related to the COVID-19 emergency.
• CMS has posted information for hospitals requesting Medicare approval for swing beds as a hospital service to provide skilled nursing care for hospitalized patients who do not need acute care but cannot find nursing home placement during the COVID-19 crisis.
• During the COVID-19 emergency, CMS is relaxing billing requirements for a limited number of laboratory tests required for a COVID-19 diagnosis. Any health care professional authorized under state law may order these tests and Medicare will pay for these tests without a written order from the treating physician or other practitioner.
• During the COVID-19 crisis, Medicare will cover medically necessary emergency and non-emergency ground ambulance transportation from any point of origin to a destination that is equipped to treat the condition of the patient consistent with state and local emergency medical services protocols where the services will be furnished.
• CMS’s Office of Minority Health has compiled federal resources on COVID-19 to assist those who work with vulnerable patients, such as older adults, those with underlying medical conditions, racial and ethnic minorities, rural communities, and people with disabilities.

Centers for Disease Control and Prevention

• The CDC has posted its original plan for guiding the reopening of the country. This is the detailed, 60-page plan that was not released publicly but was instead revised into a series of shorter advisory documents.
• The CDC has updated its information for pediatric providers about multi-system inflammatory syndrome in children (MIS-C).

Food and Drug Administration

• The FDA approved the use of succinylcholine chloride injection to facilitate tracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation.
• The FDA has issued emergency use authorization for a specific commercial diagnostic test for COVID-19.

Congressional Research Service

The CRS has published a new report titled “FCC COVID-19 Telehealth Program and Connected Care Pilot Program: Funding to Assist Health Care Providers and Patients.”

Department of Labor

The department’s Occupational Safety and Health Administration has adopted revised policies for enforcing OSHA’s requirements involving COVID-19 as economies reopen in states throughout the country.

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.)