The following is the latest COVID-19 information from Pennsylvania’s state government as of 3:00 p.m. on Wednesday, March 10.

Department of Health

• The Department of Health issued guidance on the detection of multisystem inflammatory disease in adults (MIS-A) and instructions for providers to report suspect cases of MIS-A that meet all of the case definition criteria with onsets on or after January 1, 2021 by faxing a case report form to 717-772-6975 or the local health department or by emailing the form to radhcovidcontact@pa.gov.
• The Department of Health announced that it is establishing a COVID-19 testing site in Delaware County.  The site, requested by the county, is located in Upland and will be open Tuesday through Saturday until at least April 3, with the possibility that it will continue to operate after that point if the need remains.  See the Department of Health’s announcement about the testing site.
• The Department of Health sent the following message to stakeholders via email:

On Thursday, March 11, 2021, the Special Pharmaceutical Benefits Program (SPBP) will be reinstating the early refill limit for drug claims that requires at least 75% of the previous medication dispensed to be utilized prior to refilling the medication covered by SPBP. For individuals with other drug coverage in addition to SPBP, the SPBP will default to the early refill limits allowed by the other prescription plan the client is enrolled in. The SPBP allows up to 100 day supply for medications prescribed at 1 pill per day, up to 50 day supply for 2 pills per day, and up to a 34 day supply for 3 or more pills per day. Early refill requests can be submitted to SPBP for review for vacation supplies, lost or stolen medications, wrong days’ supply previously submitted, or other similar requests. To request an early refill override, please call the SPBP customer service line.

For drug claim issues, pharmacies should contact the SPBP provider line at 800-835-4080.

For all other questions or enrollment issues, contact the SPBP customer service line at 800-922-9384.

• The Department of Health posted the following information about nursing facility licensure renewals on its provider message board:

As the Proclamation of Disaster Emergency that was issued on March 6, 2020 was renewed on February 18, 2021, the Department Division of Nursing Care Facilities continues to perform surveys in the priorities that CMS has outlined.  The extension on licenses that was granted on March 31, 2020 continues.  Licenses will be issued as licensure surveys are able to be completed.

A license that was extended will be renewed upon completion of a license renewal survey and all requirements are met, the renewed license will be in effect from the month that the survey was completed for the next year. For example, if the facility license would have expired on April 31, 2020, and pursuant to the Department’s guidance was extended and the renewal survey was completed on February 5, 2021  the renewed license the facility receives will reflect a renewal term from the month the survey was completed for the next year or February 1, 2021 to February 1, 2022.

The process may be different for Provisional Licenses.  For a provisional license the license will be effective from the date that the previous provisional license ended.

Department of Health – by the numbers

• The number of new COVID-19 cases has fallen significantly since November and December but the decline has leveled off this month.
• The daily death toll, too, is much less than it was in November and December but has leveled off this month.
• The governor’s weekly COVID-19 early warning dashboard shows that for the week from February 26 through March 4 the state’s overall COVID-19 test positivity rate fell to 5.7 percent; it was 6.3 percent the week before that.  This marked the 11^th consecutive week the rate fell.
• 22 counties have positivity rates of less than five percent and no counties have positivity rates greater than 20 percent.
• Five counties – one more than last week – are now considered to be in low levels of community transmission.  They are Cameron, Forest, Fulton, Potter, and Sullivan counties.
• 33 counties are in moderate levels of community transmission:  Adams, Allegheny, Armstrong, Bedford, Blair, Butler, Cambria, Chester, Clarion, Clearfield, Crawford, Elk, Fayette, Franklin, Greene, Indiana, Jefferson, Juniata, Lawrence, Lebanon, McKean, Montgomery, Perry, Schuylkill, Snyder, Somerset, Susquehanna, Tioga, Venango, Warren, Washington, Westmoreland, and Wyoming.
• 26 counties – the same number as last week – are still in substantial levels of community transmission:  Beaver, Berks, Bradford, Bucks, Carbon, Centre, Clinton, Columbia, Cumberland, Dauphin, Delaware, Erie, Huntingdon, Lackawanna, Lancaster, Lehigh, Luzerne, Lycoming, Mercer, Mifflin, Monroe, Montour, Northampton, Northumberland, Philadelphia, Pike, Union, Wayne, York.
• This reflects movement among the counties.  Philadelphia, for example, in moderate community transmission last week, moved back into substantial community transmission this week.  Potter County, on the other hand, experienced a substantial level of community transmission last week but this week is in a low level of community transmission.
• The numbers of Pennsylvanians hospitalized with COVID-19 and in hospital ICUs is declining modestly but the number on ventilators has held steady for the past week.
• Currently, 22 percent of adult ICU beds in the state are unoccupied, as are 17 percent of medical/surgical beds, 10 percent of pediatric ICU beds, 23 percent of pediatric beds, and 36 percent of airborne isolation units.
• As of March 10 the state’s vaccine dashboard shows that nearly 1.1 million Pennsylvanians have received their first dose of a COVID-19 vaccine and one million have received both doses of a vaccine.  These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.
• The vaccine dashboard shows vaccine totals by county.
• Philadelphia’s Department of Public Health reports that as of March 9, 422,000 doses of COVID-19 vaccine have been administered in the city:  297,000 first doses and 125,000 second doses.

Department of Human Services

DHS’s Office of Long-Term Living distributed the following message to stakeholders via its listserv:

Continuation of the Appendix K Temporary Changes to the Community HealthChoices( CHC) Waiver, OBRA Waiver, and Act 150 Program

The Centers for Medicare & Medicaid Services (CMS) approved temporary changes to the OBRA and CHC 1915(c) waivers beginning March 6, 2020 in response to the COVID-19 pandemic.  Approval of these changes is covered under Appendix K, Emergency Preparedness and Response, which states may use during emergency situations to request amendments to their approved waivers.  These changes addressed potential staffing shortages and the need for service provision not included in approved service descriptions to ensure participant health and safety needs could be accommodated for the duration of the COVID-19 statewide emergency.   The Office of Long-Term Living (OLTL) extended the same flexibilities to the Act 150 Program.   CMS approved an amendment to Appendix K which allowed some flexibilities to continue until March 5, 2021.      

In January 2021, OLTL submitted another amendment to request extension of the Appendix K flexibilities until 6 months after the end of the Public Health Emergency.  CMS has not yet approved the amendment; however, they recently instructed OLTL to assume that any previously approved flexibilities will continue to be approved in the interim.

Until further notice, the Appendix K flexibilities can continue in CHC waiver, the OBRA waiver, and the Act 150 program.  For additional details on the flexibilities, please go to the OLTL COVID19 Provider Resources web page to view the guidance updated for the CHC waiver on January 4, 2021 and updated for the OBRA waiver and Act 150 Program on January 15, 2021.

If you have questions about the information in this Listserv email, please contact the OLTL Provider Helpline at 1-800-932-0939.

Around the State

• Last Sunday officials of the four counties surrounding Philadelphia – Bucks, Chester, Delaware, and Montgomery counties – held a Zoom call with Pennsylvania’s acting health secretary to complain about what they insist is a continued shortchanging of their counties in the state’s distribution of COVID-19 vaccines.  The Philadelphia Inquirer tells the story.
• Officials in Berks County, also near Philadelphia, feel they, too, are being shortchanged by the state in the distribution of COVID-19 vaccines and are unhappy that they were not included in the Sunday call with the Department of Health, according to the Reading Eagle.
• Northampton County has launched a hotline to help seniors with limited access to the internet schedule appointments for COVID-19 vaccines, the Allentown Morning Call reports.
• The number of vaccines administered weekly in Philadelphia has nearly doubled with the opening of a FEMA-operated site and should increase still further when five new city-operated sites open in the next two weeks, according to WHYY, which also notes that the city expects its supply of vaccines to continue to exceed its capacity to administer them “for the foreseeable future.”

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention 

Main COVID-19 Page

FAQ

The following is the latest COVID-19 information from Pennsylvania’s state government as of 4:30 p.m. on Thursday, March 4.

Governor Wolf

Governor Tom Wolf and the COVID-19 Vaccine Task Force announced that Pennsylvania will use the Johnson & Johnson (Janssen) single-dose COVID-19 vaccine to vaccinate teachers and school staff members.  Learn more from this news release from the governor’s office and a Department of Education web page on the new vaccination program.

Governor Wolf has signed House Bill 326, which permits the Pennsylvania National Guard, in conjunction with the Pennsylvania Department of Health, to develop plans for the establishment and operation of regional sites for community distribution and administration of pharmaceuticals, medical equipment and supplies, and vaccines for COVID-19.  See the Wolf administration’s announcement about the bill signing.

Department of Health

The Department of Health announced that its Regional Congregate Care Assistance Teams (RCAT) will continue to operate through May 31, 2021 rather than the anticipated end date of February 28, 2021.  The RCAT program is the successor to the state’s Regional Response Health Collaborative Program (RRHC), which expired at the end of 2020 and was created to bring together established hospitals and health systems with long-term-care facilities struggling with COVID-19 challenges.

Department of Health – by the numbers

• The number of new COVID-19 cases has been remained steady in recent days, as has the daily death toll.
• The numbers of Pennsylvanians hospitalized with COVID-19, in hospital ICU units because of COVID-19, and on ventilators because of COVID-19 continues to remain steady as well.
• Currently, 22 percent of adult ICU beds in the state are unoccupied, as are 15 percent of medical/surgical beds, 12 percent of pediatric ICU beds, 24 percent of pediatric beds, and 37 percent of airborne isolation units.
• As of March 4 the state’s vaccine dashboard shows that one million Pennsylvanians have received their first dose of a COVID-19 vaccine and 826,000 have received both doses of a vaccine.  These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.

Pennsylvania Revenue Collection

Pennsylvania General Fund revenue collections for February were $2.68 billion – $509.7 million or 23.4 percent above the Independent Fiscal Office’s (IFO) projections.  According to the IFO, the increase was largely due to a temporary shift in personal income tax collections.  Fiscal-year-to-date collections are $23.87 billion, which is $267.5 million or 1.1 percent above estimate.

Around the State

• COVID-19 hospitalizations have fallen 25 percent in Allegheny County in the past week, the Pittsburgh Tribune-Review reports.
• The Tribune–Review also reports that “The Western Pennsylvania Regional Chief Medical Officer Consortium, made up of 12 hospital leaders in the region, released a letter Thursday endorsing the benefits of the newly-authorized one-dose [Johnson & Johnson] shot as a way to prevent covid-19.”  Among those who signed the letter were Dr. Donald Yealy from UPMC, Dr. Donald Whiting from Allegheny Health Network, and Dr. Carol Fox from Excela Health System.
• The Federal Emergency Management Agency (FEMA) has opened a mass vaccination site in Philadelphia.  The new site is expected to administer about 47,000 vaccines a week, according to the Philadelphia Inquirer.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

The following is the latest COVID-19 information from Pennsylvania state government as of 3:30 p.m. on Monday. March 1.

Governor Wolf

Governor Wolf has revised the state’s COVID-19 mitigation orders.  Highlights of his revised order are:

• Revised maximum occupancy limits for indoor events to allow for 15 percent of maximum occupancy, regardless of venue size.
• Revised maximum occupancy limits for outdoor events to allow for 20 percent of maximum occupancy, regardless of venue size.
• The elimination of out-of-state travel restrictions.

Learn more about the governor’s order from the following resources:

• a news release from the governor’s office
• the governor’s order for mitigation, enforcement, and immunity protections
• FAQs for the mitigation order changes
• the Acting Secretary of Health’s revised order on gatherings
• the governor’s revised order on travel
• the Acting Secretary of Health’s order rescinding travel restrictions

Department of Health

The Department of Health has updated guidance on the storage and transportation conditions required for the Pfizer vaccine based on new recommendations from the FDA.

Department of Health – by the numbers

• The number of new COVID-19 cases has been less than 2000 for the past two days – the first time this has happened since early fall.
• The daily death toll continues its steep decline.
• More than 24,000 health care workers in Pennsylvania have contracted COVID-19, as have nearly 80,000 residents and employees of 1567 long-term-care facilities across the state.  The continual increase in these numbers since the start of the pandemic has slowed dramatically.
• The governor’s weekly COVID-19 early warning dashboard shows that for the week from February 19 through February 25 the state’s overall COVID-19 test positivity rate fell to 6.3 percent; it was 6.5 percent the week before that.  This marked the tenth consecutive week the rate fell.
• 26 Pennsylvania counties – down from 40 a week ago – remain in substantial levels of community transmission of COVID-19:  Adams, Beaver, Bucks, Carbon, Centre, Clinton, Dauphin, Delaware, Erie, Huntingdon, Lackawanna, Lancaster, Lebanon, Lehigh, Luzerne, Lycoming, Mifflin, Monroe, Montgomery, Northampton, Perry, Pike, Potter, Union, Wayne, and York.  Four counties – one more than a week ago – are in low levels of community transmission:  Cameron, Forest, Fulton, and Sullivan.  The remaining counties, including Allegheny and Philadelphia counties, are in moderate levels of community transmission.
• The numbers of Pennsylvanians hospitalized with COVID-19, in hospital ICU units because of COVID-19, and on ventilators because of COVID-19 continue to decline.
• Currently, 25 percent of adult ICU beds in the state are unoccupied, as are 21 percent of medical/surgical beds, 14 percent of pediatric ICU beds, 32 percent of pediatric beds, and 39 percent of airborne isolation units.As of March 1 the state’s vaccine dashboard shows that 948,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and 739,000 have received both doses of a vaccine.  These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.
• The vaccine dashboard shows vaccine totals by county.

General Assembly

Pennsylvania House of Representatives majority leader Kerry Benninghoff announced that the House will investigate the Wolf administration’s handling of nursing homes and other senior and long-term-care facilities during the COVID-19 pandemic.  The House Government Oversight Committee will lead the investigation.

Around the State

• Spurred by concern that their counties are not receiving appropriate allocations of COVID-19 vaccines, officials of seven western Pennsylvania counties – Beaver, Butler, Fayette, Greene, Lawrence, Washington and Westmoreland – met remotely last week to discuss the possibility of creating a regional health department.  The Pittsburgh Tribune-Review tells the story.
• The city of Philadelphia has eased some of its COVID-19 restrictions, according to the Philadelphia Inquirer.  Among them:  permitting spectators at sporting events, reopening senior centers for the first time in nearly a year, permitting food and drinks to be consumed in movie theaters and more customers in retail establishments, and expanded limits on indoor and outdoor dining, and attendance at religious services.
• Philadelphia’s biggest problem with COVID-19 vaccines now is its ability to administer them and not the supply, the city’s health commissioner told KYW radio.
• COVID-19 has taken a financial and emotional toll on Pennsylvania’s hospitals, the Erie Times-News reports.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

The following is the latest COVID-19 information from the state and federal governments as of 3:15 p.m. on Thursday, February 11.

Pennsylvania Update

The Wolf Administration

Governor Wolf has created a COVID-19 Vaccine Joint Task Force with administration representatives and “…members from each legislative caucus who can share vaccine information and communicate issues and solutions expediently on behalf of and to the broader General Assembly.”  According to a news release from the governor’s office, “Task force members will represent their caucus’s point-of-view and work to streamline conversations to focus and drive issues of importance.  Wolf Administration members will serve as task force members with the subject matter expertise to listen, collaborate and provide information, answers and suggestions to solve problems in a timely manner.”  Members of the task force are co-chairs Acting Secretary of Health Alison Beam and director of the Pennsylvania Emergency Management Agency Randy Padfield; for the Senate Democratic caucus, Senator Art Haywood; for the House Democratic caucus, Representative Bridget Kosierowski; for the Senate Republican caucus, Senator Ryan Aument; and for the House Republican caucus, Representative Tim O’Neal.

Department of Health

The Department of Health has updated its guide to getting the COVID-19 vaccine, which now includes a “Your Turn” feature to help Pennsylvanians learn when they will be eligible to receive a vaccine.

Department of Health – by the numbers

• The number of new daily cases has continued to decline in recent days.
• The daily death toll remains very high although it, too, is generally declining.
• The numbers of Pennsylvanians hospitalized with COVID-19, in ICU beds because of the virus, and on ventilators are all about 60 percent of what they were three weeks ago.
• Currently, 21 percent of adult ICU beds in the state are unoccupied, as are 16 percent of medical/surgical beds, 11 percent of pediatric ICU beds, 26 percent of pediatric beds, and 34 percent of airborne isolation units.  As is usually the case, these numbers tend to decline later in the week.
• As of February 11 the state’s vaccine dashboard shows that 791,000 Pennsylvanians have received their first dose of a COVID-19 vaccine and 335,000 have received both doses of vaccine.  These numbers do not include Philadelphia, which operates its own COVID-19 vaccination program.
• The vaccine dashboard shows vaccine totals by county.

Department of State

To expand the number of health care professionals who can administer COVID-19 vaccines, the Department of State has temporarily suspended certain licensure requirements to enable practitioners from other states to administer COVID-19 vaccines without licensure in Pennsylvania provided that they hold a license in good standing in their home jurisdiction and meet the requirements of the federal Public Readiness and Emergency Preparedness (PREP) Act

Around the State

• Despite the declining number of new COVID-19 cases in Pennsylvania, on Tuesday Allegheny County reported more new cases – 405 – than it had on any day during the previous two weeks, according to the Pittsburgh Tribune-Review.
• More the norm is the situation in Westmoreland County, which has been a COVID-19 hotspot in recent months but is now averaging only about 30 percent of the new cases it was a month ago, the Tribune-Review adds.
• During the week of February 3, Montour County led Pennsylvania in COVID-19 vaccines administered per 1000 population with 79, followed by Cameron County (56 per 1000 population), Lackawanna (50), Northumberland (45), and Columbia (45).  Pulling up the rear in the state were Pike County (14), Bradford County (13), Fulton County (10), and Potter County (6).  The information, from Lancaster Online, does not include Philadelphia, which operates its own vaccination and data collection program.  The following is a complete list:

• The National Football League has offered the stadiums of all of its teams to serve as mass vaccination sites.  This idea has been received with limited enthusiasm in Philadelphia, the Philadelphia Inquirer reports.

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

Federal Update

The White House

• The White House has announced the membership of its COVID-19 Health Equity Task Force.  See this White House fact sheet to learn more about the task force, its objectives, and its members.
• The White House has announced the introduction of a community health center vaccination program next week, with doses of vaccines to be sent directly to such facilities, and an increase in the supply of vaccines to be shared with states, tribes, and territories.  Learn more from a White House fact sheet.

Centers for Medicare & Medicaid Services

• The Families First Coronavirus Response Act requires Medicare Part B to cover beneficiary cost-sharing for provider visits when a COVID-19 diagnostic test is administered or ordered.  CMS has updated the list of codes (note:  this link leads to a zip file that can be downloaded) that physicians and non-physician practitioners can use with the Cost-Sharing (CS) modifier.  Go here to learn more.
• CMS has revised the MLN Matters article “Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)” to clarify billing instructions in the skilled nursing facility benefit period waiver – provider information section.
• CMS has modified the previously extended deadline for third quarter 2020 submission of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data and extended the submission deadline for electronic clinical quality measures for acute-care hospitals and prospective payment system-exempt cancer hospitals.  Learn more about how this affects specific reporting requirements and their changing deadlines.

HHS and CMS COVID-19 Stakeholder Calls

HHS Clinical Rounds Peer-to-Peer Virtual Communities of Practice

HHS’s Office of the Assistant Secretary for Preparedness and Response sponsors COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice that are interactive virtual learning sessions that seek to create a peer-to-peer learning network in which clinicians from the U.S. and abroad who have experience treating patients with COVID-19 share their challenges and successes.  These webinar topics are covered every week:

• EMS:  Patient Care and Operations (Mondays, 12:00-1:00 PM eastern)
• Critical Care:  Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM eastern)
• Emergency Department:  Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM eastern)

Go here for information about signing up to participate in the sessions and go here for access to materials and video recordings of past sessions.

CMS Stakeholder Calls

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

CMS COVID-19 Office Hours Calls

Tuesday, February 23 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2528725

Audio Webcast link:  go here

Tuesday, March 16 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  4177586

Audio Webcast link:  go here

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

Toll Free Attendee Dial In:  833-614-0820; Access Passcode:  2769397

Audio Webcast link:  go here

Food and Drug Administration

• The FDA has issued an emergency use authorization (EUA) for bamlanivimab and etesevimab administered together for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age or older weighing at least 40 kilograms [about 88 pounds]) who test positive for COVID-19 and who are at high risk for progressing to severe COVID-19.  The authorized use includes treatment for those who are 65 years of age or older or who have certain chronic medical conditions.  Learn more from:
  • the emergency use authorization letter issued by the FDA to the manufacturer of the two monoclonal antibodies
  • an FDA fact sheet for providers
  • an FDA FAQ on use of the two drugs in combination
  • an FDA fact sheet for patients, providers, and caregivers

• The FDA has issued a final guidance document presenting its policy for temporary compounding of certain alcohol-based hand sanitizer products during the COVID-19 pandemic.

Centers for Disease Control and Prevention

• The CDC has published a checklist with steps health care workers should take in preparation for the transport and arrival of patients with confirmed or possible COVID-19.
• The CDC has updated its interim infection prevention and control guidance for health care workers during the COVID-19 emergency.
• The CDC has again updated its recommended strategies for optimizing supplies of N95 respirators.
• The CDC has introduced several documents that seek to encourage the use of masks to protect against COVID-19 and to use masks more effectively.  Those documents are:
  • an updated summary of why and how to wear masks
  • information about the results of new research on how to improve the fit of cloth and medical procedures masks to improve their ability to reduce exposure to COVID-19
  • a consumer-oriented document that offers updated information about using masks more effectively.  This is the document that suggests wearing two masks as an option for greater protection.
  • Another consumer-oriented, updated guidance document on wearing masks.