The following is the latest information from Pennsylvania’s state government as of 4:00 p.m. on Friday, July 17.

Department of Health

The Department of Health has introduced a Hand Hygiene Toolkit that consists of a  memo,  poster,  and  audit  tool,  tracking,  and  guidance  documents.

Department of Health – by the numbers

• Today’s new COVID-19 case count is the highest since the virus’s resurgence in Pennsylvania late last month.
• Nearly 40 percent of yesterday’s new cases came from Philadelphia and Allegheny counties.
• The growing number of new cases is not resulting in significant increases in the number of Pennsylvanians hospitalized for COVID-19 or breathing with the help of a machine although both of those numbers are very slowly rising.
• Pennsylvania now has 35 confirmed cases of multisystem inflammatory syndrome in children (MIS-C), with another 17 possible cases under investigation.
• 7400 Pennsylvania health care workers have now contracted COVID-19.
• Currently unoccupied are 38 percent of state hospitals’ acute-care beds, 36 percent of their ICU beds, 54 percent of their pediatric beds, 26 percent of their pediatric ICU beds, and 67 percent of their airborne isolation rooms.
• 638 Pennsylvanians have tested positive on COVID-19 serology tests.

Department of Community and Economic Development

Governor Wolf announced that the state will make available $50 million in grants through a new COVID-19 PA Hazard Pay Grant Program funded by CARES Act money and administered by the Department of Community and Economic Development to help employers provide hazard pay to workers in life-sustaining occupations during the COVID-19 pandemic.  The program seeks to help employers provide hazard pay to retain current employees.  This reimbursement-based grant is for employers that will be offering hazard pay over the eligible program period.  Grant funds may be used for hazard pay for direct, full-time, and part-time employees earning less than $20 an hour, excluding fringe benefits and overtime.  Funds may only be used for hazard pay for eligible employees for the 10-week period from August 16, 2020 through October 24, 2020.  Applicants may apply for up to $1,200 per eligible full-time equivalent employee.  The hazard pay must be paid to the eligible employee over the 10-week period of August 16, 2020 through October 24, 2020 as a $3/hour hazard pay increase to their regular pay rate. Employers may apply for a grant to provide hazard pay for up to 500 eligible full-time equivalent employees per location ($600,000 maximum grant per location).  No employer may receive more than $3 million of the funding under the COVID-19 Hazard Pay Grant Program.  Health care organizations are eligible.  For further information, see the Wolf administration’s announcement about the program, visit the Department of Community and Economic Development’s program web page, and review the program guidelines.

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 the state and federal government as of 5:00 p.m. on Wednesday, July 15.

Pennsylvania Update

SNAP Advocacy

SNAP has endorsed a federal House bill, HR 7606, that would delay implementation of the Centers for Medicare & Medicaid Services’ Medicaid fiscal accountability regulation (MFAR) until the Government Accountability Office has an opportunity to assess its impact on individual states and identify the Medicaid transparency issues that need to be addressed.  SNAP called on CMS to withdraw this proposed rule in a January letter.  The MFAR Transparency Act, sponsored by representatives Roger Williams (R-TX) and Eddie Bernice Johnson (D-TX), also would prevent implementation of MFAR without specific authorization from Congress.  See SNAP’s letter to the bill’s sponsors here.

Governor Wolf

Governor Wolf announced new mitigation efforts to attempt to stem the rising numbers of new COVID-19 cases in the state.  These guidelines impose new limits on bars, restaurants, private catered events, nightclubs, other events and gatherings, and gyms and fitness facilities and include a renewed call for businesses to perform as much work remotely as possible.  Learn more from this announcement from the governor’s office, the governor’s executive order, and an order from the Secretary of Health.

Department of Health

The Department of Health issued a memo to hospitals discussing the state’s plan to help hospitals comply with new federal data reporting guidelines.  The department is working with its data vendor to update the data reporting system so that the department will be able to take over reporting on behalf of all Pennsylvania hospitals.  In the interim, hospitals must continue reporting daily to the state’s data vendor to comply with the department’s mandatory reporting order and also must use the federal TeleTracking system or other approved method to submit their data directly to the federal government if they want to continue to have their data considered in federal COVID-related distributions of resources and support.  As a reminder, on July 10 the Department of Health revised its reporting order, including a reduction of the state’s mandatory reporting frequency from three times a day to once a day at 8 a.m.

Department of Health – by the numbers

• In the past two days Pennsylvania’s new case count has again climbed very high in comparison to the numbers for the past six weeks.  The new death count remains relatively modest.
• More than one-third of yesterday’s new cases came from Philadelphia and Allegheny counties, with nearly twice as many from Allegheny as from Philadelphia.
• The growing number of new cases is not resulting in significant increases in the number of Pennsylvanians hospitalized for COVID-19 or breathing with the help of a machine.
• Currently unoccupied are 34 percent of state hospitals’ acute-care beds, 38 percent of their ICU beds, 59 percent of their pediatric beds, 37 percent of their pediatric ICU beds, and 63 percent of their airborne isolation rooms.  Many of these numbers have been fluctuating a few points a day over the past week.

Department of Human Services

DHS has selected the health systems and academic medical centers that will participate in Pennsylvania’s Regional Response Health Collaboration Program (RRHCP), which will directly support COVID-19 continued readiness and response planning in long-term residential care facilities, seek to improve quality of care related to infection prevention, expand COVID-19 testing, and work to facilitate continuity of care and services provided by long-term care facilities in an attempt to mitigate the risk of spread of COVID-19 to staff or residents.  Learn more about the program and see a list of the organizations chosen to participate in the program in this DHS announcement.

Department of Community and Economic Development

The Department of Community and Economic Development has announced the launch of the “COVID-19 Pennsylvania Discoveries:  Responding to SARS-CoV-2 Through Innovation & Commercialization Program.”  The program seeks to support the rapid advancement of safe, effective, and commercially available vaccines, treatments, and therapeutics in response to COVID-19.  It is a $10 million grant program, individual awards are limited to $1 million (matching funds are required), and proposals are due by July 24.  Eligible applicants include colleges and universities, businesses, non-profit research institutions, economic development organizations, and academic medical centers.  To learn more about the program and the application and proposal processes, see this program guidelines document.

Federal Update

Department of Health and Human Services

• HHS has implemented new data reporting requirements for hospitals that took effect today. In some respects, these requirements differ significantly from recent practices.  Go here to see the detailed HHS document “COVID-19 Guidance for Hospital Reporting and FAQs For Hospitals, Hospital Laboratory, and Acute Care Facility Data Reporting.”
• HHS’s Health Resources and Services Administration has posted a fact sheet on the Provider Relief Fund’s next distribution for Medicaid and CHIP providers. The fact sheet includes information about eligibility criteria and application requirements.  Applications are due July 20.
• HHS has made three additions to its CARES Act Provider Relief Fund FAQ. All are marked “7/14/2020.”  Providers should go here and review the changes carefully.
• HHS announced a large-scale procurement of rapid point-of-care diagnostic test instruments and tests to be distributed to nursing homes in COVID-19 hotspot areas. This initiative has been described as a one-time procurement of devices and tests targeted to facilitate on-site testing among nursing home residents and staff.  Distribution will begin next week.  Learn more from this HHS announcement.

Centers for Medicare & Medicaid Services

• The CMS online publication MLN Matters has published the article “Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment.” Providers can learn about COVID-19 codes 87426, 0223U and 0224U.
• CMS and the CDC are holding a national webinar on “Establishing an Infection Prevention Program in a Nursing Home, With an Emphasis on COVID-19” on Thursday, July 16 at 4:00 (eastern). Advance Registration Required:  Register here.  This webinar is open to nursing home leaders, clinical and administrative staff members, and others interested in nursing home infection prevention in the era of COVID-19.

Food and Drug Administration

• The FDA has added dexamethasone sodium phosphate to the lists of drugs for temporary compounding by outsourcing facilities and pharmacy compounders during the COVID-19 public health emergency. These updates help address shortages and access concerns affecting some drugs urgently needed for hospitalized COVID-19 patients.
• The FDA has issued emergency use authorizations (EUA) for three commercial diagnostic tests for COVID-19. Find them here, here, and here.
• The FDA has issued EUAs for two commercial serology tests for COVID-19. Find them here and here.
• The FDA has added a new device to its list of authorized ventilator accessories: a CPAP mask that has been modified by combining it with an N95 mask.

Centers for Disease Control and Prevention

• The CDC has updated its Guidance for Healthcare Workers about COVID-19 (SARS-CoV-2) Testing.
• The CDC has updated its instructional materials about how to use different types of personal protective equipment.
• The CDC has updated its information about how to get CDC COVID-19 diagnostic tests and supplies.
• The CDC has updated its interim infection prevention and control recommendations for health care personnel during the COVID-19 emergency.

Internal Revenue Service

• The IRS has ruled that for-profit hospitals will be required to pay income taxes on the grants they receive from the CARES Act’s Provider Relief Fund. To learn more, see an IRS FAQ on taxation of Provider Relief Fund grants.

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 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

(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 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

(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 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

(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 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

(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 4:45 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

(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 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

(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 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.)