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Coronavirus Update for Monday, October 26

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

Provider Relief Fund:  Webcast on Phase 3 General Distribution

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

Provider Relief Fund:  Financial Reporting

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

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

Department of Health and Human Services

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

CMS COVID-19 Stakeholder Calls 

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

CMS COVID-19 Office Hours Call

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

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

Audio Webcast link:  go here to register for the call

Nursing Homes Call

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

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

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

Food and Drug Administration

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

Centers for Disease Control and Prevention

Coronavirus Update for Thursday, October 22

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Thursday, October 22.

Provider Relief Fund

  • HHS has announced that it is updating its most recent Provider Relief Fund reporting instructions to broaden how past fund recipients may use those funds.  See that announcement here.  In September HHS announced changes in instructions that had originally been issued in June, but with this announcement it appears the agency is restoring its June instructions.  In making this decision, HHS wrote that

As providers, provider organizations, and members of Congress familiarized themselves with the reporting requirements, HHS received feedback from many voicing concerns regarding this approach to permissible uses of PRF [Provider Relief Fund] money. In response to concerns raised, HHS is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenues attributable to coronavirus.

Go here for HHS’s policy memorandum on its reporting requirements decision and go here to see the amended reporting requirements.

Department of Health and Human Services

Centers for Medicare & Medicaid Services

Centers for Disease Control and Prevention

  • The CDC has updated its definition of what constitutes “close contact” for contract tracing purposes.  It now defines “close contact” as “Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.”  See the updated guidance here, including a more detailed explanation of what constitutes “close contact.”

Food and Drug Administration

Coronavirus Update for Tuesday, October 20

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

Provider Relief Fund

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

Centers for Medicare & Medicaid Services

Department of Health and Human Services

Centers for Disease Control and Prevention

Food and Drug Administration

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

Department of Labor

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

 Federal Reserve System

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

Coronavirus Update for Thursday, October 15

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

Provider Relief Fund

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

Centers for Medicare & Medicaid Services

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

Centers for Disease Control and Prevention

 

Coronavirus Update for Wednesday, October 14

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Wednesday, October 14.

Reminder:  HHS Webinar on Phase 3 General Distributions

  • HHS will hold a webcast on Thursday, October 15 at 3:00 (eastern) to give providers more information about the Phase 3 general distribution.  Go here to register and submit questions. NASH strongly recommends that any provider considering applying for a Phase 3 distribution view the webinar.  The application deadline for Phase 3 distributions is November 6.

NASH Advocacy

  • NASH has written to members of Congress urging them to prevail on HHS Secretary Alex Azar to restore his department’s June 2020 instructions for how hospitals should calculate their COVID-19-related revenue losses for purposes of receiving CARES Act Provider Relief Fund payments. Revised instructions, issued last month, include a new way of calculating hospital revenue losses that would force many private safety-net hospitals, and others, to return much of their Provider Relief Fund money.  Go here to see NASH’s request of Congress.

Provider Relief Fund

  • The Provider Relief Fund FAQ has been updated with one new question on page 6 that is marked “Added 10/9/2020.” The new question isCan providers use Provider Relief Fund distributions to repay payments made under the CMS Accelerated and Advance Payment (AAP) Program?” and the answer is “No, this is not a permissible use of Provider Relief Fund payments.”

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to its 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.

Office Hours

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

Tuesday, October 27 at 5:00  (eastern) – dial-in and other information to be announced later

Nursing Homes

Wednesday, October 28 at 4:30 (eastern) – dial-in and other information to be announced later.

Department of Health and Human Services

Food and Drug Administration

Centers for Disease Control and Prevention

Congressional Research Service

  • The Congressional Research Service has published “Medicaid Telehealth Policies in Response to COVID-19,” a brief paper that offers an “…overview of telehealth actions in response to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE).  It discusses how states leveraged existing flexibilities and PHE-specific federal authorities to increase the number of services, provider types, and other telehealth coverage options under Medicaid.”

 

NASH Asks Congress to Help Preserve Federal COVID-19 Aid for Hospitals

Protect the COVID-19 aid the federal government has given to private safety-net hospitals, NASH has asked in a letter to Congress.

The letter refers to changes in how the Department of Health and Human Services wants hospitals to calculate the revenue they lost as a result of COVID-19 – the justification in part for the Provider Relief Fund payments hospitals have received through the CARES Act.  In June, HHS told hospitals how to make that calculation but late last month it changed those directions in ways that could force many private safety-net hospitals and others to return some or even much of the federal aid they received.

In the letter, NASH asks members of Congress to sign a bipartisan letter asking HHS Secretary Alex Azar to restore the June instructions for calculating COVID-19-related lost hospital revenue.

Go here to read NASH’s message to Congress.

 

Coronavirus Update for Friday, October 9

The following is the latest COVID-19 information from the federal government as of 2:15 p.m. on Friday, October 9.

Provider Relief Fund

Centers for Medicare & Medicaid Services

  • CMS has published more information about the new terms for repaying Medicare loans the federal government made to providers through Medicare’s Advanced and Accelerated Payment Program.  The new terms include a delayed deadline for beginning repayment, an extended period to make repayment, lower interest rates for those who do not repay their loans on time, and a process for seeking an extension on loan repayment.  Learn more from the following resources:
  • CMS’s announcement of the program’s repayment terms
  • a fact sheet on the program changes
  • an FAQ on the changes

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to its 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.

Office Hours

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

Tuesday, October 13 at 5:00 (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 6379959
Audio Webcast link: https://engage.vevent.com/rt/cms2/index.jsp?seid=2607

Tuesday, October 27 at 5:00  (eastern) – dial-in and other information to be announced later.

Nursing Homes

Wednesday, October 14 at 4:30 (eastern)
Toll Free Attendee Dial-In:  833-614-0820; Access Passcode: 1897041 Audio Webcast Link: https://engage.vevent.com/rt/cms2/index.jsp?seid=2622

Wednesday, October 28 at 4:30 (eastern) – dial-in and other information to be announced later.

American Medical Association

Food and Drug Administration

Centers for Disease Control and Prevention

 

Coronavirus Update for Wednesday, October 7

The following is the latest COVID-19 information from the federal government as of 2:45 p.m. on Wednesday, October 7.

 

Centers for Medicare & Medicaid Services:  Updated Hospital Data Reporting Requirements

CMS has issued guidance in support of an interim final regulation presenting its COVID-19 data reporting requirements for hospitals as a condition for continued participation in Medicare and Medicaid.  The daily reporting requirements apply to all types of hospitals except for the following, for which reporting is required weekly:

  • psychiatric hospitals
  • distinct part psych hospitals
  • Medicaid only psychiatric hospitals
  • Medicaid only children’s hospitals
  • rehabilitation hospitals
  • Medicaid only rehabilitation hospitals

The highlights of those requirements are:

  • Hospitals are required to report selected data elements daily, including but not limited to ventilators in use, previous day’s COVID-19 deaths, and confirmed or suspected patients with COVID-19. Some current daily reporting requirements will become weekly reporting requirements.
  • Hospitals are required to report selected data for flu patients as well.
  • CMS has established an enforcement process that begins with letters hospitals will receive beginning today telling them whether they currently comply with these requirements. An estimated 86 percent of hospitals are thought to already be in compliance.
  • CMS has created a compliance process that includes warning letters for non-compliance and specific time parameters for improvement.
  • Hospitals that still are not in compliance after 14 weeks will be considered to be in violation of their conditions of participation in Medicare and Medicaid.

Key resources for hospitals seeking more information about these new requirements and the implications of failing to comply with them are:

Centers for Medicare & Medicaid Services

Food and Drug Administration

Centers for Disease Control and Prevention

Coronavirus Update for Tuesday, October 6

The Department of Health and Human Services is now providing extensive information about its planned Phase 3 distribution of Provider Relief Funds.

Background

Last Thursday HHS announced the planned distribution of $20 billion in new funding for providers on the front lines of the COVID-19 pandemic.  Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments are invited to apply for additional funding that considers financial losses and increased expenses experienced due to COVID-19.  Previously ineligible providers, such as those that began practicing in 2020, will also be invited to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic will also be eligible for relief payments.

The application portal for these funds opened on Monday, October 5, 2020 and the application deadline is November 6.

 

New Phase 3 information from HHS

Updated FAQs:  Phase 3: Overview and Eligibility

Late yesterday HHS added a new section, titled “Phase 3 – Overview and Eligibility,” to its Provider Relief Fund FAQ.  You can find the new section in the Provider Relief Fund FAQ beginning on page 40; it runs through page 48.  The new entries about the Phase 3 distribution are all marked “Added 10/5/2020.”  We encourage you to review it carefully and let us know if you have any questions.

Informational Webcast:  Provider Relief Fund – Phase 3

In addition, HHS has scheduled a webcast next Thursday, October 15, at 3:00 p.m. (eastern) to provide information about the Phase 3 distribution and answer provider questions.  Go here to register for the webinar; the registration page also includes a space for you to submit your own questions.  Unless you have decided not to pursue Phase 3 funding, we encourage you to participate in the webinar.

Conclusion

Please let us know if you have any questions or would like us to help evaluate whether you should pursue a Phase 3 distribution.

 

 

Coronavirus Update for Monday, October 5

The following is the latest COVID-19 information from the federal government as 2:45 p.m. on Monday, October 5.

Provider Relief Fund

  • HHS has updated its Provider Relief Fund information about the Phase 3 general distribution that was announced last week.  Go here for information on how to apply for Phase 3 funding and here for the terms and conditions for Phase 3 payments.  Today is the first day for providers to apply for Phase 3 funding; the application deadline is November 6.
  • HHS has updated its Provider Relief Fund FAQ with seven changes marked “Modified 10/1/2020.”  The changes, found on pages p. 23, p. 30 (two changes), and p. 31 (four changes), address the eligibility of different types of providers for Phase 3 general distributions.

Department of Health and Human Services

  • HHS Secretary Azar has renewed the COVID-19 public health emergency declaration, which was set to expire on October 23.  With this renewal, the CMS waivers made possible by the declaration will remain in effect until January 21 unless the emergency is renewed again.  View the renewal notice here. In late September HHS’s Office of the Assistant Secretary for Preparedness and Response held a webinar on optimizing personal protective equipment during the COVID-10 pandemic.  The office prepared this document to support the webinar.  Go here to see the presentation used during the webinar and for links to a transcript and a recording of the webinar.
  • HHS’s Office of the Inspector General has updated its work plan for audits, evaluations, and inspections that are under way or planned in October.  Among the subjects of audits will be HHS’s program for paying for care for uninsured COVID-19 patients and COVID-19 testing data for federal programs.

Centers for Disease Control and Prevention