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Coronavirus Resource Center

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Updates:

Click each item for more information.

5/22/2020

5/21/2020

  • Remdesivir:
    • If you are caring for a patient who in your clinical judgment meets criteria for emergency use and you recommend remdesivir, please refer to the Remdesivir Flowsheet and Remdesivir Emergency Use Checklist to guide that process. Please continue to refer to the WV Remdesivir Protocol for additional information. You can direct any questions to the WV 24/7 Coronavirus Hotline: 1-800-887-4304.
    • Background:  May 1, 2020, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) to permit the emergency use of remdesivir for patients with severe suspected or confirmed COVID-19. Except in clinical trials, remdesivir is not recommended for mild to moderate COVID19.  The West Virginia Bureau for Public Health (BPH) recently received an allotment of remdesivir from the US Department of Health and Human Resources.  Remdesivir has been distributed to four pre-positioned/Hub Hospitals in WV for the treatment of seriously ill COVID-19 patients in accordance with guidelines set forth by the protocol and the EUA.  There is access from these hospitals to other facilities who can meet the EUA requirements as well.

5/19/2020

5/17/2020

  • AMA Update:
    • Further updates on three issues:First, the American Medical Association (AMA) wrote to key House and Senate members supporting their legislation, the “Medicare Accelerated and Advance Payments Improvement Act of 2020.” We have been calling on the Centers for Medicare & Medicaid Services (CMS) to restart the program, and this legislation includes several improvements to the program that we have been urging as well. (Letters attached).Second, on Thursday, the Food and Drug Administration (FDA) issued an alert warning that Abbott Laboratories’ rapid COVID-19 tests may deliver false negative results. The alert comes after multiple studies have raised questions about the test’s accuracy. FDA said the test can still be used, but negative results may need to be confirmed with a separate molecular test.Click hereFinally, the AMA strongly urged the Drug Enforcement Administration (DEA) to not finalize its proposal to increase the registration fees for practitioners from $731 every three years to $888 every three years based on the physician practice realities during the COVID-19 pandemic and other factors. (Letter attached).
  • On May 1, 2020, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) to permit the emergency use of Remdesivir for patients with suspected or confirmed COVID-19 with severe disease. Except in clinical trials, Remdesivir is not recommended for mild to moderate COVID19.   The West Virginia Bureau for Public Health (BPH) recently received an allotment of Remdesivir from the US Department of Health and Human Resources.
    • BPH rapidly worked with health care experts around the state to develop a state wide protocol for the distribution of and criteria for use of Remdesivir.  Remdesivir is being distributed to hospitals for the treatment of seriously ill COVID-19 patients in accordance with guidelines set forth by the protocol and the EUA.
    • Attached is the State of West Virginia Remdesivir Protocol to use as a reference. In the next few days, more specific detailed information will be distributed to hospitals and providers across the state. In the meantime, we want to make certain that facilities and providers are aware of the protocol and product availability.  Please refer to this protocol and direct any questions to the WV 24/7 Coronavirus Hotline: 1-800-887-4304.

5/16/2020

5/15/2020

5/11/2020

5/7/2020

  • CMS News Alert
  • HHS Extends Deadline for Attestation, Acceptance of Terms and Conditions for Provider Relief Fund Payments to 45 Days
    • The Department of Health and Human Services has extended the deadline for healthcare providers to attest to receipt of payments from the Provider Relief Fund and accept the Terms and Conditions. Providers will now have 45 days, increased from 30 days, from the date they receive a payment to attest and accept the Terms and Conditions or return the funds. As an example, the initial 30-day deadline for providers who received payment on April 10, 2020, is extended to May 24 from May 9, 2020. With the extension, not returning the payment within 45 days of receipt of payment will be viewed as acceptance of the Terms and Conditions.
    • President Trump is providing support to healthcare providers fighting the COVID-19 pandemic through the bipartisan CARES Act and Paycheck Protection Program and Health Care Enhancement Act which provide $175 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. This funding will be used to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get treatment for COVID-19.
    • In allocating the funds, the Administration is working, among other things, to address both the economic harm across the entire healthcare system due to the stoppage of elective procedures, and addressing the economic impact on providers particularly impacted by COVID-19, and to do so as quickly and transparently as possible.
    • Visit hhs.gov/providerrelief for more information on the allocations. Recipients of payments from any of these allocations must attest and accept the Terms and Conditions within 45 days.
      • HHS is distributing $50 billion across the healthcare system to providers and facilities that bill Medicare.
      • Recognizing the financial strain from COVID-19 inpatient admissions, HHS is distributing $12 billion to hospitals that reported at least 100 COVID-19 inpatient admissions through April 10 to HHS.
      • HHS is distributing $10 billion to rural hospitals and clinics.
      • HHS is distributing $400 million to tribal healthcare providers.
      • HHS is using a portion of the Provider Relief Fund to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured.
      • HHS is working to provide relief to additional healthcare providers including skilled nursing facilities, dentists, and other providers significantly impacted by COVID-19

5/6/2020

  • Over the last week the Small Business Administration and Treasury have made several additions to “Frequently Asked Questions” to the small business relief programs that may be of interest to you.  They are:
    • The Paycheck Protection Program: These FAQs were updated yesterday and now include more than 40 questions and answers for the PPP program. The latest FAQs includes answers to questions that many of you have asked, including (question #40) guidance on the forgiveness of the loan if you are unable to bring back and employee despite a good faith effort; and (question #43) further clarification on the need for demonstrating a lack of access to liquidity for participation in the program. On the latter issue, the SBA has clarified that the date to return funds has been extended to May 14th and they will soon be issuing further guidance on the steps a borrower needs to take to remain in compliance with the program in order to qualify for loan forgiveness.
    • Employee Retention Credit: The IRS has developed informative FAQs for the Employee Retention Credit that should answer some of the questions some of you have expressed about eligibility for the program.
    • The other resource that may be helpful to you is this link to a statement Workforce West Virginia issued discussing different situations impacting the eligibility of individuals for unemployment insurance.

5/1/2020

  • The CDC has a PPE Burn Rate Calculator tool that is intended to help healthcare facilities plan and optimize their use of PPE. Click here to access.

4/30/2020

  • CMS payments for audio-only telephone visits:
    • In response to efforts by organized medicine, the Centers for Medicare & Medicaid Services (CMS) announced this afternoon that they will be increasing payments for audio-only telephone visits between Medicare beneficiaries and their physicians to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110, and the payments are retroactive to March 1, 2020.
      • This is a major victory for medicine that will enable physicians to care for their patients, especially their elderly patients with chronic conditions who may not have access to audio-visual technology or high speed Internet.
      • The American Medical Association and the Federation also worked with Senator Hyde-Smith (R-MS), along with Senators Shaheen (D-NH), Manchin (D-WV), and Moran (R-KS), to spearhead the attached letter to HHS Secretary Azar and CMS Administrator Verma on the same topic. The letter sent on April 29 had 37 signers and included the following requests:
        • Increase Medicare payment rates for telephone-based evaluation and management (E/M) codes (99441-99443) to bring payments for these codes equal to Medicare’s established in person visit codes (99212-99214) that will ensure that patients without advanced video-sharing capabilities are able to get care virtually, while helping to sustain physician practices.
        • Immediately provide guidance to Medicare Administrative Contractors (MACs) to ensure that recent CMS guidance and rules are followed appropriately to enable the payment of telephone E/M claims.
        • Provide Members of Congress with a briefing on CMS efforts to address this issue by May 8, 2020.
  • The Health Resources and Services Administration (HRSA) recently launched a COVID-19 Uninsured Program Portal where health care providers who have conducted COVID-19 testing of uninsured individuals for COVID-19 or provided treatment to uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020 can request claims for reimbursement.
    • Providers will be reimbursed, generally at Medicare rates, subject to available funding. Steps will involve:
      • Enrolling as a provider participant
      • Checking patient eligibility
      • Submitting patient information
      • Submitting claims
      • Receiving payment via direct deposit
    • To learn more about the program, including the registration and claim submission process, go to COVIDUninsuredClaim.HRSA.gov. HRSA also developed a video overview of the program. In addition, providers can access real-time technical support, as well as service and payment support, by calling the Provider Support Line at 866-569-3522. The hours of operation are 8 a.m. to 8 p.m. Monday through Friday in your local time zone.
  • Interim Final Rule from CMS Addressing Audio-Only Telehealth
  • Message from WVDHHR Secretary, Bill J. Crouch, Rescinding Of Previous Directives On Provision Of Healthcare Services - COVID19

 

4/28/2020

  • AMA Updates
    • The American Medical Association (AMA) wrote to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma regarding the Accelerated and Advance Payment (AAP) Program calling on CMS to strongly urge the agency to quickly reinstate the program after a pause was announced last weekend and to include more flexible terms as well as expanding the program to Medicaid providers. Specifically, CMS should authorize advance payments or retainer payments by state Medicaid programs to provide critically needed funds to Medicaid physicians, clinicians, and other providers and suppliers. (First Attachment)
    • The AMA also partnered with 31 other organizations to call on Congress to take immediate action to support employers and workers by protecting and expanding high quality, affordable health care coverage. Key recommendations include: (1) provide employers with temporary subsidies to preserve health benefits; (2) cover the cost of coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA); (3) expand use of Health Savings Accounts (HSA); and (4) increase eligibility for federal subsidies for the health insurance marketplaces. (Second Attachment)

4/27/2020

  • AMA Updates
    • The AMA wrote to Admiral Giroir at HHS to make several recommendations regarding COVID-19 diagnostic and serologic tests. They urge HHS to: (1) pursue a national strategy for testing during the COVID-19 pandemic; (2) receive consultation from all sectors of the laboratory community, including hospital, academic, and community laboratories; (3) ensure laboratories are adequately resourced to meet ongoing demand; and (4) provide additional guidance and education to physicians and the public regarding serologic testing. (First Attachment)
    • The AMA also wrote to Acting Administrator Dhillon to thank the DEA for its proposal to reduce the administrative burden for narcotic treatment programs (NTPs) that operate mobile components. Under the new DEA proposal, NTP registrants that operate mobile components will be able to dispense controlled substances without obtaining a separate DEA registration for the mobile component. The AMA welcomes this change and urges the DEA to finalize it soon. (Second Attachment)
  • CMS News Alert
  • The Department of Health and Human Services (HHS) has posted new Frequently Asked Questions regarding the second tranche of disbursement of the CARES Act Provider Relief Fund.  Please note there is conflicting information about whether a provider who hasn’t previously received money from the first round of funding can apply for this round.  The AMA is trying to clarify this and other questions with HHS.
  • HHS General Allocation Portal Information:
    • General Allocation Fund
      • Late this past week the Department of Health and Human Services (HHS) announced that it will begin distributing the second tranche of funds from the $100 billion in funds to hospitals and other healthcare providers impacted by the coronavirus response.  The funding will be used to support healthcare-related expenses or lost revenue attributable to COVID-19.  HHS announced that $50 billion of the Provider Relief Fund is allocated for general distribution to facilities and providers which billed Medicare in 2019, and are impacted by COVID-19, based on providers' 2018 net patient revenue.  Of this $50 billion, the initial $30 billion was distributed between April 10 and April 17, and payments to providers from that $30 billion were calculated based on providers’ portion of Medicare fee-for-service revenue.
      • Starting on April 24, a portion of providers will automatically be sent an advance payment based off the revenue data they submit in CMS cost reports.  Providers without adequate cost report data on file will need to submit their revenue information to the General Distribution Portal  for additional general distribution funds. Initially some states and specialties thought that physicians must also submit cost reports, but the AMA verified with HHS that this is not the case.  Physicians,  however, do need to submit their revenue information so that it can be verified via the General Distribution Portal .  The portal is now open. The customer service line confirmed anyone who has a Billing TIN (including a pediatric or obstetric practice) who lost revenue in March and/or can estimate lost revenue in April due to the COVID-19 crisis, should be filling out this portal.
      • The AMA has put together the below guidance to help physicians pull together the information they need to submit to the portal.  Also, attached is the additional information from HHS regarding the distribution. Below are key links from HHS with further explanations.  If the AMA learns of additional information, we will disseminate it to the Federation.
      • https://covid19.linkhealth.com/docusign/#/step/1
      • https://chameleoncloud.io/review/2977-5ea0af98f0fd0/prod
    • Additional Funding Related to Treatment of the Uninsured
      • A portion of the $100 billion Provider Relief Fund will be used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured. Physicians are eligible for this funding.  Every health care provider who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement through the program and will be reimbursed at Medicare rates, subject to available funding.  Steps will involve: enrolling as a provider participant, checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit.
      • Providers can register for the program on April 27, 2020, and begin submitting claims in early May 2020. For more information, visit coviduninsuredclaim.hrsa.gov.

4/24/2020

4/23/2020

4/22/2020

  • AMA Updates:

    • In addition to the updated joint statement (online here), the AMA also has updated its state chart regarding Board of Pharmacy restrictions and other policies relating to the prescribing and dispensing of certain medications. The chart is available here

    • The updated joint statement provides further detail and clarification about key areas that have evolved in recent weeks, including in-patient use of certain medications compared to prophylaxis, the distribution/supply chain, safety considerations and the need for adverse-event reporting, and further supports the need for evidence/science to guide discussions and decisions.

    • The AMA sent a letter to the Executive Director of National Governor’s Association urging Governors to adopt health care emergency response protections for physicians providing COVID-19 related care and those following federal, state and local directives related to COVID-19.  Specifically, they encouraged Governors to adopt civil immunity protections similar to those adopted by Executive Order in Connecticut and New York, as well as subsequent legislation enacted in New York.
      • A copy of AMA’s press release can be found here
      • A copy of AMA’s letter to NGA can be found here
  • CMS Releases Additional Blanket Waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities
    • CMS continues to release additional blanket waivers to the healthcare community in order to provide the flexibilities needed to take care of patients during this public health emergency. Today, CMS is providing additional blanket waivers related to care for patients in Long-Term Care Hospitals (LTCHs), temporary expansion locations of Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), staffing and training modifications in Intermediate Care Facilities for individuals with Intellectual disabilities, and the limit for substitute billing arrangements (locum tenens). Guidance

4/21/2020

  • AMA Urges Governors to Adopt Emergency Response Protections for Physicians
    April 20, 2020
    https://www.ama-assn.org/press-center/press-releases/ama-urges-emergency-response-protections-physicians
  • CHICAGO - In response to overwhelming circumstances, hazards and burdens that have placed the physician workforce under extreme pressure during COVID-19 pandemic, the American Medical Association (AMA) today urged the National Governors Association (NGA) to support removing obstacles to preserving and expanding the physician workforce during the current public health emergency.
  • In a letter from AMA CEO and Executive Vice President James L. Madara, M.D. to NGA Executive Director Bill McBride, the AMA warned that somefederal state and local directives related to COVID-19 can pose potential liability risks to physicians. This vulnerability remains an obstacle to physicians seeking to fill workforce gaps during the COVID-19 pandemic. To remove this barrier, the AMA asked the Governor members of the NGA to adopt health care emergency response protections to support physicians willing to risk their own health and safety in the care of COVID-19 patients.
  • The AMA letter noted that many states have already taken action through executive order or state legislation to provide temporary liability protections to physicians and others providing care to COVID-19 patients. The AMA suggested that actions by the governors of Connecticut and New York can serve as models for other states. To download a PDF copy of the letter, click here

4/20/2020

4/16/2020

  • AMA MedEd Update
  • Click here to track the status of your individual stimulus payment
  • CMS News Alert
  • COVID-19 patient registry available for clinical researchers
  • Exceptions to DEA Regulations
    • Below is important information about new COVID-19 flexibilities:In an effort to facilitate continuous patient care during quickly changing scenarios that are arising from the COVID-19 pandemic, DEA has issued two exceptions to regulations for DEA-registered hospital/clinics:
    • These two exceptions are in effect from April 10, 2020, until the public health emergency declared by the Secretary of Health and Human Services (HHS) ends, unless DEA specifies an earlier date.
    • The first letter sets forth the above exceptions and lists conditions that must be met in order to receive controlled substances at a non-registered alternate satellite hospital/clinic.  The first set of conditions pertains to what the DEA registered hospital/clinic needs to do to implement a non-registered alternate satellite hospital/clinic, along with recordkeeping procedures.  The second set of conditions pertains to the delivery and receipt of the controlled substances at the non-registered alternate satellite hospital/clinic.  As outlined in the letter, DEA registered hospital/clinics, as well as distributors of controlled substances, will need to coordinate with their local DEA offices.
    • The second letter is more for your information and provides an exception for signing an invoice at the time of receipt of controlled substances at an Opioid Treatment Center (OTP).
    • Utilize alternate satellite hospital/clinic locations under their current DEA registrations (no need to apply for a separate DEA registration for the alternate site). Distributors can ship controlled substances directly to these alternate satellite hospital/clinic locations, even though these locations do not have their own DEA registrations (non-registered).
  • Final Sign On Letter to Congressional Leadership
  • New Clarifications on Emergency Funds

4/15/2020

4/10/2020

4/9/2020

4/8/2020

4/7/2020

4/5/2020

4/4/2020

  • CMS COVID-19 Updates: Video on telehealth; additional Medicaid waivers; and Ambulatory Surgical Center guidance.
    • New Video Available on Medicare Coverage and Payment of Virtual Services
      • CMS released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.
      • Video
    • CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic
      • CMS approved its 45th Medicaid waiver to the District of Columbia, delivering urgent regulatory relief to ensure the District can quickly and effectively care for their most vulnerable citizens. In light of the urgent and evolving needs of states during the COVID-19 crisis, CMS developed a toolkit to facilitate expedited application and approval of State waivers requests in record time. The waivers support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.
      • CMS also approved an additional state waiver amendment request for Oklahoma to give emergency flexibilities in their programs that care for the elderly and people with disabilities, bringing the total to 18 approvals across 16 states.
    • Guidance for Processing Attestations from Ambulatory Surgical Centers (ASCs) Temporarily Enrolling as Hospitals during the COVID-19 Public Health Emergency
      • CMS is providing needed flexibility to hospitals to ensure they have the ability to expand capacity and to treat patients during the COVID-19 public health emergency. As part of the COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers CMS is allowing Medicare-enrolled ASCs to temporarily enroll as hospitals and to provide hospital services to help address the urgent need to increase hospital capacity to take care of patients.
      • Guidance

4/3/2020

4/2/2020

4/1/2020

3/31/2020

3/30/2020

3/29/2020

3/28/2020

3/27/2020

3/26/2020

3/25/2020

3/24/2020

3/23/2020

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