DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 409, 410, 412, 413, 414, 415, 424, 425, 440, 483, 484, and 600 Office of the Secretary 45 CFR Part 156 Medicare and Medicaid Programs, Basic Health Program, and Exchanges; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program–This interim final rule with comment period (IFC) gives individuals and entities that provide services to Medicare, Medicaid, Basic Health Program, and Exchange beneficiaries needed flexibilities to respond effectively to the serious public health threats posed by the spread of the coronavirus disease 2019 (COVID-19). These changes apply to physicians and other practitioners, hospice providers, federally qualified health centers, rural health clinics, hospitals, critical access hospitals (CAHs), community mental health centers (CMHCs), clinical laboratories, teaching hospitals, providers of the laboratory testing benefit in Medicaid, Opioid treatment programs, and quality reporting programs (QRPs) for inpatient rehabilitation facilities (IRFs), long-term care hospitals (LTCHs), skilled nursing facilities (SNFs), home health agencies (HHAs) and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. To review, go to: https://www.govinfo.gov/content/pkg/FR-2020-05-08/html/2020-09608.htm.
Executive Order GA-18 related to the reopening of Texas. This address’ social distancing, the reopening of various business’ and other public arenas, long term care, etc. To review, go to: https://www.sos.state.tx.us/texreg/archive/May82020/The%20Governor/The%20Governor.html#0.
Federal News and Information
Centers for Disease Control
NIOSH-Approved N95 Particulate Filtering Face piece Respirators
The N95 respirator is the most common of the seven types of particulate filtering face piece respirators. This product filters at least 95% of airborne particles but is not resistant to oil. This web page provides a table of NIOSH-approved N95 respirators, listed alphabetically by manufacturer. You can select a particular manufacturer by clicking on the first letter of their name on the index below. There are some products that are approved by NIOSH as an N95 respirator and also cleared by the Food and Drug Administration (FDA) as a surgical mask. To access the list of supplier and contact information, go to: https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/n95list1.html
Centers for Medicare and Medicaid Services (CMS)
QSO-20-29-NH Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes was released on May 6, 2020. On May 8, 2020, CMS published an interim final rule with comment period. This rule covers: COVID-19 Reporting Requirements, enforcement on failure to report, Updated Survey Tools, and transparency. The Long-term Care (LTC) Facility Requirements for Notification of Confirmed and Suspected Coronavirus Disease 2019 (COVID-19) Cases Among Residents and Staff: Frequently Asked Questions (FAQ) addressed a question regarding hospice and other healthcare providers. It states:
Q: Do facilities need to inform anyone who walks through their doors (e.g., a hospice or other healthcare provider) of the same numbers of suspected and confirmed COVID-19 cases that they are sharing with residents, their representatives, and families?
A: No. Facilities are not required to provide the same COVID-19 information reported to residents, their representatives, and families. However, facilities would share with the visiting healthcare provider, if the resident receiving care is suspected of, or has laboratory confirmed COVID-19. Any precautions the provider should take while in the facility (e.g., specific personal protective equipment) will be communicated to that provider by the facility as part of their standard practices under the infection prevention and control program requirement.
To review, go to: https://www.cms.gov/files/document/qso-20-29-nh.pdf.
COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers
CMS updated the Blanket Waivers. The areas of interest for hospice are:
- Training and Assessment of Aides
- Quality Assurance and Performance Improvement (QAPI)
- Waive Requirement for Hospices to Use Volunteers
- Comprehensive Assessments
- Waive Non-Core Services
- Waived Onsite Visits for Hospice Aide Supervision
- Hospice Aide Competency Testing Allow Use of Pseudo Patients
- 12 hour Annual In-service Training Requirement for Hospice Aides
- Annual Training
- Physical Environment for Multiple Providers/Suppliers; Inspection, Testing & Maintenance (ITM) under the Physical Environment Conditions of Participation
To access, go to:
Office of Inspector General
FAQs–Application of OIG’s Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
The OIG has updated its FAQs. To access, go to: https://oig.hhs.gov/coronavirus/authorities-faq.asp.
Medicare FFS Claims: 2% Payment Adjustment Suspended (Sequestration)
Providers are reminded that Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily suspends the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration. The suspension is effective for claims with dates of service from May 1 through December 31, 2020. To review, go to: https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2020-04-10-mlnc-se.
Center to Advance Palliative Care
FAQs About COVID-19 and Palliative Care
CAPC has issued a FAQ. Some hot topics include:
- Preemptive conversations with patients prior to a surge so they can make their care preferences known
- Comfort packs
- New opportunities for telehealth, including Medicare billing
- Resiliency and team health.
If you are interested in reviewing, go to: https://www.capc.org/faqs-about-covid-19-and-palliative-care/?utm_source=Center+to+Advance+Palliative+Care&utm_campaign=f49443905f-On-Demand+Virtual+Events+4.24.2020_COPY_01&utm_medium=email&utm_term=0_31106acbde-f49443905f-369376621
National Hospice and Palliative Care Organization (NHPCO)
NHPCO has shared the following information
CARES Act Funding Update: HHS Release of Long-Awaited FAQs on Provider Relief Fund General Distribution
Today, the Department of Health and Human Services (HHS) released long-awaited FAQs on Provider Relief Fund General Distribution. In the release today, HHS announced that “Generally, HHS does NOT intend to recoup funds as long as a provider’s lost revenue and increased expenses exceed the amount of Provider Relief funding a provider has received.” To access the FAQ, go to: https://www.hhs.gov/sites/default/files/provider-relief-fund-general-distribution-faqs.pdf.
The full text of one important FAQ follows:
Does HHS intend to recoup any payments made to providers not tied to specific claims for reimbursement, such as the General Distribution payments? (Added 5/6/2020)
The Provider Relief Fund and the Terms and Conditions require that recipients be able to demonstrate that lost revenues and increased expenses attributable to COVID-19, excluding expenses and losses that have been reimbursed from other sources or that other sources are obligated to reimburse, do not exceed total payments from the Relief Fund. Generally, HHS does not intend to recoup funds as long as a provider’s lost revenue and increased expenses exceed the amount of Provider Relief funding a provider has received. HHS reserves the right to audit Relief Fund recipients in the future to ensure that this requirement is met and collect any Relief Fund amounts that were made in error or exceed lost revenue or increased expenses due to COVID-19. Failure to comply with other Terms and Conditions may also be grounds for recoupment.
There are also FAQs related to the following:
- What to do if the payment is greater than expected or received in error.
- What oversight will HHS use to ensure providers meet the Terms and Conditions.
- How can a general distribution payment received under the Provider Relief fund be returned.
HHS announces the Deadline Extension to 45 Days for Signing the Attestation for the CARES Act Provider Relief Fund
Today, HHS announced that they have 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 a provider received a payment to attest and accept the Terms and Conditions or return the funds. HHS used an example: the initial 30-day deadline for providers who received payment on April 10, 2020 is extended to May 24, compared to the old deadline of May 9, 2020. If payment is not returned within 45 days of receipt, the payment will be viewed as acceptance of the Terms and Conditions. To access the terms and conditions, go to: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/terms-conditions/index.html.
CDC/HRSA Provider Relief Fund Allocations Posted
Today, the dataset was released with the list of providers who received a payment and the amount of the payment from the CARES Act Provider Relief Fund. This list includes all providers who have attested to the payments and agreed to the Terms and Conditions. The list is up to date as of May 4, 2020. To access the dataset, go to: https://data.cdc.gov/Administrative/HRSA-Provider-Relief-Fund-General-Allocation/kh8y-3es6.
New Mexico News and Information
Office of the Governor
Department of Health announces COVID-19 testing now open to all workers in New Mexico
The New Mexico Department of Health (NMDOH) announces COVID-19 testing for all workers in the state. All testing is still FREE OF CHARGE to anyone getting the test, and anyone can get tested, whether they have insurance or not. For detailed information, go to: https://cv.nmhealth.org/2020/05/12/department-of-health-announces-covid-19-testing-now-open-to-all-workers-in-new-mexico/.
COVID Testing Centers and additional COVID information are located at: https://cv.nmhealth.org/public/.
New Mexico Department of Health
As of May 5, 2020, the Public Health Order was amended to further restrict business operations and public gatherings, nursing home visitations continue to be limited, and essential business is defined. To read in detail, go to:
- https://cv.nmhealth.org/wp-content/uploads/2020/05/[email protected]_.us_20200505_150440.pdf
Texas News and Information
Office of the Governor
Governor Abbott Directs TDEM, DSHS, HHSC To Test All Nursing Home Residents, Staff In Texas
Governor Greg Abbott today directed the Texas Health and Human Services Commission (HHSC), the Texas Division of Emergency Management (TDEM), and the Texas Department of State Health Services (DSHS) to test 100% of residents and staff in Texas nursing homes. The Governor instructed HHSC, TDEM, and DSHS to develop and implement a plan based on the guidance of Vice President Mike Pence and Doctor Deborah Birx.
“The State of Texas is working to rapidly expand our testing capacity—especially among vulnerable populations in Texas nursing homes,” said Governor Abbott. “This important collaboration among HHSC, TDEM, and DSHS will ensure that any potential clusters of COVID-19 cases in nursing homes are quickly detected and contained.”
Health and Human Services Commission (HHSC)
PPE Infection Control Basics Webinar
The webinar emphasizes how to prevent or minimize the spread of infectious disease by using personal protective equipment or PPE. Using PPE protects ourselves and our fellow Texans.
During this webinar we will:
- Review standard and transmission-based precautions
- Learn proper hand hygiene techniques
- Demonstrate how to utilize PPE
- Discuss the importance of social distancing in an outbreak situation
- May 15: 8:30 a.m.
- May 22: 8:30 a.m.
- May 29: 8:30 a.m.
May 15 COVID-19 FAQs with LTCR for HCSSA Providers
There are on-going opportunities for HCSSA providers to hear about recent updates and to ask questions relating to COVID-19.
May 15, 11 a.m. – noon
To register, go to: https://hhs.texas.gov/about-hhs/communications-events/news/2020/05/may-15-covid-19-faqs-ltcr-hcssa-providers
Due to the limited time for the presentation submit questions in advance to Policy, Rules and Training: [email protected]. Include “FAQs with LTCR Question: HCSSA” in the subject line.
Weekly Coronavirus (COVID-19) Frequently Asked Questions
Assisted Living Facility: https://hhs.texas.gov/sites/default/files/documents/govdelivery/alf-faqs.pdf