02/11/2021

Today's COVID-19 Report

Thursday, February 11, 2021

Here are the latest need-to-know updates for Thursday, February 11 regarding the COVID-19 pandemic and other topics of importance.

A REMINDER TO ALL MEMBERS

Check LeadingAge's FAQs and Resources on COVID-19 Vaccines and Issues Surrounding Vaccinations frequently. The most recent update includes Q&A on implications of mandating the vaccine for staff.

The Ohio Department of Health (ODH) has released a preliminary toolkit that has been developed with talking points, language tips, social media language, and trusted resources to help providers better communicate information regarding the COVID-19 vaccines. 

In Today's Report

• Directors detail increases for PASSPORT, HCBS in House testimony
• ODM: Exclude income for individuals until guardian can be appointed
• ODM:  Revised go-live date Provider Network Module
• ODM: ‘Zero findings’ overpayment audit reports still to be sent
• ODM: Solution for hospice partial claim denials
• ODM: COVID test and flu vaccine billing for Medicaid recipients
• CDC updates quarantining guidance for fully vaccinated individuals not in a healthcare setting
• Webinar regarding vaccinations in LeadingAge Ohio affordable senior housing properties – TOMORROW at 11:30AM
• Monoclonal antibodies effective: Accessing in Ohio
• Monoclonal antibody webcast follow up: Required evaluation link to claim CEs
• Don't be fooled by survey imposters!
• 2021 LeadingAge Ohio Compensation Survey set to launch next week
• LeadingAge Need to Know

Directors detail increases for PASSPORT, HCBS in House testimony

On Wednesday, the Ohio House Finance Committee heard testimony from the directors of Ohio’s health and human services agencies, including Director of Medicaid Maureen Corcoran, Director of Health Stephanie McCloud and Director of Aging Ursel McElroy. Testimony began at 9:30AM and lasted into the evening hours.

Director Corcoran’s testimony reiterated items that had already been shared with LeadingAge Ohio, including an outline of a nursing facility quality package, which includes a bed buyback program and continuation—and modification—of the nursing home quality incentive program. Testimony also confirmed that nursing, aide and personal care services delivered under the Ohio Home Care, PASSPORT and MyCare Ohio waivers would see a 4 percent increase to rates. Ohio’s assisted living waiver would also see a 4 percent increase to reimbursement. An enhancement of home-delivered meals reimbursement has been implied, but details have not yet been shared.

Corcoran confirmed that the budget was able to be balanced with help from an enhanced federal match (eFMAP) that was included in federal COVID relief legislation—but the federal match came with strings attached. In order to receive the additional matching funds, the Ohio Department of Medicaid had to agree to refrain from disenrolling beneficiaries during the span of the public health emergency (PHE). During the PHE, Medicaid will only disenroll individuals upon death, moving to another state, or when they voluntarily request to be disenrolled. This has increased the Medicaid population by an estimated 300,000 to date, a number which will only grow over the coming years.

Director McElroy responded to questions regarding Ohio’s COVID response, explaining the need for continued focus on testing. Among the agency’s proposals was a universal background check protocol for individuals working with older adults, and initiatives that would be built upon the recommendations included in the State Action Plan on Aging, which is expected to be released this week or next. In responding to questions related to adult day, Director McElroy noted that the Department struggled to connect with these providers during the pandemic, but is hopeful to continue building relationships with the sector.  

The legislative language for the executive budget is anticipated late this week or early next week. At that point, LeadingAge Ohio will provide members with a complete analysis of the provisions which directly impact aging services providers.

As a reminder, the Executive budget is just the first step in the legislative process of adopting the 2022-2023 biennial budget which the Governor must sign by July 1. The bill now moves to the House for consideration and amendments. To hear the latest on the biennial budget, be sure to join the LeadingAge Ohio Advocacy in Action calls on the second and fourth Mondays of the month at 10AM. Questions regarding the biennial budget may be directed to Susan Wallace, Chief Policy Officer, at swallace@leadingageohio.org.

ODM: Exclude income for individuals until guardian can be appointed

During its monthly meeting with LeadingAge Ohio, staff from the Ohio Department of Medicaid (ODM) highlighted a re-interpretation of a rule related to how eligibility should be determined for individuals who are incapable of producing reliable information, such as individuals with dementia. Previously, ODM only allowed income and assets to be excluded from eligibility determination for individuals unable to report it. However, if the individual could provide income and asset information, but was unable to establish a QIT, they would not receive similar flexibility.

ODM is now moving forward with a different interpretation. Now they believe it would be allowable to exclude this income until a guardian can be appointed or someone can be identified to help set up a QIT. The eligibility staff from ODM shared that there will be a rule update to make this clearer, but it will take some time because of competing priorities. LeadingAge Ohio will share the rule update once it has it.

ODM:  Revised go-live date for Provider Network Module

The Ohio Department of Medicaid (ODM) is in the process of modernizing its management information systems to a modular system called the Ohio Medicaid Enterprise System (OMES). The Provider Network Management (PNM) is a new modular component of OMES that will replace the current MITS provider enrollment subsystem and the current MITS provider portal.

Today ODM indicated that July 26, 2021 will be the go-live date for PNM and the centralized credentialing capability that PNM will provide. Phase 2 of the PNM roll-out will occur December 20, 2021; Phase 2 capabilities include functions with the fiscal intermediary, cost reporting, and hospice beneficiary. ODM noted that information on the revised go-live dates and upcoming training will be sent to providers tomorrow afternoon. 

Benefits of the PNM platform include:

• An ease of administrative burden in the collection of information for enrollment,credentialing or re-validation/recredentialing. A provider will still need to contract with Medicaid managed care plans, but PNM will replace the credentialing process with individual plans. Once the provider contracts with a managed care plan, there will be a feedback loop to ODM.
• A hope that this will expedite credentialing processes for all providers.

ODM will provide additional information about how PNM is expected to fit into its larger strategies to LeadingAge Ohio at its next monthly meeting.

ODM: ‘Zero findings’ overpayment audit reports still to be sent

ODM is nearing completion of its post-payment review process, with the final, certified mailing being sent out today to providers who have not yet responded to the initial notification sent in October. Today, ODM assured LeadingAge Ohio that it would be notifying those providers who had zero findings reports for 2017 and 2018 of this in the coming week via email. It is critical that providers receive notification, whether they do or do not have findings, to ensure they haven’t inadvertently missed an important communication. LeadingAge Ohio encourages any members who have NOT received an email notice from ODM by next Friday to reach out to Susan Wallace, Chief Policy Officer at swallace@leadingageohio.org.

ODM: Solution for hospice partial claim denials

ODM reported last week and this week, there was a mass adjustment taking place which included nursing home and hospice claims. The claims didn’t process appropriately the first time. Some appear to have been related to hospices who billed for the prior to ensuring hospice enrollment was entered into MITS. Providers are directed to enroll first in MITS, then bill. If you have a question about this adjustment, please contact Anne Shelley at ashelley@leadingageohio.org.

ODM: COVID test and flu vaccine billing for Medicaid recipients

In response to questions about billing for COVID-related care, the Ohio Department of Medicaid (ODM) reversed the position shared last month that certain services are billable, and noted that most COVID-related expenses should be covered as part of the Medicaid per diem. ODM reminded providers that only laboratories and pharmacies are approved to submit billing of testing for Medicaid recipients. Vaccinations and antibody treatments come at no cost to providers, so they should not be billed, though eligible providers can bill for vaccine administration. At this point, the administration of the vaccine and antibodies are included in per diem.

ODM staff did indicate openness to hearing the case for allowing facilities to bill for monoclomal antibodies infusion, since the clinical procedure is particularly time-intensive and requires nursing services beyond the scope of the per diem rate. LeadingAge Ohio has encouraged ODM to reconsider this point, and will notify members of any change.  

CDC updates quarantining guidance for fully vaccinated individuals not in a healthcare setting

On February 10, the Centers for Disease Control and Prevention (CDC) updated quarantining guidance, noting that fully vaccinated individuals not in a healthcare (including long-term care) setting do not need to quarantine for 14 days after an exposure. Although not preferred, healthcare facilities can consider this strategy to mitigate critical personnel issues. CDC notes that vaccination prevents symptomatic COVID-19 which is showing to be the driver of spread. CDC is updating this guidance due to the benefits of avoiding unnecessary quarantining outweighing the risk.

Vaccinated persons with an exposure to someone with suspected or confirmed COVID-19 are not required to quarantine if they meet all of the following criteria:

• Are fully vaccinated (i.e., ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine).
• Are within 3 months following receipt of the last dose in the series.
• Have remained asymptomatic since the current COVID-19 exposure.

Healthcare facilities could consider waiving quarantine for vaccinated residents as a strategy to mitigate critical issues (e.g., lack of space, staff, or PPE to safely care for exposed patients or residents) when other options are unsuccessful or unavailable. It is recommended to make this decision in consultation with your local health department.

Any immune individual not in quarantine who becomes symptomatic should be evaluated and tested for COVID-19 if indicated.

These criteria could also be applied when considering work restrictions for fully vaccinated healthcare personnel with higher-risk exposures, as a strategy to alleviate staffing shortages. 

The exception for long-term facilities is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings. While mRNA COVID-19 vaccines have demonstrated high efficacy at preventing severe and symptomatic COVID-19, there is currently limited information on how much the vaccines might reduce transmission and how long protection lasts. In addition, the efficacy of the vaccines against emerging SARS-CoV-2 variants is not known.

Webinar regarding vaccinations in LeadingAge Ohio affordable senior housing properties – TOMORROW at 11:30AM

The state of Ohio is focused on expanding the availability of vaccinations for residents of affordable seniors housing properties across the state. On a call last Friday with a small group of LeadingAge Ohio members, Ohio Department of Aging Director McElroy stated that the state would like to partner with providers to ensure there is equity, efficiency, and an execution of the process that encourages as many residents as possible receive the vaccine. 

Please plan to participate in the call tomorrow, February 12, at 11:30AM to learn how to schedule a vaccine clinic for your property’s residents. If you have questions in the meantime, please contact Kathryn Brod at kbrod@leadingageohio.org.

Registration is required in advance for this webinar, but there is no fee to participate.

Monoclonal antibodies effective: Accessing in Ohio

The National Home Infusion Association (NHIA) has shared its paper on the results of their pilot with HHS on administration of monoclonal antibodies in long-term care. It has found the infusions to be very effective. On today’s call with the Ohio Medical Directors’ Association, LeadingAge Ohio learned that Ohio providers are encouraged to locate a participating provider of the monoclonal antibody infusion on the NHIA website.  The infusion provider will walk organizations through how to access the treatment (including details on the physician’s order, supplies, staffing, etc.).  NHIA’s available home infusion providers and other information on their efforts in this area can be found here.  While the Emergency Use Authorization indicates that monoclonal antibody infusion is contraindicated for hospice, the NHIA representative today noted that authorization for hospice patients is possible, but each situation must be evaluated and will be authorized by HHS on a case-by-case basis.  At this point in time, the infusion cannot take place in an individual’s home.

Monoclonal antibody webcast follow up: Required evaluation link to claim CEs

If you attended the "Considerations for Monoclonal Antibody Usage" webcast this past Monday, February 8 and wish to claim continuing education credit, please complete the required evaluation. The link will be available until February 22.

If you have any questions, please contact Dorothy Aldridge at Dorothy.aldridge@ohiohospitals.org.

Don't be fooled by survey imposters!

The Ohio Department of Health (ODH) wants to alert providers that there are individuals posing as ODH surveyors to obtain information from your facility. All surveyors who enter your building on behalf of ODH and the Centers for Medicare and Medicaid Services (CMS) will have proper identification, a business card, and will arrange for an entrance conference with a manager. Please remember that surveyors can enter a facility at anytime of day. A surveyor can provide you with a manager's name and contact information to confirm who they are.

To confirm the identity of an ODH surveyor, you can contact the ODH Bureau of Survey and Certification at 614-752-9524.

If you have this happen to you and are able to get any identifiable information on the individual or the vehicle, please provide that to Rebecca Sandholdt at Rebecca.Sandholdt@odh.ohio.gov.

2021 LeadingAge Ohio Compensation Survey set to launch next week

Recruiting and retaining employees is a constant focus in today’s competitive marketplace. COVID-19 has magnified these challenge, and it is important to understand how your organization’s compensation compares to that of other providers. LeadingAge Ohio, in partnership with partner L.R. Webber, will be conducting a compensation survey that will launch on Monday, February 15. LeadingAge Ohio members will receive the invitation to participate in the survey from Jennifer Taylor, Director of Member Experience, early next week.

Those organizations that participate in the survey will receive the results at no cost. LeadingAge Ohio has streamlined the questions for easier input and enhanced the employee benefits section. Participants will receive the final report with their organization’s data submission alongside the survey results.

Questions regarding the survey may be directed to Jennifer Taylor at (614) 545-9028 or email jtaylor@leadingageohio.org.

LeadingAge Need to Know: COVID-19 – February 11, 2021

LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured a message from LeadingAge Board Chair, Carol Silver Elliott.

Check out the full report here.

Questions

Please send all questions to COVID19@leadingageohio.org. Additionally, members are encouraged to visit the LeadingAge Ohio COVID-19 Working Group facebook group to pose questions to peers and share best practices. LeadingAge is continuing its daily calls for all members.  To participate in these daily online updates, members should register here.  

LeadingAge Ohio is working to ensure that the information in our daily alerts, on our website, and all coronavirus-related communications is as accurate as possible. However, LeadingAge Ohio makes no guarantees about the accuracy of the information.