04/13/2020

Today's COVID-19 Report: Monday, April 13, 2020

Monday, April 13, 2020

Here are the latest need-to-know updates for Monday, April 13 regarding the COVID-19 pandemic.

Cases Must Be Reported Within 24 Hours

LeadingAge Ohio received an alert this morning from the Ohio Department of Health (ODH) in regards to reporting cases of COVID-19, which was expanded further during Governor DeWine's press conference this afternoon. 

To comply with new CDC guidelines recommended by the Council of State and Territorial Epidemiologists, Dr. Acton has issued an amended Director’s Journal Entry with updated reporting requirements for COVID-19, requiring that both confirmed and probable cases (based on clinical and epidemiological evidence) of both residents and staff be reported to both the local health district in which the person resides and to all other residents and staff within 24 hours of the positive case. Until this new guidance was issued, only COVID-19 cases confirmed with a laboratory test were reportable to public health officials. LeadingAge Ohio will continue to update providers on this new development as it progresses. Further, the state will be providing a list of long-term care facilities where an associated individual (resident or staff) has tested positive on the ODH coronavirus website.

LeadingAge Ohio has fielded numerous calls from members concerned about the public disclosure of cases in long-term care settings. LeadingAge Ohio shares members’ concerns that this public reporting will incite panic in families and invite media scrutiny during already challenging times. LeadingAge Ohio is working to formulate a response that will address the concerns of its members as well as elevate these concerns to policymakers.

ODA Pre-surge Training Delayed

On a call with the Area Agencies on Aging, healthcare providers, and stakeholders last week, Ohio Director of Aging Ursel McElroy announced that trainings would begin over the weekend on pre-surge planning work and a toolkit that ODA has been developing in coordination with the Departments of Medicaid and Health. Since then, ODA staff have shared with LeadingAge Ohio that this training will be delayed.

As soon as the training dates/times are announced, LeadingAge Ohio will share with members via its daily COVID-19 report, or in a direct e-alert. In the meantime, questions may be directed to the COVID-10 mailbox at covid19@leadingageohio.org.

Ohio to Receive $1B from CARES Act 

The Centers for Medicare and Medicaid Services (CMS) has begun the release $30B of the emergency funds for providers included in the CARES Act, and Ohio Medicare providers are estimated to receive $1B in relief funding, beginning as early as this week. Some entities have already received electronic payments, and it is likely other providers will begin seeing them soon. 

The U.S. Department of Health and Human Services (HHS) provided a release last week on the emergency funds, as well as a write up of the CARES Act and who qualifies. Funds are disbursed based on a formula that uses the provider’s 2019 Medicare FFS payments.

Payments to practices that are part of larger medical groups will be sent to the group's central billing office

Call to Action: Send Us Your Stories

Throughout the COVID-19 pandemic, LeadingAge Ohio has been proud of the actions of our membership to support residents and reduce social isolation while still adhering to distancing requirements. Your actions are nothing short of inspirational.

LeadingAge Ohio wants to elevate this important work in the eyes of the public and policymakers. If you have stories of how you are supporting the older adults you serve during social distancing and can provide photos and videos, please consider sending them to LeadingAge Ohio. This can include resident activities, window visits, technology support for older adults, meal delivery, staff interactions, and many others. 

Please send any and all content to Patrick Schwartz, Director of Strategic Communications, at pschwartz@leadingageohio.org. Any content sent may be displayed publicly on social media and other outlets. 

Medicaid to Remove Barriers for Benefits

Governor DeWine announced on Friday that the Ohio Department of Medicaid (ODM), the managed care plans, and MyCare Ohio plans have come together to remove barriers for members receiving Medicaid benefits during this crisis.

"These groups have collaborated to maintain the health of individuals to keep them out of the hospital and reduce undue strain on our healthcare system," said Governor DeWine. "They are trying to reduce the administrative requirements of physicians and others in order to give them more flexibility so that they can focus on safe patient care."

Medicaid has eased several pharmacy benefit restrictions:

• Prior authorizations will be by-passed for new prescriptions.
• Members will receive pharmacy benefits regardless of in-network or out-of-network provider status.
• The threshold for refills on certain prescriptions will be relaxed.
• Pharmacists who dispense emergency refills without a prescription will be reimbursed.
• Pharmacies that dispense over-the-counter medications without a prescription will be reimbursed.
• Member co-pays will be waived for all prescriptions.
• 90-day supplies on maintenance medications will be authorized.

The managed care plans have already lifted prior authorizations for all but a few services. This took effect on March 27. 

More details will be available on coronavirus.ohio.gov or by calling the COVID-19 Call Center at 1-833-4-ASK-ODH.

Additional Blanket 1135 Waivers Approved by HHS

The Centers for Medicare and Medicaid Services (CMS) announced in a press release on Thursday night that it was suspending additional rules to maximize frontline workforces in hospitals, clinics and other healthcare facilities. 

Two of the 1135 blanket waivers LeadingAge requested were in the mix:

• Allowing hospices to use pseudopatients (mannequins or role players) in aide competency training; and
• Waiver of the annual 12 hour in service training requirement for hospice aides.  T

LeadingAge updated its hospice chart and plans to send additional resources in the coming days. 

HUD Official to Join Daily Call on Thursday

On Thursday, April 16, Toby Halliday, Director of HUD Multifamily Housing’s Office of Asset Management and Portfolio Oversight (OAMPO), will speak on LeadingAge’s daily COVID-19 3:30pm ET call. Affordable housing providers are encouraged to send questions in advance to Linda Couch (lcouch@leadingage.org) or Juliana Bilowich (jbilowich@leadingage.org) at LeadingAge in advance of the call. 

Nursing Homes Added to Amazon Preferred List for PPE

Amazon has added nursing homes, assisted living, and senior living to the priority list to buy PPE through its marketplace. LeadingAge Ohio members wanting to have preferred status should fill out and submit the following form. 

CMS Issues Proposed FY2021 Hospice Wage Index and Payment Rate Update

On Friday, April 10, 2020, the Centers for Medicare & Medicaid Services (CMS) issued its proposed fiscal year (FY) 2021 payment rule to update the wage index, payment rates (with a 2.6 percentage update), and cap amount.

The rule proposed changes to the hospice wage index by adopting the most recent Office of Management and Budget statistical area delineations, with a 5 percent cap on wage index decreased. In addition, the rule proposed to sunset the Service Intensity Add-on (SIA) budget neutrality factor. Finally, the rule summarizes changes to the hospice election statement proposed during the FY2020 rule cycle to become effective October 1, 2020, as well as a model election statement and sample addendum for use in delineating diagnoses and treatments that are unrelated to the hospice terminal diagnosis and related conditions. 

The overall impact of the rule is an estimated $580 million in increased hospice payments. In order for comments to be considered, they must be received no later than 5 p.m. on June 9. LeadingAge Ohio will be preparing comments through the work of the HH/Hospice Subcommittee.

Columbus Dispatch: Counties Won't Release Information

In a front-page Sunday article titled Coronavirus: At least 40 dead in Ohio nursing homes, but many counties won’t release information, the Columbus Dispatch discussed the way nursing homes in Ohio have been hard hit by the coronavirus pandemic. 

While we know that our LeadingAge Ohio members have been active in providing information to the public, the article highlights the needs of providers to know where outbreaks are happening, and discusses the risks involved with withholding that information. LeadingAge Ohio has advocated for case data to be released to Ohio’s long-term care facilities, since many of them share staff with neighboring facilities. Sharing this information would be a meaningful step towards mitigation of COVID-19 spread between congregate settings. 

Ohio Statistics: 6,881 Cases, 268 Deaths

As of today, there are 6,881 confirmed cases of COVID-19 in Ohio and 268 deaths. A total of 2,033 people have been hospitalized, with 613 Ohioans requiring ICU care. 

In-depth data can be accessed by visiting coronavirus.ohio.gov. 

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.