- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
Latest Federal Guidance and Releases in Response to COVID-19
The federal government continues to take aggressive and proactive steps to address the COVID-19 threat as the health and safety of the American people remain a top priority. Please see below for the latest guidance and releases in response to COVID-19.
Secretary Azar Announces Historic Expansion of Telehealth Access to Combat COVID-19: On Tuesday, the Trump Administration and HHS announced unprecedented steps to expand Americans’ access to telehealth services during the COVID-19 outbreak. The Centers for Medicare & and Medicaid Services (CMS) expanded Medicare coverage for telehealth visits, the HHS Office for Civil Rights (OCR) announced it will waive potential HIPAA penalties for good faith use of telehealth during the emergency, and the HHS Office of Inspector General (OIG) provided flexibility for healthcare providers to reduce or waive beneficiary cost-sharing for telehealth visits paid by federal healthcare programs. For more information see links to the CMS press release, OCR Guidance, and OIG Policy Statement.
FDA Expands Testing Capabilities: On Monday night, FDA Commissioner Hahn announced that states can set up their own system in which they take responsibility for authorizing such tests and the laboratories will not need to engage with the FDA to conduct COVID-19 testing. The updated guidance also expands the types of labs that can conduct testing and provides recommendations for test developers who are interested in developing a test. The FDA has established 1-888-INFO-FDA, to help labs with any questions they may have about the Emergency Use Authorization process, FDA policies or getting supplies. Similar to approving Roche testing last week, yesterday, the FDA also issued Emergency Use Authorizations (EUAs) to Hologic and LabCorp for their tests.
CMS Guidance for States to Apply for a Section 1135 Emergency Waiver: CMS has provided guidance for states on how to apply for a Section 1135 waiver through the Medicaid Disaster Response Tool Kit. A factsheet was released that outlines the flexibilities for healthcare providers to combat and contain COVID-19. CMS will soon provide checklists and tools to further expedite requests and approvals for waivers and other commonly requested flexibilities. Yesterday, Florida was the first state to apply for and receive approval for an 1135 waiver.
Restrictions on Gatherings: On Monday, the White House Task Force released updated guidance with a 15 day strategy to slow the spread of COVID-19 that recommends restricting gathers to 10 people or less.
CMS Nursing Home Guidance: On Friday, CMS released updated nursing home guidance that further protects nursing home residents by restricting all visitors to nursing homes except in cases of end-of-life care. The memo can be found here.
Guidance for Discontinuation of Home Isolation for Persons with COVID-19: CDC released new guidance with strategies to discontinue home isolation with options including both a time-since-illness-onset and time-since-recovery (non-test-based) strategy as well as a test-based strategy. This guidance will assist healthcare providers and public health officials managing people with COVID-19 under home isolation. Information can be found here.
Considerations in the Investigation of Cases and Clusters of COVID-19: The World Health Organization released interim guidance on Friday that includes operational guidance to for the rapid investigation of suspected COVID-19 cases after an alert or signal. It is to be used by local, regional, or national health authorities as considerations for investigating cases of COVID-19.
Regulatory Relief for Commercial Vehicles Delivering COVID-19 Supplies: On Friday, the Federal Motor Carrier Safety Administration issued an Emergency Declaration that provides regulatory relief for vehicles that are transporting medical supplies and equipment to support emergency relief efforts.
Medicaid Telehealth Guidance
As a companion piece to the earlier released Medicare Telehealth Guidance, the Centers for Medicare and Medicaid services today released Medicaid Telehealth Guidance to states. You can find a copy of the guidance here: https://www.medicaid.gov/medicaid/benefits/downloads/medicaid-telehealth-services.pdf
Additionally, you can find the homepage for general Medicaid Telehealth Guidance here: https://www.medicaid.gov/medicaid/benefits/telemedicine/index.html
President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak
On March 17, the Trump Administration announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of health care services from their doctors without having to travel to a health care facility. Beginning on March 6, 2020, Medicare—administered by CMS—will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.
For More Information:
This guidance, and earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit the coronavirus.gov webpage.
For information specific to CMS, visit the Current Emergencies website.
Report on CAH Hospital Compare Measures Released
The national Flex Monitoring Team (FMT) has released reports of Critical Access Hospital (CAH) performance and reporting rates on selected Hospital Compare measures, using data from 2018.
The Hospital Compare data in this report include several measures that are also measures for the Medicare Beneficiary Quality Improvement Project (MBQIP). Although the majority of CAHs report data on these measures to both Hospital Compare and MBQIP, the data in this report may differ from MBQIP reports because some CAHs only report data to one of these programs.
The national report may accessed here and state reports may be accessed via the links below. All FMT publications can also be found on the Flex website.
Concerns Expressed with NTP’s 2019 Monograph
In September 2019, the National Toxicology Program (NTP) released a draft monograph concluding that “fluoride is presumed to be a cognitive neurodevelopmental hazard to humans.” Before finalizing its monograph, NTP asked a committee of the National Academies of Sciences, Engineering and Medicine to review its conclusion and decide whether it is supported by the scientific evidence. In a new report, the Committee finds that NTP’s monograph failed to provide adequate support for its conclusion. The American Fluoridation Society (AFS) released a document reviewing the main points of the Committee’s report.
HRSA Retains Dental Sealant Measure for 2020
The draft dental sealant measure, CMS277, captures the percentage of children age 6-9 years, at moderate to high risk for caries who received a sealant on a first permanent molar during the measurement period. The dental sealant measure will be retained for 2020. Based on feedback received during the public comment period, HRSA will not move forward with adding the fluoride varnish measure (CMS74) for 2020.
Expanded Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak
On March 17, 2020, the Trump Administration today announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility. Beginning on March 6, 2020, Medicare—administered by the Centers for Medicare & Medicaid Services (CMS)—will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.
To read the Fact Sheet on this announcement visit: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
To read the Frequently Asked Questions on this announcement visit: https://www.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf
This guidance, and earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov. For information specific to CMS, please visit the Current Emergencies Website.
Message from PA Oral Health Coalition about COVID-19
The PA Coalition for Oral Health (PCOH) has releaesd a statement on oral health services during the COVID-19 pandemic:
“As Pennsylvania has been justifiably proactive in addressing the COVID-19 pandemic and its impacts, the PA Coalition for Oral Health supports the state issuing directives to the dental community immediately to initiate ’emergency treatment only’ policies. Stopping the spread of this virus and protecting the health and safety of patients, their family members, and dental professionals is our first priority.”
CDC Update for Rural Communities on the COVID-19 Disease Response
The Centers for Disease Control and Prevention (CDC) has put together a special program for RURAL providers and stakeholders for an update on the COVID-19 response. Registration is required by linking here.
Date: Monday, March 23, 2020
Time: 1:00 p.m. ET
Presenter: Dr. Jay Butler (Deputy Director for Infectious Diseases)
Dr. Butler will share guidance with partners, public health practitioners, healthcare providers, and others working to protect the health of rural communities. He will describe what CDC knows at this point and what CDC is doing in response to this outbreak. We will also have time for questions and answers.
Please email eocevent337@cdc.gov to submit questions in advance and indicate that questions are for the 3/23 call.
This event will be recorded. Questions not answered during it may be sent to ruralhealth@cdc.gov
REGISTER HERE:
zoom.us/webinar/register/WN_etqFB-z0Tjyp-_WGI8jfzw
Need Help with Health Insurance or Benefits in the Midst of the Crisis? PHAN Can Help!
Need help with health insurance or benefits in the midst of the crisis?
Call PHAN’s Helpline at 877-570-3642
The response to COVID-19 is changing rapidly. Many counties in our state are requiring tele-working, closing childcare centers, and more. All K-12 schools are closed, and Governor Wolf recently ordered the closing of all non-essential businesses for the next two weeks.
This means that many Pennsylvania residents will start to worry about things like health insurance, paychecks, utilities, housing, bills, and other things that could affect our families’ health and financial well-being. That’s why PHAN is offering their helpline to make sure folks get connected with appropriate programs: