The near shutdown of the state’s economy has negatively impacted General Fund revenue collections to the tune of nearly $300 million. For March, the Revenue Department reported revenue collections were $294.6 million, or 6.2 percent below estimate, wiping out the little excess revenue the state’s General Fund had built up during the first eight months of the current fiscal year. A substantial part of what will likely be a multi-billion-dollar revenue shortfall before the fiscal year concludes. Initial reports indicate that the state legislature is considering passing a 6-month budget through Dec. 31, 2020. This would allow the legislature to return in the Fall to pass another budget for the remaining six months with a better understanding of the state’s financial status.

With declining travel threatening to wipe out 5.9 million jobs by the end of April and the tourism industry greatly impacted by social distancing, WalletHub today released its report on the States Hit Hardest by COVID-19’s Impact on Tourism, along with accompanying videos.

To identify the states where tourism is most affected by COVID-19, WalletHub compared the 50 states and the District of Columbia across 10 key metrics. Our data set ranges from share of businesses in travel and tourism-related industries to travel spending per travel employee and presence of stay-at-home orders. Below, you can see highlights from WalletHub’s report and a Q&A with WalletHub analysts.

Key Stats

• New York has the highest share of businesses in travel and tourism-related food industries, 12.19 percent, which is 1.8 times higher than in Utah, the lowest at 6.89 percent.
• Nevada has the highest share of employment in travel and tourism-related accommodations industries, 16.09 percent, which is 23 times higher than in Ohio, the lowest at 0.70 percent.
• The District of Columbia has the highest share of travel and tourism consumer spending, $19,869, which is 10.8 times higher than in Ohio, the state with the lowest at $1,847.
• Connecticut has the highest travel spending per travel employee, $168,811, which is 2.2 times higher than in Mississippi, the state with the lowest at $76,458.
• The District of Columbia has the highest default probability on loans of businesses in the travel and tourism-related accommodations industry, 3.85 percent, which is 1.8 times higher than in Alaska, the state with the lowest at 2.17 percent.

To view the full report and your state’s rank, please visit:
https://wallethub.com/edu/states-hit-hardest-by-covid-impact-on-tourism/72974/

The Federal Reserve System is conducting a survey to understand and help inform how the COVID-19 crisis is affecting organizations that support community needs. Please take a moment to complete the survey today!

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Route Fifty, Bill Lucia

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.

This clarifies a prior message that appeared in CMS’ April 7, 2020 Special Edition.

CMS now waives cost-sharing (coinsurance and deductible amounts) under Medicare Part B for Medicare patients for certain COVID-19 testing-related services.  Previously, CMS made available the CS modifier for the gulf oil spill in 2010; however, CMS recently repurposed the CS modifier for COVID-19 purposes. Now, for services furnished on March 18, 2020, and through the end of the Public Health Emergency, outpatient providers, physicians, and other providers and suppliers that bill Medicare for Part B services under specific payment systems outlined in the April 7 message should use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services and to get 100% of the Medicare-approved amount.  Additionally, they should NOT charge Medicare patients any co-insurance and/or deductible amounts for those services.

The GIANT Company announced a $250,000 emergency grant program, in partnership with Team Pennsylvania, to support small businesses in Pennsylvania’s food supply chain impacted by the ongoing COVID-19 pandemic.

Applications are now being accepted online through April 24 from any small business involved in growing, making or processing food within the Commonwealth. The GIANT Company and Team Pennsylvania worked with the Pennsylvania Department of Economic and Community Development, the Pennsylvania Department of Agriculture, the Pennsylvania Chamber, and Pennsylvania Food Merchants Association to develop the program.

For additional information on criteria and to apply for an emergency grant from, visit The GIANT Company online. Recipients will be notified in early May.

On March 13, 2020, President Trump declared the 2019 Novel Coronavirus Disease (COVID-19) situation a national emergency, which allows CMS to waive certain federal requirements in the Medicare, Medicaid, and CHIP programs to ensure continued access to quality of care for all Medicare beneficiaries pursuant to section 1135(b) of the Social Security Act (Act). To streamline the section 1135 waiver request and approval process, CMS is continuously issuing a number of blanket waivers for many Medicare provisions, which primarily affect requirements for individual facilities, such as hospitals, long term care facilities, home health agencies, and so on. These waivers are in effect, with a retroactive effective date of March 1, 2020, through the end of the emergency declaration and DO NOT require a request to be sent to the 1135waiver@cms.hhs.gov mailbox or that notification be made to any of CMS’s regional offices.

The Act permits certain small, rural hospitals to enter into a swing bed agreement, under which the hospital can use its beds, as needed, to provide either acute or skilled nursing facility (SNF) care. As defined in the regulations, a swing bed hospital is a hospital or CAH participating in Medicare that has CMS approval to provide post-hospital SNF care and meets certain requirements. To qualify for SNF-level services, a beneficiary must have been hospitalized in a participating or qualified hospital or participating CAH for medically necessary inpatient hospital or inpatient CAH care for at least 3 consecutive calendar days, not counting the date of discharge.

CMS is waiving this 3-day prior hospitalization for coverage of a SNF stay, noted above, in the newly issued rules and waivers. This waiver provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who experience dislocations or are otherwise affected by COVID-19. This waiver applies to swing bed hospitals, which are hospitals or CAHs participating in Medicare that have CMS approval to provide post-hospital SNF care and meets certain requirements. See Swing Bed Factsheet located at https://www.cms.gov/Outreachand-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/SwingBedFactsheet.pdf to learn more about hospitals who may provide swing bed services. Currently, there is no waiver modifying the definition of a swing bed hospital and rules that were not amended as a result of 1135 waivers are still in place.

The recently released summary of the “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers” which is located on the website page at https://www.cms.gov/about-cms/emergency-preparednessresponse-operations/current-emergencies/coronavirus-waivers, is a listing of helpful website resources.

CMS is continuously issuing additional waivers and flexibilities, and it is vital to stay updated.

Please visit https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page for more of CMS’ actions concerning COVID-19.

Additionally, please browse our MLN Connects at https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive to keep abreast of changes and updates impacting the provider community.

Agencies Implement Legislation Guaranteeing Coverage of COVID-19 Diagnostic Testing, Including Antibody Testing, and Certain Related Services without Cost Sharing for Enrollees in Private Health Coverage

The Centers for Medicare & Medicaid Services (CMS), together with the Departments of Labor and the Treasury, issued guidance today to ensure Americans with private health insurance have coverage of 2019 Novel Coronavirus (COVID-19) diagnostic testing and certain other related services, including antibody testing, at no cost.  As part of the effort to slow the spread of the virus, this guidance is another action the Trump Administration is taking to remove financial barriers for Americans to receive necessary COVID-19 tests and health services, as well as encourage the use of antibody testing that may help to enable health care workers and other Americans to get back to work more quickly.

“It is critical that Americans have peace of mind knowing that cost won’t be a barrier to testing during this national public health emergency,” said Administrator Seema Verma. “Today’s action under the leadership of President Trump allows millions of Americans to access the vital health services they need to fight COVID-19, including antibody testing once it becomes widely available.”

In March, representatives of major health insurance companies met with President Trump, where they voluntarily committed to covering COVID-19 testing without cost sharing such as copays and coinsurance.  Building on this commitment, today’s guidance implements the recently enacted Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security (CARES) Act, which require that private health issuers and employer group health plans cover COVID-19 testing and certain related items and services furnished during the COVID-19 pandemic, with no out-of-pocket expenses.

Specifically, today’s announcement implements the requirement for group health plans and group and individual health insurance to cover both diagnostic testing and certain related items and services provided during a medical visit with no cost sharing. This includes urgent care visits, emergency room visits, and in-person or telehealth visits to the doctor’s office that result in an order for or administration of a COVID-19 test. Covered COVID-19 tests include all FDA-authorized COVID-19 diagnostic tests, COVID-19 diagnostic tests that developers request authorization for on an emergency basis, and COVID-19 diagnostic tests developed in and authorized by states. It also ensures that COVID-19 antibody testing will also be covered. Once broadly available, a COVID-19 antibody test could become a key element in fighting the pandemic by providing a more accurate measure of how many people have been infected and potentially enabling Americans to get back to work more quickly.

To see the guidance, visit: https://www.cms.gov/files/document/FFCRA-Part-42-FAQs.pdf

This action, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.