CDC Guidance released on September 1, 2022, recommends that patients 12 and older who received the primary series of any of the authorized COVID-19 vaccines should receive a booster dose of a mRNA bivalent COVID-19 vaccine. The mRNA bivalent booster dose should occur at least two months after the last dose of a COVID-19 vaccine. The bivalent Pfizer BioNTech booster is approved for patients aged 12 years and older and the bivalent Moderna booster is approved for patients aged 18 years and older. The mRNA bivalent vaccines are only available for booster vaccinations. The original monovalent COVID-19 vaccine must be used for the primary series. The original monovalent COVID-19 vaccine can no longer be used for booster doses except for children aged 5-11 who are not eligible for the booster dose of the bivalent COVID-19 vaccine. Since there are now multiple formulations of the mRNA COVID-19 vaccines it will be extremely important for vaccine providers to make sure that the correct vaccine is given to each patient. The CDC definition of up-to-date with COVID-19 vaccine is someone who has completed their primary vaccine series and received the most recent COVID-19 booster vaccine recommended for them by the CDC. It is highly recommended that patients also receive their Influenza vaccine this fall and can receive both the COVID-19 bivalent booster and the influenza vaccine during the same visit. For complete details, the full Health Advisory 659 will be available here when it is published.

The Department of Health and Human Services (HHS), through CMS, announced that people with Medicare, Medicaid, Children’s Health Insurance Program coverage, private insurance coverage, or no health coverage can get COVID-19 vaccines, including the updated Moderna and Pfizer-BioNTech COVID-19 vaccines, at no cost, for as long as the federal government continues purchasing and distributing these COVID-19 vaccines. CMS issued four new CPT codes effective Aug. 31, 2022: Code 91312 for Pfizer-BioNTech COVID-19 Vaccine, Bivalent Product; Code 91313 for Moderna COVID-19 Vaccine, Bivalent Product; Code 0124A for Pfizer-BioNTech COVID-19 Vaccine, Bivalent – Administration – Booster Dose; and Code 0134A for Moderna COVID-19 Vaccine, Bivalent – Administration – Booster Dose. Visit the COVID-19 Vaccine Provider Toolkit for more information, and get the most current list of billing codes, payment allowances, and effective dates. See the full news alert.

The Pennsylvania Department of Health (DOH) announced that vaccine providers across the state are prepared to begin administering updated COVID-19 booster vaccines as soon as they receive them. The vaccines, which provide additional protection against the original coronavirus and Omicron variants BA.4 and BA.5, were recently approved by the Centers for Disease Control and Prevention (CDC) after receiving emergency use authorization from the Food and Drug Administration.

The Department of Health (DOH), Department of General Services (DGS), and Pennsylvania Emergency Management Agency (PEMA) are collaborating to right-size the current PPE stockpile for future COVID-19 and public health emergency purposes, and to ensure partners have sufficient quantities of PPE to protect against a likely fall/winter resurgence of COVID-19.

To that end, partners are encouraged to request PPE through this form. These resources are intended to support organizations for current or future COVID-19 protection, or other associated purposes (including training purposes) and are available at no cost to the recipient. These resources are NOT permitted to be used to offset normal operational costs for the procurement of PPE.

Please note that while you will be able to indicate requested quantities and size preferences, we will not be able to accommodate requests for specific brands/styles of products in the following categories:

• N95 masks
• Surgical masks
• Isolation gowns
• Face shields
• Nitrile gloves
• Hand sanitizer
• Sanitizing wipes

Depending on how quickly you intend to use these resources, you may request to be sent “long dated” materials (expiration dates >6 months), “short dated” materials (expiration >1 month but <6 months), or recently expired materials if they are to be used for non-healthcare and/or training purposes that do not involve human contact. Organizations receiving recently expired materials must complete the attached waiver and submit to HOC_log@pa.gov prior to receipt of PPE. We encourage facilities to request the shortest timeline product that can be used by your site.

This survey will be kept open and orders will be filled on a first-come, first-served basis through at least October 2022. Please email HOC_Log@pa.gov if you have any questions about this program. Thank you.

 While the federal program for free at-home tests will be suspended on Friday, September 2, the Food and Drug Administration provides a list of authorized testing products that are still available over the counter.  In some cases, the expiration date for a test may be extended, meaning the manufacturer provided data showing that the shelf life is longer than was known when the test was first authorized.

With the eventual end of the Medicare Public Health Emergency (PHE), many of the waivers and broad flexibilities CMS provided to healthcare providers during this time will terminate, as they were intended to address the acute and extraordinary circumstances of a rapidly evolving pandemic and not replace existing requirements. To help healthcare facilities and providers understand the coming changes, CMS has developed a roadmap for the eventual end of the Medicare PHE waivers and flexibilities. Similar to the guidance CMS has made available to states, CMS is releasing fact sheets that will help the health care sector transition to operations once the PHE ends, whenever that may occur. For information on waivers and flexibilities applicable to rural healthcare facilities and providers, please see the rural crosswalk CMS published in May 2021.

Individuals who are exposed to COVID-19 are recommended to wear a high-quality mask for 10 days and get tested on day 6 after exposure. Quarantine for individuals who are exposed is no longer recommended. If you have questions about this guidance, please call your local health department or 1-877-PA-HEALTH (1-877-724-3258). For the full update, click here.

Updated guidance from the FDA advises people to perform repeat, or serial, testing following a negative result on any at-home COVID-19 antigen test. This can reduce the risk that an infection may be missed (false negative result). It will help prevent people from unknowingly spreading COVID-19 to others. If you believe you have been exposed to COVID-19, the FDA recommends repeat testing at 48-hour intervals for a total of at least three tests, regardless of whether you have COVID-19 symptoms.

The Centers for Medicare and Medicaid Services (CMS) released their Roadmap to the End of the PHE to give guidance to prepare Health Systems for operations after the public health emergency ends. Currently, the PHE is extended until October 15, 2022, but HHS Secretary Becerra has committed to providing a 60-day notice prior to ending the PHE.

The following are fact sheets for each provider type and will provide guidance on the COVID waivers CMS is planning to terminate, keep or modify after the PHE ends and can be accessed directly from the links that are provided or by clicking here.

Unless additional legislation is passed, there are many important CMS waivers that will terminate at the end of the PHE to include:

• Critical Access Hospital Bed Count and Length of Stay (see page 10 of hospital/CAH fact sheet)
• Hospital Originating Site Facility Fee for Professional Services Furnished Via Telehealth (see page 4 of Hospital/CAH fact sheet)
• Expanded Ability for Hospitals to Offer Long-term Care Services (Swing Beds) for Patients Who do not Require Acute Care but do Meet the Skilled Nursing Facility (SNF) Level of Care (see page 9 of Hospital/CAH fact sheet)
• Hospitals Classified as Sole Community Hospitals (SCHs) (see page 11 of hospital/CAH fact sheet)
• Hospitals Classified as Medicare-Dependent, Small Rural Hospitals (MDHs) (see page 11 of hospital/CAH fact sheet)
• Other Key Telemedicine Waivers (see page 13 of hospital/CAH factsheet)
• Limit Discharge Planning for Hospital and CAHs (see page 17 of hospital/CAH factsheet)​
• Physician services (see page 24-25 of hospital/CAH fact sheet)

CMS COVID-19 Waivers and Flexibilities for Providers

• Physicians and Other Clinicians  
• Hospitals and CAHs (including Swing Beds, DPUs), ASCs and CMHCs
• Teaching Hospitals, Teaching Physicians and Medical Residents 
• Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities) 
• Home Health Agencies  
• Hospice
• Inpatient Rehabilitation Facilities 
• Long Term Care Hospitals & Extended Neoplastic Disease Care Hospitals
• Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) 
• Laboratories
• Medicare Shared Savings Program
• Durable Medical Equipment, Prosthetics, Orthotics and Supplies
• Medicare Advantage and Part D Plans
• Ambulances
• End Stage Renal Disease (ESRD) Facilities
• Participants in the Medicare Diabetes Prevention Program

See below for additional information that CMS distributed:

• Creating a Roadmap for the End of the COVID-19 Public Health Emergency
• Health Care System Resiliency
  Preparing the Health Care System for Operation After the Public Health Emergency: Secretary of Health and Human Services (HHS) Xavier Becerra extended the existing COVID-19 public health emergency (PHE) through October 15, 2022 – and has committed to providing states, health care providers, and other stakeholders a 60-day notice before ending the PHE.

Earlier this month, the U.S. Department of Health & Human Services (HHS) announced an action plan to build on early research into the effects and needed response to long COVID, now estimated to affect up to 23 million Americans.  The research agenda coordinates efforts of departments across the federal government; along with HHS, these include agencies within the Department of Veteran Affairs, Department of Labor, Department of Defense, and the Social Security Administration.  Current data show that roughly one million people may be out of the workforce at any given time; research outside of government has shown a disproportionate impact on rural communities.