- GAO Seeks New Members for Tribal and Indigenous Advisory Council
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
- Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation: Request for Input
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- 2025 Marketplace Integrity and Affordability Proposed Rule
- Rural America Faces Growing Shortage of Eye Surgeons
- Comments Requested on Mobile Crisis Team Services: An Implementation Toolkit Draft
Fraud Alert: COVID-19 Scams
As the number of people and communities affected by the COVID-19 pandemic grows, so do the scams associated with it. Scammers use public health emergencies as opportunities for new fraud schemes, and because older adults and people with disabilities are at greater risk for serious illness from COVID-19, they may target these populations.
It’s important to remember that although the Centers for Disease Control and Prevention (CDC) and other public health officials may contact you if they believe you may have been exposed to the virus, they will not need to ask you for insurance or financial information.
Scammers rapidly alter their tactics and adapt their schemes to the changing landscape, and we anticipate that they will leverage the COVID-19 vaccine to prey on unsuspecting people. Be vigilant and protect yourself from potential fraud concerning COVID-19 vaccines and treatments.
Here are things you need to know about the COVID-19 vaccine:
- You likely will not need to pay anything out-of-pocket to get the vaccine during this public health emergency.
- You cannot pay to put your name on a list to get the vaccine.
- You cannot pay to get early access to the vaccine.
- You will not be solicited door to door to receive the vaccine.
- No one from Medicare or the Health Department with contact you.
- No one from a vaccine distribution site or health care payer, like a private insurance company, will call you asking for your Medicare number, Social Security number, or your credit card or bank account information to sign you up to get the vaccine.
The Senior Medicare Patrol (SMP) recommends that Medicare beneficiaries:
- Contact your own doctor if you are experiencing potential symptoms of COVID-19.
- Do not give out your Medicare number, Social Security number, or personal information in response to unsolicited calls, texts, emails, home visits, or booths at health fairs and other public venues. If your personal information is compromised, it may be used in other fraud schemes as well.
- Be suspicious of anyone going door-to-door to offer free coronavirus or COVID-19 testing, supplies, treatments, or vaccines.
- Beware of providers offering other products, treatments, or medicines to prevent the virus. Check with your health care provider before paying for or receiving any COVID-19-related treatment.
- If you get a call, text, email — or even someone knocking on your door — claiming they can get you early access to the vaccine, STOP. That’s a scam.
- Carefully review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB), looking for errors or claims for products or services that weren’t received.
- Follow the instructions of your state or local government for other actions you should be taking in response to COVID-19.
- Contact your local SMP for help. SMPs empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse.
The Senior Medicare Patrol (SMP) is ready to provide you with the information you need to PROTECT yourself from Medicare fraud, errors, and abuse; DETECT potential fraud, errors, and abuse; and REPORT your concerns. SMPs help educate and empower Medicare beneficiaries in the fight against health care fraud. Your SMP can help you with your questions, concerns, or complaints about potential fraud and abuse issues. It also provides information and educational presentations. To locate your local Senior Medicare Patrol, call 1-877-808-2468 or visit www.smpresource.org.
More Information
COVID-19 Vaccine Codes: Updated Effective Date for Moderna
On December 18, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Moderna COVID‑19 Vaccine for the prevention of COVID-19 for individuals 18 years of age and older. Review Moderna’s Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) regarding the limitations of authorized use.
During the COVID-19 Public Health Emergency (PHE), Medicare will cover and pay for the administration of the vaccine (when furnished consistent with the EUA). Review our updated payment and HCPCS Level I CPT code structure for specific COVID-19 vaccine information. Only bill for the vaccine administration codes when you submit claims to Medicare; don’t include the vaccine product codes when the vaccines are free.
Related links:
- CMS COVID-19 Provider Toolkit
- CMS COVID-19 FAQs
- CDC COVID-19 Vaccination Communication Toolkit for medical centers, clinics, and clinicians
- FDA COVID-19 Vaccines webpage
New Research Brief: Pharmacy Vaccination Service Availability in Nonmetropolitan Counties
By Fred Ullrich, BA and Keith Mueller, PhD
With the authorization of vaccines for COVID-19, plans for administering those vaccinations across the United States are being implemented. The Department of Health and Human Services has partnered with 19 “large chain pharmacies and networks that represent independent pharmacies and regional chains” to administer the vaccine. As extensive as that network of pharmacy providers is, it does not include a number of nonmetropolitan counties. This brief uses data from the National Council for Prescription Drug Programs to identify counties where there are no pharmacies capable of providing vaccination services.
Over 100 nonmetropolitan counties (n=110) with a total population of 263,007 people have no pharmacy. A much larger number of counties (n=750) do not have a retail pharmacy directly affiliated with one of the 19 HHS ‘partner’ chains/networks. An unidentifiable number of pharmacies have a third party contracting group arrangement with one of the partners and so the number of counties without a ‘partner pharmacy’ is likely lower. If pharmacies indicating that they currently provide immunization service are added to the list of identified partner pharmacies, there are still 326 nonmetropolitan counties (total population over 1.5 million people) with no pharmacy providing immunization service.
Please click here to read the brief.
Pennsylvania Department of Banking and Securities Aids Nearly 5,000 Consumers Amid COVID-19 Pandemic
The Pennsylvania Department of Banking and Securities (DoBS) responded to nearly 5,000 complaints and inquiries about financial transactions, companies, or products in fiscal year 2019-2020 according to its recently released Consumer Services Annual Report.
The department saw an 18 percent increase in inquiries over last year, largely a result of consumers impacted by COVID-19, including questions about mortgage forbearance, payment deferrals, and scams, highlighted in the report. Of the 4,970 inquiries, the most common (28 percent) complaint or inquiry was related to bank account/services, especially withdrawals, and the second most prevalent complaint (20 percent) was mortgage issues, especially with processing and underwriting. On average, department staff helped resolve consumer issues in fewer than five days. The report also highlights aspects of financial caregivers’ fiduciary responsibility and increased activity with social payments.
“The department remains committed to protecting consumers when it comes to financial services,” said Tim Arthun, Deputy Secretary for Financial Services. “The uptick in calls and emails to our office about financial products, services, and scams is not surprising given the ongoing challenges of the COVID-19 pandemic. I commend our staff for their diligence in helping consumers navigate these complex issues while adapting to remote work.”
The department’s outreach staff offered 320 presentations across 56 counties and reached more than 27,000 consumers during the fiscal year. These events, which are typically held in person, moved entirely online beginning in March to help protect public health.
“I am continually impressed by the department’s entire staff who have remained steadfast in upholding the department’s mission and vision throughout the pandemic,” added Secretary of Banking and Securities Richard Vague. “With the assistance of the Office of Administration’s IT staff who helped seamlessly transition staff to telework, our Financial Services for Consumers and Business Deputate has been unwavering in its commitment to supporting consumers and helping to resolve their financial complaints and inquiries.”
The department’s Investor Education and Consumer Outreach is part of the governor’s Consumer Financial Protection Initiative. The staff works with state and local government agencies, service providers, community and trade organizations, the General Assembly, the military community, schools, and other partners to help Pennsylvanians across the commonwealth become well-informed about the financial marketplace. There are a variety of free, non-commercial programs and presentations available, or a program can be tailored to a specific group’s needs.
Anyone can ask questions or file complaints about financial transactions, companies, or services online or by calling 1-800-PA-BANKS (800-600-0007). Members of the public can stay informed about fraud and scams by following the Department of Banking and Securities on Facebook or Twitter or by subscribing to the department newsletter. Use #GovWolfCFPI to follow the Consumer Financial Protection Initiative on Twitter.
Pennsylvanians Urged to “Answer the Call” and Download the COVID App
The Pennsylvania Department of Health announced a new tool called the Connect & Protect Form where contact tracers will now reach out to 19- through 64- year-old residents within the department’s jurisdiction to gather a digital case investigation. This process will allow public health professionals to reach more cases in an efficient time frame to gather information relating to where the case went or who they came in contact with to support both case investigation and contact tracing efforts.
Between Sunday, December 6 and Saturday, December 12, there were 71,341 COVID-19 cases statewide, an increase of 8,648 cases compared to the previous seven-day period weekly numbers. Case investigations are being prioritized to address those cases that present the highest likelihood of leading to an outbreak. Of the 71,341 newly reported cases, 13 percent, or 9,274 cases, had a case investigation started within 24 hours of receiving the positive report. Public health professionals will continue calling to complete the case investigation after the 24-hour period. An additional four percent, or 2,853 cases, had a case investigation started within 48 hours.
Although public health professionals may call to start the case investigation, not all cases to obtain additional information are successful. The Department of Health leaves voicemails, texts, and sends a letter to the home requesting a return call. There were 6,420 people, or 9 percent of cases, in this reported week that were successfully contacted by a public health professional statewide.
After the initial case investigation is complete, contact tracing begins. Within the same time period of December 6 to December 12, there were 1,675 contact tracing staff working with local and county health entities, partner organizations and the Regional Response Health Collaboration Program within the Department of Human Services as well as volunteers from Co-County Wellness in Berks County and Penn Medicine Lancaster General Health. These staff monitored 8,197 contacts who were identified during the case investigations, an increase of 1,844 additional close contacts monitored compared to last week.
Currently, all of the allotted 1,090 people have been hired through Insight Global. Some of these staff have been promoted to perform case investigations to meet the immediate needs of increased caseloads. There are 50 case investigators, 40 supervisors, and 10 resource coordinators who will help to refer Pennsylvanians to services during quarantine across the commonwealth. An additional 50 contact tracers will be promoted and trained to become case investigators over the next two weeks.
Since the implementation of the Contact Tracing Management System in early October through December 12 in those areas of the state where Pennsylvania Department of Health is responsible for contact tracing, there have been:
- 62,700 contacts have been processed for areas where PA DOH has jurisdiction;
- 47,800 people, or 76 percent of the total contacts identified, have been effectively reached to communicate their quarantine status and offer ongoing symptom monitoring;
- 11,900 people, or about 19 percent of the total contacts, were not reached; and
- 1,700 were still in the process of being contacted.
On September 22, the department launched COVID Alert PA, a free mobile app that uses Bluetooth technology to let a person know that they have been exposed to COVID-19 without compromising the identity or location of either the person using the app, or of the person to whom they may have been exposed.
The Department of Health has made updates the COVID Alert PA app to include 13- through 17-year-old residents with parental consent to download the app and four new languages. This app is interoperable with 16 other states that also utilize the same notification exposure app technology.
In addition to the traditional case investigations and contact tracing process, there have been 527 cases that confirmed their positivity and uploaded their random ID’s through the app. These uploads generated 253 exposure alerts to persons who have downloaded the app on their phones and who were in close contact (six feet for 15 minutes or more) to the case. Of those who received the alerts, 41 individuals requested a call back for further assistance from a trained contact tracer.
As the contact tracing program expands, the Department of Health continues to work in partnership with over 150 organizations, in addition to the county and municipal health departments, through regional partnerships to help gather and answer questions, identify problems and find solutions to improve contact tracing efforts within the region.
Each regional partnership has met at least once, and includes public health staff, health providers, academic institutions, community organizations, and other stakeholders interested in helping to coordinate and engage around contact tracing efforts.
Organizations and entities interested in partnering in these efforts should reach out to RA-DHCONTACTTRACING@pa.gov.
You can find more information on the state’s contact tracing efforts at the Department of Health’s website here.
COVID-19 Vaccine Distribution in Pennsylvania
Pennsylvania hospitals began receiving shipments of the Pfizer-BioNTech COVID-19 vaccine the week of December 14. Through December 20:
- 97 hospitals have received 97,500 vaccine doses.
- 17,700 doses of the vaccine have been administered.
A spreadsheet of facilities that have received vaccine can be found here.
Links to updated guidance and Frequently Asked Questions can be found below:
Frequently Asked Questions for Businesses Operating During the COVID-19 Disaster Emergency: https://www.governor.pa.gov/covid-19/business-faq/
Guidance for Businesses in the Construction Industry Permitted to Operate During the COVID-19 Disaster Emergency: https://www.governor.pa.gov/covid-19/construction-industry-guidance/
Guidance for Businesses in the Restaurant Industry Permitted to Operate During the COVID-19 Disaster Emergency to Ensure the Safety and Health of Employees and the Public: https://www.governor.pa.gov/covid-19/restaurant-industry-guidance/
COVID-19 Guidance for Businesses: https://www.governor.pa.gov/covid-19/business-guidance/
CMS COVID-19 Stakeholder Engagement Calls-December 2020
CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.
Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.
Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts
COVID-19 Care Site-Specific Call
CMS-CDC Nursing Home Stakeholder Call
When: December 22, 2020; 1-2pm ET
Where: Participant Line: (833) 614-0820 (Conference ID: 7979889)
Overview: Please join CDC and CMS for this call with Nursing Homes focused on COVID 19 vaccination among residents and staff. During this call, you’ll receive:
- Updates on Pharmacy Partnership for Long-Term Care Program;
- Critical clinical, safety, and infection prevention and control considerations associated with implementation;
- Communication resources you can use to address resident and staff questions and concerns; and
- General reminders for the holiday season.
A questions and answer session will follow updates.
Acute Hospital at Home Q&A Session
When: Tuesday, December 22, 2020 10:30 AM-11:00 AM
Where: Participant Line: (833) 614-0820 (Conference ID: 3985903)
Join CMS for an Acute Hospital Care at Home Q&A Session. This call provides an opportunity for health systems interested in participating as well as hospitals currently enrolled in the program to seek clarification from CMS subject matter experts. Prior to the call, please review the publicly posted FAQs to verify if an answer to your question is available. Acute hospital care at home FAQs (PDF)
For the most current information including call schedule changes, please click here
To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.
GAO: Urgent Actions Needed for Federal Response to Pandemic
The Government Accountability Office (GAO) is an independent, nonpartisan agency that examines how taxpayer dollars are spent and reports to Congress with information to help the government work more efficiently. In a report, the GAO listed a number of findings about challenges across the nation and made 11 specific recommendations for improving the federal response.
FDA Approves First At-Home Coronavirus Tests
The Food and Drug Administration on Tuesday issued an emergency use authorization for the country’s first coronavirus test that can run from start to finish at home without the need for a prescription. People as young as 2 years old are cleared to use the test, which takes just 15 to 20 minutes to deliver a result. Unlike many similar products, which are only supposed to be used by people with symptoms of COVID-19, this test is authorized for people with or without symptoms. Read more. A day after the FDA authorized the nation’s first home COVID-19 test, it on Wednesday cleared a second home test made by Abbott Laboratories. Abbott said the rapid BinaxNow home test will cost $25 and be available through a telehealth provider, eMed, which will determine whether a person is eligible. Only people with COVID-19 symptoms can get the home test.
Pregnant Employees Asked to Consider COVID-19 Vaccination
The COVID-19 vaccine was not tested in pregnancy, but experts say it’s still worth considering if you’re expecting. As healthcare workers prepare to receive Pfizer’s COVID-19 vaccine starting this week, a Centers for Disease Control and Prevention committee has recommended that pregnant workers–a group typically excluded from vaccine trials–still be allowed to decide with their doctors whether to receive the vaccine. Read more.