·     Health Update – 634 – 04/07/22 – UPD – UPDATE: Therapeutics to Prevent and Treat COVID-19

·     Health Advisory – 633 – ADV – Updated Reporting Requirements for COVID-19 Test Results

·     Health Update – 632 – UPD – Update to Recommendations Regarding COVID-19 Booster Vaccination

From the Kaiser Family Foundation

With more than two years having passed since the COVID-19 pandemic began in early 2020, questions are being raised about when to end the public health emergency declarations made by the federal government early on, with some advocating for their extension and others calling for their expiration. There are numerous implications to ending these emergency declarations, each of which gave the federal government flexibilities to waive or modify certain requirements in a range of areas, including in the Medicare, Medicaid, and CHIP programs, and in private health insurance, as well as to allow for the authorization of medical countermeasures and to provide liability immunity to providers who administer services, among other things. In addition, Congress also enacted legislation that provided additional flexibilities tied to one or more of these emergency declarations, and as such they too are scheduled to expire when (or at a specified time after) the emergency period(s) expires.

This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made, summarizes the flexibilities triggered by each, and identifies the implications for their ending, in the following areas:

• Coverage, costs, and payment for COVID-19 testing, treatments, and vaccines
• Medicaid coverage and federal match rates
• Telehealth
• Other Medicaid and CHIP flexibilities
• Other Medicare payment and coverage flexibilities
• Other private insurance coverage flexibilities
• Access to medical countermeasures (vaccines, tests, and treatments) through FDA emergency use authorization (EUA)
• Liability immunity to administer medical countermeasures

This is not meant to be an exhaustive list of all federal policy and regulatory provisions made in response to COVID-19 emergency declarations. For example, we do not cover the entire range of federal and state emergency authorities exercised under Medicaid Disaster Relief State Plan Amendments (SPAs), other Medicaid and CHIP SPAs, and other state-reported administrative actions; Section 1115 waivers; Section 1135 waivers; and 1915 (c) waiver Appendix K strategies. The Centers for Medicare & Medicaid Services maintains a more complete list of coronavirus waivers and flexibilities that have been exercised since early 2020; some state actions to respond to the emergency may have expiration dates that are not tied to the end of the federal emergency declarations.

Click here to read the full brief.

The Centers for Medicare & Medicaid Services (CMS) announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna COVID-19 vaccines without cost sharing as it continues to provide coverage for this critical protection from the virus. People with Medicare pay nothing to receive a COVID-19 vaccine and there is no applicable copayment, coinsurance or deductible. People with Medicaid coverage can also get COVID-19 vaccines, including boosters, at no cost.

The Centers for Disease Control and Prevention (CDC) recently updated its recommendations regarding COVID-19 vaccinations. Certain immunocompromised individuals and people ages 50 years and older who received an initial booster dose at least four months ago are eligible for another booster to increase their protection against severe disease from COVID-19. Additionally, the CDC recommends that adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least four months ago can receive a second booster dose of a Pfizer-BioNTech or Moderna COVID-19 vaccine.

The COVID-19 vaccine, including the booster doses, is the best defense against severe illness, hospitalization and death from the virus. CMS continues to explore ways to ensure maximum access to COVID-19 vaccinations. More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available at https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html and through the CMS COVID-19 Provider Toolkit.

People can visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.

CMS is committed to ensuring access to comprehensive health care coverage by providing partners with guidance and resources as they plan for the eventual end of the COVID-19 Public Health Emergency (PHE) and the Medicaid continuous coverage condition established under the Families First Coronavirus Response Act. Since the beginning of the Administration, the Department of Health and Human Services (HHS) has committed that it will provide states with 60 days of notice before any planned expiration or termination of the PHE to give states as much lead time as possible. In line with that commitment, CMS will be communicating early and often with states and other partners to support planning and coordination of this unwinding process. This communication is a part of that ongoing outreach.

KEY RESOURES

CMS has created a new Unwinding homepage with additional tools and resources.

• On this page, you can find the new Communications Toolkit and graphics to help partners begin reaching out to Medicaid and Children’s Health Insurance Program (CHIP) enrollees so that they are prepared for the upcoming renewal, along with several other unwinding resources.
• The toolkit and graphics are available in both English and Spanish.

IN CASE YOU MISSED IT

On March 3, 2022, the Centers for Medicare & Medicaid Services (CMS) provided states with additional guidance and tools as they plan for whenever the COVID-19 Public Health Emergency (PHE) does conclude. When the PHE does eventually end, states will be required, over time, to redetermine eligibility for all people enrolled in Medicaid and CHIP. The recently released guidance will help states keep consumers connected to coverage by either renewing individuals’ Medicaid or CHIP eligibility or transferring them to other health insurance options.

WHAT PARTNERS CAN DO NOW

Right now, partners can help prepare for the renewal process by educating people with Medicaid and CHIP coverage about the upcoming changes. People with Medicaid & CHIP coverage should:

1. Update their contact information with their State Medicaid or CHIP program; and
2. Look out for a letter from their state about completing a renewal form.

KEY MESSAGES FOR PARTNERS TO SHARE

There are three main messages that partners should focus on now when communicating with people that are enrolled in Medicaid and CHIP.

1. Update your contact information – Make sure [Name of State Medicaid or CHIP program] has your current mailing address, phone number, email, or other contact information. This way, they’ll be able to contact you about your Medicaid or CHIP coverage.
2. Check your mail – [Name of State Medicaid or CHIP program] will mail you a letter about your Medicaid or CHIP coverage. This letter will also let you know if you need to complete a renewal form to see if you still qualify for Medicaid or CHIP.
3. Complete your renewal form (if you get one) – Fill out the form and return it to [Name of State Medicaid or CHIP program] right away to help avoid a gap in your Medicaid or CHIP coverage.

Sample social media posts, graphics, and drop-in articles that focus on these key messages can be found in the Communications Toolkit. The Unwinding homepage will continue to be updated as new resources and tools are released.

For more information, please contact us: Partnership@cms.hhs.gov

The United States is nearing 1 million deaths from COVID — an almost incomprehensible number of lives lost that few thought possible when the pandemic began. Pennsylvania’s Mifflin County offers a snapshot into how one hard-hit community, with over 300 dead, is coping.

Connie Houtz didn’t think  would be that bad.

She’d seen many people in this rural hamlet in central Pennsylvania get infected yet recover within a few days. She did not get vaccinated because she worried about how a new vaccine, developed in record time, might affect her heart condition.

Last October, her youngest son, 45-year-old Eric Delamarter, developed a chest cold. He put off going to the doctor because he had customers waiting at his shop where he repaired cars, she said. When he finally went to the emergency room at Geisinger Lewistown Hospital, he was diagnosed with pneumonia and COVID.

Within a few days, Houtz’s oldest son, 50-year-old Toby Delamarter, had also been admitted to the hospital with the virus and shortness of breath.

Less than two weeks later, both of her sons were dead. Neither had been vaccinated.

“Even though it does not seem fair and does not seem right, down the road we will find a reason for why things happen,” said Houtz, 71, as she sat at her kitchen table.

Eric and Toby Delamarter are two of the roughly 300 people who have died of COVID in Mifflin County, where cows grazing in pastures and Amish horse and buggies are frequent sights. The county 60 miles northwest of Harrisburg leans heavily Republican — 77% of votes cast in 2020 were for Donald Trump — and the former president’s downplaying of covid-19 found fertile ground there.

Mifflin has one of the highest COVID death rates among U.S. counties with at least 40,000 people, according to government data compiled by Johns Hopkins University — 591 deaths per 100,000 residents as of mid-March, compared with 298 deaths nationally.

The United States is nearing 1 million deaths from COVID — a number that few thought possible when the pandemic began.

In March 2020, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that based on modeling of the pace of the coronavirus’s spread in the U.S. at that time, “between 100,000 and 200,000” people may die from COVID.

Reaching a million deaths seemed even more improbable when safe and effective vaccines came onto the market in December 2020. More than 60% of the 977,000 deaths have occurred since then.

Mifflin County offers a snapshot into how one hard-hit community moved from skepticism about the scientific reality of the COVID virus, and then about the vaccine, to coping with unbearable loss and processing the trauma. Roughly 8 in 10 deaths nationwide from April to December 2021 were among the unvaccinated, according to the latest analysis of data from 23 states and New York City and Seattle by the Centers for Disease Control and Prevention.

Read more.