The Pennsylvania Department of Human Services (DHS) announced that pursuant to Act 73 of 2021, the suspensions of various regulatory provisions under the state disaster emergency declaration were extended until March 31, 2022, unless reinstated sooner by DHS. Effective December 6, 2021, DHS has reinstated several suspended regulations, in whole or in part. A list of suspended regulations and their status is available here: https://www.dhs.pa.gov/coronavirus/Pages/Suspended-Regulations-Reinstatement.aspx

The Pennsylvania Department of Health will now provide weekly summaries of COVID-19 cases, deaths, hospitalizations and vaccine data, in addition to their daily updates of the interactive dashboards on the website to provide a clearer picture of what is happening than daily snapshots alone provide. The data reveals:

• Between November 29 and December 5, almost 422,000 vaccine doses were administered across the commonwealth; nearly half were boosters and about 76,000 were to children ages 5-11.
• According to the Pennsylvania Department of Health weekly report, this is a 47.2% increase in vaccines administered from the previous week.
• As of Tuesday afternoon, there were 4,298 people hospitalized with COVID-19 across the state.
• In the past seven days, the number of patients hospitalized for COVID-19 increased by 9%, the state averaged 7,338 new cases per day and a total of 654 deaths were reported.
• To date, there have been almost 1.8 million cases of COVID-19 in Pennsylvania and 34,107 virus-related deaths.

Note: the state’s vaccine data includes information from all counties except Philadelphia, which operates as a separate vaccine jurisdiction.

A data correction made by the U.S. Centers for Disease Control and Prevention last week made a dent in the state’s perceived progress on vaccinating the adult population. Under a data adjustment disclosed by the Pennsylvania Department of Health (DOH), the number of people considered fully vaccinated dropped from 73.7% of those 180and-older to 68.9% because of a reduction of about 1.2 million doses after removal of duplicate information and correction of data on first, second and booster doses.

On November 19, the Centers for Disease Control and Prevention (CDC) strengthened its guidance to recommend a booster shot https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#considerations-covid19-vax-booster of the Pfizer-BioNTech or Moderna vaccines for all adults ages 18 years or older who completed their primary vaccination more than six months ago. See the CDC statement https://www.cdc.gov/media/releases/2021/s1119-booster-shots.html This recommendation aligns with and follows the Federal Drug Administration’s authorization of the Pfizer-BioNTech and Moderna vaccines as a booster and supplements previous guidance on boosters for other COVID-19 vaccines, covered in this bulletin https://content.govdelivery.com/accounts/USHHSHRSA/bulletins/2f91b54  The following resources are available to help health centers understand what this means: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html and https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html

The Biden Administration announced that they will be making 50 Million COVID-19 at-home testing kits available – free of charge – for distribution by Rural Health Clinics and Federally Qualified Health Centers to the communities they serve.

In September, President Biden announced that his administration was going to make 25 Million at-home COVID testing kits available free-of-charge to individuals receiving care at Federally Qualified Health Centers. National Association of Rural Health Clinic (NARHC) Executive Director Bill Finerfrock wrote a letter to President Biden on September 24 expressing disappointment that a similar effort was not being undertaken for patients living in rural underserved communities served by RHCs.

In the letter, Finerfrock said,

“While this is welcome news for the millions of low-income uninsured individuals who receive care from Community Health Centers, it ignores the millions of individuals who reside in rural, underserved communities who receive care from Federally Certified Rural Health Clinics (RHCs) or Critical Access Hospitals (CAHs).

We commend our CHC colleagues for the work they are doing to help meet the COVID testing needs of underserved individuals residing in urban areas, but it is Rural Health Clinics and Critical Access Hospitals that are meeting those needs in underserved rural America.

NARHC looks forward to working with your Administration to ensure that individuals living in rural underserved areas have access to free in-home COVID testing kits through their federally certified Rural Health Clinic.”

NARHC would like to thank the Biden Administration for recognizing that RHCs are an important part of our nation’s health care safety net and that RHCs play a vital role at ensuring access to quality health care for individuals living in rural underserved areas.

NARHC has been in touch with Administration officials about the distribution of these kits and how best to get these at-home testing kits into the hands of individuals living in rural underserved areas. The details on the distribution plan are still being worked out and NARHC anticipates being involved in these deliberations. However, it may be several months before the Testing Kits become available for distribution. As we learn more about how and when RHCs can access these COVID testing kits, we will share that information with the RHC community as soon as possible.

The Centers for Medicare & Medicaid Services (CMS) announced that CMS is now requiring states to cover COVID-19 vaccine counseling visits in which health care providers talk to families about the importance of kids’ vaccination. CMS will now consider certain COVID-19 vaccine counseling visits for children and youth to be COVID-19 vaccine administration, for which state expenditures can be federally matched at 100% through the last day of the first quarter that begins one year after the end of the COVID-19 public health emergency, under the American Rescue Plan (ARP).  CMS will match COVID-19 vaccine counseling-only visits at the ARP 100% federal match rate only when they are provided to children and youth under age 21 as part of the Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.

In addition, to expand access to and affordability of at-home COVID-19 tests, the Department of Health and Human Services together with the Departments of Labor and the Treasury will issue guidance by January 15 to clarify that individuals who purchase over-the-counter COVID-19 diagnostic tests will be able to seek reimbursement from their group health plan or health insurance issuer and have insurance cover the cost during the COVID-19 public health emergency.

Finally, CMS issued a news alert encouraging those with Medicare who are fully vaccinated to get a booster dose of the COVID-19 vaccine. People with Medicare pay nothing when they get the COVID-19 vaccine and booster and there is no applicable copayment, coinsurance or deductible.

A press release is attached and available at: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-makes-100-federal-medicaid-matching-funds-available-state-expenditures.

A news alert regarding the Medicare Booster is attached and available at: https://www.cms.gov/newsroom/news-alert/cms-encourages-people-medicare-get-covid-19-vaccine-booster-shot.

To view the announcement regarding at-home COVID-19 tests, please visit: https://www.whitehouse.gov/briefing-room/statements-releases/2021/12/02/fact-sheet-president-biden-announces-new-actions-to-protect-americans-against-the-delta-and-omicron-variants-as-we-battle-covid-19-this-winter/.

If you have any questions, please contact the CMS Office of Legislation. Thank you.

The Centers for Medicare & Medicaid Services (CMS) is highlighting the impacts of the COVID-19 public health emergency (PHE) on families and individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) through the COVID-19 data snapshot release.

The snapshot includes data from March 2020 through May 2021 for reproductive health services; services delivered via telehealth; service use among beneficiaries who are 18 years of age and under; services for mental health; substance use disorders (SUD); and COVID-19 testing, treatment, and care services.

Many Medicaid and CHIP services have returned to pre-pandemic levels. but there are still services needed to make up for those missed during the COVID-19 PHE. CMS continues to partner with states to monitor data to ensure families and individuals have the access they need to critical health care services such as perinatal, mental health, and pediatric services.

To view the Medicaid and CHIP Data Snapshot, please visit https://www.medicaid.gov/stateresource-center/downloads/covid19-data-snapshot-11122021.pdf

The Centers for Medicare & Medicaid Services (CMS) is continuing to promote health and safety and address the impacts of the COVID-19 public health emergency (PHE) on nursing home residents and their families by issuing memos that revise guidance for nursing home visitation and address the backlog of complaint and recertification surveys.

The first memo, Nursing Home Visitation – COVID-19 (Revised), issues revised visitation guidance in nursing homes. Together with infection prevention safeguards, including the recent staff vaccination regulation, this guidance will promote resident health and ensure continued safety as facilities continue to open. Early in the pandemic, visitation restrictions were implemented to mitigate the risk of visitors introducing COVID-19 to the nursing home. Today’s guidance update reflects that, while visitors, residents, or their representatives should be made aware of the risks associated with visiting loved ones, visitation should now be allowed for all residents at all times. CMS has consistently updated its visitation guidance through the COVID-19 PHE, and this update represents our most comprehensive action to bring residents and loved ones closer together. CMS continues to strongly encourage that everyone get vaccinated against COVID-19.

The second memo, Changes to COVID-19 Survey Activities, includes steps to assist State Survey Agencies (SAs) to address the backlog of facility complaint and recertification surveys. This backlog was the result of the temporary suspension and reprioritization of survey activity nationwide in the early days of the pandemic as CMS and states focused their efforts on infection prevention and control and controlling the spread of COVID-19. In recent months, states have made strong concerted efforts to resume recertification surveys, and we want that to continue.

Steps to assist SAs include:

• Revising the criteria for conducting COVID-19 Focused Infection Control (FIC) Surveys;
• Guidance for resuming recertification surveys; and
• Temporary guidance and minor flexibilities related to complaint investigations.

In addition, CMS is increasing oversight in nursing homes to provide a more focused review of quality-of-life and quality-of-care concerns. For example, the memorandum instructs surveyors to specifically review and focus additional attention to the competency of nursing staff, the use of any potentially inappropriate antipsychotic medications, and other areas of care, such as unplanned weight loss, loss of function/mobility, depression, abuse/neglect, or pressure ulcers.

To view the Nursing Home Visitation COVID-19 (Revised) memo, please visit: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/nursing-home-visitation-covid-19-revised.

To view the Changes to COVID-19 Survey Activities and Increased Oversight in Nursing Homes memo, please visit: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/changes-covid-19-survey-activities-and-increased-oversight-nursing-homes