The U.S. Department of Health and Human Services (HHS), through the Assistant Secretary for Planning and Evaluation (ASPE), is releasing a new report showing the dramatic utilization trends of telehealth services for primary care delivery in Fee-for-Service (FFS) Medicare in the early days of the coronavirus disease 2019 (COVID-19) pandemic. The report analyzes claims data from January through early June.  The report underscores how telehealth flexibilities, introduced by the Trump Administration to address the care delivery disruptions caused by the pandemic, helped to spur and maintain Medicare beneficiaries’ access to their primary care providers.

At the start of the COVID-19 public health emergency (PHE), with stay-at-home orders in place and warnings on the risk for severe illness from COVID-19 increasing with age, the report found Medicare FFS in-person visits for primary care fell precipitously in mid-March. It then found that in April, nearly half (43.5%) of Medicare primary care visits were provided through telehealth compared with less than one percent (0.1%) in February before the PHE.

The press release can be found here: https://www.hhs.gov/about/news/2020/07/28/hhs-issues-new-report-highlighting-dramatic-trends-in-medicare-beneficiary-telehealth-utilization-amid-covid-19.html

The full report with additional information can be found here: https://www.aspe.hhs.gov/pdf-report/medicare-beneficiary-use-telehealth

The Centers for Medicare & Medicaid Services today released its first monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. For the first time, the snapshot includes data for American Indian/Alaskan Native Medicare beneficiaries.

The new data indicate that American Indian/Alaskan Native beneficiaries have the second highest rate of hospitalization for COVID-19 among racial/ethnic groups after Blacks. Previously, the number of hospitalizations of American Indian/Alaskan Native beneficiaries was too low to be reported.

The updated data confirm that the COVID-19 public health emergency is disproportionately affecting vulnerable populations, particularly racial and ethnic minorities. This is due, in part, to the higher rates of chronic health conditions in these populations and issues related to the social determinants of health.

In response to the first Medicare data snapshot and related call to action from CMS Administrator Seema Verma on June 22, the CMS Office of Minority Health hosted three listening sessions with stakeholders who serve and represent racial and ethnic minority Medicare beneficiaries. These sessions provided helpful insight into ways in which CMS can address social risks and other barriers to health care that will help in our efforts to reduce health disparities.

The updated data on COVID-19 cases and hospitalizations of Medicare beneficiaries covers the period from January 1 to June 20, 2020. It is based on Medicare claims and encounter data CMS received by July 17, 2020.

Other key data points:

• Black beneficiaries continue to be hospitalized at higher rates than other racial and ethnic groups, with 670 hospitalizations per 100,000 beneficiaries.
• Beneficiaries eligible for both Medicare and Medicaid – who often suffer from multiple chronic conditions and have low incomes – were hospitalized at a rate more than 4.5 times higher than beneficiaries with Medicare only (719 versus 153 per 100,000).
• Beneficiaries with end-stage renal disease (ESRD) continue to be hospitalized at higher rates than other segments of the Medicare population, with 1,911 hospitalizations per 100,000 beneficiaries, compared with 241 per 100,000 for aged and 226 per 100,000 for disabled.
• CMS paid $2.8 billion in Medicare fee-for-service claims for COVID-related hospitalizations, or an average of $25,255 per beneficiary.

For more information on the Medicare COVID-19 data, visit: https://www.cms.gov/research-statistics-data-systems/preliminary-medicare-covid-19-data-snapshot

 

For an FAQ on this data release, visit: https://www.cms.gov/files/document/medicare-covid-19-data-snapshot-faqs.pdf

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

 

CMS COVID-19 Office Hours Calls (Tuesdays at 5:00 – 6:00 PM Eastern)

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

• Increase Hospital Capacity – CMS Hospitals Without Walls;
• Rapidly Expand the Healthcare Workforce;
• Put Patients Over Paperwork; and
• Further Promote Telehealth in Medicare

This week’s Office Hours:

Tuesday, July 28^th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 1492795

Audio Webcast link: https://protect2.fireeye.com/url?k=c408e7b1-985cce9a-c408d68e-0cc47a6d17cc-d6428ab37156e652&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2297

 

Additional Office Hours:

Tuesday, August 4^th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 3296947

Audio Webcast link: https://protect2.fireeye.com/url?k=2d58ded5-710dd705-2d58efea-0cc47a6a52de-a294a2b8484144f1&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2352

 

Tuesday, August 11^th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 3498643

Audio Webcast link: https://protect2.fireeye.com/url?k=6f7db93e-3329a042-6f7d8801-0cc47adc5fa2-ed718e46a02e4dc1&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2361

 

Weekly COVID-19 Care Site-Specific Calls

CMS hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.

Home Health and Hospice (twice a month on Tuesday at 3:00 PM Eastern)

Tuesday, August 11^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5097566 Audio Webcast Link: https://protect2.fireeye.com/url?k=b4723cca-e827351a-b4720df5-0cc47a6a52de-e4916e2be973d447&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2386

 

Nursing Homes (twice a month on Wednesday at 4:30 PM Eastern)

Wednesday, August 12^th 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7857618 Audio Webcast Link: https://protect2.fireeye.com/url?k=2884bdb1-74d1b4a2-28848c8e-0cc47adb5650-5b54c104cb155c28&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2411

 

Dialysis Organizations (twice a month on Wednesday at 5:30 PM Eastern)

Wednesday, August 12^th at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1027088 Audio Webcast Link: https://protect2.fireeye.com/url?k=6b0af8ba-375ff16a-6b0ac985-0cc47a6a52de-6400b78b7f9a7c65&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2401

 

Nurses (twice a month on Thursdays at 3:00 PM Eastern)

Thursday, August 13^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7844289 Audio Webcast Link: https://protect2.fireeye.com/url?k=666e39a3-3a3b30b0-666e089c-0cc47adb5650-9c83dad655df67f4&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2421

 

Lessons from the Front Lines: COVID-19 (twice a month on Fridays at 12:30 – 2:00 PM Eastern)

Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.

This week’s Lessons from the Front Lines:

Friday, August 7^th at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 4695240

Audio Webcast Link: https://protect2.fireeye.com/url?k=c441afa6-9814a6b5-c4419e99-0cc47adb5650-c14a30d0298b73f0&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2376

 

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.

EPA has approved more than 460 products that are helping to reduce the spread of COVID-19

The U.S. Environmental Protection Agency (EPA) added 32 new surface disinfectants to List N, the agency’s list of products expected to kill SARS-CoV-2, the novel coronavirus that causes COVID-19.

“Since day one, EPA’s priority has been to provide the public with easy access to the information they need to protect themselves and their families from the virus that causes COVID-19,” said EPA Administrator Andrew Wheeler. “Through our efforts to expand List N, we are ensuring that Americans have a broad set of approved products to clean and disinfect surfaces to help reduce the spread of the coronavirus.”

Disinfectants can qualify for inclusion on List N three ways:

1. The product has been tested against the coronavirus SARS-CoV-2 (COVID-19).
2. The product has demonstrated efficacy against a different coronavirus similar to SARS-CoV-2 (COVID-19).
3. The product has demonstrated efficacy against a pathogen that is harder to kill than SARS-CoV-2 (COVID-19).

EPA has added 32 new products to List-N. These products have already been approved as tuberculocidal. While they have not yet been tested against SARS-CoV-2, they are approved for killing the pathogen that causes tuberculosis and are expected to kill SARS-CoV-2 (COVID-19) when used according to the label (category three noted above).

Many tuberculocidal products are potent disinfectants and have a long history of use for cleaning hospitals and other health care settings. When using such products, it is critical to follow the label directions, including the precautionary statements.

Disinfectant products may be marketed and sold under multiple different brand and product names. Therefore, List N users should use the first two sections of a product’s registration number when searching List N, rather than its brand name. For example, if EPA Reg. No. 12345-12 is on List N, you can buy EPA Reg. No. 12345-12-2567 and know you’re getting an equivalent product. For more information on using an EPA registration number to search List N, see our FAQ at https://www.epa.gov/coronavirus/frequent-questions-about-disinfectants-and-coronavirus-covid-19.

Throughout the COVID-19 public health emergency, EPA has provided the American public with information on disinfecting surfaces against SARS-CoV-2. For more information about EPA’s response to COVID-19 visit: https://www.epa.gov/coronavirus

AUDIENCE:

Licensees subject to Chapter 20 of Title 55 of the Pennsylvania Code.

PURPOSE:

To announce that the Pennsylvania Department of Human Services (DHS) had resumed annual inspections of programs licensed under Article IX or X of the Human Services Code, 62 P.S. §§ 901-922, 1001-1088 and 55 Pa. Code Chapter 20.

BACKGROUND:

On March 6, 2020, Governor Tom Wolf issued a Proclamation of Disaster Emergency (“the Disaster Proclamation”) to enable agencies to respond promptly to address the 2019 Novel Coronavirus (COVID-19) pandemic. With the Governor’s authorization as conferred in the Disaster Proclamation, on March 30, 2020, DHS announced that it “will not be conducting any annual licensing inspections until Governor Wolf lifts the current Proclamation of Disaster Emergency for COVID-19 or until such other time set by DHS” to support the Commonwealth’s efforts to prevent transmission and spread of COVID-19. In doing so, DHS suspended 62 P.S. §§ 911(a)(2) and 1016, to the extent those statutory provisions may be interpreted to require annual on-site visits, and the regulation at 55 Pa. Code Ş 20.31 (relating to annual inspection), which explicitly requires that DHS conduct an “on-site inspection of a facility or agency at least once every 12 months.”

DISCUSSION:

There are over 17,000 licensed settings across the Commonwealth that provide care and services to infants, toddlers, young children, individuals with mental illness, individuals with an intellectual disability or autism, and older adults.

DHS is responsible for enforcing licensing regulations intended to protect the health and safety of people who are served in licensed settings. Enforcement is primarily achieved by conducting annual on-site inspections of each setting to ensure that the licensee is in full compliance with
all applicable regulatory requirements. Regulatory requirements are applied and enforced by the following DHS program offices:

• Office of Child Development and Early Learning (OCDEL)
• Office of Children, Youth and Families (OCYF)
• Office of Developmental Programs (ODP)
• Office of Long-Term Living (OLTL)
• Office of Mental Health and Substance Abuse Services (OMHSAS)

DHS remains committed to preventing and containing the spread of COVID-19. As the Commonwealth reopens in accordance with the Governor’s Process to Reopen Pennsylvania, DHS has resumed annual on-site inspections of licensed settings. To balance the need to contain the COVID-19 virus with the responsibility for regulatory oversight and enforcement of licensed settings, DHS may apply alternative techniques for annual inspections that do not require an on-site presence in the licensed setting and when an in-person presence in the facility may contribute to the spread of COVID-19, e.g., a participant, consumer, or staff person has tested positive or is suspected to have COVID-19 in the past 21 days.

Alternative techniques include, but are not limited to, the use of videotelephony and file-sharing applications that will allow for real-time observations of conditions at the licensed setting. Use of these techniques will ensure that regulatory compliance is maintained in a manner that does not contribute to the spread of COVID-19. Additional information regarding the application of these techniques for annual inspections will be communicated to the field by DHS program office before the inspections takes place.

This suspension will remain in place only while the Disaster Proclamation remains in effect or such other time as DHS directs. DHS will continue to conduct complaint, incident, and protective services investigations on-site.

CONTACT
Please contact your regional licensing office for any questions.

July 23, 2020

The Trump administration has renewed the public health emergency for the coronavirus, ensuring that critical resources to fight the pandemic can continue while much of the country battles rising caseloads.

The news will come as relief to health care groups who worried that President Donald Trump would let the emergency declaration lapse when it was set to expire July 25, despite previous assurances from top administration officials it would be renewed.

The background: HHS Secretary Alex Azar declared the coronavirus a public health emergency in late January, shortly after Covid-19 emerged in the U.S., and the declaration was previously extended in April. Azar on Thursday evening announced through Twitter that he signed a renewal.

The emergency powers have helped the administration usher in a massive scale-up of telehealth visits, emergency approval of new drugs and tests and new flexibility for government-run health insurance programs. They have also let cash-strapped state and local health departments deploy federally funded personnel to focus on the virus.

Governors and health groups, nervous that Trump would end the emergency as he pushed for faster reopenings, for weeks had been urging the administration to authorize an extension, warning the pandemic response would be hampered without it. Vice President Mike Pence and Azar earlier this month told governors the emergency would likely be extended but had stopped short of providing a firm commitment.

Azar spokesperson Michael Caputo previously tried to knock down concerns the administration would let the emergency expire. “Enough already. @HHSGov expects to renew the Public Health Emergency due to COVID-19 before it expires,” Caputo tweeted a month ago.

What’s next: Public health emergencies last for 90 days, so the latest renewal will expire in late October without another extension. Trump at that point may be eager to tout victory over the coronavirus, but the expiration will come at the start of a flu season that federal health experts believe could be especially dangerous with the coronavirus still circulating.

The Pennsylvania Liquor Control Board (PLCB) issued clarifying guidance for licensees to reinforce the targeted statewide mitigation efforts at bars and restaurants in response to the recent rise in COVID cases. The Pennsylvania Department of Heath also recently updated frequently asked questions about the orders.

The clarifying PLCB guidance for restaurant, retail dispenser, and hotel licensees (whether offering indoor or outdoor seating); club and catering club licensees; brewery, distillery, limited distillery, winery, and limited winery licensees; and golf course licensees is summarized below:

• Sales of alcohol for on-premises consumption are only permissible as part of a larger transaction that includes a meal purchase. The term “meal” is defined in section 406 of the Pennsylvania Liquor Code as “food prepared on the premises, sufficient to constitute breakfast, lunch or dinner.” The definition expressly states that a snack, such as pretzels, popcorn, chips, or similar food, does not meet the definition of a meal.
• A customer who wishes to consume alcohol on premise must also purchase a meal; a group of customers who wish to consume alcohol on premises may do so as long as a meal is part of the purchase made by the group.
• Additional drinks may be purchased while the customer is consuming the meal, but no further drinks may be purchased after the meal is finished.
• Bar service of food and/or alcohol is prohibited.
• For Pennsylvania manufacturers (breweries, distilleries, and wineries), meals may be provided by the licensee or by a third party, such as a food truck.
• Casinos may no longer provide drink service on the casino floor.
• If a club does not sell food, either directly or through a concessionaire, it cannot use its liquor license.
• The governor’s additional order directing targeted mitigation measures specifically prohibits businesses that meet the definition of a “nightclub” under the Clear Indoor Air Act from operating.

View the PLCB guidance

View frequently asked questions about the targeted mitigation orders

Enforcement of the order is occurring through the Pennsylvania State Police and local law enforcement, the Liquor Control Board, and the Department of Agriculture.

For restaurants and bars, social distancing, mask-wearing and other mitigation measures must be employed to protect workers and patrons. In addition, occupancy is limited to 25 percent of the fire-code maximum occupancy for indoor dining, or 25 persons for a specific indoor event or gathering in a restaurant. The maximum occupancy limit includes staff.

Events and gatherings must adhere to the gathering limitations outlined previously, and below:

• Indoor events and gatherings of more than 25 persons are prohibited;
• Outdoor events and gatherings of more than 250 persons are prohibited; and
• The maximum occupancy limit includes staff.

The July 15 order also includes targeted mitigation efforts for other businesses, including a requirement to conduct operations remotely through individual teleworking of employees. Where telework is not possible, employees may conduct in-person business operations, provided that the business fully complies with all aspects of the business safety order, the worker safety order, and the masking order.

Police Bureau of Liquor Control Enforcement, the Department of Drug and Alcohol Programs, other state agencies, and local municipalities across the state. For more information about the PLCB, visit lcb.pa.gov.