Rural Health Information Hub Latest News

Total Forgiveness Offered for PPP Loans of $50,000 or Less

On Oct. 8, 2020, the U.S. Small Business Administration (SBA) issued interim final rule (IFR) guidance for the Paycheck Protection Program (PPP) that includes small business loan forgiveness relief on amounts of $50,000 or less. In addition, the SBA created a new two-page application form, Form 3508S, and related instructions for borrowers with loans of $50,000 or less. A borrower using this form is exempt from both:

  • Any reduction in its loan forgiveness amount on account of full-time equivalent reductions
  • Any reduction in its loan forgiveness amount on account of reductions in employee salaries or wages

The rule does not exempt a borrower that is using Form 3508S from submitting the required documentation to substantiate payroll and nonpayroll costs. These requirements (including the requirement that at least 60 percent of the potential forgiveness amount was used for eligible payroll costs) are largely unchanged from the existing ones. A BKD CPAs & Advisors article provides more information on the additional guidance and new lender review responsibilities.

Pennsylvania Releases Guidance on Reporting COVID-19 Test Results

The Pennsylvania Department of Health released Pennsylvania Health Alert 531 – 10/8/20 – ADV on reporting point of care SARS-CoV-2 test results. The U.S. Food and Drug Administration (FDA) issued Emergency Use Authorizations (EUA) for a number of COVID-19 point of care (POC) tests for rapid detection of SARS-CoV-2. These POC tests may be used by both traditional healthcare providers (e.g., hospitals, outpatient providers) and by non-traditional settings that have appropriate CLIA Certificate to conduct this testing. All entities conducting these POC tests are required to report these results, including positive, negative and inconclusive/indeterminate, to public health authorities through PA-NEDSS. Click here to view all the 2020 PA Health Alerts, Advisories and Updates.

Pennsylvania Releases Guidance on Point of Care Antigen Tests

The Pennsylvania Department of Health released Pennsylvania Health Alert 532 – 10/8/20 – ADV on point of care antigen test use and interpretation. The availability and use of antigen tests to detect SARS-CoV-2 is increasing. The main advantage of using these antigen tests is the rapid turnaround time for results; however, these tests are not as sensitive as molecular tests. This guidance is designed to describe what an antigen test is and how it differs from PCR testing, some best practices for sites conducting these tests, when point of care (POC) antigen testing should be considered, and circumstances that should be considered when interpreting antigen test results. Click here to view all the 2020 PA Health Alerts, Advisories and Updates.

Pennsylvania Seeks Comments on Managed Care Quality Strategy

The Pennsylvania Department of Human Services (DHS) published in the PA Bulletin the Medical Assistance (MA) and Children’s Health Insurance Program (CHIP) Managed Care Quality Strategy for the commonwealth for public review and comment. The Quality Strategy is to assure that the managed care organizations (MCOs) that are implementing DHS’s managed care programs are in compliance with the terms of their DHS agreements and have committed resources to: perform monitoring and ongoing quality improvement; contribute to the improvement of health for the populations they serve and incorporate new programmatic changes to assure that the individuals they serve have timely access to high-quality care. Interested persons are invited to submit comments regarding the MA Quality Strategy for the commonwealth to DHS at RA-PWQualityStrategy@pa.gov.

HIV/AIDS Clinics Sue HHS Over Drug Manufacturers’ Denials of 340B Pricing

The national association of HIV/AIDS clinics and two of its members sued U.S. Health and Human Services (HHS) Secretary Alex Azar in federal court to compel him to protect their rights to buy covered outpatient drugs from four manufacturers that refuse to sell them when ordered through 340B contract pharmacy arrangements. The Oct. 9 suit brought by Ryan White Clinics for 340B Access (RWC-340B), its Kentucky member Matthew 25 AIDS Services and its Tennessee member Cempa Community Care, is a major turning point in the months-long struggle over 340B contract pharmacy involving the drug industry, 340B covered entities and their trade associations, HHS, the U.S. Health Resources and Services Administration (HRSA) and Congress. It brings the federal judiciary into the equation. A second similar lawsuit against HHS and HRSA is expected soon. Click here for more information on the lawsuit.

Dept. of Health Announces Rapid Antigen Test Card Distributions 

The Wolf Administration has begun distributing the state’s first allotment of 250,000 COVID-19 antigen test kits provided by the federal government to Clinical Laboratory Improvement Amendments (CLIA)-certified institutions across Pennsylvania. Distribution is starting with Bradford, Centre, Lebanon, Montour, Northumberland, Schuylkill and Snyder counties because of the recent high disease incidence rate in these areas. The Secretary of Health also issued an order to laboratories, healthcare practitioners, healthcare providers and facilities reinforcing that all antigen test results, both positive and negative, are required to be reported to the Department of Health via its reporting system, PA-NEDSS. Click here to learn more.

NHSC and Nurse Corps Build Healthy Communities 

2020 Health Workforce Field Strength Numbers Increase Access to Primary and Substance Use Disorder Care

Read the full press release

 

There are now more than 16,000 National Health Service Corps (NHSC) members providing care to more than 17 million Americans. An additional 1.8 million patients are cared for by over 1,700 Nurse Corps clinicians. Nurse Corps also added 135 faculty to its rolls.

NHSC and Nurse Corps programs support the recruitment and retention of dedicated primary care, dental, and behavioral health providers who care for underserved patients daily in high-need areas of the U.S. and its territories.

As part of our commitment to recruiting clinicians interested in serving in underserved areas, we take an active role in connecting clinicians with employment opportunities at approved sites. After a pause this spring and summer, we recently resumed hosting Virtual Job Fairs -a live interactive platform that provides students and clinicians the opportunity to meet with hundreds of recruiters hiring in underserved communities across the country.

Share how we’re making strides to impact health equity and increase access to care for those who need it most. Forward this email and use the graphics below to share with your audiences. Follow and tag us on our NHSC and Nurse Corps Facebook, NHSC and Nurse Corps LinkedIn, and NHSC Twitter accounts.

Thank you all for the hard work you do. Your dedication and support throughout 2020 has helped communities all over the nation get through a very difficult year.

Learn about HRSA’s Coronavirus response at hrsa.gov/coronavirus

 

CMS: Enforcement Discretion Relating to Certain Pharmacy Billing

The Centers for Medicare & Medicaid Services (“CMS”) appreciates its long-standing partnership with immunizers, including pharmacies, to facilitate the efficient administration of vaccinations, particularly for vulnerable populations in long-term care facilities and other congregate care settings across America. Leveraging immunizers’ capabilities and expertise will play an important role in the Department’s ability to broadly distribute and administer COVID-19 vaccinations, including Medicare beneficiaries.

America is facing an unprecedented challenge. Quickly, safely, and effectively vaccinating our most vulnerable citizens in settings that have accounted for about 30 percent of U.S. COVID-19 deaths is a top-priority mission for the Trump Administration. Unfortunately, many long-term care facilities may not have sufficient capacity to receive, store, and administer vaccines. And some long-term care facility residents cannot safely leave the facility to receive vaccinations.

Outside immunizers can help fill that urgent need and provide onsite vaccinations at skilled nursing facilities (“SNFs”). But to do so during this global emergency, Medicare-enrolled vaccinators must be able to bill directly and receive direct reimbursement from the Medicare program. However, the Social Security Act requires SNFs to bill for certain services, including vaccine administration, even when SNFs rely on an outside vendor to perform the service. See Social Security Act §§ 1862(a)(18), 1842(b)(6)(E).

Therefore, in order to facilitate the efficient administration of COVID-19 vaccines to SNF residents, CMS will exercise enforcement discretion with respect to these statutory provisions as well as any associated statutory references and implementing regulations, including as interpreted in pertinent guidance (collectively, “SNF Consolidated Billing Provisions”). Through the exercise of that discretion, CMS will allow Medicare-enrolled immunizers, including but not limited to pharmacies working with the United States, to bill directly and receive direct reimbursement from the Medicare program for vaccinating Medicare SNF residents.

CMS will exercise such discretion (1) during the emergency period defined in paragraph (1)(B) of section 1135(g) of the Social Security Act (42 U.S.C. § 1320b-5(g)) and ending on the last day of the calendar quarter in which the last day of such emergency period occurs; or (2) so long as CMS determines that there is a public health need for mass COVID-19 vaccinations in congregate care settings—whichever is later. While CMS exercises this enforcement discretion, compliance with SNF Consolidated Billing Provisions is not material to CMS’ decision to reimburse for COVID-19 vaccine administration. If CMS decides in the future to cease exercising this enforcement discretion, CMS will provide public notice in advance and allow at least 60 days for affected outside immunizers to modify their business practices.