In response to the COVID-19 crisis, the U.S. Department of Labor (DOL) released a new rule that temporarily extends the period in which eligible employees can elect COBRA health insurance coverage. The ruling also extends the deadline for eligible employees to begin making COBRA premium payments and it extends the time for plan participants to file benefit claims or appeal denied claims. On May 4, the DOL and IRS jointly published Extension of Certain Timeframes for Employee Benefit Plans, Participants, and Beneficiaries Affected by the COVID-19 Outbreak. The DOL also posted a new set of COVID-19 FAQ’s for Participants and Beneficiaries to help both employees and employers navigate the new rule.

The Department of Health and Human Services Assistant Secretary for Preparedness and Response (ASPR) has posted a Workforce Virtual Toolkit through the ASPR’s Technical Resources, Assistance Center, and Information Exchange (TRACIE). “COVID-19 Workforce Virtual Toolkit: Resources for Healthcare Decision-Makers Responding to COVID-19 Workforce Concerns” includes pages of resources for:

• Workforce surge planning and volunteer matching
• Liability protections
• Licensure
• Scope of practice expansions
• Healthcare workforce training resources
• Workforce protection resources
• Workforce resilience/sustainability resources

You can also share your resources for other health care organizations to use.

The Health Resources and Services Administration (HRSA), through funding from the Family First Cononavirus Relief Act and CARES Act, will provide claims reimbursement to healthcare providers generally at Medicare rates for testing uninsured individuals for COVID-19 and treating uninsured individuals with a COVID-19 diagnosis. Acceptance of claims began May 6 for dates of service retroactive to Feb. 4, 2020 for this population. CMS has not issued a federal Marketplace special enrollment period (SEP) for those who are uninsured, however, special enrollment periods are still available for those who lost coverage or experienced a life event such as divorce or moving. Here’s the timeline:

• February 4 – Retroactive date to request claims reimbursement
• April 27 – Sign up period begins for the program
• April 29 – On-demand training starts
• May 6 – Begin submitting claims electronically
• Mid-May – Begin receiving reimbursement

When submitting claims you must attest that: you have checked for healthcare coverage eligibility and confirmed that the patient is uninsured; you have verified that the patient does not have individual, employer-sponsored, Medicare or Medicaid coverage, and no other payer will reimburse you for COVID-19 testing and/or care for that patient; you will accept defined program reimbursement as payment in full; and you agree not to balance bill the patient. For more, visit the COVID-19 Testing & Treatment Claims for the Uninsured website.

The Pennsylvania Department of Human Services shared information about the Emergency Cash Assistance Program opening to families with a child under age 18 or pregnant women making 150 percent of the Federal Poverty Guidelines or less. Families must also meet resource limits and have at least one person who was employed as of March 11, 2020 and lost employment or experienced an hour and wage reduction of at least 50 percent for at least two weeks due to the pandemic. Eligible families will receive a one-time payment equal to two months of the Temporary Assistance for Needy Families (TANF) benefits for their household size, so a family of three would get an average one-time payment of $806. TANF provides financial assistance to help pay for food, shelter, utilities and expenses other than medical. The program will run through June 12.

The Pennsylvania Department of Human Services (DHS) reports a decline in Medicaid applications from mid-March until early April, which occurred due to a significant decrease in paper applications. Online applications through COMPASS did increase, but not enough to compensate for the decline in paper applications. The number of paper applications is now beginning to increase to almost the same number of applications submitted prior to the County Assistance Office (CAO) closures to the public. It is important to be aware that:

• CAOs continue to accept and process Medical Assistance applications.
• Consumers are permitted to self-attest to application questions which previously required documented proof.

Those enrolling should always use the notes box on the application to highlight any important information which can assist with processing, such as “I am applying for Medical Assistance for Workers with Disabilities” or “I have a health emergency” and provide specific information.

Enrolling immigrants in public programs amid the COVID-19 pandemic with the most recent changes to the Public Charge rules can be quite confusing. Enrollment assisters are tasked with knowing what is available, who is eligible and what implications applying and enrolling may present. Protecting Immigrant Families is a coalition of hundreds of diverse organizations who develop innovative advocacy strategies, distribute educational resources and keep allies informed of all the current and potential policies that impact immigrant families. Protecting Immigrant Families has produced a helpful table with important information for those applying for benefits. Access the most recent table on Immigrant Eligibility for Public Programs here.

As part of the National Institute for Occupational Safety and Health’s (NIOSH) efforts to keep our stakeholders up to date on the CDC and NIOSH COVID-19 response, below is a summary of new information posted this week.

General Resources 

Critical Infrastructure Sector Response Planning Guidance 
This guidance is on COVID-19 response planning for the critical infrastructure sector. Maintaining critical infrastructure operations during the COVID-19 pandemic is imperative for both public health and safety as well as community well-being. A COVID-19 response plan can help critical infrastructure employers prevent or slow the spread of COVID-19 in their workplaces and continue their essential business functions.

This guidance supplements the existing CDC Guidance for Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19.

Coping with Job Stress and Building Resilience During the COVID-19 Pandemic Fact Sheets
This new guidance for employees and healthcare personnel and first responders provides ways to recognize symptoms of stress, tips to cope and enhance resilience, and where to go for help. The COVID-19 pandemic has changed the way we work, whether you are going into work or are working from home. Fear and anxiety about this disease can be overwhelming, and workplace stress can lead to burnout. 

Fatigue in the Workplace Fact Sheet
This new fact sheet has information on strategies that workers and employers can use to manage workplace fatigue and work safely during COVID-19. The fact sheet includes tips to improve sleep and what to do if you feel too tired to work safely. It also has steps employers should take to reduce workplace fatigue for workers.

Respirator Purchasing Resources 

Factors to Consider when Planning to Purchase Respirators From Another Country
This guidance provides information for potential purchasers of international respirators in making informed procurement and distribution decisions to keep their workers safe. When NIOSH approves a respirator, the user can be confident that the device will provide the expected level of protection, as long as it fits properly and is worn correctly. But when there is a shortage of NIOSH-approved filtering facepiece respirators (FFRs), as we are experiencing during the COVID-19 pandemic, other reliable options must be found.

Industry Specific Resources

Long-haul Truck Drivers Fact Sheet
This fact sheet identifies these potential exposures to help drivers and their employers prevent the spread of respiratory illness. Long-haul truck drivers may be at risk for exposure to the virus that causes COVID-19. Potential exposures include close contact with others, including other drivers.

For More Information

For more information, please visit the COVID-19 webpage. To stay up to date on new developments, sign up for the COVID-19 newsletter.

As part of the ongoing White House Task Force efforts taken in response to coronavirus disease 2019 (COVID-19), following is a summary of recent Centers for Medicare & Medicaid Services (CMS) actions. To keep up with the important Task Force work being done in response to COVID-19, click here www.coronavirus.gov. For information specific to CMS, please visit the CMS News Room and Current Emergencies Website.   CMS updates these resources on an ongoing basis throughout the day; the information below is current as of May 11, 2020 at 10:00 a.m. ET.

CMS Releases Additional Waivers for Hospitals and Other Facilities

CMS continues to release waivers for the healthcare community that provide the flexibilities needed to take care of patients during the COVID-19 public health emergency (PHE). CMS recently provided additional blanket waivers for the duration of the PHE that:

• Expand hospitals’ ability to offer long-term care services (“swing beds”);
• Waive distance requirements, market share, and bed requirements for Sole Community Hospitals;
• Waive certain eligibility requirements for Medicare-Dependent, Small Rural Hospitals (MDHs); and
• Update specific life safety code requirements for hospitals, hospice, and long-term care facilities.

Emergency Declaration Blanket Waivers

Telehealth Video: Medicare Coverage and Payment of Virtual Services

CMS updated a video that answers common questions about the expanded Medicare telehealth services benefit during the COVID-19 public health emergency. New information includes how CMS adds services to the list of telehealth services, additional practitioners that can provide telehealth services, and the distant site services that Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can provide. Further, the video includes information about audio-only telehealth services, telehealth services that hospitals, nursing homes and home health agencies can provide, along with how to correctly bill for telehealth services.

Medicare Pharmacies and Other Suppliers May Temporarily Enroll as Independent Clinical Diagnostic Laboratories to Help Address COVID-19 Testing

CMS published information for pharmacies and other suppliers that wish to enroll in Medicare temporarily as independent clinical diagnostic laboratories to help address the need for COVID-19 testing. Interested pharmacies and suppliers will need to apply for a Clinical Laboratory Improvement Amendments (CLIA) certificate. CMS wants to ensure that laboratories located in the United States applying for a CLIA certificate are able to begin testing for COVID-19 as quickly as possible.

MLN Matters Article

CMS Gives States Additional Flexibility to Address Coronavirus Pandemic

CMS has approved over 175 requests for state relief in response to the COVID-19 pandemic, including recent approvals for Alabama, Alaska, California, District of Columbia, Georgia, Maine, Massachusetts, Minnesota, Mississippi, Montana, Nebraska, New Mexico, Oregon, South Carolina, Rhode Island, Tennessee, Virginia, and Wisconsin. These approvals help to ensure that states have the tools they need to combat COVID-19 through a wide variety of waivers, amendments, and Medicaid state plan flexibilities, including support for programs that care for the elderly and people with disabilities. CMS developed a toolkit to expedite the application and review of each request and has approved these requests in record time. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

Section 1135 Waivers

Section 1115(a) Waivers

1915(c) Waiver Appendix K Amendments

Medicaid State Plan Amendments

CHIP State Plan Amendments