Here are the latest need-to-know updates for Wednesday, December 16 regarding the COVID-19 pandemic.
LeadingAge Ohio will host its bi-monthly all-member webinar focused entirely on member questions and answers today at 4:00PM. We will include any updates from the Administration’s Vaccine Workgroup meeting currently taking place.
During the unscripted, 30-minute webinar, LeadingAge Ohio policy and regulatory experts Stephanie DeWees, Anne Shelley, Kathryn Brod and Susan Wallace will field YOUR questions on the vaccine and all things compliance, including infection control, testing, surveys, reporting requirements, and other fast-moving topics. Also joining us today will be special guests Beth Husted and Mary Jo McElyea from Absolute Pharmacy.
Members will be able to chat in questions during the webinar. Registration is required, but there is no fee to participate.
While LeadingAge Ohio continues to advocate for the consent form process to be streamlined, CVS has provided the following:
For additional information and resources, please visit the ODA website for the most update information. Linked below are some of the most up to date forms:
ODA Director Ursel J. McElroy let LeadingAge Ohio know that shipments of the physical consent forms have been released to many facilities. ODA is prioritizing shipments to those facilities whose clinics are occurring earliest, and they will arrive in the coming days (variable delivery dates depending upon facility). If a facility wishes to get started on collecting consent and the shipment has not yet arrived, the attached details will offer an alternate series of options.
The Department of Health and Human Services (HHS) announced that nursing homes will receive another $1.1 billion in COVID-19 relief funding. The additional funding is part of a newly revised plan to distribute over $24.5 billion in Phase 3 funding from the Provider Relief Fund (PRF) to more than 70,000 healthcare providers. That figure is up from the $20 billion that originally was planned for Phase 3. The agency said Wednesday the additional $4.5 billion is being used to satisfy close to 90% of each applicant’s reported lost revenues. HHS enhanced the Phase 3 distribution to consider the actual revenue losses and expenses experienced by providers that were attributable to COVID-19. These funds address lost revenues, a sticking point since HHS issued its reporting requirements for PRF. With this opportunity, previously eligible Provider Relief Fund applicants were invited to apply for additional funding, along with first time applicants.
Per the release, as HHS began analyzing applications, it realized the submissions for lost revenues and net changes in expenses would exceed the $20 billion budgeted for the Phase 3 allocation. In an effort to meet the demand, HHS added another $4 billion to the allocation bringing the new total to over $24 billion. This funding will distribute to providers up to 88 percent of their reported losses. HHS noted that 35,000 applicants will not receive an additional payment either because they experienced no change in revenues or net expenses attributable to COVID-19, or because they have already received funds that equal or exceed reimbursement of 88 percent of reported losses.
If a facility hasn’t received contact from its Pharmacy Partner regarding a planned date for the first dose of vaccines to be administered, please send your facility name and appropriate contact name to Kathryn Brod at firstname.lastname@example.org. The state has provided a contact name through whom to work to make sure a facility isn’t inadvertently missed. On a call just now with the Vaccine Workgroup, stakeholders were encouraged to understand that the vaccination process for nursing homes alone may take up to 4 weeks.
Yesterday, the bipartisan group of Senators and Representatives negotiating a compromise COVID relief package finally released their bills – one on non-controversial COVID relief and one on the very controversial issues of state and local funding, and liability protections. At 4:00 PM yesterday, Speaker Pelosi invited her counterparts – Rep. McCarthy, Leader McConnell and Sen. Schumer – to her office to commence negotiations on COVID relief. LeadingAge sent a letter to the four leaders urging them to pass both bills. While these bills do not contain all the relief we have requested since April, they provide critical relief essential to get members into the next year. LeadingAge will be posting a summary of the bills today.
The United States Food and Drug Administration (FDA) has recently issued an emergency authorization (EUA) for two investigational monoclonal antibody therapy treatments for cases of mild to moderate COVID-19 in adults who are at high risk for progressing to more severe cases.
Nursing facilities will be permitted to administer the treatment, and they will also be permitted to contract with other entities to administer the treatment.
Here is what members need to know about billing for the Monoclonal treatment and the COVID-19 vaccines:
NOTE: The EUAs for COVID-19 monoclonal antibody treatments bamlanivimab, and casirivimab and imdevimab (administered together), contain specific requirements for administration that are considerably more complex than for other services that are billed using roster billing. CMS has stated that it expects that health care providers will maintain appropriate medical documentation that supports the medical necessity of the service. This includes documentation that supports that the terms of the applicable EUA are met, including that it is being used for the treatment of mild to moderate COVID-19 for a patient that is at high risk for progressing to severe COVID-19 and/or hospitalization. The documentation should also include the name of the practitioner who ordered or made the decision to administer the infusion, even in cases where claims for these services are submitted on roster bills.
Below is a listing of the CPT codes for the COVID-19 Vaccines and the Monoclonal Antibody Treatment:
The Ohio Department of Medicaid (ODM) is modernizing its systems and processes to better manage the program. This will roll out in two steps:
In 2016, the Centers for Medicare and Medicaid issued guidance on enhanced federal funding related to Medicaid Information Technology (IT) in both Medicaid Management Information Systems (MMIS) and Medicaid Eligibility and Enrollment (E&E) Systems. The agency also revised the conditions and standards state Medicaid IT systems must meet to qualify for enhanced federal funding. It urged states to leverage proven, commercial-off-the-shelf technology solutions and adopt a modular approach to technology upgrades.
ODM responded by creating the Ohio Medicaid Enterprise System (OMES) – a modular technology framework that integrates the critical capabilities and functionality of today’s siloed systems.
On March 8, 2021, ODM will launch the first component of the OMES platform -- the Provider Network Management (PNM) module – as well as a new provider portal. Together these tools will ease the administrative requirements for enrollment and revalidation.
The PNM module will allow providers to submit change requests online vs. submitting by mail or e-mail. Its single-entry provider portal will streamline:
ODM is in the early stages of provider outreach. In coming weeks, more information will be shared about what these changes mean to providers and how providers will need to prepare. ODM plans to send surveys to a randomized group of providers to identify the needs and concerns in managing this change. Results will then shape how ODM informs and trains providers for a successful, on-time transition.
LeadingAge shares the latest coronavirus news and resources with members twice each weekday. This morning's update featured more on the 2020 Year in Review: Insights, Tools, and Resources.
Check out the full report here.
Please send all questions to COVID19@leadingageohio.org. Additionally, members are encouraged to visit the LeadingAge Ohio COVID-19 Working Group facebook group to pose questions to peers and share best practices. LeadingAge is continuing its daily calls for all members. To participate in these daily online updates, members should register here.
LeadingAge Ohio is working to ensure that the information in our daily alerts, on our website, and all coronavirus-related communications is as accurate as possible. However, LeadingAge Ohio makes no guarantees about the accuracy of the information.