Coronavirus Daily Update: VNSNY Taking COVID-19 Referrals from Hospitals

During this critical time, Home Health Care News remains committed to bringing you all the essential news related to home-based care operations. At the same time, we also recognize the seriousness of the COVID-19 pandemic. In addition to our regular content, we’ll continue to highlight industry-related developments and mitigation strategies in this rolling bulletin.

What you need to know from Friday through Sunday (April 3-April 5)

— The Visiting Nurse Service of New York (VNSNY), one of the nation’s largest not-for-profit home- and community-based health care organizations, is accepting COVID-19 referrals from hospitals. New York has been hit the hardest of all U.S. states when it comes to coronavirus caseload. VNSNY will serve coronavirus patients who are stable enough to be discharged to home.

— State home health trade associations are getting creative to source PPE.

— On Friday, CMS approved another Medicaid 1135 waiver — this time for the District of Columbia. As of Sunday, CMS had issued a total of 45 Medicaid 1135 waivers, often on a retroactive basis.

— As of Sunday afternoon, the novel coronavirus had infected more than 1.2 million people and killed more than 68,000 worldwide, according to Johns Hopkins University data.

What you need to know from Thursday (April 2)

— Widespread use of telehealth — which has boomed amid COVID-19 — could be here to stay. Venture capital experts predict telehealth usage and valuations will remain strong even after the pandemic ends.

— WellSky has launched a care coordination network to help hospitals, payers and accountable care organizations (ACOs) collaborate with home-based care providers in order to keep patients out of overtaxed hospitals. The initiative builds on the Amedisys-WellSky personal care network created last year.

— President Donald Trump has issued an order under the Defense Production Act to speed up the production of ventilators by helping domestic manufacturers get the supplies they need to make them.

— Alaska, Arkansa and Nebraska have been granted 1135 waivers by CMS, bringing the total number of waivered states up to 44.

— Humana is simplifying and expediting claims and suspending prior authorization and referral requirements for certain patients and providers.

— Unemployment claims have doubled in the past week, jumping from 3.3 million to 6.6 million, according to data released by the Labor Department Thursday. The CARES Act, which was passed last week, is helping more unemployed people collect more money than ever before.

April 1

— Humana Inc. (NYSE: HUM) is waiving medical costs for beneficiaries getting testing and treatment related to the coronavirus. The insurer is also lifting administrative requirements for patients in settings where capacity is being stretched as a result of the pandemic, allowing “unencumbered movement from inpatient hospitals to safe, medically appropriate post-acute care settings” such as home health.

— A growing number of landlords are offering rent relief for senior living operators, who are especially struggling amid COVID-19.

— Yet another state — Georgia — has been granted a Medicaid 1135 waiver by CMS.

— The CDC is reconsidering its guidelines for who should wear masks to mitigate the risk of COVID-19 spreading, as more evidence suggests people without symptoms may be spreading the virus.

— The White House has predicted that between 100,000 and 240,000 people in the U.S. will die from coronavirus, with fatalities reaching their height in the next two weeks.

March 31

— The National Association for Home Care & Hospice (NAHC) thanked CMS for releasing new emergency rules and flexibilities for Medicare providers but said more work needs to be done to help home health providers.

— CMS has approved several additional Medicaid 1135 waivers, bringing the total number of waivered states up to 40. The latest additions include West Virginia, Vermont, Montana, Texas, South Carolina and Tennessee.

— The United States’ COVID-19 death toll has surpassed China’s, according to Johns Hopkins University. So far, more than 3,400 people have died in the U.S., while 3,300 people have reportedly died in China, where the virus originated.

— COVID-19 continues to batter New York, which has nearly half the country’s coronavirus cases. In response, Gov. Andrew Cuomo is calling on health care workers from across the country to come help, and NYC has turned part of Central Park into a makeshift hospital.

— Some home-based care workers are getting a pay boost for their COVID-19 response efforts. CareFinders — a Hackensack, New Jersey-based home care agency — announced it’s giving employees appreciation pay, while Maine Gov. Janet Mills is giving personal care workers raises three months early. The move in Maine comes after the state’s labor commission called for a caregiver pay hike earlier this year.

NAHC responds to new CMS flexibilities

NAHC applauded CMS’s latest round of policy flexibilities, which the agency released Monday. However, the industry needs to see more changes in the weeks to come, NAHC President Bill Dombi told HHCN in a statement.

As part of its latest round of COVID-19 policy relief, CMS announced that it is loosening the Medicare homebound requirements and suspending the Review Choice Demonstration (RCD), among other changes.

Those flexibilities and others will help increase care access, reduce paperwork burdens and create more delivery options for home-based care providers, Dombi said.

“The most valuable actions are expanded opportunities to combine telehealth services with in-person visits to patients, the suspension of burdensome claim review activities and the waiver of some operational requirements that did not affect direct delivery of care,” he said.

Dombi called CMS’s move a “big step forward,” but acknowledged the need for more home-based care relief.

“While there remains work to be done, this is progress at such an important time,” he said. “Additional changes are still needed, particularly around direct reimbursement for telehealth services as home health agencies cannot afford to provide the care for free.”

March 30

— CMS has announced yet another round of temporary rules and waivers to help providers combat and mitigate COVID-19. The changes include a suspension of the Review Choice Demonstration (RCD) and more.

— President Donald Trump extended the nationwide social distancing guidelines through April 30, while also sharing his expectation that the country would be “well on our way to recovery” by June 1.

— The Department of Labor has clarified which health care providers are exempt from new federally mandated paid sick leave rules. Home health care providers made the cut, while home care providers are optimistically seeking additional guidance.

— The Alzheimer’s Association worked with dozens of long-term care stakeholders to develop and publish new coronavirus-related guidelines for providers who care for people with dementia.

— The CDC has issued a travel warning for New York, New Jersey and Connecticut, where more than half of the nation’s COVID-19 cases are.

— A 1,000-bed Navy hospital ship docked in NYC Monday to help take some burden off of the city’s hospitals.

CMS takes action

CMS is giving Medicare providers even more flexibility to provide services via telehealth in light of COVID-19.

The agency announced Monday that it will temporarily pay (some) providers for virtual visits at in-person visit rates and that it will allow more than 80 additional services to be furnished via telehealth.

“Front line healthcare providers need to be able to focus on patient care in the most flexible and innovative ways possible,” CMS Administrator Seema Verma said in a press release announcing the news. “This unprecedented temporary relaxation in regulation will help the healthcare system deal with patient surges by giving it tools and support to create non-traditional care sites and staff them quickly.”

CMS also reiterated that face-to-face visit requirements for home health can now be fulfilled using telehealth. Additionally, providers can evaluate beneficiaries using audio alone, rather than audio and video together.

Additionally, directly related to home health care, CMS said it is loosening the Medicare homebound requirement and suspending RCD.

For daily updates from the week of March 23, click here.

For daily updates from the week of March 16, click here.

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