Coronavirus Daily Update: Second Round of CMS Emergency Payments Delayed

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 17-19)

— Despite the fact that CMS Administrator Seema Verma said there would be more guidance on the second round of emergency payments to health care providers toward the end of the week ended April 18, it seems it could be the end of the month before the remaining $70 billion is dispersed.

— Over in the U.K., health leaders say home is the second most common setting for coronavirus deaths.

— President Donald Trump has released new guidance on how and when parts of the country should reopen, however many states are arguing that the decision is theirs to make. Still, according to Trump, up to 29 states “will be able to open relatively soon. ”

— Another 5.2 million people filed for unemployment last week, meaning more than 22 million people have been put out of work in the past four weeks. 

— Millions of people who filed their taxes through sites like H&R Block and TurboTax are having trouble getting their stimulus checks due to glitches in the system.

What you need to know from Thursday (April 16)

— The Partnership for Medicaid Home-Based Care is urging Congress to grant home- and community-based service (HCBS) providers priority access to PPE and establish a direct care worker fund.

— The New York State Nurses Association plans to file multiple lawsuits next week over a lack of PPE and what it views as dangerous guidance issued by the state department of health, Politico reports. The lawsuits would be the first legal action of their kind since the COVID-19 outbreak began.

— N95 respirators can be safely decontaminated without undermining functional integrity only two or three times, a government study has found.

— Signs are pointing to the fact that America’s home-based care space will soon become the next ground zero in the battle against the coronavirus. In many ways, providers are currently experiencing the calm before the storm.

— The Small Business Administration has run out of money for its Paycheck Protection Program, leaving millions of small businesses — including in-home care agencies — unable to apply for emergency loans. Lending experts predicted that would happen last month. “My opinion is that it’ll be kind of first come, first serve,” Shep Harris, a loan officer at Live Oak Bank, previously told HHCN. “Now, will [Congress] step up and sign something else if there’s a long list thereafter? Who knows.”

Advocacy efforts continue

The Partnership for Medicaid Home-Based Care continued advocacy efforts on Capitol Hill on Thursday, specifically calling for Congress to create an emergency fund for direct care workers and add home-based care providers to those receiving priority access to PPE.

“There are over 3.2 million HCBS direct care workers providing essential support services to more than 8.3 million people in the U.S.,” the partnership’s chairman, David Totaro, said in a statement. “These essential direct care workers have continued to provide needed care day in and day out under the current state of emergency and provide health sustaining services for seniors and people with disabilities in their homes and who are at increased risk from COVID-19.”

Failure to support HCBS providers will results in the worsening of chronic conditions or disability, leading to further emergency department visits and hospitalization, Totaro argued.

What you need to know from Wednesday (April 15)

— The Department of Health & Human Services (HHS) has released new guidance for Medicare providers — such as home health agencies — receiving their portion of $30 billion in COVID-19 relief funding made possible by the CARES Act. While there was previously confusion around whether providers had to be treating COVID-19 positive patients to receive funding, HHS has clarified “care does not have to be specific to treating COVID-19.” HHS broadly views every patient as a possible case of COVID-19.

— While the first $30 billion in COVID-19 relief funding went to Medicare providers specifically, CMS Administrator Seema Verma said the $70 billion remaining in the relief fund will be distributed more broadly across the health care system. CMS should be releasing more details on disbursement later this week, Verma said on a Wednesday call with the media.

— Also from CMS: The agency announced Medicare will pay nearly double for certain “high-production” lab tests used to diagnose COVID-19, which would presumably apply to home health providers. On Wednesday’s media call, Verma explained the goal is to encourage labs to perform more coronavirus testing and ensure that reimbursement is not an issue. “That should increase testing capacity across the country,” she said. “And there’s a lot of unused capacity, so that’s something that’s not specific to nursing homes, but really across the board.”

— As of April 9, nearly 9,300 U.S. health care workers reported having COVID-19, according to a new report published by Centers for Disease Control and Prevention (CDC). The infection tally included at least 27 deaths and suggests health care workers account for about 11% of all COVID-19 cases. However, experts think the actual numbers — of both infections and deaths — could be much higher.

— President Donald Trump said he plans to cut off all U.S. funding to the World Health Organization (WHO) because of how it handled the coronavirus. He plans to freeze funding for 60 to 90 days while his administration reviews how WHO handled the crisis, a decision some worry is ill-advised in the face of a global health emergency. President Trump himself has come under fire for his early handling of the coronavirus.

April 14

— While on a call with home health and hospice providers Tuesday, CMS reiterated that it was relaxing time frames related to OASIS transmissions by extending the five-day completion requirement for the comprehensive assessment to 30 days and waving the 30-day OASIS submission requirement. Delayed submissions are permitted during the duration of the public health emergency for home health providers.

The American Hospital Association (AHA) sent a letter to CMS, urging the agency to use its authority to extend additional relief to home health agencies in order to help the overall response to the COVID-19 virus in the U.S. More help would allow hospitals to use precious resources on just the patients that required hospitalization and more intensive care, Thomas P. Nickels, the AHA’s executive VP, said in the letter. Specifically, the AHA recommended home health telehealth visits be reimbursed as in-person visits and more flexibility for physician and non-physician practitioners to verbally order home care for patients. CMS has previously told providers that it is statutorily prohibited from reimbursing telehealth visits in the same way it does for in-person visits.

— A home health care nurse quit her job at Henry Ford Health System in Detroit due to fears over the company’s COVID-19 protocols, or lack thereof. The nurse claimed that she expressed concerns about workers dealing with COVID-19 patients and non-COVID-19 patients on the same day, but that those concerns were ignored. The health system responded in a statement saying that it requires the proper personal protective equipment be used for all of its visits and that its workers were treating non-COVID-19 patients on different days than COVID-19 patients when possible.

— The Home Care Association of American (HCAOA) released its official protocol for home care agencies that had no known exposures to the COVID-19 virus. Included is a guide with steps for “agency preparedness,” “caregiver guidance” and “client awareness.”

— Over 3,800 people have died of the COVID-19 virus in long-term facilities across the U.S., the New York Times reports. Overall, more than 21,000 cases have been reported from over 2,500 facilities.

What you need to know from Monday (April 13)

— A month after LHC Group Inc. (Nasdaq: LHCG) Chief Strategy and Innovation Officer Bruce Greenstein said his company would be deploying in-home testing, not much of it has been done, NPR reported Monday.

— The CARES Act was a good start, but the next relief package should specifically aim to help seniors, Max Richtman argued in The Hill today. Richtman is the president and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM). Because seniors are more likely to suffer adverse effects if they contract the COVID-19 virus, the health care costs can cause financial shock that seniors on fixed income cannot afford. Between health care costs and basic costs of living, the current relief direct payments are not enough, Richtman believes.

On Monday, the World Health Organization (WHO) expressed concern that not all recovered COVID-19 patients develop the antibodies required to make them immune to a second infection. Proper antibody testing could be critical for health care organizations to control the virus moving forward in order to ensure a patient is not infected again. Some home-based care agencies have already prioritized securing antibody tests.

— Separately, governors on both the East Coast and West Coast announced the forming of multi-state coalitions Monday to help determine when to begin relaxing in-place restrictions and when to reopen the participating states’ economies. On the West Coast, governors from California, Washington and Oregon will be working on a joint approach to reopen their economies. On the East Coast, the group included New York, New Jersey, Pennsylvania, Connecticut, Delaware and Rhode Island. No specific planning was laid out just yet, but Gov. Gavin Newsom of California promised the decisions would be based on “facts,” “evidence” and “science.”

— In a letter addressed to CMS Administrator Seema Verma, the Medicaid and CHIP Payment and Access Commission (MACPAC) argued that Medicaid providers were being left behind in relief funding. The letter urged Verma to take into consideration the needs of those providers and other low-income populations when deciding how to disperse the federal funding that has yet to be distributed.

NPR digs into LHC Group’s COVID-19 testing

In March, President Donald Trump hosted a public address at the White House alongside top health care executives, promising in-home testing for COVID-19 moving forward. Today, few in-home tests have been conducted, NPR reports.

The home health care industry was represented by LHC Group Chief Strategy and Innovation Officer Bruce Greenstein during the address. At the time, Greenstein said his company would help deploy the at-home testing.

“We’re very proud to be part of the equation for testing in their own home,” Greenstain said on March 13. “For Americans that can’t get to a test site, or live in rural areas far away from the retail establishment, we’re here to help.”

To check in on that claim, NPR contacted more than 20 LHC Group locations in a dozen states. None of the locations NPR contacted are doing in-home COVID-19 testing.

In a response to NPR, Greenstein said LHC Group’s priority has been acquiring personal protective equipment. Additionally, he said, LHC Group will be working with a New Orleans hospital to provide testing “as soon as next week.”

For daily updates from the week of April 6, click here.

For daily updates from the week of March 30, click here.

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

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

HHCN encourages you to reach out to us individually or at [email protected] for story ideas, tips or general feedback.