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Aug. 11th COVID-19 Update

New updates pertaining to the COVID-19 emergency continue to be announced by both the state and federal government on a regular basis. The latest developments for providers of long-term/post-acute care (LTPAC) and senior services are delineated below.

As a reminder, LeadingAge NY continues to convene weekly webinars on Mondays at 11 a.m. to address emerging questions on COVID-19. Due to a scheduling conflict with the second legislative hearing on residential health care facilities and COVID-19, this week’s update will be held tomorrow, Wed., Aug. 12th. A recording of last week’s update, held on Aug. 5th due to the first hearing, is available here. If you have questions that you would like answered tomorrow or would like the webinar access information, please contact Jeff Diamond.

Cross-Sector Updates

Medicaid Recipients Cannot Be Billed for COVID-19 Expenses

The New York State Department of Health (DOH), in its July 2020 Medicaid Update, reminds providers that they may not charge Medicaid beneficiaries for protective measures, including sanitizing exam rooms and using personal protective equipment (PPE) such as masks, gowns, gloves, and shields. Cost sharing for Medicaid fee-for-service (FFS) and managed care members is limited to applicable copays based on federal rules, including New York’s Medicaid State Plan and the Medicaid Section 1115 Medicaid Redesign Team Waiver.

Billing Medicaid recipients for PPE is considered an “Unacceptable Practice” under Medicaid rules which may result in provider sanctions up to and including termination from the Medicaid program.

More Providers Eligible to Apply for Provider Relief Medicare Distributions

The Department of Health and Human Services (HHS) opened its Provider Relief Fund application portal on Aug. 10th to additional Medicare providers and reopened it for others that may have missed a prior opportunity to apply. These providers will have until Aug. 28th to apply, the same deadline that applies to the Provider Relief Fund opportunity for Medicaid, Children’s Health Insurance Program (CHIP), and dental providers.

HHS is inviting the following Medicare providers to apply for Medicare Provider Relief Funding:

  • Providers that missed the June 3rd deadline to apply for a second Provider Relief Fund payment by submitting their federal tax return and revenue loss information;
  • Providers that changed ownership in 2019 or 2020 under Medicare Part A and received no Medicare FFS payments in 2019;
  • Providers whose total General Distribution payments do not equal 2 percent of their annual patient service revenue across all payers; and
  • Providers that previously rejected General Distribution payments and want to reapply.

Those providers that have low Medicare volumes and mainly serve Medicaid beneficiaries should also consider applying since they may not have received their full General Distribution payment (i.e., 2 percent of annual patient service revenues) and they are not eligible to apply for the Medicaid/CHIP Distribution. According to HHS, there should be parity between the Medicare and Medicaid General Distribution payments. This was not possible for some providers whose Medicare cost reports did not report patient service revenues for all lines of business (e.g., assisted living). This new round of applications is those organizations’ chance to receive the full 2 percent of patient service revenue payment so they can address increased costs and lost revenues across all service lines.

For providers new to the application process and those who have questions, HHS is hosting another webinar this Thurs., Aug. 13th at 3 p.m. on the application process for both Medicare and Medicaid providers. Providers can register here.

New York Updates Travel Advisory List

LeadingAge NY has been tracking the COVID-19 Travel Advisory requiring people to quarantine if traveling to New York from certain states, with certain conditional exceptions for essential workers. On Aug. 11th, Governor Cuomo announced that Hawaii, South Dakota, and the Virgin Islands have been added, and Alaska, New Mexico, Ohio, and Rhode Island have been removed. Click here for more information and an archived list of states as they have been added or removed.

NYC DOHMH Issues Heat Alert

The New York City Department of Health and Mental Hygiene (NYC DOHMH) has issued an advisory for the current heat wave, which provides important information regarding precautions to take, as well as resources available to the community. Information regarding obtaining air conditioners and accessing cooling centers is included.

Nursing Home and Adult Care Facility (ACF)/Assisted Living (AL) Updates

LeadingAge NY CEO Jim Clyne Testifies at Legislative Hearing on COVID-19 Response and Long-Term Care

Jim Clyne, president and CEO of LeadingAge NY, testified on Aug. 10th at the second legislative hearing on the impact of COVID-19 on the long-term care system and the individuals it serves. Like the first hearing on Aug. 3rd, the focus of the Aug. 10th hearing was on nursing homes. Click here for more information.

Nursing Home and ACF Testing Requirements, Other Flexibilities Extended to Sept. 4th

On Aug. 5th, the Governor issued Executive Order (EO) 202.55 extending previously enacted EOs to Sept. 4th, including the required COVID-19 testing of personnel in nursing homes and ACFs.

More specifically, the following two EOs were extended to Sept. 4th:

  1. EO 202.30, requiring that the operator and administrator of all nursing homes and ACFs test or make arrangements for the testing of all personnel, including all employees, contract staff, medical staff, operators, and administrators, for COVID-19, twice per week. This is the initial EO which sets forth the testing requirement; and
  2. EO 202.40, changing the requirement of twice-weekly testing at nursing homes and ACFs to once-weekly testing for those facilities that are in regions that have entered Phase 2 of reopening.

All provisions under EO 202.30 were also extended, including nursing home and ACF compliance with rules and regulations, penalties for non-compliance, suspension and revocation and appointment of receiver for non-compliance, reporting requirements, prohibition of personnel refusing to test, and hospital discharges to nursing homes with negative test of patient and ability to provide proper care.

Prior EOs of interest to members remain extended as well, including many of the early flexibilities granted to providers, such as those relating to home health care supervision as soon as practicable or via telehealth, Expanded In-home Services for the Elderly Program (EISEP) eligibility criteria and assessments, utilization of licensed health care providers from out of state or Canada, ability of non-nursing staff to perform tasks under the supervision of a nurse, and professional licensing flexibilities for nurses.

For a more exhaustive list of the EO provisions extended last week, please consult this summary from LeadingAge NY counsel Hinman Straub. If you have any questions regarding the status of EO provisions, please contact our office.

Reminder: Please Complete ACF/AL and Nursing Home Cost Data Surveys by Aug. 21st

We know that members are extremely busy, but we urge ACF/AL and nursing home providers to assist us in our advocacy by completing our cost surveys. LeadingAge NY is working with other associations to collect updated cost information related to COVID-19 to help inform our advocacy efforts. The ACF/AL survey can be accessed here, and the nursing home survey is here. Please complete the surveys as soon as possible, but no later than Aug. 21st, and contact Ken Allison or Diane Darbyshire with any questions.

DOH Surveys and HCS Contact Information

DOH has requested that we remind members that the daily Health Emergency Response Data System (HERDS) survey must be completed every day by 1 p.m. The Department does not allow extensions to this or the weekly testing survey and will issue violations for failure to submit on time. LeadingAge NY suggested that the Department consider reducing the frequency of the daily survey given the many different issues providers are attending to on a daily basis.

DOH also asks that you ensure that a cell phone number is included in your Health Commerce System (HCS) Communications Directory so that DOH can reach someone during the weekends and evenings. Staff that answer phones during those hours should also ensure that DOH officials can connect with leadership if needed.

ACF/AL Infection Control Webinars

If you missed last week’s LeadingAge NY webinar entitled “Clean Up Your Infection Control Practices in ACF/Assisted Living,” you can click here for the recording and slides.

NYC DOHMH also provided an infection control webinar for NYC ACFs entitled “Competency Training and Best Practices for Preventing COVID-19 Spread in Adult Housing and Care Facilities” on Aug. 5th. The presentation and slides can be accessed on the NYC DOHMH website here; you can find the presentation under the header “Webinars.”

Affordable Housing Updates

HUD Announces October Restart of Physical Inspections

On Aug. 7th, the Department of Housing and Urban Development (HUD) announced that it will resume Real Estate Assessment Center (REAC) inspections of HUD multifamily and public housing properties in early October. The agency had halted physical inspections on March 13th due to the COVID-19 emergency and has said that it will utilize strict safety protocols to restart operations. Click here for more information from LeadingAge National.