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Oct. 6th COVID-19 Update

New COVID-19-related updates for providers of long-term/post-acute care (LTPAC) and senior services continue to be shared on a regular basis by both state and federal authorities. The latest developments are outlined below.

As a reminder, LeadingAge NY continues to convene weekly webinars on Mondays at 11 a.m. to address emerging questions on COVID-19. A recording of our most recent webinar, held on Oct. 5th, is available here. If you have questions for next week’s update, which will be held on Tues., Oct. 13th at 1 p.m. due to Columbus Day, please send them to Ami Schnauber, and be sure to check your email for the access information, or contact Jeff Diamond.

Cross-Sector Updates

Feds Extend Emergency Declaration to January 2021

The Secretary of Health and Human Services (HHS), Alex Azar, has again extended the COVID-19 public health emergency declaration. The current declaration was set to expire Oct. 23rd and is now extended for an additional 90 days through Jan. 21, 2021. Click here for more information.

Opportunity to Apply for Provider Relief Funds

Last week, HHS announced that it will be accepting applications for a Phase 3 General Distribution of Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Provider Relief Funding (PRF). This phase will distribute $20 billion and will target providers that have not yet received PRF funding equal to 2 percent of their annual patient revenue, behavioral health providers, and new providers that opened in January through March 2020. Any remaining funding will be distributed to applicants with COVID-19-related losses not otherwise reimbursed. HHS invites providers that have already received PRF payments to apply for additional funding that will consider financial losses and changes in operating expenses caused by COVID-19. Any provider that has received PRF funding or was eligible to apply for funding is eligible to apply, although whether and how much funding a provider can expect based on COVID-19 losses will not be known until all applications are considered.

The announcement is available here, and the application portal is here. Applications are being accepted until Nov. 6th, but HHS requests that applications be submitted as soon as possible. All applicants are required to submit tax as well as operating revenue and expense information even if they have submitted such information for a prior PRF distribution. Application instructions are available under the heading “How to Apply for Phase 3 General Distribution” on the PRF Provider page here. In addition, HHS has scheduled a Provider Relief Fund – Phase 3 Informational Webcast for Thurs., Oct. 15th at 3 p.m. The registration link is here.

Recoupment of Medicare Advance Payments Delayed

The delay in recoupments of Medicare Accelerated and Advance Payments is now official. Most providers who had received advance Medicare payments this spring were originally required to begin repaying the advance 120 days after receipt through automatic recoupments that would have intercepted 100 percent of their Medicare payments. In anticipation of federal legislation, the Centers for Medicare and Medicaid Services (CMS) had not begun the recoupments.

The Continuing Appropriations Act, 2021 and Other Extensions Act (Continuing Resolution) that was signed into law on Oct. 1st to authorize continued federal government operations includes provisions adding repayment flexibilities for providers participating in the Medicare Accelerated and Advance Payment Program. The provisions delay recoupments of advance payments and reduce recoupment amounts once they do begin. No recoupments will start until a full year after issuance of the payment. After the year elapses, recoupments will begin at 25 percent for the first 11 months, then continue at 50 percent for six months. Any remaining balance 29 months after the issuance of the payment will be charged interest at 4 percent (instead of 10.25 percent).

The Medicare Accelerated and Advance Payment Program was suspended in late April, with no new applications accepted after that time. As of now, there is no indication that the program will be reactivated, but providers with questions may contact the State’s Medicare Administrative Contractor, National Government Services, at 888-802-3898.

LeadingAge NY Financial Assistance Guide Updated

The LeadingAge NY COVID-19 Financial Assistance Opportunities for Not-for-Profit Providers guide has been updated with the latest details on the PRF and Medicare Advance Payments and also includes updated information on the Main Street Lending Program. The guide provides the most up-to-date information on COVID-19-related financial assistance for members.

Travel Advisory States and Process to Request Exemption for End of Life

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 Oct. 6th, the Governor announced that New Mexico has been added to the list, while no states have been removed. Click here for more information and an archived list of states as they have been added or removed.

LeadingAge NY has received questions regarding residents, at end of life, having loved ones from states on the Travel Advisory who want to visit. Click here for information on how to request an exemption from the State for certain circumstances.

Executive Order Regarding International Travel

On Sept. 29th, the Governor issued an Executive Order reminding international travelers entering New York from Level 2 and 3 countries to quarantine and fill out the New York State Department of Health (DOH) traveler health form to further prevent the spread of COVID-19. New York State has, since March 2020, required a mandatory quarantine for any traveler entering New York from a Level 2 or Level 3 country – that is all but 31 countries on the globe. Since the Centers for Disease Control and Prevention (CDC) has continued to roll back their screening measures at airports accepting international flights, this measure is necessary to link travelers to the appropriate local DOH for contact tracing purposes. More information can be found in the Governor’s press release.

New York Launches COVID Alert NY Exposure App

New York State last week launched its COVID Alert NY mobile app to provide users with an anonymous notification whenever they have been in close, extended contact with someone who has tested positive for COVID-19. The app is programmed to collect information on exposures to COVID-19-positive individuals within six feet for longer than 10 minutes. Click here for more information.

County Positivity Rates

A listing of 14-day testing positivity rates for each county in New York State from CMS is available here. Current daily county-level data for New York State are available here, and ZIP code-level data for New York City (NYC) showing infection rates during the most recent four weeks are here.

Nursing Home Updates

Nursing Home Pandemic Emergency Plan FAQs

On Aug. 20th, DOH issued Dear Administrator Letter (DAL) NH 20-09 on the new nursing home Pandemic Emergency Plan (PEP) requirement. Under the requirement, which became effective Sept. 15th, each nursing home must prepare and make available to the public on the facility's website, and immediately on request, a PEP. A number of questions were raised related to the requirement, and DOH has issued a Frequently Asked Questions (FAQ) document seeking to clarify several issues.

Adult Care Facility (ACF)/Assisted Living (AL) Updates

Guidance for ACF/AL Providers Considering Conducting Rapid COVID-19 Tests

If you are confused about the rapid point-of-care (POC) COVID-19 tests, you are not alone. Here are some details to help you determine whether you would be able to meet the requirements to conduct the tests and consider the costs and benefits to doing so.

Home and Community-Based Services (HCBS) Updates

NYC PPE Stockpile – Open to LHCSAs

Licensed home care services agencies (LHCSAs) serving NYC are invited to attend live Medline.com webinar training sessions this week to learn the steps needed to place an emergency request for personal protective equipment (PPE) on Medline.com. This training will be in preparation for the “go-live” date for LHCSA access to the Medline.com platform. As a reminder, providers should note that this is an emergency source for PPE, and by submitting a request through Medline.com, they are confirming that the PPE they are requesting is required to protect staff and patients during the COVID-19 response and the agency requesting currently has less than one week of the requested supplies on hand.

Go-Live Dates

  • LHCSAs and NYC Agencies – Oct. 12th

Agencies should have received an invitation to the following:

Webinars (only attend one)

  • LHCSAs – Oct. 6th (3-3:45 p.m.), Oct. 7th (4-4:45 p.m.)
  • NYC Agencies – Oct. 7th (2:30-3 p.m.), Oct. 8th (10-10:30 a.m.)

If providers are unable to attend the two options for training, a training guide will be provided after the webinars. Additionally, following webinar training, agencies will receive instructions from Medline.com with more information on accessing the requesting platform.

Affordable Housing Updates

HUD Issues First COVID-19 Relief Payments

The Department of Housing and Urban Development (HUD) last week began notifying Section 202 and other HUD-assisted housing providers of their approved COVID-19 Supplemental Payments (CSPs). Click here for more information from LeadingAge National.

Take the LeadingAge Affordable Housing Survey Today!

To inform our housing policy work, LeadingAge is circulating a quick survey about the impacts of COVID-19 on affordable senior communities. The deadline for completing the survey is Wed., Oct. 7th. The survey should take about three minutes to complete, and each question is optional. Thank you for taking a moment to complete the survey.