Knowledge Base Article

MMP remains committed to continuing to monitor for COVID-19 updates specific to our reader base. This week we highlight key updates spanning from May 12th through May 15th.  

Resource Spotlight This Week:

This week’s spotlight is on a May 4th pdf document titled COVID-19 Regulations & Waivers to Enable Health System Expansion highlighting how CMS has enabled significant health system flexibility during the COVID-19 Public Health Emergency (PHE) through Medicare 1135 blanket waivers and the passage of two interim final rules. You can also find this presentation on the CMS Coronavirus Waivers and Flexibilities webpage. 

May 12, 2020: Price Transparency Requirement to Post Cash Prices Online for COVID-19 Diagnostic Testing

In a May 12 Special Edition MLNConnects newsletter, CMS noted the following regarding Price Transparency Requirements:

“The Coronavirus Aid, Relief, and Economic Security (CARES) Act includes a number of provisions to provide relief to the public from issues caused by the pandemic, including price transparency for COVID -19 testing. Section 3202(b) of the CARES Act requires providers of diagnostic tests for COVID-19 to post the cash price for a COVID-19 diagnostic test on their website from March 27 through the end of the public health emergency. For more information, see the FAQs. (PDF).”

CMS has also posted a Q&A Document specific to the Price Transparency Requirement.

May 13, 2020: CMS Issues Nursing Homes Best Practices Toolkit to Combat COVID-19

This Toolkit includes recommendations and best practices from front line health care providers, governors’ COVID-19 task forces, associations, organizations and experts. It is intended to provide a catalogue of resources dedicated to address challenges facing nursing homes in the fight against COVID-19. You can read more in a related CMS Press Release.

May 14, 2020: FDA Informs Public about Possible Accuracy Concerns with Abbott ID NOW Point-of-Care Test for COVID-19

The FDA Alert indicates that early data suggests potential inaccurate results from using this point-of-care to diagnose COVID-19. Specifically, the test may return false negative results. They will continue to work with Abbott and communicate any updates publicly.

May 14, 2020: FDA Health Advisory Issued: Multisystem Inflammatory Syndrome in Children (MIS-C) Association with COVID-19

The CDC issued an official Health Advisory alert providing background information on several cases of a recently reported MIS-C associated with COVID-19 and a case definition of the syndrome. “CDC recommends healthcare providers report any patient who meets the case definition to local, state, and territorial health departments to enhance knowledge of risk factors, pathogenesis, clinical course, and treatment of this syndrome.”

The Case Definition for MIS-C includes the following:

• An individual aged <21 years presenting with fever, laboratory evidence of inflammation, and evidence of clinically severe illness requiring hospitalization, with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); AND
• No alternative plausible diagnoses; AND
• Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms

May 14, 2020: Health Affairs Research Article: Strong Social Distancing Measures in the United States Reduced the COVID-19 Growth Rate

Economists at the University of Kentucky evaluated the impact of imposed social distancing measures on growth rate of confirmed COVID-19 cases across US counties in March and April of 2020. The end date of this study was April 27 as this date coincided with the re-opening of restaurants and other entertainment facilities in Georgia. Results of this study imply there would have been more than 35 times greater spread of the disease without any of the social distancing measures having been put into place.

May 15, 2020: American College of Surgeons (ACS) Post-COVID-19 Readiness Checklist for Resuming Surgery

The ACS developed this checklist “to help surgeons ultimately communicate to their patients the important items they want to know. You can read the full announcement and download a print-friendly version of the checklist on the ACS website at https://www.facs.org/covid-19/checklist.

May 15, 2020: OCR Bulletin: Ensuring the Rights of Persons with Limited English Proficiency (LEP) in Health Care During COVID-19

This OCR Bulletin reminds health care providers that they “must take reasonable steps to provide meaningful access to individuals with LEP eligible to be served or likely to be encountered in their health programs and activities. This longstanding obligation is not waived during a National Emergency.” You will find suggestions for providing meaningful access for persons with LEP and links to several available resources.

May 15, 2020: Special Edition MLNConnects: Deadline Approaching for Nursing Homes to Report Confirmed and Suspected COVID-19 Cases

The April 30th Interim Final Rule with Comment Period requires nursing homes to begin reporting data to the CDC no later than Sunday May 17th. Facilities have to enroll in the CDC’s National Healthcare Safety Network (NHSN) to report data. “As nursing homes report this data to the CDC, CMS will be taking swift action and publicly posting this information so all Americans have access to accurate and timely information on COVID-19 in nursing homes. More information on the CDC’s NHSN COVID-19 module can be found here.”

May 15, 2020: Special Edition MLNConnects: Telephone Evaluation and Management Visits

“The March 30 Interim Final Rule with Comment Period added coverage during the Public Health Emergency for audio-only telephone evaluation and management visits (CPT codes 99441, 99442, and 99443) retroactive to March 1. On April 30, a new Physician Fee Schedule was implemented increasing the payment rate for these codes. Medicare Administrative Contractors (MACs) will reprocess claims for those services that they previously denied and/or paid at the lower rate.

There are also a number of add on services (CPT codes 90785, 90833, 90836, 90838, 96160, 96161, 99354, 99355, and G0506) which Medicare may have denied during this Public Health Emergency. MACs will reprocess those claims for dates of service on or after March 1.

You do not need to do anything.”

May 17, 2020: New CDC Activities and Initiatives Supporting the COVID-19 Response and the President’s Plan for Opening America Up Again – May 2020

This CDC Document was posted to the CDC website on May 17th. In addition to highlighting CDC activities and initiatives, this document includes the following appendices:

• Appendix A: Surveillance for COVID-19,
• Appendix B:Healthcare System Surveillance,
• Appendix C: Guidance on Infection Control and Contact Tracing,
• Appendix D: Guidance on Test Usage (Asymptomatic Populations and Serology),
• Appendix E: Assessing Surveillance and Hospital Gating Indicators, and
• Appendix F: Setting Specific Guidance.

Appendix F offers interim guidance for child care programs, interim guidance for schools and day camps, interim guidance for employers with workers at high risk, interim guidance for restaurants and bars, and interim guidance for mass transit administrators. The CDC notes the guidance in Appendix F is meant to assist establishments as they open. Further, they will update guidance as more is learned about COVID-19 and best practices to prevent its spread.