Questions After the End of The PHE: What Do We Do Now?

The COVID-19 Public Health Emergency (PHE) officially ended on May 11 and providers worked to make sure they were handling associated waivers and flexibilities appropriately. As they focused on everyday operations and regulatory requirements, some questions arose about the COVID-19 vaccination requirements and screening guidance, as well as several other topics. Each topic is discussed…

CDC Issues Guidance for Masking in Health Care Settings

The Centers for Disease Prevention and Control (CDC) has issued revised guidance for Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic . The guidance applies to all health care settings and provides a framework to implement select infection prevention and control practices based on their individual circumstances.…

How At Home Care Providers Can Talk to Patients About COVID-19 Treatments

The Centers for Disease Control and Prevention (CDC) has finalized its COVID-19 Personal Action Plan, which contains tools, information, and action steps to share with your family, colleagues, and patients. NAHC believes the Personal Action Plan will be a helpful resource for having conversations about whether they would benefit from COVID-19 treatments, what to do…

CMS Updates COVID-19 Guidance for Surveys, Visitation and Testing

The Centers for Medicare & Medicaid Services (CMS) revised the COVID-19 Focused Infection Control (FIC) Survey Tool and visitation restrictions for acute and continuing care (ACC) facilities through a revised QSO-21-08-NLTC memo.  This memo supersedes the instructions in QSO-20-16-Hospice and QSO-20-18-HHA. State survey agencies (SA) and accrediting organizations (AO) have returned to the existing standard…

CDC’s New Guidance for Health Care Workers

Last Friday the Centers for Disease Control and Prevention (CDC) issued new guidance for several COVID-19 pandemic infection control recommendations in health care delivery settings. The new guidance does away with the vaccination status of health care workers when determining whether to screen them for COVID-19, quarantine those workers, or employ “source control” measures such as…

Flu Shot: Encourage Preferred Vaccines for Patients 65+

It’s time to talk with your patients about flu shots. The CDC recommends annual flu shots for everyone 6 months and older by the end of October or as soon as possible each flu season. You can give flu and COVID-19 vaccines at the same visit. New for this flu season: Patients 65 and older should get…

Monkeypox Prevention and Control

Monkeypox Fact Sheet The World Health Organization declared the monkeypox outbreak a global health emergency, as the number of confirmed cases has increased to over 30,000 across 88 countries, with more than14,000 cases in the U.S. On August 4, 2022, President Biden declared monkeypox a national public health emergency. Although patients infected with monkeypox may…

Eligible Patients Can Receive Free 2nd COVID Booster

On April 6, the Center for Medicare & Medicaid Services (CMS) announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna COVID-19 vaccines without cost sharing, as it continues to provide coverage for this critical protection from the virus. People with Medicare pay nothing to receive a COVID-19 vaccine, and there is no applicable copayment, coinsurance, or deductible. People with Medicaid coverage can also get COVID-19 vaccines, including boosters, at no cost.

The CDC recently updated its recommendations regarding COVID-19 vaccinations. Certain immunocompromised individuals and people ages 50 years and older who received an initial booster dose at least 4 months ago are eligible for another booster to increase their protection against severe disease from COVID-19. Additionally, the CDC recommends that adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least 4 months ago can receive a second booster dose of a Pfizer-BioNTech or Moderna COVID-19 vaccine.

The COVID-19 vaccine, including the booster doses, is the best defense against severe illness, hospitalization, and death from the virus. CMS continues to explore ways to ensure maximum access to COVID-19 vaccinations. More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available at and through the CMS COVID-19 Provider Toolkit.

People can visit (English) or (Spanish) to search for vaccines nearby.

Eligible Patients Can Receive Free 2nd COVID Booster

On April 6, the Center for Medicare & Medicaid Services (CMS) announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna COVID-19 vaccines without cost sharing, as it continues to provide coverage for this critical protection from the virus. People with Medicare pay nothing to receive a COVID-19 vaccine,…

CDC Proposes Updates to Controversial 2016 Opioid Prescribing Guidelines

On February 10, 2022, the Centers for Disease Control and Prevention (CDC) issued new proposed guidelines for prescribing of opioids for acute, sub-acute and chronic pain. The clinical practice guideline updates and expands the CDC Guideline for Prescribing Opioids for Chronic Pain— United States, 2016, and provides evidence-based recommendations for clinicians who provide pain care, including those prescribing opioids, for outpatients age 18 years and older with acute pain (duration less than 1 month), subacute pain (duration of 1–3 months), or chronic pain (duration of 3 months or more).

The guideline explicitly EXCLUDES sickle cell disease-related pain management, cancer pain treatment, palliative care, and end-of-life care.

The clinical practice guideline includes recommendations for primary care clinicians (including physicians, nurse practitioners, and physician assistants) as well as for outpatient clinicians in other specialties (including those managing dental and postsurgical pain in outpatient settings and emergency clinicians providing pain management for patients being discharged from emergency departments).

This voluntary clinical practice guideline provides recommendations and does not require mandatory compliance; and the clinical practice guideline is intended to be flexible so as to support, not supplant, clinical judgment and individualized, patient-centered decision-making.

As part of the guideline issuance, CDC is asking interested persons or organizations to submit written views, recommendations, and data. In order to be considered, written comments must be received on or before April 11, 2022.  Instructions for submitting comments and various materials are available HERE; the revised guideline and other supporting materials are located in the “Enhanced Content” box in the lower right hand corner of the page.

A major area of concern associated with the 2016 guideline was the emergence of misapplication of the guideline by various state and local governments. In 2018 the National Association for Home Care & Hospice (NAHC) was invited to testify before the House Energy & Commerce Committee regarding hospice disposal of controlled substances.

As part of his testimony, NAHC’s representative Dr. John Mulder of the Trillium Institute and Faith Hospice in Michigan, commented on the misapplication of the 2016 CDC guideline by states that have resulted in delayed treatment for pain experienced by individuals receiving palliative or hospice care. In 2019, CDC issued a Media Statement  on the 2016 guideline cautioning against:

  • Misapplication of recommendations to populations outside of the Guideline’s scope;
  • Misapplication of the Guideline’s dosage recommendation that results in hard limits or “cutting off” opioids;
  • Abrupt tapering or sudden discontinuation of opioids; and
  • Misapplication of the Guideline’s dosage recommendation to patients receiving or starting medication-assisted treatment for opioid use disorder.

These concerns, in part, led to issuance of the revised guideline that is currently under review.