CMS Issues Addition Guidance on Emergency Preparedness Testing

The Quality, Safety & Oversight (QSO) Group at the Centers for Medicare & Medicaid Services (CMS) has issued a revised QSO -20-41-All memo to provide additional guidance and clarifications on the emergency preparedness standard for testing requirements due to the ongoing COVID-19 public health emergency (PHE). If a provider experiences an actual natural or man-made emergency that…

Sequestration Resumes for Medicare Providers

The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare fee-for-service claims. As a result of this Act, a suspension on the sequestration was put in place due to the COVID-19 public health emergency (PHE.) The sequestration was suspended through March 31, 2022.

Effective April 1, 2022, the one percent sequestration payment adjustment will be applied for claims with dates of services from April 1, 2022 to June 30, 2022.

Of note, the sequestration payment adjustment will revert to the two percent rate for claims with dates of services as of July 1, 2022. This will bring the total sequestration rate to two percent, which was the rate in effect prior to the PHE.

For home health providers, the adjustment applies to the respective “through” date on the claim.

The sequestration payment adjustment decrease will appear on the RA with a CARC 253, used to report the sequestration reduction. The code will appear as a CO 253 on the RA “Sequestration – reduction in federal payment” as the reason.

Sequestration Resumes for Medicare Providers

The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare fee-for-service claims. As a result of this Act, a suspension on the sequestration was put in place due to the COVID-19 public health emergency (PHE.) The sequestration was suspended through March 31, 2022. Effective April 1, 2022, the one percent sequestration…

Private Duty Home Care Deserves Provider Relief

The CARES Act Provider Relief Fund has been a lifesaver to thousands of health care providers across the country. Through the fund distributions, the Department of Health and Human Services (HHS) has been able to stabilize access to care during the Public Health Emergency and help preserve the health care infrastructure for the post-pandemic future. We very much appreciate Congressional action creating the fund and the swift actions taken by HHS to prioritize the distribution of the funds.

The National Association for Home Care & Hospice strongly believes direct relief funds should be provided to personal care home care providers, and we are advocating directly to congressional leadership on this issue.

NAHC firmly believes Congress must take immediate steps to provide funds to an essential part of our health care system that, to date, has not received this crucial support. Home care companies that serve millions of Americans with vital personal health care supports, such as assistance with the administration of prescribed medications, exercise programs that maintain and improve functional capabilities, hygiene, feeding, and numerous Activities of Daily Living (ADLs) are a core part of community-based health care. These services, and the dedicated caregivers that provide them, have been uniformly recognized as essential health care providers by state and federal policymakers. However, the companies that provide this care have not received any Provider Relief Fund support since the creation of the Fund, except where those companies bill Medicare and/or Medicaid.

The companies that have been left out so far do participate in many government health programs, such as the Veterans Administration and the Administration on Aging, along with providing services funded by long term care insurance and private payment from their patients. It is estimated that they serve several million senior citizens and persons with disabilities each year, avoiding the need for high-cost institutional care. We need these companies to be operating today and tomorrow to meet the needs of our growing aged population.

Support from the Provider Relief Fund would be consistent with other distributions that have occurred so far. These include distributions to home care agencies that provide this same care through Medicaid, assisted living facilities, and behavioral health providers. Similarly, HHS has provided funding supports beyond Medicare and Medicaid providers to dentists and behavioral health providers, among others. As such, the standards and structures are in place to allow these
companies to apply for funding.

As potential legislation is drafted to provide further COVID-19 PHE relief, we request that specific PRF funding be allocated for home care providers that have not previously qualified due to their not being Medicare and/or Medicaid providers. These providers have faced the same COVID-related challenges as their Medicare and Medicaid colleagues, including workforce shortages, added expenses for personal protective equipment and cleaning supplies, and lost revenue due to added caregiver time properly performing COVID precautions and increased overtime expense.

Private duty home care providers are an essential part of allowing people to remain independent, living in their own homes, and slowing the spread of the novel coronavirus, COVID-19 and its variants.

Private duty care providers have been on the front lines of the fight against COVID-19, without the recognition and support they deserve. It is long past time to remedy that.

Private Duty Home Care Deserves Provider Relief

The CARES Act Provider Relief Fund has been a lifesaver to thousands of health care providers across the country. Through the fund distributions, the Department of Health and Human Services (HHS) has been able to stabilize access to care during the Public Health Emergency and help preserve the health care infrastructure for the post-pandemic future.…

U.S. Renews Public Health Emergency Again

On Wednesday, April 13, Secretary of Health & Human Services (HHS) Xavier Becerra renewed the Public Health Emergency (PHE) that has been in effect since January 27, 2020 due to the outbreak of the novel coronavirus COVID-19.

As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective April 16, 2022, the ​January 31, 2020, determination by former Secretary Alex M. Azar II… that a public health emergency exists and has existed since January 27, 2020, nationwide.

This latest renewal of the PHE will last for 90 days, at which point it will lapse or be renewed again.

This news is not a surprise, as the Biden administration had hinted for some time that a renewal was coming.

The most recent renewal of the PHE occurred on January 14, 2022.

A declaration of a PHE permits, among other things, emergency use authorization of vaccines, the access to funding to address the emergency, and deployment of military trauma care providers.

Renewing the public health emergency declaration ensures health care providers and state and territorial health departments have continued flexibility to respond to the pandemic, helping save lives. These flexibilities support efforts such as rapid patient care during emergencies, including waivers from the Centers for Medicare and Medicaid Services for certain requirements under section 1135 of the Social Security Act. Examples of such requirements include preapproval requirements and temporarily reassignment of state, territorial, tribal or local staff who typically are funded by federal grants in order to respond to the emergency.

HHS will provide states and territories with no less than 60 days’ notice prior to the termination of the public health emergency declaration for COVID-19.

U.S. Renews Public Health Emergency Again

On Wednesday, April 13, Secretary of Health & Human Services (HHS) Xavier Becerra renewed the Public Health Emergency (PHE) that has been in effect since January 27, 2020 due to the outbreak of the novel coronavirus COVID-19.

As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective April 16, 2022, the ​January 31, 2020, determination by former Secretary Alex M. Azar II… that a public health emergency exists and has existed since January 27, 2020, nationwide.

This latest renewal of the PHE will last for 90 days, at which point it will lapse or be renewed again.

This news is not a surprise, as the Biden administration had hinted for some time that a renewal was coming.

The most recent renewal of the PHE occurred on January 14, 2022.

A declaration of a PHE permits, among other things, emergency use authorization of vaccines, the access to funding to address the emergency, and deployment of military trauma care providers.

Renewing the public health emergency declaration ensures health care providers and state and territorial health departments have continued flexibility to respond to the pandemic, helping save lives. These flexibilities support efforts such as rapid patient care during emergencies, including waivers from the Centers for Medicare and Medicaid Services for certain requirements under section 1135 of the Social Security Act. Examples of such requirements include preapproval requirements and temporarily reassignment of state, territorial, tribal or local staff who typically are funded by federal grants in order to respond to the emergency.

HHS will provide states and territories with no less than 60 days’ notice prior to the termination of the public health emergency declaration for COVID-19.

U.S. Renews Public Health Emergency Again

On Wednesday, April 13, Secretary of Health & Human Services (HHS) Xavier Becerra renewed the Public Health Emergency (PHE) that has been in effect since January 27, 2020 due to the outbreak of the novel coronavirus COVID-19. As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation…

What You Need to Know to Prepare for the End of the COVID-19 Public Health Emergency

The Centers for Medicare & Medicaid Services (CMS) is providing partners with guidance and resources as they plan for the eventual end of the COVID-19 Public Health Emergency (PHE) and the Medicaid continuous coverage condition established under the Families First Coronavirus Response Act. In line with that commitment, CMS will be communicating early and often with states and other partners to support planning and coordination of this unwinding process.

KEY RESOURES:

CMS has created a new Unwinding homepage with additional tools and resources.

  • On this page, you can find the new Communications Toolkit and graphics to help partners begin reaching out to Medicaid and Children’s Health Insurance Program (CHIP) enrollees so that they are prepared for the upcoming renewal, along with several other unwinding resources.
  • The toolkit and graphics are available in both English and Spanish.

IN CASE YOU MISSED IT:

On March 3, 2022, the CMS provided states with additional guidance and tools as they plan for whenever the COVID-19 Public Health Emergency (PHE) does conclude. When the PHE does eventually end, states will be required, over time, to redetermine eligibility for all people enrolled in Medicaid and CHIP. The recently released guidance will help states keep consumers connected to coverage by either renewing individuals’ Medicaid or CHIP eligibility or transferring them to other health insurance options.

WHAT PARTNERS CAN DO NOW

Right now, partners can help prepare for the renewal process by educating people with Medicaid and CHIP coverage about the upcoming changes. People with Medicaid & CHIP coverage should:

  1. Update their contact information with their State Medicaid or CHIP program; and
  2. Look out for a letter from their state about completing a renewal form.

Key Messages for Partners to Share

There are three main messages that partners should focus on now when communicating with people that are enrolled in Medicaid and CHIP.

  1. Update your contact information – Make sure [Name of State Medicaid or CHIP program] has your current mailing address, phone number, email, or other contact information. This way, they’ll be able to contact you about your Medicaid or CHIP coverage.
  2. Check your mail – [Name of State Medicaid or CHIP program] will mail you a letter about your Medicaid or CHIP coverage. This letter will also let you know if you need to complete a renewal form to see if you still qualify for Medicaid or CHIP.
  3. Complete your renewal form (if you get one) – Fill out the form and return it to [Name of State Medicaid or CHIP program] right away to help avoid a gap in your Medicaid or CHIP coverage.

Sample social media posts, graphics, and drop-in articles that focus on these key messages can be found in the Communications Toolkit. The Unwinding homepage will continue to be updated as new resources and tools are released.

Legislation Introduced to Extend the Hospital at Home Program

Bipartisan legislation has been introduced in both houses of Congress to extend the acute care hospital at home waiver program, initially created during the first year of the COVID public health emergency (PHE) to provide an alternative setting of care for certain conditions, such as asthma, pneumonia, and COPD. The Hospital Inpatient Services Modernization Act would trigger a…