DEA Guidance on Medication Assisted Treatment (MAT) Evaluations by Telephone

April 3, 2020

Normally, an Opioid Treatment Program (OTP) must conduct an in-person medical evaluation of a patient before prescribing or directly dispensing controlled substances, including buprenorphine; but the COVID-19 health emergency has caused regulating bodies to modify this requirement. Click here to read the full article.

CDC Updates COVID-19 Infections Control Guidance

April 3, 2020

On April 1, 2020, the CDC updated its Interim Infection Prevention and Control Recommendations, applicable to all U.S. healthcare settings but not applicable to non-healthcare settings or persons outside of such settings. The updated guidance addresses three key concepts: 1) Limiting how germs can enter the facility; 2) Isolating symptomatic patients as soon as possible; and 3) Protecting healthcare personnel. The updated guidance is based on current information about COVID-19, including reports of community transmission, infections identified in healthcare personnel, shortages of facemasks, N95 respirators and gowns.

CMS Issues Key Recommendations to Nursing Homes

April 3, 2020

On April 2, 2020, CMS announced critical recommendations to state and local governments, as well as to nursing homes, to help mitigate the spread of COVID-19 in nursing homes. The CMS’ previous March 13, 2020 guidance advised nursing homes to restrict visitors to help prevent the spread of the virus into these facilities. A round of infection control surveys completed during the week of March 30, 2020, prompted CMS to issue additional guidance. The additional guidance advises nursing homes to take, in sum, the following additional steps: focus on and ensure compliance with CDC’s hand hygiene guidance; perform self-assessments of compliance with the CDC checklist for COVID-19 infection control plans; pursue CDC strategies and work with state and local governments to conserve and optimize personal protective equipment (PPE) for staff; ensure all staff are using appropriate PPE during patient and resident interactions; immediately implement the CDC’s symptom screening for everyone in the facility; use separate staffing teams for COVID-19 positive residents. See the April 2, 2020 Guidance for additional details on the recommendations.

Suspension of Routine Medicare Facility Surveys

April 3, 2020

Included in the broad Section 1135 waivers, CMS has temporarily suspended routine, non-emergency survey inspections of Medicare facilities across the country. In its March 31, 2020 National Stakeholder Call, Administrator Verma said that inspectors will continue to conduct surveys focused on cases of abuse or neglect that pose immediate jeopardy and on more targeted surveys around infection control, including the spread of COVID-19 (as discussed in the next paragraph below). On this call, Administrator Verma also clarified that the suspension of routine surveys includes life safety code surveys. CMS has posted separate Coronavirus survey memos for various provider types on its webpage for Coronavirus Updates for State Surveyors and Accrediting Organizations.

Waiver of 3-Day Prior Hospitalization for SNF Part A Admissions

April 3, 2020

Under the Section 1135 waiver authority, CMS has waived the 3-day hospital stay requirement that must immediately precede a covered Part A qualified stay at a skilled nursing facility (“SNF”). During the CMS National Stakeholder Call on March 31, 2020, CMS Administrator Seema Verma confirmed that this waiver is not geographic specific and applies to all SNFs regardless of whether the SNF is in a community then currently experiencing a COVID-19 crisis or surge. Administrator Verma also confirmed that patients admitted to a SNF under this waiver need not have a COVID-19 diagnosis. Additional information about the SNF waivers are available in the CMS “Tear Sheet” for Long-Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities) on the CMS Coronavirus Waivers & Flexibilities website.

Cybersecurity Ransomware Alert

April 3, 2020

The Microsoft Threat Intelligence Center (MSTIC) issued an alert specific to healthcare providers regarding a type of ransomware known as REvil that cyber criminals have tailored to exploit remote healthcare workers during the COVID-19 public health emergency. The MSTIC “strongly recommends that all enterprises review VPN infrastructure for updates.” The MSTIC alert provides guidance specific to the healthcare sector on how to detect, protect and prevent this type of ransomware. Click here to read the alert.

KY Updated Telehealth Guidance

April 3, 2020

On April 1, 2020, the Kentucky Department for Medicaid Services published additional guidance in its updated Provider Telehealth FAQs. Among other updates, DMS clarified that cost sharing for all services is waived, and prior authorization requirements for all medical and behavioral services, including drug benefits administered through the medical benefit (but not drugs under pharmacy benefits), are suspended. These waivers and suspensions are also applicable to managed care organizations.

Kentucky Board of Nursing Updates

April 3, 2020

In response to Senate Bill 150 signed into law by Governor Andy Beshear on March 30, 2020 requesting state licensing boards to take several actions to expand licensing activities and their licensees’ scope of practice, the Kentucky Board of Nursing, pursuant to directives and emergency regulations issued by the Governor’s office, implemented several changes, including permitting issuance of temporary work permits for reinstatement applicants, lifting requirements for APRNs to maintain collaborative agreements with a physician for the prescribing of controlled substances, modifying clinical education requirements, and issuing provisional licenses for exam applicants and temporary work permits for endorsement applicants.

Hospital Lab Reports

April 3, 2020

On March 29, 2020, Vice President Mike Pence sent a letter to hospitals requesting that they report their COVID-19 testing data directly to the Department for Health & Human Services. In particular, the administration requested that academic, university, and in-house labs that were not already sharing their full testing results report such results to HHS every day at 5 p.m. ET, so that government agencies can track and analyze the virus. The Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN), in support of this effort, introduced a new COVID-19 Patient Impact and Hospital Capacity Module within NHSN’s Patient Safety Component (click here). The Module enables hospitals to report daily counts of patients with suspected and confirmed COVID-19 diagnoses and current use and availability of hospital beds and mechanical ventilators. The American Hospital Association (AHA) provides an overview of the hospital COVID-19 data collection efforts in response to Pence’s letter, along with relevant links, on its webpage here.

Medicare Payment Advances

April 3, 2020

On March 28, 2020, CMS announced an expansion of its accelerated and advance payment program for Medicare participating health care providers and suppliers, to help ensure that they have the resources needed to combat COVID-19. This expansion, based on changes from the recently enacted Coronavirus Aid, Relief, and Economic Security (CARES) Act, provides emergency funding and addresses cash flow issues based on historical payments when there is disruption in claims submission or claims processing. The payments can be requested by eligible hospitals, doctors, and other providers and suppliers by contacting their individual Medicare Administrative Contractor. The CMS clarified in its March 31, 2020 National Stakeholders Call with Administrator Seema Verma, that the accelerated and advance payments are not subsidies and will be recouped through a review and reconciliation process for subsequently filed claims.