SNAPShots

HomeSNAPShots

Back Off 340B Cuts, HHS Tells Drug Company

Eli Lilly and Company is being presumptuous in assuming that the federal government will approve its plan to cease providing some federally mandated prescription drug discounts under the section 340B prescription drug discount program and does so at its own peril, the U.S. Department of Health and Human Services warned the company in a strongly worded letter.

Without addressing the merits of Eli Lilly’s request, HHS found the manner in which the company sought to force the federal government’s hand on the matter to be unacceptable.  HHS also questioned the timing of the company’s request in its recent letter, writing that

…we believe the timing of your pricing changes is, at the very least, insensitive to the recent state of the economy.  Although the economy is rebounding at a record rate, the unemployment and under-employment rates are still temporarily higher than at the beginning of the year due to COVID-19.  Many Americans and many small businesses have had difficulty making ends meet.  Lilly, on the other hand, seems to be enjoying an outstanding year.

The HHS letter also observes that

…during this same period, most health care providers, many of which are covered entities under section 340B, were struggling financially and requiring federal assistance from the Provider Relief Fund established by the CARES Act.  Many continue to struggle and depend on emergency taxpayer assistance.  It is against this backdrop that you are effectively increasing the price of 10 mg and 20 mg Cialis by more than 500,000 percent and have done the same for other drugs in your portfolio.

The 340B program, which enables hospitals that serve especially large numbers of low-income patients to purchase prescription drugs at a discount to dispense to such patients on an outpatient basis, has long been a vital tool in the ability of Pennsylvania safety-net hospitals to serve their communities.  SNAP has long supported the program, doing so most recently in a letter to members of Pennsylvania’s congressional delegation.

The HHS letter to Eli Lilly and Company – one of five companies attempting to redefine 340B requirements – concludes with a warning that should the company proceed with its plan, doing so could result in legal action “…in the event that Lilly knowingly violates a material condition of the program that results in over-charges to grantees and contractors.”

Go here to see the HHS letter to Eli Lilly and Company.

Filed under: 340b, Pennsylvania safety-net hospitals

COVID-19 Update: Tuesday, September 22

The following is the latest COVID-19 information from Pennsylvania’s state government (as of 3:30 on Tuesday, September 22) and the federal government (as of 2:45 p.m. on Monday, September 21).

Pennsylvania Update

Governor Wolf

Governor Wolf and Health Secretary Levine introduced “COVID-19 Alert PA,” a new cell phone app that the state hopes will facilitate contact tracing.  The app, which works on Android and Apple cell phones, uses bluetooth technology to identify people who were recently near someone who has been diagnosed with COVID-19.  The app notifies individuals who may have been exposed and directs them to resources but does not provide the name of the person who was diagnosed and does not provide the state with the names of people who may have been exposed, protecting the privacy of everyone involved and leaving responsibility to act at the discretion of the people with the app on their phone.  The app, which is free, does not track people and their location.  Learn more from this news release.

Department of Health

The Department of Health answered several provider questions in its COVID-19 Guidance Wrap-up document related to recommendations for eye protection, data sources for county positivity rates, and skilled nursing facility data reporting.

The Department of Health issued a new health alert on Testing and Management Guidance for Patients After Exposure to SARS-CoV-2, recommending testing for asymptomatic persons who were in close contact with someone who tested positive for COVID-19.

The Department of Health announced that Walmart is closing its remaining nine drive-through parking lot COVID-19 testing sites on September 26.

Department of Health – by the numbers

  • This week’s joint news release from Governor Wolf and the Department of Health revealed that during the week of September 11 to September 17 the number of new COVID-19 cases rose 10.5 percent but the state-wide rate of positive tests fell from 4.2 percent to 3.8 percent.
  • Counties with especially high positivity rates are Centre (12.1 percent), Indiana (11.6) and York (7.8 percent).
  • On a day-to-day basis the number of new COVID-19 cases continues to fluctuate considerably.
  • The continued high numbers are driven in large part by major increases in the number of young people between the ages of 19 and 24 who are contracting COVID-19.  Eight percent of all cases of COVID-19 among children between the ages of five and 18 occurred between September 11 and September 27.
  • The number of Pennsylvanians currently hospitalized with COVID-19 and the number of such patients breathing with the help of a ventilator continue to decline slowly.
  • More than 10,400 health care workers in the state have contracted COVID-19.
  • 21 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  24 percent of adult ICU beds, 16 percent of pediatric ICU beds, 37 percent of pediatric beds, and 40 percent of airborne isolation rooms.

Department of Human Services

DHS has updated its guidance on COVID-19 for personal care homes, assisted living residences, and private intermediate-care facilities.

Federal Update (as of Monday, September 21)

Provider Relief Fund Reporting Requirements

HHS has updated its Provider Relief Fund web page with the document “General and Targeted Distribution:  Post-Payment Notice of Reporting Requirements.”  The purpose of this document is to inform recipients of Provider Relief Fund payments that received one or more payments exceeding $10,000 in the aggregate of the data elements they will be required to report as part of the post-payment reporting process.  This is important because it identifies how HHS will calculate lost revenue and COVID-related expenses for both general distribution and targeted Provider Relief payments for reporting requirements.

A key passage in this document, on page 1 under “Reporting Guidance on Use of Funds,” states that “Recipients will report their use of PRF [Provider Relief Fund] payments by submitting the following information:”

Healthcare related expenses attributable to coronavirus that another source has not reimbursed and is not obligated to reimburse, which may include General and Administrative (G&A) or healthcare related operating expenses (further defined within the data elements section below).

PRF payment amounts not fully expended on healthcare related expenses attributable to coronavirus are then applied to lost revenues, represented as a negative change in year-over-year net patient care operating income (i.e., patient care revenue less patient care related expenses for the Reporting Entity, defined below, that received funding), net of the healthcare related expenses attributable to coronavirus 2 calculated under step 1. Recipients may apply PRF payments toward lost revenue, up to the amount of their 2019 net gain from healthcare related sources. Recipients that reported negative net operating income from patient care in 2019 may apply PRF amounts to lost revenues up to a net zero gain/loss in 2020. 

If recipients do not expend PRF funds in full by the end of calendar year 2020, they will have an additional six months in which to use remaining amounts toward expenses attributable to coronavirus but not reimbursed by other sources, or to apply toward lost revenues in an amount not to exceed the 2019 net gain. For example, the reporting period January – June 2021 will be compared to the same period in 2019.

Providers should review the entire documentGeneral and Targeted Distributions:  Post-Payment Notice of Reporting Requirements” very carefully.

In addition, HHS has updated its Provider Relief Fund web page with the following notice:

In accordance with the Office of Management and Budget’s Memorandum M-20-21, all financial information that agencies are required to report concerning their disposition of CARES Act and other supplemental COVID-19 appropriated funds is publicly available on USAspending.gov. View the COVID-19 Spending profile page.

Medicare Accelerated and Advance Payment Program

  • In an interview with Modern Healthcare, CMS Administrator Seema Verma confirmed that the federal government is delaying recoupment of the Medicare revenue provided to hospitals through the CARES Act’s Accelerated and Advance Payment Program to help them weather the onslaught of COVID-19 and the loss of revenue they anticipated because of their temporary need to suspend non-urgent procedures during the early months of the pandemic.  The original plan was for CMS to withhold 100 percent of Medicare payments to hospitals beginning in August until the money advanced to them was repaid, but that withholding has now been put off for an unspecified period of time.  Find the interview with Administrator Verma (by subscription only) here.
  • The House has released a draft bill for a continuing resolution to fund the federal government when the 2021 fiscal year begins on October 1 through December 11.  That bill addresses the same Accelerated and Advance Payment Program.  Its highlights include:
  • For the first 11 months during which a provider is repaying, the recoupment may be up to 25 percent of what Medicare would otherwise be paying that provider for items and services provided.
  • For the next six months the offset may be up to 50 percent of what Medicare would be paying that provider.
  • Providers have 29 months from the date the first accelerated payment was made to repay the amount in full.
  • The interest on accelerated and advance payments only appears to begin 30 days after the 29-month period at four percent.  Under the CARES Act, the interest rate is around 10 percent.
  • The continuing resolution would establish a $10 million cap a year for future advance payments to Medicare Part B providers.
  • CMS is given two weeks to publish a list of providers that received these payments on a public website.
  • Learn more from this House summary of the bill or go here to see the bill itself.

Department of Health and Human Services

The department released the following statement on this action:

Before and after this action, no regulation issues from any part of HHS without the approval of the Secretary and the White House. The only change made by this memo is that, instead of the Secretary’s just approving all agency regulations, each regulation now also will be formally signed by him. Any speculation about this memo being motivated by policy considerations is utterly misinformed. This good-government action is only prospective in effect and minimizes litigation risk for the department’s public health actions, prevents potential future abuse of authority, and is consistent with congressional intent. The memo should have no effect on operational work and does not pertain in any way to guidance or any vaccine or drug approval or authorization. This action will not slow any HHS agencies’ work. It is simply the ministerial, administrative act of attaching a signature to a document.

Centers for Medicare & Medicaid Services

CMS has posted new information on Medicare payment for COVID-19 testing in nursing facilities based on whether the payer is Medicare, Medicaid, the Provider Relief Fund, the Centers for Disease Control and Prevention, or private insurance.  The information includes a summary of clinical laboratory fee schedule codes.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to its response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

CMS COVID-19 Office Hours Call

Tuesday, September 22 at 5:00 – 6:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 2409459

To join call, go here.

Home Health and Hospice Call

Tuesday, September 22 at 3:00 – 3:30 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 1169237
To join call, go  here.

Dialysis Organizations Call

Wednesday, September 23 at 5:30 – 6:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 7026727
To join call, go  here.

Nurses Call

Thursday, September 24 at 3:00 – 3:30 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 5872398
To join call, go here.

Conference lines are limited, so CMS encourages interested parties to join via audio webcast.  To listen to the audio files and read the transcripts for these and past COVID-19 Stakeholder calls, visit CMS’s Podcast and Transcripts page.

Food and Drug Administration

… includes a discussion to facilitate the availability of investigational convalescent plasma when blood establishments, hospitals, and healthcare providers collect plasma that does not meet the Conditions of Authorization of the Emergency Use Authorization (EUA).

Centers for Disease Control and Prevention

Government Accountability Office

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

Filed under: Coronavirus, COVID-19

COVID-19 Update: Friday, September 18

The following is the latest coronavirus information from Pennsylvania’s state government as of 1:30 p.m. on Friday, September 18.

The Courts

A federal court has ruled that parts of Governor Wolf’s orders closing down aspects of life and commerce in the state in response to the COVID-19 emergency were unconstitutional.  Find the entire court decision in this Pittsburgh Tribune-Review article that also summarizes the decision, its implications, and reactions to it.

Governor Wolf

Governor Wolf called on the General Assembly to provide an additional $225 million in CARES Act funding for the state’s COVID-19 hazard pay program to support front-line workers risking their health to continue working in life-sustaining industries during the COVID-19 pandemic.

 Department of Health

Department of Health – by the numbers

  • This week’s joint news release from Governor Wolf and the Department of Health revealed that during the week of September 4 to September 10 the number of new COVID-19 cases fell 8.9 percent but the state-wide rate of positive tests rose from 4.0 to 4.2 percent.
  • Counties with especially high positivity rates are Columbia (13.4 percent), Indiana (10.7 percent), Juniata (10.3 percent), and Centre (9.2 percent), and these are also the counties the state believes are experiencing the highest rate of community transmission.
  • For the past week the number of daily cases has differed significantly from day to day, from some of the state’s highest to some of its lowest numbers in the past six weeks.
  • The continued high numbers are driven in large part by major increases in the number of young people between the ages of 19 and 24 who are contracting COVID-19.  In southeastern Pennsylvania, for example, nearly five percent of COVID-19 cases fell in this age group in April; in September so far, that number has risen to nearly 32 percent.  The trends are similar in other parts of the state except in the north central part of the state, where the proportion of 19-24-year-olds contracting COVID-19 rose from seven percent of cases in April to 71 percent this month so far, and in northeastern Pennsylvania, where the number of people in this age group diagnosed with COVID-19 rose from six percent of that region’s total in April to 39 percent in September.
  • Despite this, the number of Pennsylvanians currently hospitalized with COVID-19 and the number of such patients breathing with the help of a ventilator are lower than they have been since the spring of 2020.
  • More than 10,200 health care workers in the state have contracted COVID-19.
  • 20 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  25 percent of adult ICU beds, 16 percent of pediatric ICU beds, 38 percent of pediatric beds, and 40 percent of airborne isolation rooms.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

 

Filed under: Coronavirus, COVID-19

MFAR is Dead

At least for now.

The controversial Medicaid Fiscal Accountability Regulation, slated for implementation this fall over the objections of many health care stakeholders, will not move forward at this time.

In a tweet earlier this week, Centers for Medicare & Medicaid Services Administrator Seema Verma wrote that

We’ve listened closely to concerns that have been raised by our state and provider partners about potential unintended consequences of the proposed rule, which require further study.  Therefore, CMS is withdrawing the rule from the regulatory agenda.

If implemented, opponents maintained, the regulation would have:

  • Deprived states of important, established policy-making prerogatives.
  • Created major new administrative burdens for state governments and hospitals.
  • Inappropriately regulated financing of the state share of Medicaid spending.
  • Introduced new, unspecified standards for state Medicaid programs.

While CMS maintained that MFAR would have enhanced the transparency of state Medicaid programs, the rule’s opponents maintained that it could lead to a major reduction of resources for serving the Medicaid population.

SNAP was among those opponents, arguing that the regulation could have hurt Pennsylvania safety-net hospitals and others that serve low-income communities by inappropriately regulating how states can finance their Medicaid programs.  CMS proposed the rule last November; SNAP submitted formal comments expressing its opposition in January; and SNAP rallied Pennsylvania’s congressional delegation to oppose the rule in February, March, and July.

It is worth noting that in “withdrawing the rule from the regulatory agenda,” Verma did not preclude the possibility of reintroducing MFAR at some point in the future.

Learn more from article “Trump administration backing off Medicaid rule that states warned would lead to cuts” in the online publication The Hill.

Filed under: Federal Medicaid issues, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

Medicaid Enrollment on the Rise

More people are enrolling in Medicaid, and much of the increase is driven by the COVID-19 emergency.

Or so reports the organization Families USA in a new study.

Pennsylvania State MapAccording to the study,

Over half of the 38 states reporting monthly enrollment through May or later have seen greater than 7% growth in enrollment since February. For the eight states reporting August enrollment, their average enrollment growth since February is approximately 11%.

But the implications are even greater, according to the analysis, which found that in large part because of COVID-19 job loss,

Medicaid enrollment among the 38 states reporting has already increased by 4.3 million people and is poised to increase much more in the near future. Analysis by Health Management Associates projects that up to 27 million people will lose their job-based insurance this year and that Medicaid will see an increase in enrollment of up to 18 million people by the end of 2020, depending on the severity of the economic downturn.

The effects of COVID-19 job loss and accompanying loss of insurance already appears to be visible in Pennsylvania, where Medicaid enrollment rose from 2.84 million in March of 2020 to 2.89 million in April, 2.94 million in May, and 2.977 million in June.  Growing Medicaid enrollment poses a challenge for Pennsylvania’s safety-net hospitals because they care for so many low-income patients and payments from the state’s Medicaid program often do not cover the cost of the care they provide.

Learn more about the nation-wide trend in the Families USA report “Rapid Increases in Medicaid Enrollment: A Review of Data from Six Months.

 

Filed under: Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania safety-net hospitals

Eliminate Medicaid DSH Cut, SNAP Asks PA Delegation

A Continuing Resolution to fund the federal government in FY 2021 should eliminate a cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states, and the Safety-Net Association of Pennsylvania has written to the state’s congressional delegation asking its members to convey this message to congressional leaders.

Safety-Net Association of Pennsylvania logoThe cut was mandated by the 2010 Affordable Care Act but has never been implemented.

In its letter to the delegation, SNAP wrote that

The Medicaid DSH cut was predicated on the expectation that the Affordable Care Act would greatly reduce the number of uninsured Americans, and while it has, millions remain uninsured, including nearly 700,000 Pennsylvanians – a number thought to be rising because of the job loss associated with COVID-19. When these people are sick or injured, most will turn to the state’s 41 private safety-net hospitals for care. These hospitals depend heavily on their Medicaid DSH payments to underwrite the cost of care for their uninsured patients, so they have never needed the resources afforded by Medicaid DSH more than they do today. Congress has always questioned the wisdom of this cut and has never permitted those cuts to go into effect. The most recent delay expires after November 30..

Because they serve so many uninsured and underinsured patients, Medicaid DSH payments from the state are especially important for Pennsylvania’s safety-net hospitals.

Learn more from SNAP’s Medicaid DSH letter to Pennsylvania’s congressional delegation.

Filed under: Affordable Care Act, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

COVID-19 Update: Friday, September 11

The following is the latest coronavirus information from the state and federal governments as of 1:30 p.m. on Friday, September 11.

Pennsylvania State Government

Department of State

The Department of State has suspended the initial medical history and physical examination required for prescribing buprenorphine via telemedicine to treat opioid use disorder for the duration of the COVID-19 disaster declaration.

Department of Health

The Department of Health has revised its health alert Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for 2019 Novel Coronavirus (COVID-19) in a Healthcare Setting to add information on extended-use eye protection and to update language regarding the use of respirators.

The Department of Health has clarified that it does not need to approve a skilled nursing facility’s testing plan before it is used by the facility and providers should defer to the CMS-reported county positivity rate if there is a conflict between CMS and Department of Health data.  Learn more here.

Department of Health – by the numbers

  • This week’s joint news release from Governor Wolf and the Department of Health revealed that during the week of August 28 to September 3, the number of COVID-19 cases rose 30 percent over the previous week, the state-wide rate for positive tests rose from 3.2 percent to four percent, and community transmission was high in Columbia and Centre counties.
  • Since that time, the number of daily cases has differed significantly from day to day, from some of the state’s highest to some of its lowest numbers in the past six weeks.
  • In recent days the number of COVID-19 cases in Pennsylvania surpassed 142,000 and the number of COVID-19 deaths rose past 7800.
  • Despite this, the number of Pennsylvanians currently hospitalized with COVID-19 continues a very slow decline, as does the number of such patients breathing with the help of a ventilator.
  • The number of health care workers in the state who have contracted COVID-19 just surpassed 10,000.
  • More than 21,700 residents of long-term-care facilities and 4700 people who work in those facilities have contracted COVID-19 in 947 such facilities in 61 of the state’s 67 counties.
  • 22 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  26 percent of adult ICU beds, 13 percent of pediatric ICU beds, 35 percent of pediatric beds, and 42 percent of airborne isolation rooms.

Federal Update

Provider Relief Fund

  • Reminder: Applications are currently open for Phase 2 general distribution funding for Medicaid, Medicaid managed care, the Children’s Health Insurance Program (CHIP), dental providers, certain Medicare providers, hospitals that have changes in ownership, and assisted living facilities.  All groups have until September 13, 2020 to submit their tax identification number for validation and apply for funding from the phase 2 general distribution.  Go here for more information.
  • HHS has updated its Provider Relief Fund FAQ with one modified question marked 9/4/2020 on page 32 of the document. The revised response addresses the tax treatment by parent companies of grants awarded to subsidiaries with separate National Provider Identifiers.

American Medical Association

  • The American Medical Association has published an update of the Current Procedural Terminology (CPT) code set that includes two code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic. Learn more from this AMA announcement.

Department of Health and Human Services

  • HHS has published a request for information seeking stakeholder input regarding the ability of CLIA-accredited commercial, academic, medical center, and public health laboratories to feasibly perform more COVID-19 testing if additional testing instruments were made available to them. Interested parties have ten days to submit written comments.
  • HHS has issued new guidance authorizing state-licensed pharmacists to order and administer, and state-licensed or registered pharmacy interns acting under the supervision of the qualified pharmacist to administer, COVID-19 vaccinations to persons ages three or older, subject to certain requirements. See HHS’s announcement of the new guidance and go here to see the guidance itself.

Centers for Medicare & Medicaid Services

  • CMS has posted the document “New COVID 19 Testing and Reporting Requirements” that collects and summarizes the latest testing, training, and data-reporting requirements for nursing homes.
  • In late August, CMS published a regulation that required nursing homes to test their staff for COVID-19; that regulation included other testing and reporting requirements as well. The frequency of such testing was to be tied to the degree of community spread of COVID-19, with the details of how that would work to be announced later.  CMS has now published the county-by-county positivity rates on which the frequency of nursing home testing will be based.  Find those rates here.
  • CMS has updated its tip sheets to help providers understand its public reporting strategy for quality programs during the COVID-19 emergency.  Find tip sheets for the following types of providers:
    • For long-term-care hospitals, here and here.
    • For skilled nursing facilities, here and here.
    • For inpatient rehabilitation faculties, here and here.
    • For home health providers, here and here.
  • CMS has published updated provider-specific fact sheets on new COVID-19-related waivers and flexibilities for home health agencies, ambulances, and durable medical equipment.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information related to its response to COVID-19.  These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

CMS COVID-19 Office Hours Call

Tuesday, September 22 at 5:00 – 6:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 2409459

To join call, go  here.

Lessons from the Front Lines: COVID-19

Friday, September 18 at 12:30 – 2:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 4446447

To join call, go  here.

Home Health and Hospice Call

Tuesday, September 22n at 3:00 – 3:30 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 1169237
To join call, go  here.

Nursing Homes Call

Friday, September 18 at 12:30 – 2:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 4446447

To join call, go here.

Dialysis Organizations Call

Wednesday, September 23 at 5:30 – 6:00 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 7026727
To join call, go  here.

Thursday, September 24 at 3:00 – 3:30 PM Eastern

Toll-free attendee dial-in: 833-614-0820; Access Passcode: 5872398
To join call, go  here.

Conference lines are limited, so CMS encourages interested parties to join via audio webcast.  To listen to the audio files and read the transcripts for these and past COVID-19 Stakeholder calls, visit CMS’s Podcast and Transcripts page.

Centers for Disease Control and Prevention

Food and Drug Administration

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

 

Filed under: Coronavirus, COVID-19, Uncategorized

SNAP Asks PA Delegation to Help Prevent Attempt to Undermine 340B

Pharmaceutical companies are attempting to prevent safety-net hospitals and others from receiving the full benefits of the section 340B prescription drug discount program and the Safety-Net Association of Pennsylvania has asked of the state’s congressional delegation to sign a congressional letter to Health and Human Services Secretary Alex Azar asking to him intervene and stop the pharmaceutical companies.

Safety-Net Association of Pennsylvania logoIn asking members of the delegation to sign onto the bipartisan letter, SNAP notes that

The 340B program is essential for Pennsylvania’s safety-net hospitals, other qualified Pennsylvania providers, and others like us throughout the country, enabling us to obtain discounts on prescription drugs we dispense on an outpatient basis to qualified, low-income patients. The program greatly enhances the ability of hospitals to serve their low-income patients and does not cost taxpayers a single dime, but in recent weeks several pharmaceutical companies have taken steps to prevent hospitals from receiving the prescription drug discounts that Congress clearly intended when it created the 340B program nearly 30 years ago.

Learn more about the 340B problem and what SNAP and others are asking Secretary Azar to do to help in this SNAP message to members of Pennsylvania’s congressional delegation.

Filed under: 340b, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

COVID-19 Update: Friday, September 4

The following is the latest coronavirus information from the state and federal governments as of 1:30 p.m. on Friday, September 4.

Pennsylvania Update

Independent Fiscal Office

The Independent Fiscal Office reports that Pennsylvania collected $2.55 billion in General Fund revenue for August, an increase of $355.5 million (16.2 percent) over August 2019 collections.  The IFO estimates that roughly $235 million of the $355.5 million increase was associated with extended tax due dates related to the COVID-19 pandemic.  Personal income tax revenue, sales, use, and hotel occupancy revenue, and corporate net income tax revenue all exceeded estimates.  See the IFO’s full August report here.

Department of Health

The Department of Health has revised its guidance for skilled nursing facilities with a recommended testing plan for facilities not experiencing a COVID-19 outbreak, safe access for compassionate care, access to the facility for resident advocates, and a revised timeline for lifting restrictions after a mitigated outbreak.  See a news release describing the new guidance and go here to see the guidance itself.

Department of Health – by the numbers

  • In the past three days the number of COVID-19 cases in Pennsylvania surpassed 135,000 and the number of COVID-19 deaths rose past 7700.
  • Thursday marked the first time since late July that the state registered more than 1000 new cases in a single day.
  • Despite this, the number of Pennsylvanians currently hospitalized with COVID-19 is, with one exception, lower than it has been since before June.
  • Fewer of these patients are on ventilators today than at any time in the past three months.
  • More than 9800 health care workers in the state have contracted COVID-19.
  • More than 21,300 residents of long-term-care facilities and 4600 people who work in those facilities have contracted COVID-19 in 942 such facilities in 61 of the state’s 67 counties.
  • 26 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  22 percent of adult ICU beds, 15 percent of pediatric ICU beds, 38 percent of pediatric beds, and 41 percent of airborne isolation rooms.

Department of State

Because of the challenges of finding continuing education opportunities to fulfill professional requirements during the COVID-19 emergency, the Department of State has authorized the granting of continuing education credits for nursing home administrators, physical therapists, social workers, marriage and family therapists, professional counselors, speech language pathologists, and audiologists who serve as poll workers in this November’s election.  See the Department of State notice here.

Federal Update

Provider Relief Fund

  • Reminder: Applications are currently open for Phase 2 general distribution funding for Medicaid, Medicaid managed care, the Children’s Health Insurance Program (CHIP), dental providers, certain Medicare providers, and assisted living facilities.  All groups have until September 13, 2020 to submit their tax identification number for validation and apply for funding from the phase 2 general distribution.  Go here for more information.
  • HHS announced that assisted living facilities may apply for funding under the Provider Relief Fund phase 2 general distribution allocation. Go here to see HHS’s announcement.
  • HHS has announced some of the details of an upcoming $2 billion Provider Relief Fund performance-based incentive payment distribution to nursing homes. HHS will measure nursing homes against a baseline level of infection in the community where individual facilities are located.  Learn more from HHS’s announcement of this distribution.
  • HHS has updated its Provider Relief Fund FAQ with new and modified questions.
    • Changes marked 9/1/2020 can be found on pages 22, 23, 29, and 32. The new information focuses largely on the newly announced distribution for assisted living facilities, criteria for eligibility, and applying to participate in the distribution.
    • One change, marked 9/2/2020 and on page 23, describes how HHS identified assisted living facilities that are eligible to receive distributions from the Provider Relief Fund.
    • Five changes, marked 9/3/2020 and found on pages 2, 9, and 17, address HHS requests for additional financial information, how to report Provider Relief Fund grants on Medicare cost reports, and the responsibility of parent organizations to send to their subsidiaries grants intended for those subsidiaries.

Find all of these changes in the Provider Relief Fund FAQ.

American Medical Association

The American Medical Association has updated codes and guidelines for office and other outpatient evaluation and management (E/M) services. Some of the changes were introduced earlier this year in response to the COVID-19 emergency.  The AMA has recommended to CMS that it implement these changes on January 1, 2021.  Learn more in this AMA news release.

Centers for Medicare & Medicaid Services

  • CMS has updated the article “Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment” in its online publication MLN Matters to reflect an update that includes additional COVID-19 codes. Some of those codes took effect on August 10 and others take effect on October 1.
  • CMS has updated the article “Update to the International Classification of Diseases, Tenth Revision (ICD-10) Diagnosis Codes for Vaping Related Disorder and Diagnosis and Procedure Codes for the 2019 Novel Coronavirus (COVID-19)” in its online publication MLN Matters to include new procedure codes.

Department of Health and Human Services

Centers for Disease Control and Prevention

Food and Drug Administration

The FDA has issued guidance to health care providers on the use of convalescent plasma for treating patients with COVID-19.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

Filed under: COVID-19, DSH hospitals

COVID-19 Update: Tuesday, September 1

The following is the latest coronavirus information from Pennsylvania’s state government as of 3:30 p.m. on Tuesday, September 1.

Governor Wolf

Governor Wolf has signed a second renewal of his 90-day disaster declaration for the COVID-19 pandemic.  This declaration provides for increased support for state agencies involved in the continued response to the virus and recovery during reopening, including expediting supply procurement and lifting certain regulations to allow for efficient and effective mitigation.  The disaster declaration also has facilitated waivers and extensions to support Pennsylvanians, Pennsylvania businesses, and Pennsylvania caregivers during the pandemic.  Learn more from the governor’s news release announcing the signing and see the emergency declaration itself.

Governor Wolf asked the General Assembly to pass legislation for paid sick and family leave for workers who need to miss work for an illness or to take care of a loved one.  Such leave could be used to recover from an illness, such as COVID-19, for medical appointments, to care for a family member, or to seek help from abuse or violence.

Department of Human Services/Department of Health

Department of Human Services Secretary Teresa Miller and Department of Health Secretary Dr. Rachel Levine announced that all assisted living residences, personal care homes, and private intermediate-care facilities in the state have completed universal baseline COVID-19 testing.  One hundred percent of the 1363 DHS-licensed personal care homes, assisted living residences, and private intermediate-care facilities in Pennsylvania completed universal baseline testing by the August 31 deadline.  This effort was assisted by the Regional Response Health Collaborative (RRHC) Program launched in late July to provide clinical support, technical assistance, and education to long-term-care facilities as they work to prevent and mitigate spread of COVID-19.  Learn more from this Wolf administration news release.

Department of Health – by the numbers

  • The weekly COVID-19 status report released by Governor Wolf and the Department of Health found 353 fewer new cases of COVID-19 during the week of August 21-27 than during the week of August 14-20.
  • The rate of positive tests declined from 3.4 percent to 3.2 percent, the fifth consecutive week the rate has declined.
  • Counties that still have troubling positive test rates are Columbia (13.5 percent), Armstrong (8.3 percent), Perry (6.9 percent), Northumberland (6.7 percent), Potter (5.9 percent), Beaver (5.7 percent), Dauphin (5.3 percent), Fulton (5.3 percent), and York (5.0 percent).
  • The past week saw 20 percent fewer COVID-19 deaths in Pennsylvania than the previous week.
  • The state’s contact tracing efforts found that 50 percent of the people who had new cases of COVID-19 and who also reported visiting a business during the previous two weeks said they visited a restaurant, 12 percent said they had visited a bar, 12 percent said they visited a gym or fitness center, and nine percent said they visited a salon or barber shop.
  • More than 9600 health care workers in the state have contracted COVID-19.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators declined slightly in the past week.
  • 24 percent of the beds in Pennsylvania’s acute-care hospitals are currently unoccupied, as are  25 percent of adult ICU beds, 17 percent of pediatric ICU beds, 37 percent of pediatric beds, and 43 percent of airborne isolation rooms.

Resources to Consult

Pennsylvania Department of Human Services

Main COVID-19 Page

COVID-19 Provider Resources

Press Releases

Pennsylvania Department of Health

Main COVID-19 Page

PA Health Alert Network

Centers for Disease Control and Prevention

Main COVID-19 Page

FAQ

(To receive this daily update directly, sign up for our mailing list at   info@pasafetynet.org.)

Filed under: Coronavirus, COVID-19

P:(717)234-6970; F:(717)234-6971
2012 Safety-Net Association of Pennsylvania