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March 31, 2020
CMS Announces Expansion of Medicare Accelerated Payment Program
Expanded eligibility during the COVID-19 emergency will allow expedited payments to Medicare providers and suppliers. Read the advisory
DHHS Information
Updated Guidance on Evaluation and Testing Persons for COVID-19

This Health Alert is to advise regarding:
 - increased COVID-19 lab testing options
 - modified recommendations for COVID-19 laboratory testing.

One of our highest priorities is to increase COVID-19 testing to identify as many
persons currently infected with COVID-19 virus, so these persons can be isolated, and their contacts quarantined.

Testing pipelines are opening wider by the day but supply chain issues could arise,
including: nasopharyngeal swabs, viral transport media, personal protective equipment (PPE) for those collecting the N-P swabs, and lab reagents required for extraction, processing, and testing.

Additional testing capacity is expected to evolve soon as companies with an installed platform base (e.g.s, Cepheid and Biofire) move to COVID-19 testing on their systems.

Public health welcomes and encourages additional testing capacity to fulfill our goal to test persons with symptoms consistent with COVID-19 infection. Read more.
DHHS Informational Calls for Infection Prevention Guidance - Acute Healthcare Facilities

Mondays, Wednesdays and Fridays (recurring) | 12:00 - 1:00 p.m. CT
Dial-In Number: (415) 655-0003
Meeting Number: 924 627 702
Meeting Password (for Webex Link): ACU20

AHA News/Updates

AHA launches “100 Million Mask Challenge” to aid front line health professionals
The American Hospital Association (AHA) today announced a national initiative to secure millions of masks for the physicians, nurses and caregivers who are treating coronavirus patients and at greater risk due to a nationwide shortage of personal protective equipment. The effort will facilitate private sector partnerships to address these shortages in the fight against COVID-19. Read more.

Medicare Update

WPS Hotline for COVID-19
WPS has established a telephone hotline for several COVID-19 related issues, including allowing physicians and non-physician practitioners to initiate provisional temporary Medicare billing privileges via telephone, provider accelerated/advanced payment requests, and addressing questions regarding provider enrollment flexibilities afforded by the COVID-19 waiver. Staff will be available to assist you with your provisional Medicare billing privileges, accelerated/advanced payment inquiries, and Provider Enrollment COVID-19 related inquiries. The phone number for this hotline is (844) 209-2567.
This hotline is exclusively for those topics listed above, and it should not be used for normal billing inquiries, etc. To ensure our focus remains on providing access to care and payment, please respect the use of this line. Please direct inquiries on how to complete an enrollment application, application status, or billing inquiries to our normal Customer Service toll-free numbers.

Business

CARES Act Includes Employee Benefits Related Provisions
Congress has passed the Coronavirus, Aid, Relief, and Economic Security Act (The CARES Act), a $2 trillion stimulus package containing many provisions designed to bolster the economy during the COVID-19 crisis (including an expansive Paycheck Protection Program for small businesses, nonprofits and others with 500 or fewer employees).

While the financial- and bank-related provisions are likely to capture most of the headlines, the CARES Act also includes several provisions that affect employee benefit plans, which are summarized in this alert courtesy of LMC. 
Hospitals Should Track Expenses
Federal funding may become available for COVID-19-related expenses through the Federal Emergency Management Agency. Hospitals that wish to apply for these funds will be well-served to ensure that those expenses are appropriately documented per FEMA standards. 
FEMA fact sheet
As a best practice, some hospitals are setting up COVID-19 Response Cost Centers. This ensures that hospitals have expenses tracked and sufficiently documented. Hospitals are reporting that they are electronically assigning staff time and wages, supplies and equipment purchases used to treat patients. Such practices help quickly assess the cost of COVID-19 and substantiate future possible reimbursement opportunities.

The following Hospital Incident Command System forms may be helpful in identifying and recording expenses.

Quality/Data

The Trump Administration is requesting that hospitals report COVID-19 testing data to the U.S. Department of Health and Human Services (HHS), Specifically, they are requesting that all hospitals report data on their COVD-19 testing performed in your hospital “in-house” laboratories.  If all your COVD-19 testing is sent out to private labs and performed by one of the commercial laboratories on the list below you DO NOT NEED to report using this spreadsheet.
The list of Commercial laboratories includes: LabCorp, BioReference Laboratories, Quest Diagnostics, Mayo Clinic Laboratories and ARUP Laboratories.
In addition, they are requesting that hospitals report data each day to the National Healthcare Safety Network (NHSN) Patient impact and hospital capacity Module, which has been made available for hospitals to use beginning March 27, 2020.  All hospitals that currently use NHSN have received an e-mail from the CDC with additional details about how to report the new module. 

Additional details can be found at the website https://www.cdc.gov/nhsn/acute-care-hospital/covid19/index.html. For questions about this module please contact NHSN@cdc.gov and put “COVID-19 Module” in the subject line.
CMS Updates
CMS Approves Waivers for Nebraska
The Centers for Medicare & Medicaid Services (CMS) has approved Nebraska for the following waivers (see attached) related to a number of federal Medicaid and Medicare requirements pursuant to section 1135 of the Social Security Act to address the challenges posed by the COVID-19. Read the details here.
CMS is developing additional waivers for Nebraska but the scope and timetable is unclear at this point.  
This authority took effect as of 6 p.m. Eastern Daylight Time on March 17, 2020, with a retroactive effective date
of March 1, 2020.
Please contact Mike Feagler or Andy Hale with any questions. 
__________

Trump Administration Makes Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge

The Centers for Medicare & Medicaid Services (CMS) today is issuing an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility to respond to the 2019 Novel Coronavirus (COVID-19) pandemic. Made possible by President Trump’s recent emergency declaration and emergency rule making, these temporary changes will apply immediately across the entire U.S. healthcare system for the duration of the emergency declaration. This allows hospitals and health systems to deliver services at other locations to make room for COVID-19 patients needing acute care in their main facility.
The changes complement and augment the work of FEMA and state and local public health authorities by empowering local hospitals and healthcare systems to rapidly expand treatment capacity that allows them to separate patients infected with COVID-19 from those who are not affected.
CMS’s temporary actions announced today empower local hospitals and healthcare systems to:
- Increase Hospital Capacity – CMS
Hospitals Without Walls;
- Rapidly Expand the Healthcare Workforce;
- Put Patients Over Paperwork; and
- Further Promote Telehealth in Medicare
You can find a copy of the full press release here:  https://www.cms.gov/newsroom/press-releases/trump-administration-makes-sweeping-regulatory-changes-help-us-healthcare-system-address-covid-19
For additional background information on the waivers and rule changes, go to: https://www.cms.gov/newsroom/fact-sheets/additional-backgroundsweeping-regulatory-changes-help-us-healthcare-system-address-covid-19-patient
For more information on the COVID-19 waivers and guidance, and the Interim Final Rule, please go to the CMS COVID-19 flexibilities webpage: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers. 

These actions, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov.

For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.
__________
Navigating the Challenges of COVID-19
Hospital and health system leaders are working diligently to prepare for and respond to COVID-19. What are the critical issues for boards of trustees to consider? What information does the board absolutely need to know? This briefing highlights these important questions and areas for board consideration in a practical seven-point framework. Read more.

Hospital News

Nebraska Medicine to consolidate labor and delivery to prepare for COVID-19
Nebraska Medicine will consolidate labor and delivery services at Nebraska Medical Center starting Saturday, April 4.
Expecting mothers who were planning to deliver at Bellevue Medical Center have been informed of the change by their prenatal care providers. Read more.
Governor's Office
March 27 - Governor Pete Ricketts issued an executive order to expedite the entry of medical professionals into the workforce. Nebraska currently has ample providers to meet the demand for care.  The purpose of the order is to prepare for the possibility of a surge in COVID-19 cases and/or the unavailability of some medical professionals due to quarantine restrictions.
The Governor’s order authorizes the credentialing of retired or inactive health professionals who wish to serve Nebraskans during the coronavirus 2019 (COVID-19) emergency.  It also defers the requirements for healthcare providers to pay initial licensing fees or to complete continuing education. 
Additionally, the Governor is temporarily waiving the restrictions on licensed out-of-state medical professionals working in Nebraska.  Furthermore, the executive order temporarily suspends the limitations on the number of physician assistants that a physician may supervise. Read more.

Baird Holm's April Health Law Webinar
COVID-19, Stark, and Physician Financial Relationships - What to Do and Not to Do
 
Wednesday, April 1, 2020 
10:00 a.m. - 11:00 a.m. CT
Free to NHA members
Register
Stay informed. Visit our COVID-19 web page on our NHA website for information and resources.
Questions? Please reach out to the NHA via info@nebraskahospitals.org.

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