Month: December 2020

State of the Healthcare Industry: Market Updates for Rural Strategy

NOSORH, in partnership with Stroudwater Associates, announces and invites you to participate in a series of quarterly market updates for rural healthcare stakeholders to stay current on the changes in the healthcare marketplace in order to strategize responses to ensure vital services for rural communities.

Register Here

By the end of these sessions, participants will be able to:

  • Describe the current market dynamics of the healthcare industry
  • Evaluate the effects of these trends on rural providers
  • Apply this understanding to their own organization

Who: 

State Offices of Rural Health, rural hospitals, primary care practices, non-profit organizations, rural philanthropy organizations, policymakers, government agencies, and other rural health stakeholders will gain from the insight and discussion provided during these unique quarterly updates.

When: 

Quarterly at 2:00 pm ET

  • Jan 26, 2021
  • April 27, 2021
  • July 27, 2021

Presenter:

Eric K. Shell, Director and Chairman, Stroudwater Associates 

COVID-19 Vaccine Codes: Updated Effective Date for Moderna

On December 18, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Moderna COVID‑19 Vaccine for the prevention of Coronavirus Disease (COVID-19) for individuals 18 years of age and older. Review Moderna’s Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) regarding the limitations of authorized use.

During the COVID-19 Public Health Emergency (PHE), Medicare will cover and pay for the administration of the vaccine (when furnished consistent with the EUA). Review the updated payment and HCPCS Level I CPT code structure for specific COVID-19 vaccine information. Only bill for the vaccine administration codes when claims are submitted to Medicare; don’t include the vaccine product codes when the vaccines are free.

Related links:

Pharmacy Vaccination Service Availability in Nonmetropolitan Counties

A new rural policy data brief is available from the RUPRI Center for Rural Health Policy Analysis:

Pharmacy Vaccination Service Availability in Nonmetropolitan Counties

Fred Ullrich, BA; and Keith Mueller, PhD 

With the authorization of vaccines for COVID-19, plans for administering those vaccinations across the United States are being implemented. The Department of Health and Human Services (DHHS)has partnered with 19 “large chain pharmacies and networks that represent independent pharmacies and regional chains” to administer the vaccine. As extensive as that network of pharmacy providers is, it does not include a number of nonmetropolitan counties. This brief uses data from the National Council for Prescription Drug Programs to identify counties where there are no pharmacies capable of providing vaccination services.

Over 100 nonmetropolitan counties (n=110) with a total population of 263,007 people have no pharmacy. A much larger number of counties (n=750) do not have a retail pharmacy directly affiliated with one of the 19 DHHS ‘partner’ chains/networks. An unidentifiable number of pharmacies have a third party contracting group arrangement with one of the partners and so the number of counties without a ‘partner pharmacy’ is likely lower. If pharmacies indicating that they currently provide immunization service are added to the list of identified partner pharmacies, there are still 326 nonmetropolitan counties (total population over 1.5 million people) with no pharmacy providing immunization service.

Please click here to read the brief.

Webinar: Preparing Your Health Center to Administer Outpatient COVID-19 Monoclonal Antibodies

The Health Resources and Services Administration (HRSA), Operation Warp Speed, and the Food and Drug Administration (FDA) will host a webinar to share information about preparing your health center to administer outpatient COVID-19 monoclonal antibodies (mAbs). What does readiness entail? What staff do I need? How many patients can I serve? Which patients can benefit from mAb? Does our insurance cover this practice? Speakers will answer these and other questions. Speakers from health centers that are already providing infusion therapy, as well as HRSA leadership, will be featured.

Tuesday, December 22
1:00-2:00 p.m. ET
Register here

Eli Lilly and Regeneron both received emergency use authorizations (EUA) from FDA for COVID-19 monoclonal antibodies (mAbs) indicated for at-risk patients with mild to moderate symptoms to reduce disease progression and hopefully prevent hospitalizations. Eli Lilly’s product (bamlanivimab) is a single mAb therapy. Regeneron’s product (casirivimab and imdevimab) is a therapy consisting of two mAbs that must be administered as a single infusion. The Department of Health and Human Services (HHS) is currently allocating both treatments to states/jurisdictions on a weekly basis.

To learn more about how you can prepare your health center for outpatient administration of these products, join this webinar and see the Operation Warp Speed Therapeutics Monoclonal Antibodies Playbook.

Monitoring for Hospital Price Transparency

Hospital Price Transparency requirements go into effect January 1, 2021. The Centers for Medicare and Medicaid Services (CMS) plans to audit a sample of hospitals for compliance starting in January, in addition to investigating complaints that are submitted to CMS and reviewing analyses of non-compliance, and hospitals may face civil monetary penalties for noncompliance. 

Is your institution prepared to comply with the requirements of the Hospital Price Transparency Final Rule? Effective January 1, 2021, each hospital operating in the United States is required to provide publicly accessible standard charge information online about the items and services they provide in 2 ways:

  • Comprehensive machine-readable file with all items and services
  • Display of 300 shoppable services in a consumer-friendly format

In the final rule, CMS outlined a monitoring and enforcement plan to ensure compliance with the requirements. CMS finalized a policy that CMS monitoring activities may include, but would not be limited to, the following, as appropriate:

  • Evaluation of complaints made by individuals or entities to CMS
  • Review of individuals’ or entities’ analysis of noncompliance
  • Audit of hospital websites

If CMS concludes a hospital is noncompliant with one or more of the requirements to make public standard charges, CMS may take any of the following actions, which generally, but not necessarily, will occur in the following order:

  • Provide a written warning notice to the hospital of the specific violation(s)
  • Request a Corrective Action Plan (CAP) if noncompliance constitutes a material violation of one or more requirements
  • Impose a civil monetary penalty not in excess of $300 per day and publicize the penalty on a CMS website if the hospital fails to respond to CMS request to submit a CAP or comply with the requirements of a CAP

See 45 CFR part 180 Subpart C- Monitoring and Penalties for Noncompliance.

Visit the Hospital Price Transparency website for additional information and resources to help hospitals prepare for compliance, including:

Caring for Women with Opioid Use Disorder

The HRSA Office of Women’s Health is excited to announce the availability of Caring for Women with Opioid Use Disorder: A Toolkit for Organizational Leaders and Providers (PDF – 5.8 MB). Communities throughout our nation continue to be impacted by the opioid epidemic, which has been exacerbated by the effects of the COVID-19 pandemic. Women are uniquely impacted by opioid use: women who use opioids progress to dependence more quickly than men, experience more cravings, and are more likely to relapse. Because opioid use disproportionately impacts those living in medically underserved areas, Health Resources and Services Administration (HRSA)-supported settings are uniquely positioned to address this health crisis. 

The toolkit developed by the HRSA Office of Women’s Health, with support from the Department of Health and Human Services (HHS) Office on Women’s Health, provides resources and information to bolster care coordination services for women with opioid use disorder. A webinar introducing this toolkit and how to navigate it will be held on January 28. For questions or comments related to the toolkit, please contact HRSAOWH@hrsa.gov.

HHS Increases and Begins Distributing Over $24 Billion in Phase 3 COVID-19 Provider Relief Funding

December 16, 2020

The Trump Administration, through the Health Resources and Services Administration (HRSA), is announcing it has completed review of Phase 3 applications from the Provider Relief Fund (PRF) program and will distribute $24.5 billion to over 70,000 providers. Up from the $20 billion originally planned, the addition of another $4.5 billion in funding is being used to satisfy close to 90 percent of each applicant’s reported lost revenues and net change in expenses caused by the coronavirus pandemic in the first half of 2020. The U.S. Department of Health and Human Services (HHS) recognizes this pandemic has upended the health care system and caused significant financial hardships. These resources, along with previous distributions, have provided much needed relief. Payment distribution will continue through January, 2021.

Read the news release.