CMS Returning to Certain Pre-COVID-19 Policies in Long-term Care and Other Facilities

Date: April 7, 2022

CMS Returning to Certain Pre-COVID-19 Policies in Long-term Care and Other Facilities

The Centers for Medicare & Medicaid Services (CMS) is taking steps to continue to protect nursing home residents’ health and safety by announcing guidance that restores certain minimum standards for compliance with CMS requirements. Restoring these standards will be accomplished by phasing out some temporary emergency declaration waivers that have been in effect throughout the COVID-19 Public Health Emergency (PHE). These temporary emergency waivers were designed to provide facilities with the flexibilities needed to respond to the COVID-19 pandemic.

During the PHE, CMS used a combination of emergency waivers, regulations, and sub-regulatory guidance to offer health care providers the flexibility needed to respond to the pandemic. In certain cases, these flexibilities suspended requirements in order to address acute and extraordinary circumstances. CMS has consistently monitored data within nursing homes and has used these data to inform decision making.

With steadily increasing vaccination rates for nursing home residents and staff, and with overall improvements seen in nursing homes’ abilities to respond to COVID-19 outbreaks, CMS is taking steps to phase out certain flexibilities that are generally no longer needed to re-establish certain minimum standards while continuing to protect the health and safety of those residing in skilled nursing facilities/nursing facilities (SNFs/NFs). Similarly, some of the same waivers are also being terminated for inpatient hospices, intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), and end-stage renal disease (ESRD) facilities.

“Patient and resident health and safety are top priorities for CMS, and today’s actions are focused on ensuring every nursing home resident is cared for in a safe, high-quality environment,” said CMS Administrator Chiquita Brooks-LaSure. “We’ve learned a lot from the pandemic over the last two years and are committed to using that knowledge to re-envision the next chapter of health care quality and patient safety and build a stronger health care system.”

Recent onsite long-term care (LTC) survey findings have provided insight into issues with resident care that are unrelated to infection control, such as increases in residents’ weight-loss, depression, and pressure ulcers. The lack of certain minimum standards, such as training for nurse aides, may be contributing to these issues. By ending some of the temporary waivers, CMS is helping nursing homes to redirect efforts back to meeting the regulatory requirements aimed at ensuring each resident’s physical, mental, and psychosocial needs are met. In addition, CMS expects providers to have integrated practices to address any COVID-19 outbreaks into their normal operations.

CMS will maintain flexibility for certain requirements, such as making temporary waivers available for nurse aides’ certification if there are documented capacity issues in training or testing programs, and CMS will retain the ability until the expiration or termination of the national COVID-19 PHE to issue individual state-based, county-based, or facility-based waivers as needed. Centers for Disease Control & Prevention and CMS data, tracking trends in the number of COVID-19 cases in local communities and nursing homes, provide CMS with the ability to grant waivers in specific situations. For example, if there is a severe outbreak in a facility or geographically distinct group of facilities, CMS can quickly grant waivers to support the facilities’ response to COVID-19. If there is a nationwide surge of nursing home COVID-19 cases in the future, CMS can quickly re-issue national blanket waivers during the PHE.

CMS is ending specific waivers in two groups: one group of waivers will terminate 30 days from the issuance of this new guidance, and the other group will terminate 60 days from issuance. These timeframes give providers and state agencies time to adjust their operations to the reinstituted requirements.

Details can be found in the Quality, Safety, and Oversight (QSO) memo here: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/update-covid-19-emergency-declaration-blanket-waivers-specific.

A New Way for Medicare Beneficiaries to Get Free Over-the-Counter COVID-19 Tests

Date: April 4, 2022

Biden-Harris Administration Announces a New Way for Medicare Beneficiaries to Get Free Over-the-Counter COVID-19 Tests

On April 4, 2022, The Biden-Harris Administration announced that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration (FDA) approved, authorized, or cleared over-the-counter COVID-19 tests at no cost. People with Medicare can get up to 8 tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.

“With today’s announcement, we are expanding access to free over-the-counter COVID-19 testing for people with Medicare Part B, including those enrolled in a Medicare Advantage plan. People with Medicare Part B will now have access to up to 8 FDA-approved, authorized or cleared over-the-counter COVID-19 tests per month at no cost. This is all part of our overall strategy to ramp -up access to easy-to-use, at-home tests free of charge,” said HHS Secretary Xavier Becerra. “Since we took office, we have more than tripled the number of sites where people can get COVID-19 tests for free, and we’re also delivering close to 250 million at-home, rapid tests to send for free to Americans who need them. Under the Biden-Harris Administration’s leadership, we required state Medicaid programs, insurers and group health plans to make tests free for millions of Americans. With today’s step, we are further expanding health insurance coverage of free over-the-counter tests to Medicare beneficiaries, including our nation’s elderly and people with disabilities.”

This is the first time that Medicare has covered an over-the-counter self-administered test at no cost to beneficiaries. This new initiative enables payment from Medicare directly to participating eligible pharmacies and other health care providers to allow Medicare beneficiaries to receive tests at no cost, in addition to the 2 sets of 4 free at-home COVID-19 tests Americans can continue to order from covidtests.gov. National pharmacy chains are participating in this initiative, including: Albertsons Companies, Inc., Costco Pharmacy, CVS, Food Lion, Giant Food, The Giant Company, Hannaford Pharmacies, H-E-B Pharmacy, Hy-Vee Pharmacy, Kroger Family of Pharmacies, Rite Aid Corp., Shop & Stop, Walgreens, and Walmart.

“Testing remains a critical tool in mitigating the spread of COVID-19, and we are committed to making sure people with Medicare have the tools they need to stay safe and healthy,” said Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. “By launching this initiative, the Biden-Harris Administration continues to demonstrate that we are doing everything possible to make over-the-counter COVID-19 testing free and accessible for millions more Americans.”

Providers and suppliers eligible to participate include certain types of pharmacies and other health care providers who are enrolled in Medicare and able to furnish ambulatory health care services such as preventive vaccines, COVID-19 testing, and regular medical visits. To ensure that people with Medicare have access to these tests, Medicare is not requiring participating eligible pharmacies and health care providers go through any new Medicare enrollment processes. If a health care provider currently provides ambulatory health care services such as vaccines, lab tests, or other clinic type visits to people with Medicare, then they are eligible to participate in this initiative.

“For the first time in its history, Medicare is paying for an over-the-counter test,” said Deputy Administrator Dr. Meena Seshamani, Director of the Center for Medicare at CMS. “This is because COVID-19 testing is a critical part of our pandemic response. Combined with the free over-the-counter tests available through covidtests.gov, this initiative will significantly increase testing access for Americans most vulnerable to COVID-19 and will provide valuable information for future payment policy supporting accessible, comprehensive, person-centered health care.”

A list of eligible pharmacies and other health care providers that have committed publicly to participate in this initiative can be found here. Because additional eligible pharmacies and health care providers may also participate, people with Medicare should check with their pharmacy or health care provider to find out whether they are participating.

This initiative adds to existing options for people with Medicare to access COVID-19 testing, including:

  • Requesting free over-the-counter tests for home delivery at covidtests.gov. Every home in the U.S. is eligible to order 2 sets of 4 at-home COVID-19 tests.
  • Access to no-cost COVID-19 tests through health care providers at over 20,000 testing sites nationwide. A list of community-based testing sites can be found here.
  • Access to lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost through Medicare.
  • In addition to accessing a COVID-19 laboratory test ordered by a health care professional, people with Medicare can also access one lab-performed test without an order and cost-sharing during the public health emergency.

People with Medicare can get additional information by contacting 1-800-MEDICARE and going to: https://www.medicare.gov/medicare-coronavirus. Medicare also maintains several resources to help ensure beneficiaries receive the correct benefits while also avoiding the potential for fraud or scams. More details—particularly on identifying scams due to COVID-19—can be found at https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse.

Pharmacies and other health care providers interested in participating in this initiative can get more information here: https://www.cms.gov/COVIDOTCtestsProvider.

More Information:

Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost

Date: April 6, 2022

Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost

Today, April 6, 2022, the Centers for Medicare & Medicaid Services (CMS) announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna COVID-19 vaccines without cost sharing as it continues to provide coverage for this critical protection from the virus. People with Medicare pay nothing to receive a COVID-19 vaccine and there is no applicable copayment, coinsurance or deductible. People with Medicaid coverage can also get COVID-19 vaccines, including boosters, at no cost.

The Centers for Disease Control and Prevention (CDC) recently updated its recommendations regarding COVID-19 vaccinations. Certain immunocompromised individuals and people ages 50 years and older who received an initial booster dose at least four months ago are eligible for another booster to increase their protection against severe disease from COVID-19. Additionally, the CDC recommends that adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least four months ago can receive a second booster dose of a Pfizer-BioNTech or Moderna COVID-19 vaccine.

The COVID-19 vaccine, including the booster doses, is the best defense against severe illness, hospitalization and death from the virus. CMS continues to explore ways to ensure maximum access to COVID-19 vaccinations. More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available at https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html and through the CMS COVID-19 Provider Toolkit.

People can visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.

Developing Workforce Retention and Resiliency within an Integrated Care Setting

Date: April 5, 2022

Developing Workforce Retention and Resiliency within an Integrated Care Setting

Webinar Date: April 20, 2022

Time: 1:00 PM ET

Click to Register

The impact of COVID on healthcare worker retention and burnout has been staggering. According to the American Medical Association, nearly half (49%) of healthcare workers reported experiencing burnout. The National Healthcare Retention & RN Staffing Report states that since 2015, the average hospital has turned over 89% of its workforce and COVID has accounted for a 10% decrease in healthcare employment. This webinar will cover strategies to bolster healthcare workforce retention and prevent workforce burnout. This webinar is designed to answer the following questions:

  • What are the key factors contributing to burnout, compassion fatigue, and employee turnover among primary and behavioral health providers?
  • How have these factors been exacerbated by the pandemic?
  • What are supervisory strategies that have been found to be effective in supporting employee engagement, resilience, and retention?
  • What are key organizational policies and practices that can enhance workforce retention and resilience?

Presenters: Philip H. Rainer, M.S.W., LCSW-R, SAP; Fran Basche, M.A.

  • Philip H. Rainer, M.S.W., LCSW-R, SAP is a Senior Program Associate II at Advocates for Human Potential (AHP). Mr. Rainer is a New York State Licensed Clinical Social Worker and Federal Department of Transportation qualified Substance Abuse Professional with experience including direct clinical care; program design, implementation, and management; and senior organization leadership roles in behavioral health care.
  • Fran Basche, M.A. is a seasoned leader with extensive experience in the development, management, and evaluation of programs and policies in the fields of integrated behavioral health, HIV and behavioral health workforce. Much of her work has focused on providing training and technical assistance (TTA) related to the integration of behavioral health and primary care, workforce development, the intersection of behavioral health with HIV, and programs for women and girls.

Governor Parson Announces End to COVID-19 Crisis in Missouri

Date: March 30, 2022

Governor Parson Announces End to COVID-19 Crisis in Missouri

On March 30, 2022, during a press conference at the State Capitol, Governor Mike Parson announced an end to the COVID-19 crisis in Missouri and that the state will be shifting to an endemic phase of the pandemic on Friday, April 1, 2022. 

A whole-of-government COVID-19 emergency response was taken for more than two years, an effort that responded to the needs of all Missourians during the global pandemic and sustained state operations as more was learned about the novel virus. Vaccines, testing resources, and treatments are now readily available for all Missourians, and much of the population now has some immunity to the virus.

“Over the past two years, we have learned a lot that will help us respond to future outbreaks and challenges that may come our way,” Governor Parson said. “We don’t know if this virus will ever completely go away, but we do know that there is no longer a need to live in crisis mode and that we can shift our response to meet the current needs of Missourians. The COVID-19 crisis is over in the state of Missouri, and we are moving on.”

The SARS-CoV-2 virus, which causes COVID-19, is expected to continue to circulate in communities, meaning it will be considered endemic like many other diseases. The endemicity also means that surveillance priority will change from monitoring case numbers to monitoring disease severity and societal impact as new waves of infection come and go. This transition does not minimize the continued importance of public health surveillance, investigation, and response activities, as is necessary to mitigate any disease.

“As we enter this phase of our state’s recovery, we continue to encourage Missourians to safeguard their own health and the health of loved ones through tried and true public health measures,” said Department of Health and Senior Services Acting Director Paula Nickelson. “Missourians should feel confident that we will remain vigilant when monitoring COVID-19 levels throughout the state.”

Over the past two years, the state was able to achieve some incredible milestones in responding to COVID-19:

Testing Capacity

  • More than 14 million tests performed by public health partners

Treatment Options

  • More than 81,000 treatment courses distributed by the State of Missouri

Vaccine Availability

  • More than 8.7 million doses administered by public health partners

In addition to vaccines, testing, and treatment options, which are some of the most effective tools to fight COVID-19, Missouri has expanded capabilities over the past two years in areas of personal protective equipment (PPE), hospital capacity, and data collection. These capabilities allow Missouri to adapt to changing needs regarding COVID-19 in the future. 

Missouri’s approach moving forward will allow state and local health officials to closely monitor community level of COVID-19, determine which variants of SARS-CoV-2 are circulating through the genomic surveillance, and assess disease severity and impact of COVID-19-associated illnesses.

Beginning Friday, the Department of Health and Senior Services will provide weekly dashboard updates that will include 7-day case rate data, activity by region and county, statewide data on COVID-19 hospitalizations, and circulating virus variants. This is a flexible approach allowing accommodation for future surges, should they occur, and require more frequent updates and additional datasets.

More information about vaccines, testing resources, and treatment options along with the updated COVID-19 dashboard and details about this phase of the pandemic can be found by visiting health.mo.gov/coronavirus.  

A booklet with more information regarding the transition to endemic phase can be found by clicking here

Webinar: COVID-19 Impact on Emergency Preparedness for RHC

Date: March 25, 2022

This session will explore additional requirements and revisions made to emergency preparedness for Rural Health Clinics (RHCs) due to COVID-19 with focus on how and what to update in the current plan, how to incorporate new requirements into “practice exercises”, as well as other practical applications. The session will be structured to ensure ample time for participant questions.

Learning Objectives – Following the session, participants will be able to:

  • Describe two new requirements or updates to emergency preparedness rules for RHCs
  • Detail how the RHC might incorporate new requirements into their practice exercises
  • Identify needed revisions to their current emergency preparedness plan

Webinar Date: March 29, 2022

Time: 3:00 PM ET

Register Here

HHS Call – COVID-19 Uninsured Program/Coverage Assistance Fund

Date: March 25, 2022

Due to high demand, the Health Resources and Services Administration (HRSA) is holding a second session. Like many of you, the National Rural Health Association (NRHA) was not able to join the March 25, 2022 conversation but will plan to participate on the March 29, 2022 conversation and report back any findings.  

Please join Administrator Carole Johnson from the HRSA to learn more about the COVID-19 Uninsured Program and the COVID-19 Coverage Assistance Fund.

As you may be aware, due to a lack of additional COVID funding from Congress, HRSA’s COVID-19 Uninsured Program stopped accepting claims for testing and treatment on Tuesday, March 22, 2022 at 11:59 pm ET. The Uninsured Program and the COVID-19 Coverage Assistance Fund will also stop accepting vaccination claims due to a lack of additional COVID funding from Congress on April 5, 2022 at 11:59 pm ET.

Administrator Johnson will share the latest updates followed by Q & A. 

Webinar Date: March 29, 2022

Time: 12:30 PM ET

Register in advance for this meeting.

Webinar Today: COVID-19 Uninsured Program/Coverage Assistance Fund

Date: March 24, 2022

As you may be aware, due to a lack of additional COVID-19 funding from Congress, Health Resources and Services Administration’s (HRSA) COVID-19 Uninsured Program stopped accepting claims for testing and treatment March 22, 2022 at 11:59 pm ET. The Uninsured Program and the COVID-19 Coverage Assistance Fund will also stop accepting vaccination claims due to a lack of additional COVID-19 funding from Congress on April 5, 2022 at 11:59 pm ET. 

NRHA understands that these programs have been lifelines for many of you in the treatment of the uninsured during COVID-19. Please join U.S. Department of Health and Human Services Administrator Carole Johnson from the HRSA this Friday, March 25, at 1:00 PM ET to learn more about the COVID-19 Uninsured Program and the COVID-19 Coverage Assistance Fund. 

Administrator Johnson will share the latest updates followed by Q & A.  HRSA hopes you are able to join for this important call.  Zoom details below: 

Webinar Date: March 25, 2022

Time: 1:00 PM ET 

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Meeting ID: 161 447 4241 

Passcode: 031463 

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Webinar: COVID-19 Impact on Emergency Preparedness for RHCs

Date: March 24, 222

COVID-19 Impact on Emergency Preparedness for Rural Health Clinics (RHCs)

This session will explore additional requirements and revisions made to emergency preparedness for RHCs due to COVID-19 with focus on how and what to update in the current plan, how to incorporate new requirements into “practice exercises”, as well as other practical applications. The session will be structured to ensure ample time for participant questions.

Learning Objectives – Following the session, participants will be able to:

  • Describe two new requirements or updates to emergency preparedness rules for RHCs
  • Detail how the RHC might incorporate new requirements into their practice exercises
  • Identify needed revisions to their current emergency preparedness plan

Webinar Date: March 29, 2022

Time: 3:00 PM ET

Register Here

HRSA: Providers Ineligible for 340B during COVID can Reapply

Date: March 24, 2022

Providers that were kicked out of the 340B Drug Pricing Program during the pandemic will be able to apply for reinstatement, the Biden administration has announced. Disproportionate share hospitals, sole community hospitals, rural referral centers, children’s hospitals, and free-standing cancer hospitals that were terminated from the program after January 26, 2020, due to a change in patient mix can apply to be reinstated. Providers must prove that the share of Medicare or Medicaid patients treated decreased as a result of the public health emergency or the pandemic. The National Rural Health Association (NRHA) focus on paving a path for the future of 340B and much more with more than 80 sessions at NRHA’s 45th Annual Rural Health Conference hybrid events May 10-13 in Albuquerque, New Mexico and virtually.