Elevating the Post-Acute and
Long Term Care Profession

July 12, 2021

FDA and CDC Clear the Air on Booster Shots - for Now. The Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) issued a joint statement on booster shots for the COVID-19 vaccines. The statement appears to be designed to stem the tide of rumors that vaccine protection is wearing off and that booster shots are needed now. The statement does not specify if they will or will not be required later, just that they are not now, and the agencies are studying the issue:

Americans who have been fully vaccinated do not need a booster shot at this time. FDA, CDC, and NIH are engaged in a science-based, rigorous process to consider whether or when a booster might be necessary. 

Any requirement for a booster shot for any of the three vaccines with FDA Emergency Use Authorizations will have to be issued by the federal agencies through their formal processes.

Molina to Pend SNF Claims Until Medicaid Rates Set. As SNF members know, the Department of Medicaid (ODM) announced that SNF rates for July 1, 2021, are not ready, and there is no date for when they will be ready. In response, Molina Healthcare released a bulletin last Friday that gives their plans. Molina wrote:

The Ohio Department of Medicaid (ODM) has advised that the July 1, 2021 Nursing Facility rates are delayed.

Molina Healthcare will pend any nursing facility claims received with a date of service of July 1, 2021 or after until such time as the new rates are finalized and configured; at that time the claims will be released for processing. As more information is received from ODM regarding the timeline to finalize the July 1 rates, Molina will provide an anticipated claims’ release date.

For questions, please reach out to your Provider Services Team at OHProviderRelations@MolinaHealthcare.com.

This approach is obviously concerning because MyCare Ohio plans have 30 days after they receive rates from ODM to load them into their systems and begin paying them. If ODM does not finalize the new rates soon, there will be a cash-flow problem under Molina's approach, which differs from state statute for fee-for-service Medicaid that requires ODM to pay June 30 rates if they do not complete the new rates by August 15. No other managed care plans have made announcements like Molina's yet.

Department of Aging Schedules Public Forums for Alzheimer's Task Force. The Department of Aging (ODA) is holding a series of six virtual public forums tomorrow, Wednesday, and Thursday for professionals and members of the public to offer their thoughts on dementia in Ohio. The forums are to support the work of the Alzheimer's Disease and Related Dementias Task Force, created by Senate Bill 24, which will make findings and issue recommendations on this subject by August 5 and again 3 months later. OHCA is represented on the task force, but please feel free to weigh in if you have ideas on this subject. Please see ODA's task force web page for information about the times of the forums and how to register to speak (scroll down to the expanding item, "Public Forums"). 

CMS Positivity Rates: Lawrence is Only Yellow County. This week's Centers for Medicare and Medicaid Services (CMS) COVID-19 positivity ratings again show Ohio as nearly all green. On the Ohio table, only Lawrence County remains yellow, with an inordinately high positivity rate of 11.9%, but with only 395 tests reported. That is the lowest number in the state, even compared to less populous counties. Morgan County, which was yellow last week, is now at 1.2% positivity.