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June 17, 2020

Re-opening SNFs. Members and consumers regularly contact us to point out that continued visitation restrictions in SNFs, while assisted living communities and ICFs/IID are re-opening, have a deleterious effect on patients' health. Nonetheless, the Director of Health's visitation order remains in full effect for SNFs. OHCA is having conversations with Director of Aging Ursel McElroy and other interested parties about re-opening SNFs, but at this time, no date or process for that has been established.

Medicaid Targeted Distribution webinars. The Department of Health and Human Services posted the following announcement on their Provider Relief Fund (PRF) web page. Please note that the webinars pertain only to the Medicaid Targeted Distribution, not other PRF distributions.

Note: HHS expects to distribute $15 billion to eligible Medicaid and CHIP providers through the Provider Relief Fund. Join our webcast to learn more about the application process. Please pre-register to reserve a spot on your preferred date:

UHC Extends Telehealth Reimbursement Waivers. Today, UnitedHealthcare (UHC) announced that they are extending the temporary telehealth expansion and reimbursement provisions for their various product lines through September 30, 2020. The waivers previously were scheduled to terminate on July 24, 2020. Additionally, UHC will continue to reimburse providers for telehealth visits at parity with the rate they would receive for an in-person visit. UHC is one of the few health plans paying home health agencies for telehealth visits at regular per-visit rates. UHC also extended cost-share waivers for home health, hospice, and therapy telehealth visits for in-network providers. Out-of-network provider member cost shares will resume on July 24, 2020.

ODM audits and exception reviews continue on hold. The Department of Medicaid's (ODM's) Mark Graves reported that the department will not resume MDS exception reviews until after the baseline National Guard testing of SNF employees is completed, which he said is expected to be in mid-July. After that, the exception review process will be virtual, under a plan to be determined. Mr. Graves added that the overpayment recovery (audit) notices for State Fiscal Years 2017 and 2018 also will not go out until then.

VA CCN authorization extensions. Today, the Veteran’s Health Administration (VA) Office of Community Care announced that all community care referrals in HealthShare Referral Manager (HSRM) covered by the Optum Care Network in Ohio, except those in cancelled or Episode of Care (EoC) complete status with an expiration date between March 1, 2020, to July 31, 2020, will be extended to September 30, 2020. Certain services OHCA members provide are excluded from this extension, including SNF skilled admissions, adult day services, home health aide homemaker services, and in-home respite care. If you are unsure whether your services require additional authorization, please email or check in HSRM for updated authorization time frames.

ODH posts testing guidance. The state's testing guidelines and other materials released Monday evening now are posted on the Health Department's "Testing in Nursing Homes" web page. We recommend you use this page to review the documents in case any of them are changed. The state's web page does not include the Excel download for the hospital partner list, which we will maintain on the OHCA COVID-19 page.

AHCA offers EIP webinar. Following up on an issue receiving a lot of attention lately, AHCA posted a pre-recorded webinar on Economic Impact Payments (EIPs or stimulus checks) sent to facility residents. According to AHCA,

The webinar covers what EIPs are and what steps we should take to protect beneficiaries receiving this benefit. EIP funds belong to the resident and they make decisions about fund use or may request assistance and guidance (such supports are acceptable). The recording also covers such areas as whether a resident can give their EIP funds to a family member and what to do if EIP funds are being misused. Finally, a variety of resources from the Social Security Administration to the National Center on Elder Law and Rights are available at the end of the webinar in which you can find further information that will be of assistance.

Compendium of HCBS emergency rules. As we previously reported, ODM published several emergency rules that reflect waivers and flexibilities granted through 1135, managed care, and emergency telehealth waivers. In addition to extending home health plan of care signature authority to advanced practice nurses and physician assistants, ODM gave home and community-based services (HCBS) providers greater flexibility in several ways. Please find a summary below of each program change with references and links to the relevant Administrative Code rules. Most of these changes were announced previously by OHCA, ODM, and the Department of Aging (ODA).

  • Home health
    • Home health and private duty nursing policy adds telehealth to the visit description (5160-12-04).
    • Private duty nursing authorization waiver (5160-12-02.3).
    • Home health agency re-accreditation by accrediting organizations is suspended during the COVID-19 emergency (5160-12-03.1).
    • Registered nurse assessments can be completed via telehealth, along with the physician face-to-face requirement (5160-12-08).
  • PASSPORT Waiver
    • ODA given authority to approve providers (5160-31-06).
  • Assisted living
    • Once enrolled in the Assisted Living Waiver (ALW), an individual will not be disenrolled unless they request disenrollment, move out of state, transition between the ALW and the Mycare Ohio Waiver, or expire (5160-33-03).
  • Ohio Home Care Waiver
    • The electronic signature requirement is waived until the next face-to-face visit to continue enrollment. Level of care requirements for enrollment are waived, and beneficiaries who turn 60 during the emergency can continue services until their next face-to-face visit (5160-46-02).
    • Allows family and foster caregivers, reduces the adult day health center services staffing ratio to 1:10, allows first aid certification through internet-only courses, allows the face-to-face requirement to be met telephonically or electronically, and allows ODA to certify providers (5160-46-04).
    • Adds to the hospice definitional rule the telehealth definition from the emergency rule (5160-56-01).
  • MyCare Ohio Waiver
    • Waives the plan signature requirement until the next face-to-face visit with the case manager (5160-58-01).