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June 20, 2020


Tuesday all-provider webinar on SNF testing program. The Department of Medicaid (ODM) released the following announcement about a webinar Tuesday on the testing program and other regulatory matters.

Please join the Governor’s Office, the Ohio Department of Health, the Ohio Department of Medicaid, and members of the Congregate Care Unified Response Team (CCURT) to hear updates from the State team regarding testing in nursing homes, to learn about ODH’s recently released Guidelines and guidance documents for testing in nursing homes, as well as other regulatory updates from the ODH. 

WHO: The webinar’s target audience is nursing facility administrators, local health departments, hospitals, provider associations, and other health care stakeholders. Associations are encouraged to invite each of their members to attend this webinar. We request that only one or two individuals from each unique organization / facility join the webinar to ensure all interested parties have an opportunity to participate. The webinar will be recorded and posted for later viewing.

WHEN: 10:00-11:30 am on Tuesday June 23rd, 2020

WHERE: Please register for the webinar here: https://attendee.gotowebinar.com/register/5089201027473316876

After registering, you will receive a confirmation email containing information about joining the webinar.*Please note: the webinar will require attendees to listen through their computer audio, so calling in from a phone will not be an option.

OHCA free webinar on quality measures for July 1 Medicaid SNF rates. We apologize that the notice of this webinar in yesterday's SNF News Bites lacked the time. The webinar will be held on Monday, June 22, at 1:30 p.m. It will review the quality measures that ODM will use to calculate Medicaid rates for July 1, along with the latest available data and other updates on the rate-setting. To join, use the Unified Meeting link and select the "Call Me" option or use your telephone to dial the conference call number: (866) 503-4605, 9542661414#. To view the slides, go to this link (they are not posted yet). Live access to this webinar is limited to 300, but it will be recorded and available on the OHCA Medicaid web page. OHCA calculated the "new quality" points for all Ohio SNFs, so members may email pvanrunkle@ohca.org for their data.

Medicaid Targeted Distribution webinars Tuesday and Thursday. 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:

Member observations on testing. Anecdotal reports from OHCA members about the National Guard testing program confirm that the testing itself has gone smoothly, but a number of members expressed concerns about late notifice of when the Guard would arrive at the building, making it difficult to inform off-dusty staff members when to come in. The testing has identified very few positives for the number of tests administered, although the state has not yet shared data. Some members have chosen to have their staff tested independently of the National Guard program, which is explicitly permitted by the state guidance (see question 25, page 5). The state published return-to work guidelines (see especially page 2) but continues to insist that laboratory fees must be billed to employee health insurance, even when the employer is self-insured. This is a priority issue for OHCA's advocacy, as a number of other states are paying for testing in SNFs.

Technology grant awards appearing. ODM has begun to release grant awards to SNFs for communication technology to allow patients and families to stay connected during this continuing period of no visitation. The notice appears to be coming as a secure email from Tatia Baxter of ODM. The grants were delayed for a considerable period of time after ODM determined they needed Controlling Board approval to disburse the money, which approval occurred on June 1.

Governor signs HB 481. Yesterday, Governor Mike DeWine signed House Bill 481, an omnibus bill that contains statutory changes relating to July 1, 2020, SNF rates. Because the bill is an emergency measure, it took effect immediately upon the Governor's signature, in plenty of time for the July 1, rates.

ODM COVID-19 Managed Care Contract Update. The ODM Managed Care Policy team shared an updated document listing COVID-19 emergency provisions included in the new managed care contracts that take effect July 1, 2020. Previously, ODM implemented emergency provider agreement changes affecting administrative policies, telehealth services, and service authorization requirements. The changes relevant to OHCA member providers include the following:

  • The managed care plans (MCPs) and Mycare Ohio plans (MCOPs) must continue to extend timely filing limits to accept claims from all provider types up to 365 days from the date of service.
  • The MCOPs and MCPs must continue to cover emergency telehealth expansion services.
  • The MCPs may resume prior authorization requirements for services beginning on July 1, 2020. Please note, prior authorization waivers for the MCOPs applied to services where Medicaid is the primary payor.
  • The MCPs and MCOPs no longer are required to compensate out-of-network providers at fee-for-service rates effective July 1, 2020.

The updated ODM managed care provider agreements for July 1, 2020, will be posted to this website closer to the effective date.

Updates from CMS ICF Staff. OHCA had the opportunity to participate on a call with both CMS Central Office and regional representatives who work directly with the ICF-IID program. Don Howard, CMS’s lead for ICFs with the Quality, Safety, and Oversight Group (QSOG), responded to questions previously submitted by OHCA and other members of AHCA’s ID/DD Committee. Mr. Howard said CMS will not issue any more blanket waivers for ICFs, but will accept and review 1135 waiver requests submitted by individual providers or associations.

A key question on the call was when surveys will re-start and how surveyors will view program changes implemented to ensure health and safety of ICF residents during the pandemic. Mr. Howard said CMS is still discussing the timeline, but when annual surveys resume, CMS will direct the State Survey Agencies to take into consideration both CMS-issued waivers and any state direction to providers. CMS clearly intends to allow each state the authority to implement guidelines and direction based on its particular circumstances.

CMS releases weekly update of SNF COVID-19 data as of June 7, 2020. The following is an announcement from CMS.

In case you missed it, the Centers for Medicare & Medicaid Services (CMS) posted the second set of coronavirus disease 2019 (COVID-19) nursing home data today available here. The data will be updated weekly going forward; for more information on nursing homes, including a link to the COVID-19 nursing home data, visit Nursing Home Compare. CMS also released additional frequently asked questions on the nursing home COVID-19 data available here.

Governor announces PPE stockpile. Governor DeWine heralded a new Hospital PPE Readiness Stockpile, which will be compiled and stored by hospitals throughout the state. Items in the stockpile will be distributed to residents and staff at long-term care facilities should there be an increase in COVID-19 cases. Hospitals are to build a 30-day reserve of PPE based on several calculations, including the state’s surge models, the number of residents and staff at Ohio SNFs, and recent Federal Emergency Management Agency PPE allocations to each SNF. Each hospital will have a different stockpile expectation that is calculated specifically for the region. The stockpile is a collaborative effort between the Ohio Hospital Association, hospitals throughout the state, and several state agencies, including the departments of Health, Medicaid, and Public Safety. This initiative presumably will tie to the hospital-SNF partner list.

Expansion of good cause for refusing return to work. Governor DeWine also signed an executive order that expands the definition of good cause for an employee who is receiving Unemployment Compensation not to return to work during the COVID-19 State of Emergency. An employee forfeits unemployment benefits if they refuse to return to work without good cause. For the duration of the emergency period, good cause now includes the following situations:

  • A medical professional recommends that the employee not return to work because they fall into a category considered high-risk for catching COVID-19 by CDC and their employer cannot offer teleworking options.
  • The employee is 65 years of age or older.
  • There is tangible evidence of a health and safety violation by the employer that does not allow the employee to practice social distancing or hygiene or to wear PPE.
  • The employee potentially has been exposed to COVID-19 and is subject to a quarantine period prescribed by a medical or health professional.
  • The employee must stay home to care for a family member who is suffering from COVID-19 or is subject to a prescribed quarantine period by a medical or health professional.