ODH order posted. The Department of Health (ODH) today posted Director Dr. Amy Acton's notification order, which was announced on Monday. The order requires providers to notify residents, families, and staff members within 24 hours after a resident or employee is confirmed positive or probable for COVID-19 and to send a copy of the notice to ODH. A probable case is a person who has not been tested but has symptoms and no other explanation for them. Here are a few key questions and answers about the order:

• To whom does the order apply? The order applies broadly to SNFs, residential care facilities, and residential facilities licensed by the Department of Developmental Disabilities (DODD), including both ICFs/IID and licensed waiver homes.
  
• How must the notice be given? The order does not require a specific method of notification. OHCA recommends telephone calls to families (or emails if unable to reach them by phone) and in-person communication to staff.
  
• Does a provider have to give notice for each positive/probable case? No, only the first one.
• What has to be in the notice? That the positive/probable case exists and the measures the facility is taking to reduce spread of infection. Providers may include other information if they wish.
• What if we had a case two weeks ago and notified residents, families, and staff? Do we need to do it again? No, notification of a past positive/probable case under the order is required only if it was not provided at the time.
  
• Is notice required if a facility admits a person who has COVID-19 but is no longer infectious? No, but if the person still has active disease and is the facility's first case, notice must be provided.
• Is notice required if a contractor is positive, but no facility employees or residents are infected? No, the order applies to residents and staff, not outside contractors.
  

Trouble getting COVID-19 testing? ODH Director Acton has indicated that when there is a positive COVID-19 case in a congregate health care setting, other residents and staff are a priority for testing because of the urgent need to prevent spread of the virus. She suggested notifying ODH if the local health department does not perform testing. If this situation happens to you, please contact OHCA, and we will follow up with ODH.

Ohio 1135 waiver/Appendix K submission. Review of the 1135 waiver and Appendix K submission that the Department of Medicaid (ODM) filed yesterday reveals that it contains little that was not announced previously. Most of the changes allow various administrative functions to be performed remotely instead of in person. The waiver request does not include any payment provisions for Medicaid providers other than allowing enhanced reimbursement for Health Care Isolation Centers. The document also omits a set of ICF regulatory relief items that OHCA proposed in our 1135 submission with LeadingAge Ohio and that the state indicated on Friday would be in their application. We understand that the state may make corrections to its filing. Some items in the state's request that may be of interest to providers (and that the state already put in place) are:

• Telehealth expansions.
• Flexibility to provide day services for people with disabilities and people in the Department of Aging system in non-traditional ways.
• Self-attestation of resource requirements for Medicaid long-term services and supports (LTSS) applications and suspension of renewals. The waiver request also expands presumptive eligibility, as determined by hospitals or ODM, to include the LTSS population.
• Suspension of provider revalidations.
• Use of alternative sites for care.
• Suspension of prior authorization requirements in fee-for-service and managed Medicaid.
• Greater flexibility in waiver funding and providers serving consumers across waivers and across services within a waiver.
  

DODD update. Today, DODD released guidance temporarily lifting the 90-day limit for residential respite, but it must be approved by the county board. A webinar to address Adult Day Supports during COVID-19 is scheduled for Friday, April 17, at 1:00 p.m. Register for the webinar here. Both of these changes are included in the Appendix K application discussed above.

IRS eases stimulus payments for SSI recipients. The Internal Revenue Service (IRS) published a notice allowing individuals on Supplemental Security Income (SSI) to receive their $1,200 stimulus payments automatically, without having to take any action to request the payments. The IRS action eliminates the need for individuals or their representative payees to complete an online form to receive the money. SSI recipients wishing to claim the $500 child payment still must complete the form.

Aetna system fix. We reported previously that an issue with Aetna Better Health's automated claims processing system required them to process claims manually, resulting in payment delays. Aetna notified us that last Thursday the issue was addressed, automated processing resumed, and members should experience quicker turn-around.