Perhaps the most efficient way to hone in on the key answers is to view slides 34-39 of the
slide deck, which were not in last week's webinar for all providers. These slides address such points as pro re nata (PRN) staff, new hires, contract and agency staff, assisted living staff in the same building or on the same campus, refusals, missing the testing day, staff who previously tested positive, who can swab, and billing. The billing section emphasizes completing the insurance information and includes the following statement; "[t]he State is developing a process to financially support employee testing for nursing homes that are self-insured. Additional information about this process is forthcoming." The general rule for PRN staff, other staff members who are not present on testing day, and new hires is that they should be swabbed before starting work on their next shift, but they can start working while awaiting results.
The 40th slide in the deck gives an overview of the Clinical Laboratory Improvement Amendments (CLIA) waiver process for SNFs that wish to receive point-of-care antigen testing devices from the federal government. Earlier in the deck, at slide 9, the state affirms that antigen tests using a Food and Drug Administration-approved device from one of the two approved manufacturers are acceptable for opting out of state-supported testing. Another change is SNFs, whether they opt in or opt out, will report results to the state using an as-yet-unavailable survey instead of the emailed letter used for the baseline testing.
Deadline Reminders. Please note the following key reimbursement-related deadlines.
August 28 - this is the deadline for three separate opportunities under the federal Provider Relief Fund:
- Phase 2 General Distribution for Medicaid-only providers such as ICFs/IID and home and community-based waiver providers. This deadline was extended from today.
- Second chance for Medicare providers to declare additional patient revenue under the Phase 1 General Distribution. This opportunity will become available next week.
- Distribution to providers who could not participate in the Phase 1 General Distribution because of a change of ownership, also available next week.
August 5 - this is the deadline to file a Medicaid SNF rate reconsideration under OAC 5160-3-24 because of a calculation error. The deadline is 30 days after the date on the rate package, which we understand was July 6. DODD COVID-19 Rule Extensions. The Department of Developmental Disabilities (DODD) previously filed emergency rules to give providers regulatory relief during the pandemic. The emergency rules will expire 120 days after their effective date(s), so DODD is filing additional rule changes to extend these regulatory relief measures during the “COVID-19 state of emergency." Although the rules technically are considered permanent rules, the majority of the changes include an additional paragraph that specifies they are effective only until the end of the COVID-19 state of emergency.
DODD Compliance Reviews. OHCA received the following from DODD’s Angel Morgan:
As DODD resumes compliance reviews virtually, we have made a few changes to our process to help things go smoothly. One of those changes is that we will now be asking the county boards to provide the Individual Service Plans and Assessments. We recognize that it is more likely that the county boards will have the most current versions and that they will already be in some electronic format, whereas it may not be the case for all providers. We are also expecting providers to electronically send us quite a bit of data, and thought this would be one way to ease the burden for providers. We have updated our previous request for information to county boards to reflect this change. We will be resuming reviews on Monday, August 3. If you have any questions or concerns, please contact the Office of System Support & Standards at 614-466-6670.
CMS Proposes to Lock In Some Medicare Telehealth Expansions. The Centers for Medicare and Medicaid Services (CMS) announced this evening several proposed annual rulemaking actions, including the physician fee rule, in which CMS proposes to codify permanently certain telehealth expansions that began because of the Public Health Emergency (PHE). For other services, CMS proposes to extend telehealth coverage through the end of the year when the PHE ends. A separate news release on the physician fee rule contains tables detailing both groups of services.