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January 6, 2021


Progress on DD Waiver Payments. The Department of Developmental Disabilities (DODD) shared today that revisions to Ohio's Appendix K to allow another lump sum payment to DD waiver providers currently are pending approval by Department of Medicaid leadership. DODD anticipates the Appendix K changes will be submitted to the Centers for Medicare and Medicaid Services (CMS) by the end of the week. While CMS approval is necessary for these payments, the federal agency had no concerns with Ohio’s similar request in September and approved it rapidly. Once Ohio receives CMS approval, DODD will calculate amounts for each provider using their total claims payments for dates of service August 1 to October 31, 2020. If you have not submitted all of your waiver claims for those dates of service or need to submit claims adjustments, please do so by 5:00 p.m. on Wednesday, January 13, 2021. Individual provider payment amounts will be prorated based on each provider's percentage of the total claims from the August-October period multiplied by the total funds available for this payment (approximately $77 million). The department estimates this amount will equal approximately two weeks of claims payments.  

On a related note, Ohio's Appendix K submission also will include a request to extend the current Appendix K provisions, which are set to expire January 26, 2021. If approved, the revised Appendix K will extend the current authority for Start Toward Emerging Possibilities (STEP) services, as well as other emergency measures, for up to six months following the end of the Public Health Emergency (PHE). The PHE expires January 21, 2021, but AHCA/NCAL heard from a federal source that the Secretary of Health and Human Services plans to extend it for an additional 90 days before the Trump Administration leaves office.

Correcting BWC Grant Deadline. In last Saturday's SNF News Bites, we wrote that the deadline for the Bureau of Workers' Compensation's (BWC's) COVID-19 Indoor Air Quality Assistance Program was extended from December 30, 2020, to June 30, 2021. This statement was incorrect. The actual extension is to March 31, 2021, or until the funds appropriated for the program are exhausted. Please see BWC's web page for confirmation of the deadline and information on how to apply for these grants, which are available to licensed SNFs and residential care facilities (assisted living communities), as well as to adult day centers participating in the PASSPORT, Ohio Home Care, or MyCare Ohio waivers and adult day support providers for people with intellectual and developmental disabilities. BWC told OHCA that while they originally planned to extend the air quality program through June 30, 2021, they received several hundred new applications on December 30, 2020, which led them to set the earlier cut-off date. They will reevaluate extending the program an additional quarter as March 31 approaches.

TB Tests and Vaccination. We heard today about some confusion about vaccination and tuberculosis (TB) testing, specifically that one of the pharmacy companies said a person who had a TB test cannot be vaccinated for 28 days. This is false. It is actually a reversal of the Centers for Disease Control and Prevention (CDC) guidelines, which suggest waiting 28 days after vaccination to administer a TB test:

Inactive vaccines do not interfere with tuberculosis (TB) test results. There is no immunologic reason to believe either a Tuberculin Skin Test (TST) (administered by intradermal placement of 0.1 cc of purified protein derivative) or blood draw for interferon gamma release assay (IGRA) would affect the safety or effectiveness of mRNA COVID-19 vaccines. We have no data to inform the impact of the COVID-19 mRNA vaccines on either TB test for infection (i.e., TST or IGRA).

For healthcare personnel or patients who require baseline TB testing (at onboarding or entry into facilities) at the same time they are to receive an mRNA COVID-19 vaccine:

  • Perform TB symptom screening on all healthcare personnel or patients.
If utilizing the IGRA, draw blood for interferon gamma release assay prior to COVID-19 vaccination. If utilizing the TST, place prior to COVID-19 vaccination.If vaccination has been given and testing needs to be performed, defer TST or IGRA until 4 weeks after COVID-19 vaccine 2-dose completion.
  • All potential recipients of COVID-19 vaccination should weigh the risks and benefits of delaying TST/IGRA with their providers.

New #GetVaccinated Videos Now Available (from AHCA/NCAL). Dr. David Gifford, AHCA/NCAL Chief Medical Officer, addresses important questions about the COVID-19 vaccine in a series of new videos as part of the AHCA/NCAL #GetVaccinated campaign. Questions include:

Please continue to check the AHCA/NCAL #GetVaccinated page for additional resources and updates. 

New COVID-19 ICD-10 Codes. CDC recently released six new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes that describe certain secondary conditions that can accompany COVID-19. These codes took effect January 1, 2021, but are not yet in the CMS SNF Patient-Driven Payment Model ICD-10 mapping and may create issues with MDS software, so you should contact your software vendor if you need to use one of these codes. See this blog post by AHCA/NCAL's Dan Ciolek for more information about the new codes and their impact.

For home health agencies, CMS has included the new codes in the Home Health Prospective Payment System Grouper Software for the Patient-Driven Groupings Model (PDGM). Please see this CMS web page for more information on incorporation of these codes into PDGM.