Controlling Board approves LTSS funding. Today the legislatively-dominated Controlling Board, without objection, approved three items that authorize COVID-19 funding for long-term services and supports (LTSS) providers. The requests were submitted by the Office of Budget and Management (OBM) on behalf of the DeWine Administration. The funding comes from the federal Coronavirus Aid, Relief, and Economic Security Act. The Controlling Board has authority to allow state agencies to expend money beyond amounts appropriated in the state budget. The sums the board approved today are as follows:
- For SNFs, $91.1 million (this is half of the ultimate amount; the remainder is to come before the Controlling Board on July 27). This amount will be distributed using the formula OHCA proposed.
- For SNFs, an additional $25 million for infection control incentive payments based on April 2020 Medicaid days and Focused Infection Control survey results.
- For other LTSS providers, $78.5 million, which also is half of the eventual total. The state's filing with the Controlling Board lists these providers as "ICF/IDD, MyCare Waiver, Ohio Home Care Waiver, Passport, Medicaid Home Health, [and] Assisted Living providers." The request does not list Department of Developmental Disabilities waiver providers, but we believe they are included. We are attempting to get confirmation of that.
After the Controlling Board meeting this afternoon, we met with the Department of Medicaid to work through the details of the calculations for SNFs. Calculations for the other provider types included in the distribution are in process. The state appears to be intent on making the payments as soon as possible - possibly even before July 27. Providers will apply through a portal to be opened by OBM, but no details are available yet.
Heads-up! SNF resident testing coming. Rebecca Sandholdt of the Health Department this afternoon sent the following message to the SNF provider associations, indicating that there will be further discussion during our weekly meeting tomorrow:
On May 27, 2020, the Ohio Department of Health Director issued a Public Health Order requiring Nursing Homes to take additional action to control and prevent the spread of COVID-19 within their facility. As we near completion of baseline testing for all staff, we will begin baseline testing of all residents that reside within a Nursing Home in the State of Ohio. All Nursing Homes in the state will be invited to a webinar on Wednesday, July 15th, 2020 in the morning to discuss updates to resident testing plans, logistics, and partners for the pre-testing, test scheduling, and post-test support. A link to the webinar will be sent out Tuesday afternoon.
CMS expects to resume Medicare claim audits beginning August 3, 2020. (From AHCA's Dan Ciolek.) The Centers for Medicare and Medicaid Services (CMS) recently updated their COVID-19 Provider Burden Relief Frequently Asked Questions (FAQs) related to claim audit waivers for multiple services. On March 30 CMS suspended most Medicare Fee-For-Service (FFS) medical review because of the COVID-19 pandemic. This included pre-payment medical reviews conducted by Medicare Administrative Contractors (MACs) under the Targeted Probe and Educate program, and postpayment reviews conducted by the MACs, Supplemental Medical Review Contractor (SMRC) reviews and Recovery Audit Contractor (RAC). CMS expects to resume these audit activities beginning on August 3, 2020, regardless of the status of the public health emergency.
If selected for review, providers should discuss with their contractor any COVID-19-related hardships they are experiencing that could affect audit response timeliness. CMS notes that all reviews will be conducted in accordance with statutory and regulatory provisions, as well as related billing and coding requirements. Waivers and flexibilities in place at the time of the dates of service of any claims potentially selected for review will also be applied.
Reminder: July 20 deadline for Medicaid Targeted Distribution. Providers who are eligible for the Medicaid Targeted Distribution (MTD) from the Provider Relief Fund must apply through the Department of Health and Human Services (HHS) portal by July 20. In its latest update of frequently-asked questions (FAQ), HHS clarified that applying means submitting a tax identification number (TIN) for verification, not completion of the verification process. Notwithstanding rumors to the contrary, HHS did not announce in the FAQ that it is re-opening the General Distribution process to allow providers who did not report all of their patient revenue under a single TIN to update their data. Instead, HHS repeated the somewhat shopworn statement that these providers may be eligible for a future distribution. Likewise, HHS declined the opportunity to specify how long after application an eligible MTD applicant would be paid, again stating (in the context of another distribution), "HHS is working to process all providers’ submissions as quickly as possible. HHS may seek additional information from providers as necessary to complete its review." The Provider Support Line for questions or assistance is 866-569-3522.
CMS webcast on establishing infection prevention programs in SNFs. On Thursday, July 16, beginning at 4:00 p.m., CMS, together with the Centers for Disease Control and Prevention and the Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs), will continue their SNF COVID-19 training series with a webcast on establishing an infection prevention program. The emphasis will be on COVID-19, and the program will discuss the key components of an infection prevention program, describe best-practice strategies, and discuss key elements necessary for ongoing infection prevention surveillance. To learn more and to register, please click here.