CMS issues more blanket waivers. The Centers for Medicare and Medicaid Services (CMS) released a number of documents this evening providing additional flexibility for Medicare/Medicaid providers, especially hospitals, to address the COVID-19 pandemic. One of the releases is a second set of blanket 1135 waivers. A number of the blanket waivers apply to SNFs, home health agencies, and hospices. Please see this CMS fact sheet describing these waivers. Pages 9-13 address long-term services and supports. Among many other regulations, CMS waived nurse aide training and MDS and OASIS submission requirements. In some cases - nurse aide training is an example - a state waiver also is required to effectuate the change, but most of them are purely federal and are retroactive to March 1. Please review the list of waivers carefully and let us know if you have any questions.
CMS also published documents by provider type compiling the various waivers and other changes they have made at different times in response to COVID-19. These compilations include home health, hospice, and SNF.
OHCA submits 1135 waiver application. Today, OHCA and LeadingAge Ohio teamed up to present an 1135 waiver application to CMS, joining a growing number of associations that are doing so. We are aware of at least two associations that received approvals. Our waiver submission covers home health agencies, hospice programs, SNFs, and ICFs/IID. 1135 waivers excuse compliance with specific federal regulatory provisions. Ironically, a number of the key items in our submission were included in the CMS blanket waivers discussed above, except that the blanket waivers do not address ICFs.
CMS finally issues ICF guidance. After issuing Quality, Safety, and Oversight (QSO) letters for all other federally regulated long-term services and supports provider categories, CMS got around to publishing QSO 20-23-ICF/IID & PRTF. Like some of the other QSOs, 20-23 takes the form of a question-and-answer document covering a broad range of topics. We recommend all ICF members review the 2-page QSO carefully and compare it to guidance already issued by the Department of Developmental Disabilities (DODD).
OHCA guidance on optimizing PPE. As the shortage of personal protective equipment (PPE) continues, it becomes ever more important to use it as efficiently as possible. To help members in this crucial endeavor, OHCA compiled available Centers for Disease Control and Prevention (CDC) guidelines into three easy-to-use documents specific to facemasks, gowns, and eye protection and placed them, along with a CDC checklist on N95 respirator optimization, into a web-based folder for member use.
Use of face shields and options for sourcing. Per the CDC guidelines, full face shields that extend below the chin are an acceptable form of personal protection when masks are not available or when healthcare personnel are utilizing a homemade mask. Laird Plastics confirmed to OHCA that they have an abundance of face shields available immediately for purchase. The Laird Face Shield flyer provides a complete description of the product, and pricing starts at $8.00 per shield for quantities of 100. Prices drop considerably for larger members who may wish to purchase in larger quantities. Questions can be directed to Matthey Magoteaux at 614-272-0777 or mmagoteaux@lairdplastics.com.
Today's DODD guidance. DODD released several updated guidance documents today. They include a revised version of DODD's frequently asked questions (FAQ) on the adult day services order, which includes new material on the services residential providers can provide, hiring new staff, and sharing staff with other agencies. The guidance for waiver providers was updated to remind providers that electronic visit verification (EVV) requirements remain in effect, and the COVID-19 FAQ was changed to reflect the Director of Health's stay-at-home order. This last guideline gives providers the option of refusing to allow a person who has left the home to return to the home or isolating the person for a 14-day quarantine upon return. This guidance applies both to ICFs-IID and to waiver group homes. In addition, Director Jeff Davis shared a video message to providers and direct support professionals.
Separately, DODD also issued a new health and welfare alert on infection control giving basic measures everyone can use to protect against COVID-19 infection. DODD's weekly Memo Monday publication included COVID-19-related news, including extension of the ICF cost report due date to April 28, 2020, and extension of the Building Innovative Service Model and Employer Transformation grant deadlines.
EVV-based survey to screen for COVID-19. The Department of Medicaid announced that electronic visit verification (EVV) users will be able to utilize a phone survey to screen people for COVID-19. See this document for more information about the survey.
COVID-19-related news from Aetna. Aetna Better Health of Ohio informed OHCA that SNF claims are taking longer to process this month because errors in their automated claims system caused them to process all SNF claims manually. Aetna told us, "claims are now being processed around the 30 day time frame."
In addition, Aetna Better Health of Ohio posted the same notification waiving post-acute care authorizations for SNFs until April 23, 2020, as they previously published for other product lines.
EMA warns of COVID-related scams. The Emergency Management Agency released a notice listing a number of scams by which unscrupulous people are attempting to take advantage of the COVID-19 crisis. Also noteworthy is a piece at the end of the notice about the Attorney General investigating price-gouging on facemasks.