Legislature returns to COVID-19 issues. After passing House Bill 197 in late March, the General Assembly left Columbus until this week. The House of Representatives immediately swung into action by amending Senate Bill (SB) 1 with a provision that would limit orders of the Director of Health to 14 days unless approved by a super-majority of the Joint Committee on Agency Rule Review. This provision's fate is uncertain in the Senate. The House also amended an unrelated measure, SB 55, to reduce penalties for violating a state or local health department order.

Not to be outdone, the Senate in a single day passed SB 310, which digs into $4.55 billion the state received from the Coronavirus Relief Fund. The legislation appropriates $350 million to state and local governments, which is only part of their allotted share under the federal distribution formula. Unlike the two House amendments, which were largely party-line, SB 310 passed unanimously.

Budget Director gives a little more detail on cuts. State Budget and Management Director Kim Murnieks presented additional information on the $775 million in budget cuts that Governor Mike DeWine announced yesterday. The cuts unveiled by Director Murnieks turned out to be $776 million in General Revenue Fund (GRF) spending plus an additional $352 million in non-GRF, for an all-funds total of $1.1 billion. April revenue numbers showed an $866.5 million reduction in tax revenues, with more than $500 million of that because the income tax filing deadline was moved to July. Director Murnieks catalogued the impact on universities and local school districts but did not offer any documentation of the $212 million in GRF and $9 million in non-GRF Medicaid cuts. She was quoted as saying, "it's likely to be largely an adjustment to the managed care rate and we will be working with the managed care organizations as well as (the Centers for Medicare and Medicaid Services) to implement those rate changes."

CMS QSO on SNF COVID-19 reporting. As expected, the Centers for Medicare and Medicaid Services (CMS) issued a Quality, Safety, and Oversight (QSO) letter, 20-29-NH, explaining the Interim Final Rule on SNF reporting of COVID-19 information to residents, families, and the Centers for Disease Control and Prevention. The QSO begins by repeating the rule provisions and the registration process for the National Healthcare Safety Network, then outlines the survey and enforcement aspects, including civil money penalties (CMPs). Finally, the QSO incorporates a frequently-asked questions document, which notably allows a grace period until May 24 for SNFs to report data and until June 7 before they become liable for a CMP. In tomorrow's COVID-19 Update, we plan to give more highlights of the QSO.

HHS confirms no pay-back of Provider Relief Fund "overpayments." After the second-tranche payments from the Provider Relief Fund, some providers discovered that they received more than 2% of their 2018 net patient revenue in the first tranche, which was based on 2019 fee-for-service Medicare revenue. These providers received no payments from the second tranche, but were concerned that they had been overpaid in the first tranche and would have to repay that amount. AHCA and NAHC both reported this is not the case. AHCA wrote that the Department of Health and Human Services (DHHS) will not recover unless, "DHHS identifies an overpayment associated with revenue calculations which were incorrect based upon improper or incorrect information on the cost reports. DHHS also noted the Department is collecting tax filing information to be uploaded to verify the revenue."

DODD adopts standards of care. Today the Department of Developmental Disabilities (DODD) released new guidance entitled "COVID-19 Standards of Care for Vulnerable Populations." The guidance outlines various rights of people with disabilities relative to hospital care, including that hospital systems and medical professionals cannot use disability status to determine allocation of treatment or resources and that a family member or caregiver should be allowed bedside access for patients who typically require assistance with activities of daily living. We applaud DODD for issuing this guidance in conjunction with the Departments of Medicaid and Health, as other states have de-prioritized medical care for people with developmental disabilities, and this guidance shows Ohio’s support for our most vulnerable citizens.

Complimentary webinars on caring for individuals with dementia during COVID-19. Relias, OHCA’s learning management and e-learning partner, teamed up with renowned dementia care educator Teepa Snow to offer practical and realistic strategies on caring for people living with dementia in congregate settings during the COVID-19 pandemic. Members can learn more about the first webinar and listen to the on-demand recording by clicking here. On Wednesday, May 13, 2020, from 3:00-4:00 p.m., Ms. Snow will conduct a follow-up to her original webinar by providing in-depth answers to many of the questions asked during the first session. In addition, she will offer real-life scenarios and role playing and will give attendees an opportunity to ask more questions. To register for the complimentary May 13 webinar, please click here.