Editor's note: This article will be updated with new information about the novel coronavirus outbreak as it relates to home health, home medical equipment and the aging-in-place community as we receive it. Please make sure you check homecaremag.com/coronavirus for longer articles, news releases and other updates on a daily basis. Note that date stamps are Central time.

If you have questions about the material included here or information to share, please email HomeCare Editor Hannah Wolfson at hwolfson@cahabamedia.com or HomeCare Managing Editor Kristin Easterling at keasterling@cahabamedia.com.


Monday, March 30, 4:25 p.m. 

The American Association for Homecare (AAHomecare) figures that home medical equipment providers in non-rural and non-bid areas will see a reimbursement rate increase of about 30%, thanks to the COVID-19 legislative package passed last week. The package includes relief for suppliers serving Medicare beneficiaries in non-rural areas that are not subject to competitive bidding. Dating back to March 6, the reimbursement rate for items that have been receiving 100% of the competitive bidding adjusted fee schedule will now get a blended rate of 75% adjusted and 25% unadjusted rates (the 2015 fee schedule). 

AAHomecare has done a rate analysis on popular HCPCS codes. They anticipate that oxygen concentrator (E1390) will see a 36% increase, portable oxygen concentrator (E1392) will see a 10% increase, and gas portable oxygen system (E0431) will see a 21% increase. 

The legislation also removes the 2% sequester cuts from May 1-December 31, 2020. AAHomecare estimates that will bring roughly $137.8 million back to the industry. 

 

Monday, March 30, 11:30 a.m.

The National Association for Home Care & Hospice issued guidance to members over the weekend advising that most providers would be exempt from the Families First Coronavirus Response Act. Recent Department of Labor guidance suggests health care providers are not "eligible employees" for the benefit.

 

Wednesday, March 25, 1:46 p.m.

Bill Dombi, president of the National Association for Home Care and Hospice, just gave a quick update from Washington at the conclusion of a NAHC webinar on home health's response to COVID-19. Items he touched on that are pending or under consideration include: 

  • The latest Congressional stimulus package, which the Senate is expected to vote on this afternoon, includes allowances for non-physician practitioners, including nurse practitioners and physician assistants, to certify eligibility for home health;
  • There is an emergency rule, currently pending with the Office of Management and Budget, that would include some encouragement for home health Telehealth services and some more flexible definitions of "homebound" patients, although not a waiver of the homebound requirement; and
  • The Centers for Medicare & Medicaid Services (CMS) is considering a number of pending measures, including a suspension of the Review Choice Demonstration and living the requirement for signed orders from physicians.  

Dombi also said NAHC is working on an emerging issue in which a number of nursing facilities and assisted living facilities (ALFs) are refusing to allow hospice or home health staff on the premises to provide care to residents. Dombi said there is guidance from CMS that skilled nursing facilities should allow hospice staff in to work with patients they have in their service, but some facilities are interpreting the "should" to mean it's at their discretion. CMS doesn't have jurisdictions over ALFs, but Dombi said NAHC is working with trade organizations to fix the issue. 

Dombi is doing regular videos to update members and others in the home health and Homecare community on the fast-changing situation. You can see the latest here

 

Wednesday, March 25, 12:00 p.m.

FAIR Health released a brief today estimating the total costs for COVID-19 patients may range from a low of $362 billion in charges and $139 billion in estimated in-network amounts to a high of $1.449 trillion in charges and $558 billion in estimated in-network amounts. The projections are derived from estimates issued by public health experts, that from 66 million to 198 million Americans may become infected with the novel coronavirus that causes COVID-19, and that from 4.9 million to 19.8 million of them may require inpatient stays. Find the full brief here.

Wednesday, March 25, 8:43 a.m. 

The Environments for Aging Expo & Conference, which was scheduled for April 25-28 at the Kentucky International Convention Center in Louisville, has been cancelled due to coronavirus restrictions. "We look forward to you joining us at the next EFA Expo & Conference in 2021," organizers wrote in a news release.They published a list of frequently asked questions here

 

Wednesday, March 25, 8:03 a.m. 

The Senate and White House reached a deal early this morning on a coronavirus stimulus package worth about $2 trillion; the Senate is expected to vote mid-day today. The package includes aid for affected companies and workers and direct payments to individuals. It also offered aid to laid off workers and incentives to encourage closed companies to keep paying employees. It includes $350 billion for lending programs for small businesses that keep payrolls steady during the epidemic. 

 

Tuesday, March 24, 10:17 a.m. 

The Centers for Medicare & Medicaid Services (CMS) has announced a series of relief measures when it comes to Medicare quality reporting to ease the strain of COVID-19 response, including for post-accuse providers. Read the full story here

 

Tuesday, March 24, 9:53 a.m. 

The Centers for Medicare & Medicaid Services announced last night that it has given Section 1135 Medicaid waivers to an additional 11 states, bringing the total number to 13. The waivers allow the states to make changes to prior authorization and provider enrollment requirements and facilitate reimbursement for care delivered in alternative settings. The new list of states includes: Alabama, Arizona, California, Illinois, Louisiana, Mississippi, New Hampshire, New Jersey, New Mexico, North Carolina and Virginia, on top of previously approved waivers for Florida and Washington state. 

 

Monday, March 23, 4:45 p.m. 

The U.S. Department of Health and Human Services Office of Inspector General (OIG) is alerting the public about fraud schemes related to the novel coronavirus (COVID-19), with perpetrators targeting beneficiaries through telemarketing calls, social media and in-person visits. Read more here

 

Friday, March 20, 2:45 p.m.

The American Association for Homecare and VGM is assessing the HME industry's quantities of patient-ready ventilators. If you supply ventilators or home oxygen, take the survey here. Please only one response per company.

 

Thursday, March 19, 3:30 p.m.

Prochant, an HME billing and process outsource company, is also tracking the impact of the coronavirus outbreak on their website. Follow the live thread at this link for updates from payers, CMS and more. 

 

Wednesday, March 18, 12:57 p.m. 

We're getting word of several upcoming events in the industry cancelling, postponing or moving online. Here's the latest. (If you'd like to share changes to your event, please email us.) Please visit our Industry Calendar to check the status of your event.

The National Hospice and Palliative Care Organization Leadership and Advocacy Conference, scheduled for March 23-27 has been cancelled. Leadership is taking Advocacy Day online.

Aging in America, scheduled for March 24-27 in Atlanta, is cancelled. Conference organizers are exploring virtual options.

The National Home Infusion Association Annual Meeting, scheduled for April 5-9 in Denver, Colorado, has been cancelled. Organizers are looking to move the conference sessions online.

The LeadingAge Leadership Summit, set for April 20-22 in Washington, D.C., has been postponed to August 10-12. 

The Midwest Association for Medical Equipment Services and Supplies (MAMES) Spring Excellence in HME Conference, scheduled for April 28-30 in Des Moines, Iowa, has been cancelled. Much of the content will be moved forward to the fall show Oct. 7-9 and registration fees may be refunded or moved to the fall event. 

The ATA 2020 Annual Conference and Expo, set for May 3-5 in Phoenix, Arizona, is moving online with a target date of early summer. ATA is also offering COVID-19 webinars addressing telehealth matters. 

AAHomecare's Washington Legislative Conference, scheduled for May 20-21 in Arlington, Virginia, has been cancelled. The association is looking for additional opportunities for advocacy throughout the year.

 

Tuesday, March 17, 1:17 p.m. 

Wondering what happened with Congress' COVID-19-related stimulus package? The House, after revisions that scaled back the paid-leave program in the bill, passed it Monday evening, sending it to the Senate. The new measure would still provide two weeks of sick leave to some workers affected by the coronavirus outbreak. The Wall Street Journal reports that some senators have questioned the bill; the Trump administration is pushing for aid to small and mid-sized businesses; and Politico reports that senators are already working on a new, separate version of the bill. 

 

Tuesday, March 17, 12:54 p.m. 

To keep vulnerable seniors at home and lighten the load on clinicians an health care facilities, the Centers for Medicare & Medicaid Services (CMS) announced today that it will expand Medicare's telehealth coverage to allow beneficiaries to receive a wider range of services without having to travel to a health care facility in response to the coronavirus outbreak. Dating back to March 6, 2020, Medicare will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country. You can read the full coverage here

 

Monday, March 16, 11:37 a.m.

Some agencies may be experiencing an increase of denial of service due to the coronavirus outbreak, Synzi CEO Lee Horner tells HomeCare--either nurses refusing to take home visits or patients not allowing caregivers to enter because they want to self-isolate. Remote check-ins might be one solution. Read our Q&A with Horner to learn more. 

 

Friday, March 13, 4:46 p.m.

Pres. Trump on Friday declared a national emergency on Friday, allowing the Federal Emergency Management Agency to access billions of dollars and giving the Department of Health and Human Services (HHS) license to waive regulations and laws about hospital operations and other health care matters. Trump said he would give HHS head Alex Azar "broad new authority." 

In a statement posted on the HHS website in response, Azar said that the declaration "gives HHS important powers to enhance state and local communities’ ability to respond to the outbreak, including flexibility around Medicare and Medicaid rules. The entire Trump administration, including our leaders at HHS, is identifying every flexibility we can offer and any obstacle we can eliminate to help those on the frontlines protect Americans from this outbreak.”

 

Friday, March 13, 3:02 p.m.

The Centers for Medicare & Medicaid (CMS) has issued a FAQ sheet about what constitutes covered essential health benefits (EHBs) when it comes to the coronavirus outbreak. Read the details here

 

Friday, March 13, 1:12 p.m.

The Compliance Team, Inc., a nationally recognized health care accreditation organization, is holding a webinar next week to help DME and other health care providers understand reporting requirements and guidelines from the Centers for Medicare & Medicaid Services (CMS). Founder and CEO Sandra Canally, RN should be available for questions during the webinar. You can register here. 

Meanwhile, The Compliance Team recommends reviewing your infection control and emergency preparedness policies to ensure you are following them to protect staff and patients. The company is prioritizing all surveys to make sure providers have the ability to provide continuity of care. 

 

Friday, March 13, 11:53 a.m.

In a memorandum to be released in the Federal Register on Monday, March 16, President Trump has ordered that the Department of Health and Human Services "shall take all appropriate and necessary steps" to make sure respirators are available for health care personnel. 

"Unfortunately, at present, public health experts anticipate shortages in the supply of personal respiratory devices (respirators) available for use by healthcare workers in mitigating further transmission of COVID-19," reads the memo, which is dated March 11. 

It also requires the Department of Labor to consider steps to increase the availability of respirators. 

Read the memo here

 

Friday, March 13, 9:44 a.m.

Politico reports that the Democrats and Republicans on Capitol Hill expect to hash out a virus-related aid package today. The two sides are in disagreement over sick leave provisions. Two proposals are out there. One, which HomeCare previously reported, would require employers to offer 14 days of paid leave during a public health emergency and would include a refundable tax credit for employers with 500 employees or less. Home health agencies have already said it would create an undue burden for their businesses. The other is a proposed temporary federal sick leave program that would give workers who have become ill with COVID-19 or are caring for family members with the disease would receive some part of their wages for up to three months. 

 

Friday, March 13, 9:04 a.m.

The National Home Infusion Association (NHIA) has cancelled its 2020 Annual Conference at the Gaylord Rockies Resort & Convention Center in Denver, Colorado, scheduled for April 5-9, 2020.

NHIA has been closely monitoring the COVID-19 situation in the U.S. and understands the important role association members play in providing healthcare products and services to high-risk populations that are vulnerable to the virus.

The decision was made out of concern for the safety of attendees and in response to public health advisories to limit travel and large gatherings where increased exposure to the virus is likely to occur.

“Each year, NHIA has been proud and excited to gather with the home and specialty infusion community at our annual conference, offering an unparalleled opportunity to network and learn about the latest industry practices, products, and services,” said NHIA President & CEO Connie Sullivan, BSPharm, in a press release. “I want to thank everyone that has been working tirelessly to ensure a fantastic conference.”

NHIA will continue to monitor the virus and assess options for providing virtual content or holding the conference later in 2020.

 

Thursday, March 12, 4:08 p.m.

A list of recommendations to Congress for what to include in coronavirus-related legislation supported by more than 20 health care experts includes several suggestions that involve home health, including funding home health providers to provide nutritional services to quarantined vulnerable populations.

The letter, published on the Health Affairs Blog on Thursday, is titled “Health Care Priorities For A COVID-19 Stimulus Bill: Recommendations To The Administration, Congress, And Other Federal, State And Local Leaders From Public Health, Medical, Policy And Legal Experts." Signatories include representatives from Harvard University, Johns Hopkins University, Yale Medical School and Yale University, the Icahn School of Medicine at Mt. Sinai, the Brookings Institution, the Aspen Institute, the Commonwealth Fund and others. It was open for additional signatures; you can sign it here.

Much of the letter focuses on public health infrastructure, hospital care and the development of treatments and vaccines. But several points are of interest to those in homecare:

1. Under the heading "low-income families," they recommend a $1 billion increase in the Social Services Block Grant to help, among other things, "Prevent or reduce inappropriate institutional care by providing for community-based care, home-based care, or other forms of less intensive care."

2. Under the heading "Implement Specific Protections for Especially Vulnerable Groups," it says "Access to food is a critical part of health for vulnerable populations under quarantine; consider funding existing visiting nurses or home health providers to provide nutritional services to quarantined vulnerable populations."

3. Under the heading "Institute Protections for Health Care Workers of All Professions On the Frontlines of the Epidemic," it discusses options to make sure all health care workers have adequate safety equipment; encourages setting up a fund to protect health care workers, including nurses, nursing assistants, respiratory therapists and others, from financial harm; and also discusses providing child and elder care tax breaks for health care workers called on to work extra hours.