COVID-19 RURAL DIGEST

MAY 6, 2020

HHS to begin disbursements to small rural CAH and PPS hospitals

• On May 1, HHS announced processing of CARES Act payments specifically targeted at aiding rural hospitals in the financial situation surrounding COVID-19.
• HHS is also disbursing $10 billion to hospitals, clinics and health centers in rural areas. The agency said rural acute care hospitals and critical access hospitals will receive at least $1 million, with additional payments based on operating expenses.
• The hospitals will receive the funds via direct deposit in coming days, HHS said.
• Read HHS’s press release: https://www.hhs.gov/about/news/2020/05/01/hhs-begins-distribution-of-payments-to-hospitals-with-high-covid-19-admissions-rural-providers.html

CMS announces changes to audio-only telehealth visits

• Medicare payments for audio-only telephone evaluation and management (E/M) visits (CPT codes 99441-99443) are now equal to payments for comparable office or outpatient visits with established patients.
• CMS also broadened the list of services it will cover as audio-only telephone visits.
• See full list along with coding and billing guidelines: https://www.aafp.org/journals/fpm/blogs/inpractice/entry/telephone_visits.html?cmpid=em_FPM_20200506

Rural coronavirus infection on the rise and expected to continue

• The month of April saw an 8-fold increase in the rates of infections in rural areas.
• Rural hospitals located near ‘nexus’ sites (correctional facilities, meat/poultry factories, and large elder care facilities) are warned to prepare for increased community transference.
• Read more: https://www.kff.org/other/issue-brief/covid-19-in-rural-america-is-there-cause-for-concern/
• Read more: https://time.com/5831319/coronavirus-rural-america/
• Read more: https://www.dailyyonder.com/covid-19-update-april-saw-rural-americas-infection-rate-increase-8-fold/2020/05/04/

CMS announces extensions to increasing hospital capacity – CMS Hospitals Without Walls

• CMS is giving providers flexibility during the pandemic to increase the number of beds for COVID-19 patients while receiving stable, predictable Medicare payments. For example, teaching hospitals can increase the number of temporary beds without facing reduced payments for indirect medical education.
• CMS is excepting certain requirements to enable freestanding inpatient rehabilitation facilities to accept patients from acute-care hospitals experiencing a surge, even if the patients do not require rehabilitation care.
• CMS will allow certain provider-based hospital outpatient departments that relocate off-campus to obtain a temporary exception and continue to be paid under the OPPS. Importantly, hospitals may also relocate outpatient departments to more than one off-campus location, or partially relocate off-campus while still furnishing care at the original site.
• Long-term acute-care hospitals can now accept any acute-care hospital patients and be paid at a higher Medicare payment rate, as mandated by the CARES Act. This will make better use during the pandemic of available beds and staffing in long-term acute-care hospitals.

New rules to support and expand COVID-19 diagnostic testing for Medicare and Medicaid beneficiaries

• Under the new waivers and rule changes, Medicare will no longer require an order from the treating physician or other practitioner for beneficiaries to get COVID-19 tests and certain laboratory tests required as part of a COVID-19 diagnosis.
• COVID-19 tests may be covered when ordered by any healthcare professional authorized to do so under state law.
• A written practitioner’s order is no longer required for the COVID-19 test for Medicare payment purposes.

CMS clarifies recommendations and policies under Emergency Medical Treatment and Labor Act (EMTALA) related to COVID-19

• Every hospital or CAH with a dedicated emergency department (ED) is required to conduct an appropriate medical screening examination (MSE) of all individuals who come to the ED, including individuals who are suspected of having COVID-19.
• Every ED is expected to have the capability to apply appropriate COVID-19 screening criteria when applicable, to immediately identify and isolate individuals who meet the screening criteria.
• Read the full requirements: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/emergency-medical-treatment-and-labor-act-emtala-requirements-and-implications-related-covid19

FDA approves Remdesivir for potential, emergency treatment of COVID-19

• Following the results of two clinical trials for the experimental antiviral drug remdesivir, the U.S. Food and Drug Administration issued an emergency use authorization opening its use as a treatment for those with severe cases of COVID-19.
• Read more: https://homelandprepnews.com/stories/48550-fda-approves-remdesivir-for-potential-emergency-treatment-of-covid-19/

The Pennsylvania State University continues ECHO series on COVID-19 topics

• Project ECHO is coordinated set of experts that provide telementoring over a wide range of clinical issues.
• Register: https://pennstatehealthnews.org/event/webinar-penn-state-project-echo-covid-19-series-for-skilled-nursing-facilities/2020-05-07/
• See more ECHO sessions: https://echo.unm.edu/covid-19

FDA orders companies and hospitals to submit COVID-19 testing data

• The Food and Drug Administration announced on Monday that companies selling coronavirus antibody tests must submit data proving accuracy within the next 10 days or face removal from the market
• Read more: https://www.nytimes.com/2020/05/04/health/fda-antibody-tests-coronavirus.html?action=click&module=Well&pgtype=Homepage%C2%A7ion=Health