COVID-19 RURAL DIGEST

MARCH 31, 2020

The emergence of COVID-19 has caused an almost unprecedented amount of change in the framework surrounding rural care. The CORH team is dedicated to providing regular updates on this evolving situation to healthcare leaders across the country.

As the pandemic unfolds, we foresee sending out updates twice a week on Tuesdays and Thursdays with new developments.

CDC’s Number of Confirmed Cases of Covid-19 (03.30): 140,904

CDC’s Number of Confirmed Deaths due to Covid-19 (03.30): 2,405

See a city-by-city map of confirmed cases: https://coronavirus.jhu.edu/map.html

CMS announces ‘Sweeping Regulatory Changes’

  • INCREASE HOSPITAL CAPACITY – CMS HOSPITALS WITHOUT WALLS
    • Hospitals may provide service outside of hospital building.
      • For example, hospital may provide care in a hotel or ambulatory care center.
    • Physician owned hospitals may increase number of beds.
    • Ambulance providers have a wide range of options if hospital is not appropriate: e.g. FQHCs, physician’s offices, or urgent cares.
    • Medicare to pay lab technicians for travel to patients’ homes for sample collection.
  • RAPIDLY EXPAND THE HEALTHCARE WORKFORCE
    • Medicare offering payments for services to medical providers including child care, laundry services, and more.
    • Medicare easing restrictions on provider enrollment.
    • CMS also will permit wider use of verbal orders rather than written orders by hospital doctors so they can focus more of their time on taking care of patients.
  • PUT PATIENTS OVER PAPERWORK
    • CMS temporarily eliminating paperwork requirements.
    • CMS will suspend document requests during crisis.
  • FURTHER PROMOTE TELEHEALTH IN MEDICARE
    • Patients deemed high risk for covid-19 can qualify for homebound payments.
    • Virtual check-ins can be provided to new patients, removing the requirement for an existing relationship.
  • Read full release: https://www.cms.gov/newsroom/fact-sheets/additional-backgroundsweeping-regulatory-changes-help-us-healthcare-system-address-covid-19-patient

FDA warns of fraudulent COVID-19 tests and resources

Project ECHO expands training for providers treating COVID-19

  • Through ECHO’s online learning networks, primary care clinicians gain the expertise and support they need to manage patients who have complex, chronic illnesses.
  • See available, ongoing ECHOS: https://echo.unm.edu/covid-19

Trump administration provides financial relief for Medicare providers

  • CMS announced accelerated and advanced payments to Medicare providers
  • Providers must match the following criteria:
    • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/ supplier’s request form,
    • Not be in bankruptcy,
    • Not be under active medical review or program integrity investigation, and
    • Not have any outstanding delinquent Medicare overpayments.
  • Full requirements, information, application process can be found: https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf

Administration engages hospitals in unprecedented data sharing

More states approved for 1135 waivers

  • The states: New York, Colorado, Hawaii, Idaho, Massachusetts, Maryland, Connecticut, Delaware, Minnesota, Pennsylvania and Wyoming are were approved for the emergency waiver Friday.
  • These join Iowa, Indiana, Rhode Island, Kansas, Kentucky, Missouri, Oregon, North Dakota, South Dakota, Oklahoma, Alabama, California, New Hampshire, New Mexico, New Jersey, Arizona, Virginia, North Carolina, Mississippi Louisiana, Illinois, Washington and Florida as waiver approved states.
  • Check with responding state authorities for specific details of the waivers.

Many Rural counties yet to be hit hard by COVID-19 but a third of all rural counties experiencing cases