March 30th Newsletter

State Updates

Governor Cuomo Announces Statewide Hospital Partnership

Today (March 30^th), Governor Cuomo announced that the State, in collaboration with its public and private hospitals, will create a central coordination system to handle surging demand due to COVID-19. This is intended to let hospitals who approach their “load threshold” to transfer incoming patients to other hospitals that have remaining capacity. The collaboration will also facilitate sharing of staff and resources among hospitals across the state through central purchasing and stockpiling of items such as personal protective equipment (PPE). Information will be centrally collected from both public and private hospitals, and the system will incorporate the newly-opened temporary hospitals in the Javits Center and the USNS Comfort, which will handle non-COVID-19 patients as overflow.

The Governor also announced the federal government’s approval of four additional 1,000-bed temporary hospitals to be constructed in the other four boroughs of New York City as previously proposed, as well as the identification of new facilities that will provide additional hospital capacity downstate, including three sites that will treat only COVID-19 patients (South Beach Psychiatric Facility in Staten Island, Westchester Square in the Bronx, and SUNY Downstate in Brooklyn).

Addressing testing capacity, the Governor said that New York State’s Wadsworth Laboratory has been developing a new, less intrusive test for COVID-19 that uses a saliva sample and can be self-administered. The new testing is expected to begin in the next week. The Governor also announced a new mobile testing site at the Bay Plaza Mall Parking Lot in the Bronx. This site will provide tests by appointment only and will prioritize symptomatic individuals who had close exposure to a positive COVID-19 case, health care workers and first responders displaying symptoms, and those working in or having recently visited a nursing home who exhibit COVID-19 symptoms.

The Governor’s recent press conferences are available here.

Governor Cuomo Issues New Executive Orders

Over the weekend, Governor Cuomo signed new Executive Orders No. 202.12 (available here) and No. 202.13 (available here). Like other parts of Executive Order 202, they contain directives to address the COVID-19 emergency. The Governor extended the NY on PAUSE regulations, which require non-essential employees to work from home and in-person businesses to be restricted, through April 16^th, and stated that he will continue to review extensions on a rolling two-week basis. The orders also move the tax filing deadline for personal and corporate taxes to July 15^th and delay the presidential primary and special elections until June 23^rd.

The Orders also include the following health and social services provisions:

• Allow employees of programs licensed or certified under State agencies (OPWDD, OCFS, OASAS, or OMH) who have previously undergone the appropriate background checks to be employed by a program under a different State agency without undergoing new background checks.
• Require all Article 28 facilities to permit the attendance of one support person (who does not have a fever at the time of labor/delivery) for a patient giving birth during both labor/delivery and the immediate postpartum period. The Governor has since announced that this will be extended to include the recovery period.
• Allow school districts to host day care free of charge.

OMH Updates Telemental Health Guidance and Self-Attestation

Today (March 30^th), the Office of Mental Health (OMH) released consolidated guidance on the use of telemental health services during the COVID-19 emergency (available here). This document supersedes OMH’s four previous guidance and supplemental guidance on this topic and includes more specific guidance by provider type, including outpatient, inpatient, residential, and community-based services. In general, the guidance reiterates that providers may deliver any appropriate service via telemental health to the extent possible, and all face-to-face service requirements are waived, although residential programs must continue to maintain on-site staff.

OMH has also updated the self-attestation form (available here) to more accurately reflect all applicable program and staff types and to remove references to waived requirements, and posted a table listing appropriate telehealth modifiers for each rate code/procedure code combination (available here).

New York State Guidance Documents

New York State agencies are continuing to release other detailed guidance documents for specific topics and provider areas. A compilation of documents we have not previously reported is below:

• DOH Update for NYS Healthcare Providers on COVID-19
• DOH COVID-19 Guidance for Hospital Operators Regarding Visitation
• DOH COVID-19 Release From Home Isolation
• DOH COVID-19 Telephonic and Telehealth Services Available to Statewide Adult Day Health Care
• DOH Protocols for Essential Personnel to Return to Work Following COVID-19 Exposure or Infection
• DOH COVID-19 Infection Control Guidance for Nursing Homes and Adult Care Facilities
• DOH COVID-19 Guidance regarding 1915(c) HCBS Children’s Waiver
• DOH Medicaid Changes to Private Duty Nursing Policy 
• DOH Medicaid Changes to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Policy
• DOH COVID-19 Infection Control Guidance for NYS DOH Supportive Housing Programs 
• DOH Updated Medicaid Pharmacy Guidance
• DOH Health Home FAQ During COVID-19
• DOH Updated Medicaid Coverage and Reimbursement Policy for Services Related to COVID-19
• OCFS COVID-19 Guidance to Child Care Providers
• OCFS COVID-19 Guidance for Voluntary Foster Care Agency and Detention Programs

Federal Updates

CMS Requests that Hospitals Share COVID-19 Testing Data

On March 29^th, CMS, on behalf of Vice President Mike Pence, sent a letter to U.S. hospitals requesting that they report in-house laboratory COVID-19 testing data to HHS. Additionally, the letter requests that hospitals provide daily reports regarding bed capacity and supplies to the Centers for Disease Control and Prevention National Healthcare Safety Network COVID-19 Patient Impact and Hospital Capacity Module. The letter is available here.

CMS Expands Accelerated and Advance Medicare Payments Program

On March 28^th, CMS announced the expansion of its Accelerated and Advance Payment Program in light of the COVID-19 emergency. All Medicare Part A or Part B participating health care providers and suppliers are now eligible to receive accelerated or advance payments so that they will have funds on hand in case of a disruption in claims submission and/or claims processing. In order to qualify for payments, providers/suppliers must:

• 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.

A fact sheet detailing the accelerated and advance payments is available here.

CMS Issues Telehealth Toolkit for Long Term Care Nursing Home Facilities

On March 29^th, CMS issued an electronic toolkit regarding telehealth and telemedicine for Long Term Care Nursing Home Facilities. The document contains links to sources of information on telehealth and telemedicine, including the changes made by CMS over the last week in response to the National Health Emergency. Specifically, it contains links to documents that CMS identified as useful for choosing telemedicine vendors, equipment, and software, initiating a telemedicine program, monitoring patients remotely, and developing documentation tools. The toolkit is available here.