State Updates
Governor Cuomo Sees Preliminary Success in Flattening the Curve, Announces Extended Unemployment Benefits
Today (April 8th), Governor Cuomo held a press conference during which he confirmed that data now indicates that the “NY on PAUSE” social distancing measures were successfully working to reduce the severity and “flatten the curve” of the COVID-19 outbreak in New York State. New hospitalizations continue to decrease and many hospitals are having more discharges than new admissions. However, the State also saw another new record single-day increase in deaths yesterday. Accordingly, the Governor indicated that New Yorkers must continue to follow social distancing guidelines.
The Governor announced that New York State will be making an additional $600 payment to all individuals who have applied for unemployment and will be extending the period covered by unemployment benefits for an additional thirteen weeks (for a total of 39 weeks). The Governor also announced that individuals would have the option to file absentee ballots for elections taking place on June 23rd.
CMS Approves OPWDD 1915(c) Waiver Appendix K Emergency Authority
On April 7th, CMS approved New York’s application for Appendix K emergency provisions for the Office of People with Developmental Disabilities (OPWDD) 1915(c) Home and Community-Based Services (HCBS) waiver. The full waiver request is available here. Among other provisions, the Appendix K authority:
- Offers increased rates for supervised residential facilities to reflect the suspension of day programs;
- Authorizes retainer payments for up to 14 days for day habilitation, community habilitation, and prevocational programs (providers cannot receive both this and enhanced residential habilitation rates simultaneously);
- Offers increased respite and community habilitation rates, and allows such services to be delivered in certified residences when regular day services cannot be delivered (providers cannot receive both this and enhanced residential habilitation rates simultaneously);
- Allows day habilitation and prevocational services to be delivered in the home or other emergency residential setting;
- Allows residential habilitation to be delivered from temporary emergency residences as needed; and
- Provides exemptions from training and background screening requirements.
Updated Guidance Documents
The following guidance documents have been posted by New York State and City agencies in the last week:
- (Updated) COVID-19 Guidance for the Authorization of Community Based Long-Term Care Services and Supports (LTSS) (4.8.20)
- COVID-19 Guidance for Managed Care Organization (MCO) Contracting and Surveillance Relief (4.8.20)
- Guidance for 1915(c) Children’s Waiver HCBS Providers Regarding Respite Services (4.8.20)
- Guidance for Providing Adult Social Day Care (SDC) Services Telephonically (4.7.20)
- Response to Frequently Asked Questions (FAQs) from Non-Emergency Medical Transportation (NEMT) Providers (4.7.20)
- OPWDD Memo Regarding PPE Shortage (4.6.20)
- Strategies for Reuse and Extended Use of Personal Protective Equipment (PPE) (4.6.20)
Federal Updates
CMS to Distribute $30 Billion in CARES Act Funding
On April 7th, CMS Administrator Seema Verma announced that CMS will begin distributing $30 billion of the $100 billion Congress allocated in emergency provider relief funding through the Coronavirus Aid, Relief, and Economic Security (CARES) Act starting this week. The announcement was made at the White House coronavirus task force briefing,. The first wave of grant distributions will be based on providers’ Medicare fee for service revenue. Funding will be directly deposited into providers’ bank accounts if possible.
CMS Approves Almost $34 Billion in Accelerated/Advance Payments
On April 7th, CMS announced that the agency delivered approximately $34 billion to providers in the past week through the expansion of the Accelerated and Advance Payment Program. In that time, CMS received over 25,000 requests, and has approved over 17,000 of them. Each request was processed within four to six days. Prior to the COVID-19 emergency, CMS had approved just over 100 total requests in the past five years.
A fact sheet on the expansion of the Accelerated and Advance Payment Program is available here.
ET3 Model Timeline Delayed
On April 8th, CMS announced that the Emergency Triage, Treat, and Transport (ET3) Model start date will be delayed from May 1st to Fall 2020, due to the COVID-19 public health emergency. CMS recently expanded flexibilities offered specifically to ambulances through an Interim Final Rule with Comment Period, which is summarized here.
CMS Releases Infection Control Guidance for Inpatient and Outpatient Settings
On April 8th, CMS issued a series of updated guidance documents focused on infection control to prevent the spread of COVID-19 in a variety of inpatient and outpatient settings. The guidance, which is based on Centers for Disease Control and Prevention (CDC) guidelines, covers patient triage, screening and treatment, the use of alternate testing and treatment sites and telehealth, drive-through screenings, limiting visitations, cleaning and disinfection guidelines, staffing, new instructions for dialysis facilities, and more. The guidance applies to the following:
- Dialysis facilities and Special Purpose Renal Dialysis Facilities;
- Critical Access Hospitals;
- Psychiatric hospitals;
- Ambulatory Surgical Centers;
- Community Mental Health Centers;
- Comprehensive Outpatient Rehabilitation Facilities;
- Outpatient Physical Therapy or Speech Pathology Services;
- Rural Health Clinics;
- Federally Qualified Health Centers;
- Intermediate Care Facilities for Individuals with Intellectual Disabilities; and,
- Psychiatric Residential Treatment Facilities.
The updated guidelines are available here.