July 31st Newsletter - Sachs Policy Group

Governor Cuomo Announces Funding for Contact Tracing and Flu Prevention

Today, Governor Cuomo announced that COVID-19 hospitalizations, infections, and deaths remain stable across New York State. There were 576 total hospitalizations yesterday and 5 deaths related to COVID-19. Of the 68,869 individuals tested yesterday, 644 (0.93 percent) were positive.On July 30^th, the Governor announced over $30 million in funding to enhance COVID-19 contact tracing and flu prevention ahead of the fall flu season. The funding will be distributed as grants to counties to support an increase in local health department staffing capacity for enhanced detection, surveillance, and prevention of COVID-19. Awards are based on county populations plus a supplemental award for the percentage of statewide COVID-19 cases in each county. The Governor also announced $2 million in additional immunization funds to expand flu vaccination rates statewide. The list of awarded counties is available here. The Governor’s press release is available here.

Governor Cuomo Issues Executive Order 202.54

Today, Governor Cuomo signed Executive Order 202.54 (available here) that continues the provisions of Executive Order 202.37 (available here) allowing for special education services and instruction to be provided in person for the summer term, if conducted in accordance with state and federal guidance. The Order also extends through August 29^th the provision that allows a questionnaire administered by a New York State-licensed physician through an asynchronous electronic interface or electronic mail to be sufficient to establish a practitioner-patient relationship for the purposes of ordering a clinical laboratory test.

DFS Extends Emergency Regulation on Cost-Sharing for Essential Worker Mental Health Services

On July 30^th, the Department of Financial Services (DFS) extended until September 28^th its emergency regulation requiring regulated health insurance plans to waive out-of-pocket costs (i.e. cost-sharing, deductibles, copayments, and coinsurance) for in-network mental health services for frontline essential workers during the COVID-19 emergency. Frontline essential workers include:

Health care workers;
First responders;
Transit workers;
Food service workers;
Retail workers at essential businesses; and
Other frontline essential employees who directly interact with the public.

This prohibition applies to both in-person and telehealth services covered by DFS-regulated plans. However, if the individual is covered by a high-deductible plan, the service may be subject to the plan’s annual deductible if required by federal law. Additional details and a full list of qualifying essential workers are available in the DFS circular letter to insurance plans here. Questions may be submitted to health@dfs.ny.gov.

HHS Updates CARES Act Provider Relief Funding FAQ

On July 30^th, the U.S. Department of Health and Human Services (HHS) updated the CARES Act Provider Relief Funding FAQ document. The updated document includes the following new questions or modifications to questions of note:

As explained in the notice of reporting requirements (available here), providers must submit reports on the use of relief fund money no later than July 31, 2021. HHS expects that providers will fully expend their payments by this date and will provide directions in the future on how to return unused funds.
Providers who receive the results of their TIN validation after the August 3^rd deadline for the Medicaid, CHIP, and dental provider distribution will still be able to complete and submit their application.
Providers who received Medicaid Home and Community Based Services (HCBS) retainer payments are eligible for the Medicaid provider distribution, in addition to providers who received funding from the Small Business Administration Payroll Protection Program (PPP) or from the Federal Emergency Management Agency (FEMA).
Disability service providers and other providers of Medicaid-funded HCBS (e.g., day habilitation, HCBS waiver program services) are eligible for the Medicaid provider distribution.

The FAQ also provides updated or new questions related to parent organizations and their subsidiaries, audit requirements, the application portal, and Fiscal Management Services (FMS) organizations. The FAQ document is available here.

CMS Updates COVID-19 FAQs on Medicare Fee-for-Service Billing

On July 28^th, the Centers for Medicare and Medicaid Services (CMS) released an updated COVID-19 Medicare fee-for-service FAQ document. The added FAQs:

Provide clarification on billing codes and modifiers for COVID-19 tests.
Address separate payments to hospitals for COVID-19 outpatient testing prior to inpatient admission.
Clarify which health care professionals and sites can furnish and bill for diabetes self-management training (DSMT) services delivered via telehealth.
Confirm that Medicare will not pay for telehealth services furnished by providers located outside the United States.
Outline the claim types and facility types used to identify inpatient services that trigger an episode of care for treatment of COVID-19 when adjusting Shared Savings Program calculations and provide other details on episode of care claims and timeframes.
Clarify hospital billing requirements for remote services.

The FAQ document is available here.

Updated Guidance Documents

Recently released New York State and City guidance documents are listed below: