Governor Cuomo Reports Low Infection Rate, Announces New Testing Initiatives
Today (August 24th), Governor Cuomo held a press conference during which he announced that New York’s COVID-19 infection rate yesterday was 0.66 percent, which is the lowest since the declared start of the pandemic. The State’s infection rate has now continuously been under 1 percent for the last 17 days. However, the Governor noted that Western New York has seen a recent increase in cases, and the region’s infection rate, with the percent of positive tests above 1 percent for six straight days. The State is monitoring the increase in the region, which may be driven in part by clusters at a steel plant and food processing factory, new cases in nursing homes, pre-hospital procedure screening, and testing of seasonal labor at farms.
To limit the spread of COVID-19 from out-of-state travelers, the Governor announced that Port Authority and NYC Health and Hospitals will be setting up new testing sites at John F. Kennedy and LaGuardia Airports for incoming passengers.
Governor Cuomo Issues Executive Order 202.57
On August 20th, Governor Cuomo signed Executive Order 202.57 (available here) which extends several provisions related to the COVID-19 emergency through September 19th, including the following:
- Authorizing licensed pharmacists to order tests to detect SARS-CoV-2 or its antibodies, and to administer COVID-19 tests after completion of appropriate DOH training.
- Permitting licensed pharmacists to be designated as a qualified health care professional for the purpose of directing a clinical service laboratory to test patients for COVID-19 or its antibodies.
- Allowing physicians to order COVID-19 tests for self-collection, without otherwise having an initial physician-patient relationship with the patient.
- Allowing clinical laboratories to accept and examine specimens for COVID-19 testing from personnel of nursing homes and adult care facilities without a prescription or order from an authorized ordering source, and to report the results of such tests to the appropriate operators and administrators of the nursing home or adult care facility.
The Order also extends a directive prohibiting the eviction of any commercial tenant through September 20th and allows for the resumption of certain indoor activities, following social distancing and cleaning guidelines, including bowling alleys, gyms/fitness centers, and low-risk arts and cultural activities.
OPWDD Interim Billing Guidance Following the Conclusion of the Day Service Retainer Program
Today, the Office for People with Developmental Disabilities (OPWDD) released a billing guidance document (available here) for Day Habilitation, Supplemental Day Habilitation, and Site-Based Prevocational Service providers following the July 21st conclusion of the Day Service Retainer Program. The temporary changes outlined in the document are effective from July 22nd through October 14th. For all Day Habilitation and Site-Based Prevocational Service Providers, temporary changes include:
- Defining program day duration to include all of the following: face-to-face service time; time spent engaging consumers using remote telehealth delivery (in accordance with COVID-19 telehealth guidance); and mealtimes.
- Changing the standard for the program day duration to require that the provider deliver and document at least two hours of service (previously, the standard was four hours) to bill a full unit and at least one hour (previously, the standard was two hours) to bill a half unit. Documentation standards are not changed. In particular, the provider must document at least two services for a full unit payment and at least one service for a half unit payment.
- Requiring providers that opt to use the modified program day duration standards to comply with daily billing limits and financial limits as described in the guidance document.
- Rescinding prior emergency guidance allowing providers to bill for non-face-to-face services, such as staff time spent traveling to a person’s home and taking out their garbage, effective August 24th. For service dates between July 22nd and August 23rd, providers may use either the previous guidance’s non-face-to-face flexibilities or this document’s modified program day duration flexibility.
Providers that participated in the Day Service Retainer Program through July 21st will continue to have flexibility to offer day services without additional authorizations or modifications to the person’s Life Plan or to address a crisis. Updates to the Life Plan and Staff Action Plan may be using the COVID-19 Life Plan and Staff Action Plan Addendum. Otherwise, an individual’s current Life Plan and Staff Action Plans remain in place.
Subject to OPWDD authorization, Supervised Individual Residential Alternative (IRA) providers may continue to deliver and bill for Group Community Habilitation – Residential (CH-R) provided to IRA residents who, prior to the public health emergency, participated in Day Habilitation or Prevocational Services delivered by a different provider. However, Group CH-R may not be billed if the individual receives day services on that day, or a full week (five days) of day services that week.
OPWDD will host a webinar on August 25th at 1pm that will provide an overview of these temporary billing protocols. Registration for the webinar is available here.
FDA Issues COVID-19 Plasma EUA
On August 23rd, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for investigational convalescent plasma for the treatment of COVID-19 in hospitalized patients. FDA found that there is sufficient evidence of safety and efficacy to indicate that plasma “may be effective,” as required to issue an EUA. As such, convalescent plasma may be distributed throughout the United States and administered by health care providers to treat suspected or laboratory-confirmed COVID-19 in hospitalized patients with COVID-19.
The EUA is available here.
CMS to Require Positive COVID-19 Tests for MS-DRG Payment Bonus
The Centers for Medicare and Medicaid Services (CMS) has clarified the requirements for claims to be eligible for the 20 percent increase in the Medicare Severity-Diagnosis Related Group (MS-DRG) Group weighting factor for COVID-19 services, as contained in the CARES Act. Such claims will now be required to have a positive COVID-19 laboratory test documented in the patient’s medical record. Positive tests must be demonstrated using only the results of viral testing, and tests may be performed either during the hospital admission or prior to the hospital admission. This policy applies to Inpatient Prospective Payment System (IPPS) hospitals, Long-Term Care Hospitals (LTCHs), and Inpatient Rehabilitation Facilities (IRFs) who bill Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.
The guidance is available here.