State Updates
Governor Cuomo Announces COVID-19 Vaccine Updates, Addresses Budget Concerns
On December 16th, Governor Cuomo held a press conference during which he announced updates on the State’s COVID-19 vaccination efforts. The State has received 87,750 doses of the Pfizer/BioNTech vaccine to date, with approximately 80,000 additional doses expected in the coming days to support vaccination at nursing homes. The State expects an additional 346,000 doses of the Moderna vaccine to be delivered next week, pending federal and state vaccine approval.
Following completion of Phase I of the State’s vaccine administration plan that is currently underway, which includes vaccination of health care workers and nursing home/congregate care staff and residents, the State expects to pivot to Phase II in late January 2021. Phase II will include essential workers and priority members of the general public. The State has designated Regional Vaccination Hubs, led by local hospital systems, that will coordinate Phase II vaccination in their designated region. Regional Vaccination Hub coordinators, which include Greater New York Hospital Association (GNYHA) in New York City and Northwell Health in Long Island, will be required to submit plans for Phase II administration to be reviewed and approved by the State Department of Health (DOH) in the first week of January 2021.
The Governor also addressed the State’s $15 billion budget deficit, noting that developing a budget at this time without any federal relief for state and local governments would require significant tax increases and new sources of revenue. The Governor indicated that he favored waiting to develop a budget until February/March 2021 while the State continues to advocate for federal stimulus funding. In the meantime, the State plans to advance $1.5 billion to organizations requiring cash flow through February/March 2021.
The Governor’s press release is available here.
Commissioner of Health Dr. Howard Zucker Issues New Directives for Hospitals
On December 16th, Commissioner of Health Dr. Howard Zucker sent a letter to hospital administrators (available here), which announces the following three new State directives for hospitals:
- Hospital systems must complete a patient load balancing plan among all facilities in their system and form agreements with neighboring hospital systems to balance patient load;
- Hospitals that are not part of a hospital system must forge relations with neighboring hospital systems to participate in local patient load balancing; and
- Hospitals must be prepared to achieve 15 percent staffed bed capacity growth within 72 hours if a significant COVID-19 surge occurs. If they are unable to achieve this, they must cancel elective procedures or expand bed capacity to ensure they can always have an additional 15 percent staffed bed availability within 72 hours.
In order to achieve the 15 percent staffed bed capacity, hospitals can take various approaches including shifting staff, opening and closing facilities, and moving surgeries. DOH defines the 15 percent as the net available capacity after all adjustments are made by the hospital or hospital system. Hospitals or hospital systems must alert DOH if they have or project to have less than 15 percent staffed bed capacity within the next three weeks (based on the current statistical rate of hospitalization increases in their area) to allow the State to take emergency actions, including a shutdown of economic activity in the region (“NY on PAUSE”).
Ken Raske of GNYHA and Bea Grause of the Hospital Association of New York State (HANYS) will be supporting DOH and hospitals with these directives. Additionally, Michael Dowling of Northwell Health will provide support and technical assistance.
To ensure compliance with the directives of this letter, the CEO of each hospital/hospital system must certify its content and return a signed copy to DOH within 48 hours. Failure to completely follow these directives and/or notify DOH prior to a critical capacity issue could result in sanctions such as license suspension and revocation.
DFS Issues Directive Requiring Insurance Plans to Cover COVID-19 Immunizations
On December 16th, the New York State Department of Financial Services (DFS) released a Circular Letter (available here) to regulated insurance plans requiring them to cover COVID-19 vaccinations without cost-sharing for members. Insurance plans are required to provide coverage of COVID-19 vaccines and administration immediately upon the earlier of the following events:
- The issuance by the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices of a recommendation for the COVID-19 immunization;
- The issuance by the U.S. Preventive Services Task Force of a recommendation with an “A” or “B” rating for the COVID-19 vaccine; or
- The determination by the Superintendent of Financial Services, in consultation with the Commissioner of Health, that a policy or contract must cover the COVID-19 immunization.
COVID-19 immunization and administration, including any visits necessary to obtain the vaccination, may not be subject to any member cost-sharing or other out-of-pocket cost, regardless of administration location. COVID-19 immunizations administered by out-of-network providers must be covered until the expiration of the federally declared public health emergency and the New York State disaster emergency under Executive Order 202. Additionally, insurance plans must cover vaccinations provided by any professional authorized to administer the vaccine or at any authorized alternate site of care as part of Governor Cuomo’s scope of practice and site expansions.
Consistent with Governor Cuomo’s recently issued Executive Order 202.82 (available here), the regulation also requires COVID-19 immunizations to be covered by grandfathered health plans under the Affordable Care Act.
The DFS press release is available here. The regulation is available here. Questions may be sent to health@dfs.gov.
OMH COVID-19 Question and Answer Sessions
The New York State Office of Mental Health (OMH) will host a weekly Question and Answer session for behavioral health care providers statewide every Wednesday from 1pm-2pm. Sessions will give providers the opportunity to ask questions and receive guidance regarding COVID-19 related issues. Providers may submit questions during the session or can submit questions ahead of time during the registration process.
The first session will take place next Wednesday, December 23rd. Registration is available here.
Federal Updates
CMS Sends COVID-19 Infection Control Letter to Facilities Caring for Individuals with I/DD
On December 17th, the Centers for Medicare and Medicaid Services (CMS) sent a letter to state survey agency directors regarding COVID-19 infection control in facilities caring for individuals with intellectual and/or developmental disabilities (I/DD). The letter provides guidance for psychiatric hospitals, Psychiatric Residential Treatment Facilities (PRTFs) and Intermediate Care Facilities with the aim of improving their infection control and prevention practices and ultimately lessening the need for interventions that involve the use of seclusion and restraint. The letter includes frequently asked questions that address the following areas:
- Best practices, measurement, and mitigation strategies for infection control during the public health emergency (PHE);
- The use of isolation, cohorting and personal protective equipment;
- Intervention, mitigation, and training strategies;
- Transition and discharge during the PHE;
- Engaging family, caregiver, support personnel, and community resources; and
- Guides and web links for available local, State and Federal resources.
The guidance is available here.
HRSA Announces Completion of Phase 3 PRF Application Reviews
On December 16th, the Health Resources and Services Administration (HRSA) announced that the agency has completed its review of Phase 3 applications from the Provider Relief Fund (PRF). HRSA will now distribute an additional $4.5 billion to the $20 billion originally planned, and will compensate for close to 90% of each applicant’s reported lost revenues and net change in expenses caused by the COVID-19 pandemic in the first half of 2020. Payments to Phase 3 applicants began on December 16th and will continue as application quality reviews and recipient payment set up are completed.
In the first batch of Phase 3 payments, providers in New York State will receive 4,941 payments totaling $891,935,762. A state-by-state breakdown on the first batch of Phase 3 payments can be found here.
FDA Issues EUA for Pfizer COVID-19 Vaccine
The COVID-19 vaccine currently being distributed in New York resulted from the December 11th Emergency Use Authorization (EUA) issued to Pfizer from the Food and Drug Administration (FDA). This EUA represents the first authorization for a COVID-19 vaccine in the United States. The FDA released a fact sheet with detailed instructions for preparation and administration of the vaccine, which is available here, as well as a separate fact sheet for vaccine recipients and caregivers of vaccine recipients, which is available here.