Federal Update
Congress Prepares to Vote on COVID-19 Relief and Government Funding Package
Today (December 21st), Democratic and Republican Congressional leaders announced that they had reached an agreement on a new emergency COVID-19 relief and omnibus spending package to avert a government shutdown. The COVID-19 relief package consists of approximately $900 billion of funding for households and businesses, testing, vaccine distribution, and more. Among other provisions, the bill will:
- Provide an additional $300 per week for all workers receiving unemployment benefits through March 14, 2021;
- Issue a new round of direct Economic Impact Payments of $600 to individuals making up to $75,000 per year and $1,200 for couples making up to $150,000 per year, as well as a $600 payment for each child dependent; and
- Add approximately $284 billion to the Paycheck Protection Program (PPP), $20 billion for new Economic Injury Disaster Loan (EIDL) Grants for businesses in low-income communities, $3.5 billion for continued Small Business Administration (SBA) debt relief payments, and $2 billion for enhancements to SBA lending.
Health care and COVID-19-specific relief items include:
- An additional $3 billion for the Provider Relief Fund (PRF), along with:
- A clarification that lost revenues, for purposes of the PRF, may be calculated using the June 2020 guidance, including the difference between the provider’s budgeted and actual revenue if the budget was approved before March 27, 2020, and
- A requirement that at least 85 percent of unobligated funds will be made available to reimburse providers for “losses and changes in operating expenses” between July 1, 2020 and March 31, 2021;
- About $20 billion to the Biomedical Advanced Research and Development Authority (BARDA) for procurement of vaccines and therapeutics;
- More than $3 billion for the Strategic National Stockpile;
- Nearly $9 billion for the Centers for Disease Control and Prevention (CDC), including $4.5 billion to be distributed to State and local public health departments; and
- More than $22 billion to be sent to states for testing, tracing, and COVID-19 mitigation programs, including $2.5 billion for a targeted effort to improve testing capabilities and contact tracing in high-need and underserved populations.
Congress is expected to pass the bill later today. The bill will then go to President Donald Trump for his signature. The full text of the bill is available here.
State Updates
Governor Cuomo Announces COVID-19 Vaccine Administration Updates, Vaccine Equity Task Force
Today, Governor Cuomo held a press conference during which he provided updates on the State’s ongoing efforts to combat the COVID-19 pandemic. Now that the Moderna vaccine has been approved, the State expects to receive an initial shipment of 346,200 doses this week. The State also expects an additional 120,000 doses of the Pfizer vaccine to arrive this week. Priority populations that will receive the vaccine this week will be expanded to include:
- Federally Qualified Health Center (FQHC) workers;
- Emergency Medical Technicians (EMTs);
- Coroners, medical examiners, and funeral home workers; and
- Other congregate care workers and residents.
Additionally, the Federal Nursing Home Vaccination Program began today and is expected to take approximately six weeks to complete. The program includes the following three “Clinical Days” at each facility:
- Clinical Day 1: All residents/portion of staff receive first dose (expected to be completed over next two weeks).
- Clinical Day 2: All residents/portion of staff receive second dose and remaining portion of staff receive first dose.
- Clinical Day 3: Remaining portion of staff receive second dose.
The Governor also announced the development of the New York State COVID-19 Vaccine Equity Task Force, which will create operational and logistical plans to break down vaccination barriers and ensure equitable distribution statewide. Co-chairs of the task force include:
- Rossana Rosada (NYS Secretary of State)
- Letitia James (NYS Attorney General)
- Pat Wang (President and CEO of Healthfirst)
- Mark Morial (President and CEO of National Urban League)
The State is also developing Community Vaccination Kits to support these efforts, which are self-contained units that include everything required to set up a vaccination site, including office supplies, personal protective equipment, vials, cleaning supplies, and IT equipment. Community Vaccination Kits will be deployed to “health care deserts” statewide, which include communities unreached by existing health care infrastructure.
Governor Cuomo Issues Executive Order 202.83
On December 18th, Governor Cuomo signed Executive Order 202.83 (available here), which extends several provisions related to the COVID-19 emergency through January 17, 2021. This includes a provision that permits a practitioner to establish a patient relationship using only a questionnaire for the purpose of ordering a clinical laboratory test, which may be administered through an asynchronous electronic interface such as email.
The Order also reinstates relief around health care providers maintaining recordkeeping requirements. Specifically, providers acting reasonably and in good faith will be afforded absolute immunity from liability for any failure to comply with any recordkeeping requirement, if needed to perform tasks to respond to the COVID-19 outbreak. This includes, but is not limited to, requirements related to:
- Maintaining medical records that accurately reflect the evaluation and treatment of patients;
- Assigning diagnostic codes; or
- Creating or maintaining other records for billing purposes.
DOH Issues Guidance on Use of Pfizer/BioNTech COVID-19 Vaccine Vial Extra Doses
On December 18th, the New York State Department of Health (DOH) announced that it has approved the use of extra doses of the Pfizer/BioNTech COVID-19vaccine that have been discovered in vaccine vials. Providers have consistently been able to draw more than the five expected doses from one vial of the Pfizer/BioNTech vaccine, with some vials yielding six or seven doses.
DOH has released guidance (available here) authorizing providers to withdraw more than five doses from a vial and use any extra vaccine that can meet the 0.3 ml dose requirement. However, extra vaccine from one vial cannot be combined with extra vaccine from another vial to make an additional dose. The guidance also instructs providers on how to report additional vaccine doses and how to modify inventory in the New York State Immunization Information System (NYSIIS).
A letter to providers from Commissioner of Health Dr. Howard Zucker is available here.
Updated Guidance Documents
Recently released or updated New York State guidance documents are listed below: