Federal Updates
Biden Announces HHS Secretary Nominee Xavier Becerra, Other Health Team Members
Framing it in the context of day one readiness to address the COVID pandemic, on December 7th President-elect Joe Biden’s transition team announced its selection of an array of health care nominees and appointees for the incoming Federal administration. Biden will nominate Attorney General of California Xavier Becerra to become Secretary of the Department of Health and Human Services. Becerra has notably defended the constitutionality of the Affordable Care Act (ACA) in recent Supreme Court litigation over an appeal of the Fifth Circuit’s decision in Texas vs. U.S. In recent years, Becerra has fought various Trump administration policies on healthcare, the environment, immigration and reproductive rights. Prior to becoming California Attorney General, Becerra was a Democratic member of the House of Representatives from California from 1993 to 2017 and was involved in the passage of the ACA.
Other announced nominees and appointees include:
- Dr. Vivek Murthy as Surgeon General;
- Dr. Rochelle Walensky as Director of the Centers for Disease Control and Prevention (CDC);
- Dr. Marcella Nunez-Smith as COVID-19 Equity Task Force Chair;
- Dr. Anthony Fauci as Chief Medical Advisor on COVID-19;
- Jeff Zients as Coordinator of the COVID-19 Response and Counselor to the President; and
- Natalie Quillian as Deputy Coordinator of the COVID-19 Response.
More information on the nominees and appointees is available on the transition website here.
HHS Updates Targeted and General Distribution PRF FAQs
HHS continues to update the Targeted Distribution Provider Relief Fund (PRF) frequently asked questions (FAQs), the General Distribution PRF FAQs, and the PRF General Information FAQs. Notable updates include the following:
- The Nursing Home Infection Control Distribution Terms and Conditions and restrictions on use of funds also apply to nursing home quality incentive payments (i.e., they can only be used for infection control expenses).
- Providers that experienced a change in ownership that prevented them from receiving a Targeted Distribution payment are not eligible for Phase 2 payments, however, they may be eligible for future Targeted Distributions.
- PRF applicants who provide care across multiple different facilities and bill under a single taxpayer identification number (TIN) are required to report patient revenue and change in operating revenues from patient care (minus operating expenses from patient care for every facility that bills underneath the TIN) as a single parent organization.
- Providers who received $10,000 or more in aggregate PRF payments will need to submit a report on how the payments were used. Some providers will also be subject to Single Audit requirements. Providers can receive an extension to the submission due date for audits conducted under 45 CFR Part 75.
- If fundraising revenues, grants or donations contribute to funding patient care services, they should be included in the lost patient care revenue calculation.
The Targeted Distribution PRF FAQs are available here, the General Distribution PRF FAQs are available here, and the PRF General Information FAQs are available here.
State Updates
Governor Cuomo Announces New Initiatives to Address Hospital Capacity Issues
Today (December 7th), Governor Cuomo held a press conference during which he announced several initiatives to address the ongoing COVID-19 pandemic and corresponding hospital capacity issues statewide. To address hospital capacity issues, the State will continue to implement “surge and flex” procedures by ordering hospitals to increase bed capacity by 25 percent. The State continues monitoring hospital capacity daily, and if a region’s 7-day average hospitalization growth rate shows that within three weeks the region will hit critical hospital capacity (90 percent), the State will close down the region by enacting “NY on PAUSE.” If after five days a region’s hospitalization rate has not stabilized, indoor dining will be closed in New York City and reduced to 25 percent in the rest of the state (with the exception of Orange Zones where indoor dining is already closed).
The State will also be calling for nurse and doctor retirees to return to service if able, and from this effort, expects to add approximately 20,000 nurses and doctors to the workforce. Nurse and doctor retirees returning to the workforce will automatically receive renewed registrations at no cost. The State will also continue to caution the public regarding COVID-19 spread at small gatherings and prepare to aggressively distribute vaccines and educate the public regarding vaccine safety.
Governor Cuomo Issues Executive Order 202.79
On December 2nd, Governor Cuomo signed Executive Order 202.79 (available here) which extends the State Disaster Emergency and most provisions of several previous orders through January 1, 2021. These Orders provide flexibility on major areas such as telehealth, provider qualifications, background checks, and provider locations and implement the State’s COVID-19 micro-cluster action plan. The extended orders include Executive Orders 202 through 202.21, 202.27 through 202.31, 202.38 through 202.43, 202.48 through 202.52, 202.55 through 202.56, 202.60 through 202.63, and 202.67 through 202.68. More details on specific extended provisions are available in SPG’s updated Waiver Timeline Tracker.
In addition to these extensions, Executive Order 202.79 will:
- Permit general Article 28 hospitals that are treating patients during the disaster emergency to rapidly transfer or receive such patients, and enable inter- or intra-system patient load balancing as may be required by the Commissioner of Health. Such facilities should take all reasonable measures to protect the health and safety of such patients, including safe transfer practices.
- Modify the directive related to the micro-cluster strategy to provide that schools located within the geographic areas designated as “red zones” and “orange zones” may conduct in-person instruction during the period of time in which the zone is designated as “red” or “orange,” subject to compliance with guidance and directives of the State Department of Health (DOH).
DOH Bi-Weekly Provider COVID-19 Webinar
On December 3rd, DOH held its bi-weekly provider webinar (here). The webinar provided global, national, and New York State epidemiological updates, reviewed updated school testing requirements, and discussed recently released DOH guidance for universal eye protection for health care providers (see below).
The webinar also provided an update on COVID-19 vaccines, including overviews of the Pfizer/BioNTech and Moderna vaccines, current recommendations for Phase 1a prioritization for vaccine administration, and the timeline of vaccine approval and delivery. Additionally, the webinar reviewed the process for providers to enroll in the State’s COVID-19 Vaccination Program (for providers outside the five boroughs of New York City) through the Health Commerce System (HCS). New York City (NYC) locations should enroll in the NYC Department of Health and Mental Hygiene program through the City Immunization Registry (CIR). Providers who have some sites in NYC and others outside NYC will need to separately enroll those locations in the NYC CIR system or the State HCS as applicable. The webinar recommended that providers outside NYC who are intending to enroll prepare as follows:
- Review the Enrollment Instruction Guide and other resources.
- Ensure you have an HCS account.
- Determine if your locations are set up in the New York State Immunization Information System (NYSIIS) with an organization account.
- Ensure that appropriate staff have NYSIIS administrative user access.
- Prepare to report adult vaccine doses in NYIIS.
Also on December 3rd, DOH released a vaccination program enrollment letter (available here) to providers outside the five boroughs of NYC that announces the availability of an online enrollment application tool accessible through HCS. Providers must complete the enrollment application in the HCS online application tool by December 18th. Practices that are part of larger organizations should confirm with the parent organization whether it has or will be enrolling the practice under its application or if the practice should enroll directly. Questions on the enrollment process can be sent to COVID19Vaccine@health.ny.gov.
DOH’s provider webinars are held every other Thursday at 1pm and can be viewed here. The next webinar will be held on December 17th.