Federal Updates
Biden Administration Increases Medicare Payment for COVID-19 Vaccine
On March 15th, the Centers for Medicare & Medicaid Services (CMS) announced that Medicare will increase the payment rate for the administration of the COVID-19 vaccine. Effective immediately, the Medicare national average payment rate will be increased to for $40 per dose. As a result, reimbursement for single-dose vaccines will rise from about $28 to $40, while reimbursement for two-dose vaccines will rise from approximately $45 to $80. A provider’s specific rate will be further adjusted by provider type and geography.
These rates will also apply to Medicare Advantage enrollees, since traditional Medicare is reimbursing providers directly on their behalf. For Medicaid and the Children’s Health Insurance Program (CHIP), the Administration stated that it is ready to work with states to increase reimbursement rates for vaccinations to take advantage of the American Rescue Plan (ARP)’s 100% Federal Medical Assistance Percentage (FMAP) for such services. CMS will provide more information on the ARP’s updates to Medicaid reimbursement for COVID-19 vaccine administration in updates to the Medicaid toolkit (here).
The CMS announcement can be found here. Specific details on Part B coding and reimbursement for COVID-19 treatments including vaccines can be found here.
Biden Administration Announces Updates on Combatting COVID-19
This week, the Biden Administration announced new steps to combat the COVID-19 pandemic:
- The Administration expects to reach the milestone of 100 million vaccinations administered within the next 10 days. It has set a goal of May 1st for all states to expand eligibility for COVID-19 vaccination to all adults.
- The Administration has announced an increase of the supply of Pfizer and Moderna vaccines to 20 million doses per week. Johnson and Johnson’s vaccine is also expected to increase its supply soon, with the result that the administration expects to have 100 million doses by the end of May. Combined with the Pfizer and Moderna vaccines, this would be sufficient to vaccinate all American adults.
- President Biden announced the appointment of Gene Sperling, former director of the National Economic Council, as White House American Rescue Plan Coordinator, to manage implementation of COVID-19 relief.
- To improve equitable access to COVID-19 vaccinations in underserved communities, the Administration has invited an additional 700 federally qualified health centers (FQHCs) to participate in the Health Center COVID-19 Vaccine Program, for a total of 950 FQHCs. Through this program, the Administration will provide the FQHCs with a direct supply of COVID-19 vaccine doses. The additional FQHCs invited include those serving high proportions of low income and minority patients. The full list of invited health centers can be found here.
State Updates
Governor Cuomo Signs Legislations Providing Employees with Excused Leave for COVID-19 Vaccination
On March 12th, Governor Cuomo signed legislation (S.2588-A/A.3354-B) that grants public and private employees with time off to receive the COVID-19 vaccination. Employees will have up to four hours of excused leave per injection, which may not be charged against any other leave the employee has earned or accrued. The legislation is effective immediately.
The Governor’s press release is available here.
OPWDD Updates COVID-19 Interim Visitation Guidance for Residential Facilities
On March 15th, the Office for People with Developmental Disabilities (OPWDD) released updated COVID-19 interim visitation guidance for certified residential facilities (available here). The updated guidance indicates that certified residential facilities should expand visitation if facilities are able to continue following the core principles of infection control and prevention, including allowing for visitation if there has been no new onset of COVID-19 cases in the previous 14 days and if the facility is not currently conducting outbreak testing. The updated guidance also specifies that all facilities must allow for visitation in accordance with this guidance unless otherwise prohibited by a directive of OPWDD, the State Department of Health (DOH), or local department of health. Providers may not impose additional restrictions without specific authority by DOH or OPWDD.
DOH Updates Protocols for Health Care Personnel to Return to Work Following COVID-19 Exposure
On March 10th, DOH released updated guidance (available here) for personnel in health care and other direct care settings to return to work following COVID-19 exposure, including updated quarantine and furlough requirements for different health care settings and guidance for personnel who are fully vaccinated. The guidance clarifies that while most health care personnel may return to work following a COVID-19 exposure after a 10-day quarantine without testing if they are asymptomatic, staff of nursing homes or adult care facilities certified as Enhanced Assisted Living Residences (EALR) or licensed as Assisted Living Programs (ALPs) may not return to their workplace (must furlough) until the 14th day after their exposure. The guidance also clarifies that New York State essential worker exemptions for domestic travel do not apply to international travel, and health care personnel returning from travel to another country must follow the Center for Disease Control and Prevention (CDC)’s international travel requirements for testing and quarantining.
The updated guidance also:
- Outlines the CDC strategies for mitigating health care personnel staffing shortages, which must be in place before health care entities can request authorization to allow exposed staff to return to work early;
- Provides guidance for asymptomatic, fully-vaccinated health care personnel exposed to COVID-19 regarding quarantine and furlough requirements during the first three months following full vaccination; and
- Updates guidelines and the checklist/attestation for health care entities that are continuing to experience staffing shortages that threaten the provision of essential patient services.
Updated Guidance Documents
Recently released New York State and City COVID-19 guidance documents are listed below.