April 20th Newsletter - Sachs Policy Group

State Updates

Governor Cuomo Forms Task Force on Reopening the Economy, Announces Statewide Antibody Testing

Today (April 20^th), Governor Cuomo held a press conference during which he announced that total COVID-19 hospitalizations have ticked down slightly, while new hospitalizations and COVID-19-related deaths remain relatively flat. Addressing next steps for “reopening” the economy, the Governor announced the development of a “Reimagine New York” task force that will focus on specific details related to reopening. The Governor also said the State was considering how to allow hospitals with capacity to resume elective surgeries and would release a policy tomorrow with a formula taking into consideration the infection rate of a region and available vacant beds to decide if a hospital may resume.

The Governor reiterated his call for the federal government to provide further relief funding for states and said that without such funding, New York State’s financial plan forecasts a 20 percent cut to schools, local governments, and hospitals. The Governor also called on the federal government to increase hazard pay for essential public workers, including health care workers, firefighters, and police officers, saying they should get a 50 percent bonus. The Governor announced a new partnership with Ready Responders to expand prevention measures and diagnostic testing in New York City public housing facilities. As part of this effort, the State will be delivering more than 500,000 cloth masks and 10,000 gallons of hand sanitizer to public housing communities.

The Governor also discussed continued efforts to conduct large-scale antibody testing. Over the weekend, the State announced that the Department of Health (DOH) will today begin to conduct a statewide antibody testing survey. The testing survey will randomly sample 3,000 people to help determine the percentage of the population that is now immune to the virus, potentially allowing more individuals to safely return to work. The State will continue to work with the federal government to assist with the supply chain and coordinate private labs to ramp up diagnostic testing. The Governor’s press release is available here.

Governor Cuomo Issues New Executive Orders

Over the weekend, Governor Cuomo signed three new Executive Orders containing new directives related to the COVID-19 emergency. Executive Order 202.19 (available here) allows businesses that initially notified the Department of Labor of layoffs, but who are now are receiving federal Paycheck Protection Program funding and who are subsequently rehiring employees, to provide required notices as soon as practicable but not necessarily within the required 90 days. The Order also:

Establishes a statewide coordinated testing prioritization process that will be required to be followed by all laboratories in the State that are conducting COVID-19 diagnostic testing, both public and private, including prioritizing entities or individuals as directed by the statewide process.
Prevents laboratories, unless they receive an exemption from DOH, from entering into an agreement that would reserve testing capabilities for any public or private entity.
Implements a fine of up to $10,000 or three times the value of testing provided for violations of the above directive on the statewide testing process, and allows the Commissioner to revoke any operating certificate or license of a laboratory in violation.
Establishes a penalty of $2,000 per violation per day for any skilled nursing facility, nursing home, or adult care facility that fails to notify a family member or next of kin if any resident tests positive for COVID-19 or suffers a COVID-19 related death within 24 hours. (See also related CMS guidance below.)
Prohibits any local government or local department of health from taking any actions that could affect public health without consulting with the State DOH, and prohibits any local government official from taking any action that could impede or conflict with any other local government or State actions related to managing the COVID-19 emergency.

Executive Orders 202.20 (available here) and 202.21 (available here) contain directives that address issues related to obtaining marriage licenses during the emergency given that many marriage bureaus have temporarily closed. Such directives include:

Waiving the required 60 days to obtain a marriage license for New Yorkers to whom marriage licenses were issued.
Allowing the issuance of a marriage license application, marriage license, or witnessing or solemnizing of a marriage ceremony to be performed via audio-video technology under certain conditions.

New York State Medicaid Program Launches Online Medicaid Provider Enrollment Portal

Today, the New York State Medicaid program released a special Medicaid Update (available here) announcing the development of an online provisional provider application process that allows physicians, registered physician assistants (RPAs), nurse practitioners (NPs), registered nurses (RNs), and licensed practical nurses (LPNs) to enroll in fee-for-service Medicaid on a temporary basis for the purpose of assisting with COVID-19 activities. The portal and online application process is intended to expedite and simplify the process for providers who are assisting with the COVID-19 emergency, including providers enrolled in either Medicare or another state’s Medicaid program, or those licensed outside of New York State who are not excluded from New York State Medicaid and who do not appear on the Office of Inspector General Exclusions Database. Additionally, to further expedite the process, DOH will be waiving application fees and screening requirements, including fingerprint-based criminal background checks. Temporary provider enrollments will be retroactive to March 1, 2020.

Updated Guidance Documents

The New York State Office of Mental Health (OMH) has updated its Disaster Emergency FAQ (available here), indicating that guidance is forthcoming on Medicare/Medicaid crossover claims for dually eligible individuals. Additional recently released or revised New York State and City guidance documents and webinars are available below:

Federal Updates

CMS Issues Recommendations for Providing Essential Non-COVID-19 Care

On April 19^th, CMS issued guidance on providing essential non-COVID-19 care to patients without symptoms of COVID-19 in regions with low and stable incidence of COVID-19. The recommendations update earlier guidance provided by CMS on limiting non-essential surgeries and medical procedures, and suggest a gradual transition to providing more non-COVID-19 services. In general, CMS recommends that providers prioritize surgical/procedural care and high-complexity chronic disease management. The recommendations also encourage health care providers to coordinate with local and state public health officials, and to review the availability of supplies (such as personal protective equipment) as well as workforce availability, facility readiness, and testing capacity when making the decision to re-start or increase in-person care. The recommendations are aimed at healthcare facilities and providers in areas with reduced COVID-19 incidence. Facilities and providers in areas still seeing a higher number of COVID-19 cases are encouraged to continue following the recommendations made by CMS last month.

The recommendations are available here.

CMS Announces New Nursing Home Requirements

On April 19^th, CMS announced new regulations that will require nursing homes to inform residents, their families and representatives of COVID-19 cases in their facilities. At a minimum, nursing home must inform residents and their representatives within twelve hours of the occurrence of a single confirmed COVID-19 infection, or three or more residents or staff members develop respiratory symptoms within 72 hours. All updates must be provided at least weekly or on each subsequent occasion one of the aforementioned situations occur. Facilities must include information on mitigating actions implemented to prevent or reduce the risk of transmission, including if normal operations in the nursing home will be altered. Additionally, nursing homes will be required to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC). Information sent to the CDC will be used to support surveillance of COVID-19 at a local and national level.

The requirements are available here.

USDA Distance and Telemedicine Learning Grants

On April 14^th, the United States Department of Agriculture (USDA) announced a second funding window for the Distance Learning and Telemedicine (DLT) Grants. The DLT Program provides financial assistance to enable and improve DLT services in rural areas. Funding supports the use of telecommunications-enabled information, audio and video equipment, and related advanced technologies by students, teachers, medical professionals, and rural residents. These grants support increasing rural access to education, training, and health care resources that are otherwise unavailable or limited in scope. Eligible applicants include consortia and not-for-profit or for-profit entities. Distant (hub) telemedicine sites located in non-rural areas are not eligible for grant assistance unless they are necessary to provide DLT services to rural residents at end user sites.

The first funding window opened in February 2020 and included $71.7 million in available funding. This second funding window will include funding not awarded in the first window (to be announced in the coming months), as well as up to $25 million received from the Coronavirus Aid, Relief, and Economic Security (CARES) Act. As a result, applicants are encouraged, but not required, to identify specific ways in which their application addresses COVID-19. Funding awards will be between $50,000 and $1 million.

The funding opportunity announcement is available here. Applications are due on July 13^th.