State Updates
Governor Cuomo Announces New Antibody and Diagnostic Testing Efforts, Plans for Reopening
Today (April 27th), Governor Cuomo held a press conference during which he announced that the statewide COVID-19 antibody survey had tested 7,500 New Yorkers. Based on the increased sample size, the infection rate is now estimated at 14.9% (up from 13.9%). The antibody survey will be expanded this week to focus on a sample size of 6,000 first responders, including: 1,000 NYPD officers; 1,000 FDNY officers; 3,000 frontline health care workers; and 1,000 transit workers. Antibody testing for frontline health care workers in New York City will be conducted at Bellevue Hospital, Elmhurst Hospital Center, Montefiore Medical Center and SUNY Downstate Medical Center. The State also plans to expand the scope of diagnostic testing as capacity increases. As of April 26th, it has expanded statewide diagnostic testing criteria to include asymptomatic first responders, health care workers, and essential employees (see “Updated Guidance Documents” below).
The Governor announced a new project, the Nourish New York Initiative, that will purchase food and products from upstate farms with surplus goods to be distributed to food banks across the State that are in need. The State will also be providing $25 million from the Special Public Health Emergency Fund to food banks and providers most impacted by COVID-19.
The Governor said that NY on PAUSE, which is currently in effect until May 15th, may end as of that date in some regions. The decision will be made based on factors such as a 14-day decline in hospitalization rates, health care facility capacity, business precautions in place, and testing/tracing efforts. The phased approach to “un-pausing” will include regional coordination among schools, transportation systems, and testing/tracing programs. The first phase will permit certain industries, including construction and manufacturing operations with low risk, to open. The second phase will open certain industries based on priority and risk level; however, attractions and businesses that might draw large visitors from outside the local area will not be permitted to reopen. Additionally, there will be two weeks in between each phase to monitor the effects of reopening and ensure that infection and hospitalization rates are not increasing. The Governor stated that temporary medical facilities built for the COVID-19 pandemic response (including Westchester County Center, Javits Center, SUNY Old Westbury, and SUNY Stony Brook) may remain in place through the fall flu season in preparation for a future outbreak.
Additional details on the Governor’s phased “reopening” plan is available in a press release here.
Governor Cuomo Issues Two New Executive Orders
Over the weekend, Governor Cuomo signed Executive Order 202.23 (available here) codifying his announcements last week to:
- Authorize the Commissioner of Health to suspend or revoke the operating certificate of any skilled nursing facility or adult care facility if that facility has not complied with regulations or directives from the State Department of Health (DOH).
- Provide all eligible voters with postage-paid applications to receive an absentee ballot for the elections to be held on June 23rd, and cancelled certain special elections.
The Governor also signed Executive Order 202.24 (available here), which contains the following directives:
- Authorize licensed pharmacists to order COVID-19 tests approved by the Food and Drug Administration (FDA) to detect SARS-CoV-2 or its antibodies, and to administer COVID-19 tests after completion of appropriate DOH training.
- Permit licensed pharmacists to be designated as a qualified health care professional for the purpose of directing a clinical service laboratory to test patients for COVID-19 or its antibodies if such a test is FDA-approved and waived for use in a limited service laboratory.
State Releases Enacted Budget Financial Plan
Over the weekend, the New York State Division of the Budget (DOB) released the Financial Plan for Fiscal Year (FY) 2021 (available here). The Plan provides the State’s financial projections for FY 2021 through FY 2024 based on the enacted New York State FY 2021 Budget. As per new authority granted in the enacted budget, the Budget Director has reviewed COVID-19 related expenses and tax receipts for the month of April and has included in the Financial Plan a set of proposed payment adjustments that would balance the budget.
Compared to the Executive Budget forecasts prior to the COVID-19 pandemic, DOB has reduced the FY 2021 estimate for tax receipts by $13.3 billion, and expects receipts to remain lower through FY 2024, for a total four-year difference of $60.5 billion. Based on the current lack of direct federal aid that would replace the loss in expected State tax receipts, the Budget Director has proposed over $10 billion in reductions to balance the budget, including reductions to aid-to-localities programs ($8.2 billion), State agency operations ($1.6 billion), debt services costs ($293 million), and others. If enacted, nearly every program in the aid-to-localities budget would face significant cuts, including special education, children’s health insurance, residential services, substance abuse programs, and others. Spending for State agency operations will also be reduced considerably, with hiring, salary increases, and purchasing all put on hold.
DOB is preparing a detailed plan itemizing the specific appropriations and disbursements that would be reduced or withheld, which will be released in May to the State Legislature. The Legislature will have the opportunity to adopt their own plan to close the gap within 10 days, after which the plan prepared by DOB will take effect immediately.
Updated Guidance Documents
On April 26th, DOH released revised guidance regarding COVID-19 testing protocols (available here) for providers and local health departments, pursuant to Executive Order 202.19 (available here), which established a statewide coordinated testing prioritization process, and Governor Cuomo’s announcement regarding expanded diagnostic testing capacity for essential workers (see above). The guidance expands the qualifying types of individuals who will receive priority for testing, in the following order:
- Symptomatic individuals (particularly if high-risk);
- Individuals who have had close (i.e. within six feet) or proximate contact with a person known to be positive with COVID-19;
- Individuals who are employed as health care workers, first responders, or in any position within a nursing home, long-term care facility, or other congregate care setting; and
- Essential employees who directly interact with the public while working.
Individuals in one of these categories who do not otherwise have access to testing may call 1-888-364-3065 or visit DOH’s website here to be screened for eligibility and set up an appointment.
Additional recently released or revised New York State and City guidelines are listed below:
- COVID-19 Pandemic Patient Surge: Preparing for Crisis Care (4.26.20)
- Interim COVID-19 Guidance Regarding Day Habilitation (4.24.20)
Federal Updates
HRSA Launches COVID-19 Uninsured Program Portal
Today, the Health Resources and Services Administration (HRSA) launched the COVID-19 Uninsured Program Portal (available here), allowing providers to begin to enroll in the program. The program offers reimbursement (at Medicare rates) for a range of medical services, including office visits, outpatient and inpatient hospital services, specimen collection and testing, skilled nursing facility (SNF) services, home health, and others. Providers must attest that they have verified the patient’s uninsured status and that they will accept the program reimbursement as payment in full. Claims will be processed by UnitedHealth Group for services dated from February 4th, and will include the use of an Optum ID, but will not involve a contract with UnitedHealth. UnitedHealth will provide technical assistance to providers starting April 29th, including a webinar planned for that date (registration details forthcoming).
On the portal, HRSA has published various guidance documents related to this program, including:
· Terms and Conditions for Testing Services
CMS to Reevaluate Accelerated Payment Program and Suspend Advanced Payment Program
On April 26th, the Centers for Medicare and Medicaid Services (CMS) announced that the agency is reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance Payment Program to Part B suppliers effective immediately. CMS had expanded these temporary loan programs on March 28th in light of the COVID-19 outbreak, resulting in the approval of over 21,000 applications totaling $40.4 billion in payments.
An updated fact sheet on the Accelerated and Advance Payment Programs is available here.