State Updates
Governor Cuomo Issues Executive Order 202.17
Yesterday (April 15th), Governor Cuomo signed Executive Order 202.17 (available here) which includes new directives related to the COVID-19 emergency. The Order modifies a directive in Executive Order 202.16 (available here) related to issuing no-action or no-filing letters by requiring such letters to be issued by the Attorney General rather than the New York City Department of Law. The Order also requires any individual over the age of two who is able to medically tolerate a face covering to cover their nose and mouth with a mask or cloth covering when in a public place and unable to maintain adequate social distance from others. This requirement is effective at 8pm on Friday, April 17th.
Governor Cuomo Extends NY PAUSE through May 15th, Says Hospitalizations Continue Decreasing
Today (April 16th), Governor Cuomo held a press conference during which he announced that the NY PAUSE social distancing measures would be extended through May 15th, in order to ensure that the State’s current success in managing the outbreak continues. The latest data shows that COVID-19-related hospitalizations, intubations, and ICU admissions all continue to decrease. The Governor reiterated plans discussed earlier this week to “reopen” businesses based on factors such as how “essential” the business service or product is, the risk of workplace or customer infection associated with reopening that business, and what changes that business can make to make the workplace safer.
Addressing the new Executive Order (outlined above) requiring New Yorkers to wear face coverings in public, the Governor indicated that such face coverings would be required when taking public transportation, private transportation carriers, and for-hire vehicles. Additionally, all operators of public systems, private carriers, and for-hire vehicles should wear face coverings at all times.
New York Congressional Delegation Requests Additional Federal Funding for New York State
Yesterday, a New York congressional delegation, comprised of a bipartisan group of U.S. Representatives and Democratic Senators Chuck Schumer and Kirsten Gillibrand, sent a letter (available here) to HHS Secretary Alex Azar and CMS Administrator Seema Verma regarding emergency funding to address the COVID-19 pandemic. In the letter, the delegation urges the federal government to prioritize additional funding for New York State and other areas of the country that have been severely impacted by the COVID-19 pandemic by distributing funds to states based on their share of national COVID-19 infections.
The letter references the strained hospitals and health systems in New York, who are reporting significant financial losses due to cancelled elective procedures, increased staffing and overtime costs, expanded bed capacity, and increased spending on supplies and equipment to address the surge of COVID-19 patients. Because of this disproportionate burden on New York health care facilities, the delegation argues that New York should receive increased support in subsequent federal funding distributions.
OPWDD Hosts Second Webinar on New Day Services Retainer Program
Today, the Office for People with Developmental Disabilities (OPWDD) held a second webinar on the new Day Services Retainer Program. This program uses New York’s Appendix K emergency authority for the OPWDD 1915(c) Home and Community-Based Services (HCBS) waiver (available here), which was approved by CMS last week. The new program will provide retainer payments to providers of Day Habilitation, Prevocational Services, and Community Habilitation. Such providers may choose to participate in the program by signing an attestation which promises that the provider will retain service program staff and will work to sign a cooperative staffing agreement with another agency and submit it by June 15th. Participating providers will receive 80% of their average revenue from July to December 2019 in bi-monthly retainer payments. Claims may be submitted to eMedNY starting on May 1st, using new rate codes.
Providers may continue to accrue additional revenue by billing for the provision of services or from shared staffing, up to a ceiling of 100% of the average revenue, after which the retainer payment will be reduced (in reconciliation). Supervised Individualized Residential Alternatives (IRAs) who are billing the enhanced residential rate will not receive the retainer payments through this program. The webinar also clarified that the program allows flexibility in the modality of service delivery, and that Day Habilitation, Prevocational Services, and Community Habilitation may be temporarily provided remotely via telehealth without prior approval. Additionally, during the State’s mandatory school closure, Community Habilitation may be temporarily delivered during weekday, daytime hours to students.
OPWDD anticipates distributing the attestation form to providers on April 20th, to be returned to OPWDD on April 28th. Last week’s webinar slides introducing the program are available here. Today’s presentation will be posted here when available. Additional guidance documents on the program are forthcoming from OPWDD.
DOH Weekly Health Care Provider Update Webinar
Today, DOH held its weekly webinar providing an update to health care providers on COVID-19. The webinar provided an epidemiological update on COVID-19 globally, nationally, and within New York State. The webinar also discussed testing updates, health care personnel back to work guidance, and infection prevention and control protocols.
The webinar presentation is available here. Webinars are held on Thursdays from 1pm to 2pm.
Updated Guidance Documents
Today, the New York State Office of Mental Health and Office of Addiction Services and Supports (OASAS) released program and billing guidance (available here) for designated providers of adult behavioral health HCBS and recovery coordination services during the emergency response to COVID-19. The guidance outlines essential services to be provided during the emergency by these providers, expectations for providers of behavioral health HCBS and recovery coordination services, and changes in documentation and billing requirements.
Federal Updates
CMS Lessons from the Front Lines: COVID-19
CMS Lessons from The Front Lines is a weekly series on held on Fridays, with varying topics each week. Tomorrow (April 17th), from 12:30pm to 2pm, CMS will hold a call series to hear physicians and other clinical leaders share their experiences, best practices, strategies, and insights related to COVID-19. To access the event, attendees can call 877-251-0301 and use the access code 8672948. Alternatively, attendees can access the audio webcast link here.
FDA Will Allow Hospitals to Compound Sedatives During COVID-19 Emergency
On April 16th, the Food and Drug Administration (FDA) announced a temporary policy allowing hospitals to compound a range of sedatives used for patients affected by COVID-19. The medicines, which include forms of fentanyl, hydromorphone, and ketamine, are used to aid patients on ventilators. The FDA guidance allows hospitals to make their own copies of pre-mixed drugs and portion out the drugs themselves. The list includes the following 13 dugs:
- Cisatracurium besylate
- Dexmedetomidine hydrochloride
- Etomidate
- Fentanyl citrate
- Furosemide
- Hydromorphone hydrochloride
- Ketamine hydrochloride
- Lorazepam
- Midazolam hydrochloride
- Norepinephrine bitartrate
- Rocuronium bromide
- Vancomycin hydrochloride
- Vecuronium bromide
The FDA’s temporary policy is available here.