Issue: March 21, 2020

Published on March 21, 2020

Articles in this issue:

AHCA: COVID-19 Update #15 | Beware of COVID-19 Scammers

Author: Stephen Hanse* Published in From the President

In This COVID-19 Update:

Beware COVID-19 Scams Selling PPE or Other Supplies

Providers are receiving vendor emails or other contact offering PPE supplies, and some may not be legitimate vendors or businesses. Please beware that some offers are scams and are not credible businesses. To help you spot the difference between legitimate businesses and scams, the Federal Trade Commission (FTC) has provided some general guidance on COVID-19-related scams. AHCA/NCAL has also compiled a list of helpful questions to ask yourself and the business in question.

States Actions to Provide Childcare for Health Care/Essential Workers 

AHCA/NCAL has collected some information on how states are handling childcare for healthcare workers and other essential employees.   

As we hear of other state actions, we will continue to update this document. 

Resident Laundry Guidance with COVID-19 and When Families Want to Do Residents’ Laundry

With the restriction around non-essential visitors to skilled nursing centers and assisted living communities to minimize the risk of spread of COVID-19, there have been many questions on handling residents’ personal laundry, including for those who may have previously had their laundry done by a family member.   

AHCA/NCAL has developed some additional guidance on this. You can also follow CDC guidelines for environmental infection control in healthcare facilities . CDC states that “Infection has not been linked to laundry procedures in residential-care facilities, even when consumer versions of detergents and laundry additives are used.”

CMS is Delaying Implementation of the October 1, 2020 MDS Update

The Centers for Medicare and Medicaid Services (CMS) announced that they are delaying the Minimum Data Set (MDS) 3.0 v1.18.1 release, which had been scheduled for October 1, 2020. The MDS item sets are used by Nursing Home and Swing Bed providers to collect and submit patient data to CMS. This MDS data informs payment, quality, and the survey process.

This delayed release will eliminate the need for significant SNF MDS training during the upcoming months as well as avoid increased documentation nationwide. 

CMS staff continues to be actively engaged in discussions with AHCA and various other stakeholders, regarding the various changes, the impacts of these changes, as well as, the timeline to educate and train facility staff and update software and IT systems.

CMS Provides Medicare Advantage Flexibilities Related to COVID-19

CMS has provided Medicare Advantage (MA) organizations with flexibilities. However, it is up to each individual MA plan to determine what flexibilities they will implement.  It also applies to Medicare Medicaid Plans (MMPs).  
MA organizations have the ability to:

  1. Waive or reduce enrollee cost-sharing for beneficiaries impacted by the outbreak.
  2. Provide enrollees access to Medicare Part B services via telehealth in ANY geographic area and from a variety of places, including a beneficiaries’ home.
  3. Waive plan prior authorization requirements that otherwise would apply to tests or services related to COVID-19.
  4. Relax “refill too soon” edits and provided maximum extended day supply on drugs.
  5. Reimburse enrollees for prescriptions obtained from out of network pharmacies.
  6. Relax plan-imposed policies that may discourage certain methods of delivery such as mail or home delivery, for retail pharmacies that choose to offer these delivery services in these instances.
  7. Waive prior authorization requirements at any time that would otherwise apply to Part D drugs used to treat or prevent COVID-19 if or when such drugs are identified.

MA organizations are required to:

During disaster or emergency (declared by the Governor of a state or Protectorate) the following are in effect until the end date identified in the State declaration or for 30 days, if no end date is identified in the declaration. 

  1. Cover benefits furnished at non contracted facilities if the facilities have participation agreements with Medicare.
  2. Waive, in full, requirements for gatekeeper referrals where applicable.
  3. Provide the same cost sharing for the enrollee at a non-contracted facility as if it were a contracted facility.
  4. Changes that benefit the enrollee can be effective immediately without the 30-day notification requirement (examples include reductions in cost sharing and waiving prior authorizations). 

Medical Review Audits During COVID-19

AHCA is aware that several members are receiving additional development review (ADR) medical review documentation requests for Medicare Part A, Part B, and Medicare Advantage (MA) services from Medicare contractors and MA plans. Such requests have a limited response time and often require front-line clinical staff to provide the supporting documentation. 

While AHCA is awaiting clarification from CMS about possible audit relief, we recommend that providers receiving any ADRs immediately contact the contractor or MA plan and request suspension of any pre-pay review and an extension for any post-pay review due to the COVID-19 crisis

Let’s Spread #CareNotCOVID

This has been a challenging time for everyone: staff, residents and their loved ones. We know many of you are going to extraordinary lengths to keep your residents safe from this virus, as well as help keep them engaged while they’re unable to visit with family members, volunteers, and even each other due to social distancing. With many individuals now staying home, we thought this would be a good opportunity for members of the public to send some messages of support to our residents.

So, we’re happy to announce the release of www.carenotcovid.com to make it easy for anyone to send a video message to our seniors and individuals with disabilities. We’re also collecting stories from around the internet, so everyone can feel uplifted and inspired to chip in where they can. Whether it’s encouraging donations of hand sanitizer to your local facility, or asking children (who are at home while schools are closed) to create a homemade card, we hope you’ll show your residents www.carenotcovid.com every day to let them know that we’re all thinking about them. 

Feel free to even take a photo or video of your residents reacting to the messages on this website – we'd be happy to share those too. Send us any messages, inspiring stories or random acts of kindness by: 

And if you’re looking for ideas on how to keep your residents engaged and adjust some of your activities in light of this pandemic, check out our new resource

Please email COVID19@ahca.org for additional questions, and visit www.ahcancal.org/coronavirus for additional information and resources.  

NYSHFA/NYSCAL CONTACT:

Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11

NYSHFA/NYSCAL "Love Pic"

Author: Stephen Hanse* Published in From the President

In this time of unprecedented stress, anxiety and uncertainty, it is crucial to remember that we are ALL in this together – staff, residents and families – each and every one of us! 

When we are facing so many seemingly overwhelming issues at work and in our personal lives, it can be extremely difficult to notice all the moments of love, compassion and joy that are occurring regularly within our facilities. But these moments are occurring all around us! If we strive to seek out these moments of love, compassion and joy, we will find them! 

The photo below is just one example of the love and joy that is all around us. I am asking each and every member of our NYSHFA/NYSCAL family to actively seek out these moments at your facility, take a “LOVEpic” photo with a phone (with no associated words or names) or have a resident or family member share a photo and e-mail it to Jessica Van Wormer at jvanwormer@nyshfa-nyscal.org for posting on our website. 

In life, great things are done by a series of small things brought together. Through our care and compassion in serving others we serve ourselves. 

Thank you.