7/31 Update: OHA Summarizes COVID-19 Business Directives from CMS, AHA, State Agencies

OHA has categorized several COVID-19-related items issued by entities including CMS, AHA and state agencies over the past few weeks. This list will be updated frequently to inform members of new and updated directives. To search for specific topics, click Ctrl+F.

This inventory is current as of July 31 @ 10:50 a.m. 

Recent Updates

  • July 31 - CMS extends deadline to September 3, 2020 for submission of the occupational mix survey for the FFY22 wage index. Additional information can be found here.
  • July 30 - AHA advocates for continued flexiblity in telehealth.
  • July 23 - ODM announces suspension of Episodes of Care value-based purchasing program for calendar years 2020 and 2021. Additional Finance News article found here
  • July 17 - Gov. Mike DeWine announces the extension of emergency telehealth rules, effective July 16. These new rules are largely an extension of the prior rules. Additional information can be found here.

OHA Advocacy, Analyses, and Tools

  • May 13 - OHA testified in support of SB 308, a bill that would provide enhanced liability protection to health care providers.
  • April 17 - OHA Board approves framework to responsibly restart surgeries and procedures. Click here to view the Finance News item.
  • April 15 - OHA summarizes COVID-19 impact, priorities, ODM information request. Click here to view the Finance News item.
  • April 13 - Hospitals and payers discuss reimbursement concerns around COVID-19 designated regional centers. Click here to view the Finance News story. 
  • April 13 - Financial opportunities checklist developed for members. Click here to view the Finance News item.
  • April 10 - OHA submitted another 1135 waiver request letter to CMS seeking additional waivers for Ohio hospitals. 
  • April 9 - Governor asked to spur payers to release funds due to hospitals. Click here to view the Finance News item.
  • April 7 - OHA provides resources regarding allocating scarce medical resources. Click here to view the OHA document.
  • April 6 - OHA has compiled a list of resources for our members to help with PPE shortages. 
  • April 2 - OHA requesting financial relief for members, monitoring CARES Act options. Click here to view the Finance News item.
  • March 30 - CMS grants several OHA-requested Section 1135 waivers, while other remain under consideration. Click here to view the Finance News item. 
  • March 25 - OHA today submitted a request to CGS Administrators, LLC and CMS to delay upcoming deadlines. Click here to view the Finance News item.​​
  • ​March 24 - OHA members report the estimated negative financial impact of this outbreak is approaching $1.2 billion per month. This represents about 30% of Ohio hospitals’ average monthly revenue during more normal times – a 30% overnight drop in overall hospital funding. 
    • ​OHA continues to work with the private sector, state government and the federal government on solutions to address issues like: dwindling days cash on hand, looming decisions on furloughs for non-clinical staff, violations of bond covenants, reduced volumes across the board, leading to payment shortfalls for programs like the hospital franchise fee and upcoming assessments hospitals owe state government. Based on our consultations with members and other state hospital associations, OHA is advocating the creation of an emergency fund to financially support distressed hospitals as an effective way of getting money to hospitals. This could be fueled by federal emergency relief for hospitals, but also potentially through emergency funding from the Federal Emergency Management Agency.
  • March 22 - OHA issued several letters to request state administrations to consider extraordinary measures to ensure hospitals can maintain 100% focus on providing critical care to Ohioans in need. Click here to view the Finance News item.
  • March 20 - ​​Hospital chief executives and chief medical officers March 20 joined Gov. Mike DeWine and Department of Health Director Amy Acton, MD to discuss COVID-19 issues. Click here to view the talking points. 
  • ​March 18 - ​OHA is working with the Nursing Board to ensure expedited licensure for nurses from other states to work in Ohio under a temporary license (effective for 180 days). We are also working with the Medical Board to enhance telemedicine opportunities for providers by relaxing certain rules requiring in-person patient encounters. Click here to view the State Medical Board of Ohio’s Board Action on Telemedicine, Emergency Licensure and Continuing Education Changes for State Medical Board of Ohio Licensees. Click here for more information regarding the Board of Nursing’s mobility of nurses provisions.
  • ​OHA Resource Tracker - OHA launched a new data reporting platform for hospitals to report bed availability and status of vital resources such as PPE, ventilators and specific types of health care professionals. Hospitals must submit this data daily by 8:30 a.m. This platform is replacing the SurgeNet platform. Click here for more information. 
  • ​OHA Cost Tracking Tool - OHA released a tracking tool to assist hospitals in tracking the extraordinary costs related to COVID-19. Click here to view the OHA Finance News item.

State Legislation

  • June 5 - OHA Asks Governor to Allocate $1 Billion in Ohio CARES Funding to Hospitals. Click here to view the Finance News item.
  • May 5 - Gov. Mike DeWine Tuesday announced he is cutting general revenue fund spending for the final two months of fiscal year 2020 by $775 million to balance the state budget by June 30. Medicaid spending is to be reduced by $210 million, but no Medicaid rate cuts are projected.
  • May 1 - Brown and Portman call on insurers to release payables. Click here to view the Finance News item.
  • May 1 - Director's ReStartOhio order released. Click here to view the Finance News item.
  • April 28 - Gov. Mike DeWine announced all medically necessary procedures that do not require an overnight stay or do not require inpatient hospital admission and minimize use of personal protective equipment may move forward beginning May 1. This includes regular doctor visits, well-care checks, well-baby visits, out-patient surgeries, imaging procedures and diagnostic tests.
  • April 6 - Governor DeWine signed an executive order that will allow Ohioans to more easily access telehealth services from individual counselors, social workers and marriage and family counselors.
  • ​March 30 - Gov. DeWine signs Ohio COVID-19 package (H.B. 197). Click here to view the Newswire item. 
  • Gov. Mike DeWine issued an Executive Order to allow for the establishment and licensure of Temporary Pandemic Child Care Centers to serve children of parents employed providing health, safety and other essential services during the COVID-19 pandemic. Click here to view the emergency rules issued by the ODJFS.

Federal Legislation and Funding Programs

  • June 9 - With negotiations for the next COVID-19 relief package underway, the Ohio Hospital Association sent a letter to members of Ohio’s Congressional delegation urging continued support for loan forgiveness for the Medicare Advanced Accelerated Payment program.
  • June 5 - President signs bill easing Paycheck Protection Program restrictions. Click here to view the AHA Special Bulletin. 
  • June 3 - HHS announced it is providing an additional $250 million to aid health systems' response to the COVID-19 pandemic. The funding, which was authorized by the Coronavirus Aid, Relief, and Economic Security Act, adds to the $100 million initially disbursed in April by the HHS Office of the Assistant Secretary for Preparedness and Response. 
  • May 28 - The SBA released an interim final rule and second interim final rule around the Paycheck Protection Program. For more information, visit OHA's COVID-19 Financial Relief Opportunities webpage.
  • May 28 - The Federal Reserve has announced that it is establishing a Main Street Lending Program to support lending to small and medium-sized businesses that were in sound financial condition before the onset of the COVID-19 pandemic. Click here to view the Finance News item.
  • May 26 - HHS has extended the deadline for health care providers to attest to receipt of payments from the Public Health and Social Services Emergency Fund and accept the terms and conditions. Providers now will have 90 days, increased from 45 days, from the date they receive a payment to attest and accept the terms and conditions or return the funds. 
  • May 22 - HHS announced that it has begun distributing nearly $4.9 billion from the Public Health and Social Services Emergency Fund to skilled nursing facilities to help them combat COVID-19.
  • May 22 - HHS began distributing $500 million in Public Health and Social Services Emergency Funds allocated to tribal hospitals, clinics and urban programs. 
  • May 20 - HHS provides $225 million for rural communities' COVID-19 testing. Click here for the HHS press release.
  • May 20 - HHS reminded eligible health care providers that they have until June 3 to attest to receipt of payments from the Public Health and Social Services Emergency Fund, accept the terms and conditions and submit their revenue information to potentially qualify for an additional payment from the $50 billion general distribution. 
  • May 19 - The SBA Friday released the application that borrowers must submit to the lender servicing their Paycheck Protection Program loan to request forgiveness for some or all of the loan.
  • May 14 - HHS awards $15 million to support telehealth providers during the COVID-19 pandemic.
  • May 13 - FEMA updates policy on medical care costs eligible for financial assistance.
  • May 13 - SBA clarifies Paycheck Protection Program's good-faith certification provisions.
  • May 12 - House Democrats unveil $3 trillion COVID-19 relief package.
  • May 8 - HRSA COVID-19 Uninsured Program questions and answers from the April 29 and 30 Provider Webcasts are available here.
  • May 7 - HHS released updated FAQs related to payments from the Public Health and Social Services Emergency Fund. 
  • May 7 - HHS extends deadline for attestation of Provider Relief Fund distributions to 45 days. Click here to view the Finance News item.
  • May 7 - Ohio rural hospitals receive $332.4 million in CARES Act funding. Click here to view the Finance News item. 
  • May 4 - U.S. Small Business Administration issued additional guidance clarifying certain provisions implementing the Paycheck Protection Program, including whether public hospitals are eligible for a PPP loan.
  • May 1 - HHS awards $20 million in funding to increase telehealth access and infrastructure.
  • May 1 - HRSA releases additional resources on COVID-19 Uninsured Testing/Treatment reimbursement.
  • April 30 - Federal Reserve expands Main Street Lending Program Eligibility and Scope. Click here to view the Finance News item.
  • President signs Paycheck Protection Program and Health Care Enhancement Act - signed into law April 24
    • Click here to view the Finance News item. 
  • CARES (Coronavirus Aid, Relief, and Economic Security) Act - signed into law Mar 27, 2020
    • July 20 - HHS announces a second round of funding for COVID-19 high-imact hospitals totaling $10 billion. Eligible hospitals are those with over 161 COVID-19 admissions between Jan. 1 and June 30 (1 admission per day) or hospitals that have a disproportionate intensity of COVID-19 admissions. Distribution is $50,000 per admission. HHS indicates that in Ohio, 31 eligible hospitals will receive a total of $227.7 million.
    • June 18 - CMS releases summary of the CARES Act Provider Relief Fund distributions. This includes details on eligiblity and distribution methodology.
    • June 18 - AHA releases charts of the terms and conditions and the basis, formulas, and allowable uses of funds for each allocation of the CARES Act Provider Relief Fund.
    • June 9 - HHS said in a release that it expects to distribute as part of the CARES Act approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Allocation. HHS plans to distribute $10 billion in Provider Relief Funds to safety net hospitals that serve our most vulnerable citizens. 
    • May 1 - HHS begins distribution of payments to hospitals with high COVID-19 admissions and rural providers. 
    • April 26 - HHS opens COVID-19 Uninsured Program portal. Click here to view the Finance News item.
    • April 24 - SBA clarifies certain public hospitals are eligible for Paycheck Protection Program. Click here to view the interim final rule.
    • April 22 - HHS announces allocations of remaining $70 Billion in CARES Act funding. Click here to view the Finance News item.
    • April 22 - CARES Act requires hospitals to submit data by April 25. Click here to view the Finance News item.
    • April 22 - HRSA Federal Office of Rural Health Policy awarded $161.5 million in CARES Act funding to help rural hospitals and communities respond to the COVID-19 emergency. The funding includes $150 million to assist 1,779 hospitals through the Small Rural Hospital Improvement Program, and $11.5 million for telehealth resource centers to assist rural and underserved areas.
    • April 16 - Hospitals must confirm receipt of funds from the $30 billion of $100 billion of the CARES Act. Click here to view the Finance News item.
    • April 10 - Section 3709 of the CARES Act temporarily suspends the 2% payment adjustment currently applied to all Medicare FFS claims due to sequestration. The suspension is effective for claims with dates of service from May 1 through December 31, 2020.
    • ​April 10 - Ohio hospitals begin receiving CARES Act emergency funds. Click here to view the Finance News item.
    • ​​April 1 - CARES Act eliminates scheduled DSH cut for FY20, Ohio hospitals save $181 Million. Click here to view the Finance News item.
    • ​Federal lawmakers and the Trump administration reached an agreement March 25 on a roughly $2 trillion coronavirus emergency rescue package. OHA has been in regular contact with our congressional delegation to urge support for key hospital priorities, and U.S. Sen. Sherrod Brown yesterday participated in a Q & A with member CEOs on a conference call. Click here to view the Finance News item.
    • March 22 - Click here to view the AHA's legislative update regarding the Coronavirus Aid, Relief, and Economic Security Act (CARES/ S. 3548).
  • Families First Coronavirus Response Act - signed into law on Mar 18, 2020
    • April 3 - The Department of Labor issued a temporary rule to enable new paid sick leave and expanded family and medical leave requirements established under the Families First Coronavirus Response Act. ​
    • March 26 - The Department of Labor has released information on common issues employers and employees face when responding to COVID-19, and its effects on wages and hours worked under the Fair Labor Standards Act, job-protected leave under the Family and Medical Leave Act, and paid sick leave and expanded family and medical leave under the Families First Coronavirus Response Act. Click here for more information.
    • March 18 - ​The Senate March 18 passed the Families First Coronavirus Response Act (H.R. 6201). The House of Representatives March 16 passed by unanimous consent a revised version of the bill that made technical corrections to the legislation that the House originally approved March 14. Among other provisions, the legislation would eliminate patient cost-sharing for COVID-19 testing and related services; establish an emergency paid leave program; expand unemployment and nutrition assistance; establish a mechanism for covering testing costs for the uninsured; and provide a temporary increase in the Medicaid Federal Medical Assistance Percentage. The president is expected to sign the bill.
  • Coronavirus Preparedness and Response Supplemental Appropriations Act - signed into law on March 6, 2020
    • CMS announced it will prioritize and conduct only certain surveys during the COVID-19 national emergency’s three-week enforcement discretion period. These include surveys related to complaints and facility-reported incidents that are triaged at the immediate jeopardy level, and targeted infection control surveys of providers identified in collaboration with the CDC and Office of the Assistant Secretary for Preparedness and Response. Click here for more information.
  • ​March 30 - U.S. House passes COVID-19 relief legislation. Click here to view the Newswire item. 

AHA Advocacy

  • July 1 - AHA releases its study of COVID-related financial losses on hospitals and health systems.
  • July 1 - AHA releases information regarding changes to HHS's distribution of remdesivir in the months of July, August, and September. Hospitals are now expected to purchase the medication from Gilead and its distributor, AmeriSource Bergen, with the amounts determined through the TeleTracking web portal process.
  • July 1 - AHA encourages hospitals and health systems to contact their U.S. Senators to support a number of provisions in the next COVID-19 relief package.
  • July 1 - AHA sends letter to CMS requesting to delay implementation of the hospital price transparency rule.
  • June 29 - AHA sends letter to CMS requesting the temporary extension of certain waivers and the permanent adoption of others.
  • June 29 - AHA sends letter to Senators Blunt and Murphy in support of temporary reciprocity legislation.  
  • June 2 - AHA issued a letter urging HHS to distribute substantial additional emergency funds to hospitals and health systems in an expedited manner and using a phased approach.  
  • May 29 - AHA voiced support for legislation that would provide an additional $2 billion for hospitals and other health care providers to expand broadband and telehealth services during the COVID-19 crisis through the Federal Communication Commission Rural Health Care Program.
  • May 26 - AHA voiced support for the Paycheck Protection Program Flexibility Act (H.R. 6886), which would allow PPP loan forgiveness for expenses beyond the current eight-week period; non-payroll expenses to exceed 25% of loan proceeds and the loan term to exceed two years; defer payroll taxes for loan recipients; and extend the rehiring deadline to offset the effect of enhanced unemployment insurance.
  • May 20 - AHA provided input to FEMA's upcoming meeting regarding the use of the Defense Production Act’s voluntary agreement clause (Section 708) to respond to the COVID-19 pandemic.
  • May 15 - AHA issued a letter urging the nation's primary federal regulators for insured depository institutions to prepare to take prompt action to assist health care providers on the front line of the COVID-19 pandemic should the need to do so arise.
  • May 14 - The AHA provided comments on a number of provisions affecting hospitals and health systems that were included in the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act.
  • May 8 - AHA issued a letter urging the Federal Communications Commission to grant expedited approval to its request that the agency extend the COVID-19 Telehealth Program to all hospitals and other direct patient care facilities, regardless of their size, location, or for-profit or not-for-profit status.
  • May 8 - AHA identifies health care priorities for next round of federal funds. Click here to view the Finance News item.
  • May 7 - The AHA and other national hospital organizations issued a letter asking congressional leaders to include in the next COVID-19 legislative package provisions to shield from unwarranted liability the health care facilities and providers treating patients during the pandemic. 
  • May 6 - AHA issued a letter urging bankers to work with stressed hospitals.
  • May 5 - In a new report, the AHA estimates that the financial impact to hospitals and health systems from COVID-19 expenses and revenue losses over the four-month period from March 1 and June 30 totals $202.6 billion, with losses averaging over $50 billion per month.
  • May 4 - AHA issued a letter urging HRSA to issue further guidance on COVID-19 Uninsured Program.
  • May 2 - AHA issued a letter urging CMS to withdraw 340B hospital survey. 
  • May 1 - AHA and ANA urged Congress to provide additional support to hospitals, health systems and front-line caregivers responding to COVID-19. 
  • May 1 - AHA and its American Organization for Nursing Leadership voiced strong support for the Healthcare Workforce Resilience Act, bipartisan legislation that would recapture 40,000 authorized but unused visas to help address the nation's shortage of nurses and physicians. 
  • May 1 - AHA, others urged DOJ to match CMS and OIG relief from certain fraud and abuse sanctions. 
  • April 28 - AHA, businesses and insurance providers send letter to Congress to keep Americans covered during the COVID-19 pandemic.
  • April 28 - Members of the Partnership to Amend 42 CFR Part 2, including the AHA, issued a letter urging HHS to issue a rule as soon as possible on the Part 2 provisions in the CARES Act. 
  • April 24 - AHA issued a letter urging CMS to extend Comprehensive Care for Joint Replacement model on voluntary basis and hold hospitals harmless in 2020.
  • April 23 - CMS offers COVID-19 telehealth toolkit for Medicaid/CHIP.
  • April 23 - AHA issued a letter urging improvements to Medicare Accelerated and Advance Payment Program.
  • April 17 - AHA, others issue roadmap for safely resuming elective surgery. Click here to view the AHA announcement. 
  • April 16 - AHA issued a letter urging HHS to distribute substantial additional emergency funds in an expedited manner. 
  • April 16 - Hospitals, physicians, nurses issued a letter urging HHS to address COVID-19 disparities.
  • ​April 13 - AHA seeks guidance on Main Street New Loan Facility Provision of CARES Act. Click here to view the Finance News item.
  • ​April 13 - AHA issued a petition urging the FCC to reconsider immediately its decision to limit participation in the COVID-19 Telehealth Program to certain nonprofit or public health care providers, noting that the CARES Act included "no such restriction" on the program's $200 million in funding. 
  • April 9 - AHA requests assistance and guidance from HHS for behavioral health providers. Click here for more information.
  • April 9 -  AHA issued a letter asking the Small Business Administration to make small- and mid-size public hospitals eligible for its newly-authorized Paycheck Protection Program. 
  • April 7 - AHA issued a letter urging HHS and CMS to waive interest or substantially reduce interest rate on accelerated/advanced payments.
  • April 7 - AHA issued a letter urging HHS to temporarily suspend certain requirements on health care providers.
  • April 7 - AHA issued a letter urging CMS to extend the 20% hospital add-on payment to LTCHs.
  • April 6 - AHA issued a letter urging the Department of Treasury and Federal Reserve to implement a Mid-Sized Business Loan Program quickly and in a manner that ensures such access will be attainable for hospitals.
  • April 3 - AHA issued a letter urging the Small Business Administration to ensure that small- and mid-size hospitals are allowed to apply for and receive loans under the SBA Paycheck Protection Program that was established by the CARES Act. 
  • April 2 - AHA issues letter urging leaders from the nation's five largest private health insurance companies — Aetna, Anthem, Humana, Cigna and UnitedHealthCare — and organizations that represent insurers to join hospitals and health systems to "meet the historic challenge" caused by COVID-19 to "ensure that the health care system is there for anyone who needs care."
  • ​April 2 - AHA, along with other associations, requested that the Internal Revenue Service provide a six-month automatic extension for filing Forms 990, 990-T, and 4720 to any Section 501(c)(3) organization that is required to file Form 990, Schedule H. Click here to view the letter.
  • April 1 - AHA issues letter urging HHS and CMS to 'directly and expediently' distribute funds to hospitals and health systems as designated by CARES Act. 
  • March 25 - AHA urged the Department of Health and Human Services to clarify the Emergency Medical Treatment and Labor Act and Health Insurance Portability and Accountability Act waivers issued under the public health and national emergency declarations. Click here to view the letter.
  • March 20 - AHA urged CMS to allow all hospitals to elect to receive periodic interim payments or accelerated payments immediately, and with minimal administrative barriers. Click here to view the AHA letter.
  • March 19 - AHA issued a letter to Congress requesting that enforcement of the Stark Law and Anti-Kickback Statute be suspended to enable hospitals and health systems to meet the unique and exigent circumstances created by the COVID-19 public health emergency. Click here to view the AHA letter.
  • March 19 - AHA issued a letter to Congress urging direct funding to frontline health care personnel and providers including nurses, physicians, hospitals and health systems. Click here to view the AHA letter.
  • March 18 - ​AHA joined physician and other groups urging CMS to take steps to ensure COVID-19 does not derail the Alternative Payment Model and value movement. Click here to view the AHA letter.
  • March 17 - AHA issued a letter to Congress quickly pass "critically needed" direct financial assistance for hospitals and health systems to combat the pandemic, including assistance for hospitals investing in infrastructure, equipment and supplies, and a full payroll tax credit or other mechanism to offset uncompensated care, bad debt and charity care costs for treating coronavirus patients. Click here to view AHA’s letter.
  • ​March 16 - ​AHA submitted a comprehensive letter to HHS requesting additional 1135 waivers on behalf of all hospitals and health systems. Click here to view the AHA letter.

CMS Updates

  • June 8 - CMS issues COVID-19 guidance for non-federal governmental plans implementing the Families First Coronavirus Response Act requirement to cover COVID-19 diagnostic testing and certain related items and services without cost-sharing, prior authorization or other medical management restrictions during the public health emergency.  
  • June 3 - The Center for Medicare and Medicaid Innovation announced several COVID-19-related modifications to current and future CMMI alternative payment models. The adjustments are captured in a summary table and are related to the models' financial methodologies, quality reporting requirements and timelines. 
  • June 2 - CMS clarified when to use the catastrophe/disaster-related modifier as well as the disaster-related condition code for Medicare claims submission. 
  • May 29 - CMS released additional FAQs on recent COVID-19-related waivers to help providers, including physicians, hospitals, and rural health clinics.
  • May 27 - CMS released a fact sheet for state and local governments seeking Medicare, Medicaid or Children's Health Insurance Program payment for inpatient and outpatient care provided at hospital alternative care sites during the COVID-19 emergency. The fact sheet covers hospital requirements, 1135 waivers, Medicare hospital enrollment and provider flexibilities.
  • May 20 - CMS released additional waivers for hospitals and ground ambulance organizations.
  • May 20 - CMS updated guidance around Medicare payment for COVID-19 diagnostic tests, giving broad payment-setting authority to MACs.
  • May 15 - CMS issued new guidance to states to allow temporary COVID-19-related modifications in provider payment methodologies and capitation rates under Medicaid managed care plans. 
  • May 14 - CMS posted a FAQ on the CARES Act requirement that providers of COVID-19 diagnostic tests make public the cash price for the tests on their website during the public health emergency.
  • May 11 - CMS continues to release waivers for the health care community that provide the flexibilities needed to take care of patients during the COVID-19 public health emergency. CMS recently provided additional blanket waivers for the duration of the PHE that: Expand hospitals’ ability to offer long-term care services (“swing beds”); Waive distance requirements, market share, and bed requirements for Sole Community Hospitals; Waive certain eligibility requirements for Medicare-Dependent, Small Rural Hospitals (MDHs); and Update specific life safety code requirements for hospitals, hospice, and long-term care facilities.
  • May 8 - CMS updates video provides answers to common questions about the expanded Medicare telehealth services benefit under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.
  • May 7 - CMS releases additional Medicaid and CHIP COVID-19 FAQs or state Medicaid and CHIP agencies.
  • May 1 - CMS announces independent commission to address safety and quality in nursing homes.
  • April 30 - CMS issues additional COVID-19 waivers. Click here to view the Finance News item.
  • April 30 - CMS releases updated FAQ on EMTALA. Click here to view the Finance News item.
  • April 30 - A revised MLN Matters Special Edition Article SE20016 on New and Expanded Flexibilities for Rural Health Clinics and Federally Qualified Health Centers During the COVID-19 Public Health Emergency is available.
  • April 28 - CMS launches 340B survey despite objections. Click here to view the Finance News item.
  • April 26 - CMS announced that it 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. 
  • April 23 - CMS and the Assistant Secretary of Preparedness and Response ASPR released a new toolkit to help state and local healthcare decision makers maximize workforce flexibilities when confronting COVID-19 in their communities.
  • April 23 - CMS issued guidance to issuers of individual, small group, Medicare Advantage, and Part D plans, addressing the flexibilities available related to utilization management and prior authorization during the COVID-19 public health emergency. 
  • April 22 - CMS issues FAQ on health plan administrative flexibilities.
  • April 22 - CMS will give hospitals until July 1, 2021 to implement admission, discharge and transfer notification requirements once its final rule on interoperability and patient access is published in the May 1 Federal Register.
  • April 22 - CMS releases additional blanket waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities.
  • April 22 - CMS launches new toolkit to help states navigate COVID-19 health workforce challenges.
  • April 20 - CMS announces new nursing homes COVID-19 transparency effort.
  • April 20 - CMS issues recommendations to re-open health care systems in areas with low incidence of COVID-19.
  • April 17 - To support Rural Health Clinics, Federally Qualified Health Centers, and their patients, Congress and CMS made changes to requirements and payments during the COVID-19 Public Health Emergency. Click here to view MLN SE20016.
  • April 17 - CMS announces Medicare telehealth payment rate for rural health centers.
  • April 17 - CMS issues FAQs on legislations' COVID-19 Medicaid/CHIP provisions.
  • April 15 - CMS postpones HHS-operated Risk Adjustment Data Validation for 2019 benefit year.
  • April 15 - CMS clarified that the agency is waiving the Medicare coverage requirement for a three-day prior hospitalization requirement for both skilled nursing facilities and swing-bed services furnished by critical access hospitals and rural swing-bed hospitals, the agency says in a new COVID-19 FAQ on Medicare billing, specifically question 4. 
  • April 15 - CMS implements changes to increase payments to IPPS hospitals and LTCHs under Sections 3710 and 3711 of the CARES Act. Click here to view MLN SE20015.
  • April 15 - Medicare nearly doubles payment for high-throughput diagnostic tests. Click here for the CMS announcement.
  • April 14 - CMS provides supplemental information for transferring or discharging residents between SNFs and/or nursing facilities based on COVID-19 status. 
  • April 13 - CMS announced expanded coverage for essential diagnostic services amid COVID-19 public health emergency. Click here for more information.
  • April 9 - CMS releases additional COVID-19 waivers for clinicians. Click here to view the Finance News item.
  • April 9 - CMS does not have the authority to postpone the Open Payments data publication deadline of June 30. Click here for more information.
  • April 6 - CMS clarifies Accelerated/Advance Payment programs. Click here to view the AHA's summary of clarifications.
  • April 3 - CMS issued critical recommendations to state and local governments, as well as nursing homes, to help mitigate the spread of COVID-19 in nursing homes. Click here to view the press release and here for the guidance document. 
  • April 1 - CMS issues a sweeping array of new rules and waivers of federal requirements to ensure that local hospitals and health systems have the capacity to absorb and effectively manage potential surges of COVID-19 patients. Click here to view the CMS Newsroom Fact Sheet.
  • April 1 - CMS issues additional blanket 1135 waivers. Click here to view the complete list.
  • ​April 1 - The Secretary of Health and Human Services issued blanket waivers of important provisions of the federal Physician Self-Referral Law (also known as the Stark Law) under his 1135 waiver authority. Click here for more information.
  • April 1 - CMS revises EMTALA waiver language to allow more flexibility for hospitals to set up alternative care sites. Click here for more information.
  • April 1 - CMS issues exceptions and extensions for quality reporting requirements for specific facilities. Click here for more information.
  • March 27 - ​Health and Human Services Secretary Alex Azar yesterday asked the nation's governors to immediately allow health professionals licensed or certified in other states to practice in their state in person or through telemedicine. Click here to view the letter.
  • March 30 - CMS sent a letter to the nation’s hospitals on behalf of Vice President Pence requesting they report data in connection with their efforts to fight the 2019 Novel Coronavirus. 
  • ​March 30 - Hospital may apply for CMS Accelerated and Advance Payment Program during COVID-19 emergency. Click here to view the Finance News item.
  • March 26 - CMS released a news alert including FAQs and guidance on payment and grace periods, telehealth for private coverage, prescription drugs, and enhanced FMAP. Click here to view the news alert.
  • March 23 - CMS announces relief for the clinicians, providers and facilities participating in Medicare quality reporting programs. Click here to view the Finance News item.​ Click here to view the MIPS FAQ.
  • March 22 - ​CMS released tools to permit states to access emergency administrative relief, make temporary modifications to Medicaid eligibility and benefit requirements, relax rules to ensure that individuals with disabilities and the elderly can be effectively served in their homes and modify payment rules to support health care providers impacted by the outbreak. Click here to view the CMS press release.
  • ​March 2020 - CMS released FAQs on Medicare Provider Enrollment Relief related to COVID-19 including the toll-free hotlines available to provide expedited enrollment and answer questions related to COVID-19 enrollment requirements. Click here to view the FAQ.
  • March 18 - ​CMS permits states to expand the groups for which hospitals can make presumptive eligibility determination. Click here to view the CMS FAQ for state Medicaid and CHIP agencies.
  • March 18 - ​​CMS issued FAQs to clarify coverage for the diagnosis and treatment of COVID-19 by catastrophic health plans. Click here to view the FAQ.
  • March 13 - CMS approves Medicaid Section 1135 Waivers for states in response to COVID-19. Click here to view the CMS Fact Sheet. Click here to view the current list of states that have approved waivers.
    • OHA March 20 hosted a webinar for member hospitals' legal counsel to review the blanket Section 1135 waivers issued by CMS. The slides are available here, and the audio recording here.

Private Payers

  • OHA aggregates private payers' COVID-19 policies. Click here to view the OHA webpage.
  • March 19 - OHA asked the director of the Ohio Department of Insurance for the DeWine administration to consider extraordinary measures to ensure hospitals can maintain 100% focus on giving critical care to Ohioans in need. Specifically, OHA requested the administration seek a commitment from health plans that offer coverage in Ohio to eliminate, until further notice, administrative processes that could serve as a barrier to appropriate reimbursement for treatments administered in the course of caring for suspected or confirmed COVID-19 patients. Hospitals also asked for a commitment from health plans to offer financial stability at this time when hospitals are encouraging patients to postpone elective procedures in response to the outbreak. Click here to view the OHA letter.

Telehealth - Medicaid

  • April 14 - ODM releases COVID-19 telehealth resources for providers. 
  • March 19 - ​Gov. Mike DeWine announced an executive order that will expand access to medical and behavioral health services using telehealth. Click here to view the executive order. 
    • Pursuant to Executive Order 2020-05D, the Ohio departments of Medicaid and Mental Health and Addiction Services March 20 issued emergency rules to immediately expand and enhance access to certain medical and behavioral health services using telehealth. Click here to view the OHA Finance News item.
  • Additional information:
    • ​Medicaid FAQs can be found here
    • OhioMHAS FAQs can be found here

Telehealth - Medicare

  • March 20 - CMS releases updated MLN Matters Special Edition Article SE20011 on Medicare Fee-for-Service Response to the Public Health Emergency on COVID-19 to cover the use of modifiers on telehealth claims and to explain that the DR condition code is not needed on telehealth claims under the waiver. Click here to view the MLN.
  • ​March 17 - ​The Center for Connected Health Policy released a telehealth coverage policies fact sheet that includes a summary of what is covered by various public and private payers. Click here to view the fact sheet.
  • March 17 - Beginning with encounters on March 6, clinicians can provide and bill for telehealth services provided to Medicare beneficiaries. Click here to view the CMS Telehealth Fact Sheet. Click here to view the Medicare telehealth FAQ. 
  • Additional information:
    • Click here for the telehealth toolkit for general practitioners.
    • Click here for the telehealth toolkit for ESRD providers.
    • Click here to view the CMS telehealth guidance document for states.
    • ​Click here to view the Office for Civil Rights' HIPAA COVID-19 bulletin.
    • Click here to view the Office for Civil Rights' FAQs on telehealth and HIPAA.
    • Click here to view the CMS telehealth and telemedicine toolkit for Long Term Care Nursing Home Facilities.
    • ​April 6 - CMS released a video providing answers to common Medicare telehealth questions. 

COVID-19-Related Billing Guidance and Announcements

  • June 24 - ODM announces the reinstatement of fee-for-service hospital utilization reviews beginning July 1, 2020, and the recoupment of previously denied claims past appeal effective August 2020. Additional information can be found here.
  • May 7 - CMS released May 7 MLN, providing information around billing requirements for lab tests required for a COVID-19 diagnosis, new HCPCS codes C9803, G2023 and G2024, and more.
  • May 1 - ODM reports MCO readiness for COVID-19 claims. Click here to view the Finance News item.
  • April 28 - Addition of the QW modifier to HCPCS code U0002 and 87635. Click here for more information.
  • April 15 - ODM requests additional 1135 waivers. Click here to view the Finance News item.
  • April 14 - AMA releases two CPT codes for COVID-19 antibody testing. Click here for more information.
  • April 13 - ODM provides updates regarding COVID-19 systems changes. Click here to view the Finance News story. 
  • April 13 - ​ODM announces COVID-19 managed care plan emergency provisions. Click here to view the Finance News item. 
  • ​April 10 - Providers should use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services and to get 100% of the Medicare-approved amount. Click here for more information.
  • April 3 - The AHA's April 1 webinar on the new ICD-10-CM code for COVID-19 testing is now available online. Click here to access the webinar.
  • April 2 - ODM provides information around their response to COVID-19. Click here to view the PPT.
  • March 27 - ODM suspends FFS hospital retrospective utilization reviews. Click here to view the Finance News item.
  • March 26 - ODM announces that it cannot bypass the requirement for patient signatures on forms ODM 03199 (Acknowledgment of Hysterectomy Information) or OMB 0937 0166 (Consent for Sterilization). Click here to view the Finance News item.
  • March 26 - The National Uniform Billing Committee has issued claims guidance to help health care providers flag claims for COVID-19-related services. Click here to view the Finance News item.​​
  • March 18 - The CDC will implement the new specific ICD-10-CM code for COVID-19, U07.1, April 1 rather than Oct. 1 as originally planned. Click here to view CDC’s announcement. 
    • An updated ICD-10 MS-DRG Grouper software package to accommodate the new ICD-10-CM diagnosis code, U07.1, COVID-19, effective with discharges on and after April 1 will be made available. This updated grouper software package will replace the grouper software package V37.1 that was developed in response to the new ICD-10-CM diagnosis code U07.0, Vaping-related disorder, also effective with discharges on and after April 1. Click here for detailed information regarding the assignment of new diagnosis code U07.1, COVID-19, under the ICD-10 MS-DRGs.
  • Medicare and ODM are updating their claims processing systems to accept new COVID-19 testing HCPCS codes, U0001 and U0002, beginning April 1 for dates of service on or after Feb 4. Click here to view CMS’ Coverage and Payment Medicare Fact Sheet. ​

​Resources and Toolkits

  • May 13 - CMS issues Nursing Homes Best Practices Toolkit to combat COVID-19.
  • April 17 - FEMA releases COVID-19 resource for hospitals.
  • CMS Stakeholder Calls and Transcripts - Click here for the calls and transcripts available for download.
  • Cybersecurity - AHA has released a compendium of resources for hospitals and health systems related to cybersecurity threats during the COVID-19 pandemic. Click here to access the resources.
  • Kaiser Family Foundation - The Kaiser Family Foundation has aggregated details on COVID-19-related activity across the country. Click here to access the webpage. 

Other Items

  • July 20 - The IRS announces that it has extended the deadline for tax-exempt hospitals to meet their community needs assessment obligations to Dec. 31.
  • June 23 - ODH releases information regarding how Medicaid Managed Care Plans can assist members with asthma.
  • June 4 - HRSA updated its guidance related to COVID-19 for 340B hospitals registering outpatient sites.
  • May 28 - BWC is deferring Ohio employers' premium installments for the months of June, July, and August. Businesses will have the option to defer the monthly premium payments with no financial penalties.
  • May 1 - The Medicare Promoting Interoperability Program Hardship Exception Application for Eligible Hospitals and Critical Access Hospitals is now available
  • April 28 - The Substance Abuse and Mental Health Services Administration Friday awarded $450 million in grants, including $250 million in emergency COVID-19 funding, to expand access to mental health and substance use disorder treatment services through certified community behavioral health clinics. 
  • April 21 - Report examines pandemic's early impact on hospital finances.
  • April 21 - New report makes recommendations to address U.S. rural health care crisis.
  • April 21 - BWC this week will send more than 170,000 checks amounting to $1.6 billion in dividends to Ohio employers.
  • April 20 - Ohio manufacturing alliance launches exchange to facilitate access to PPE. Click here to read the full press release.
  • April 16 - FDA announced easing compounding policy for hospitalized COVID-19 patients.
  • April 16 - Governors in Illinois, Michigan, Ohio, Wisconsin, Minnesota, Indiana and Kentucky announce plan to coordinate on reopening of economy. OHA will provide details once they are released.
  • April 15 - The departments of Health and Human Services, Labor and Treasury April 11 issued joint guidance implementing legislative provisions specific to COVID-19 diagnostic testing and services. 
  • April 10 - HHS Office for Civil Rights will not enforce HIPAA rules at certain COVID-19 testing sites. Click here for more information.
  • April 10 - BWC to Pay $1.6 billion in dividends to Ohio employers. Click here for the official announcement.
  • April 9 - BWC providers COVID-19 resources. Click here to view the Finance News item.
  • April 9 - OhioMHAS issued a revised telehealth waiver opportunity to their April 2 waiver memo.
  • April 7 - OIG to hold off on anti-kickback sanctions for COVID-19 activities covered by CMS Blanket Waivers of Stark. Click here to view the OIG statement.​
  • April 6 - The Federal Communications Commission released an order establishing a telehealth program to support health care providers responding to the pandemic, and adopted final rules for the longer-term Connected Care Pilot Program.
  • April 6 - The White House Coronavirus Task Force will prioritize rapid COVID-19 testing to support remote, rural parts of the country with the least access to testing, including nursing homes and the Indian Health Services. Click here for more information.
  • April 6 - OhioMHAS takes steps to expend private psychiatric hospital capacity by issuing a memorandum to invite waiver requests regarding expanded usage of telemedicine, relax staffing ratio requirements and relax patient admission timelines. Instructions for psychiatric hospitals to request a waiver are included in the memo.
  • April 3 - ODM extends June cost report due date to Aug. 31. Click here to view the Finance News item.
  • April 2 - The final cutoff for changes to Medicaid cost reports is May 15. For more information, click here.
  • April 2 - Ohio Nursing Board guidance eases licensure process for out-of-state nurses. Click here for more information.
  • March 30 - The Federal Communications Commission extended to June 30 the application deadline for the Rural Health Care Program, which provides funding for eligible health care providers to support telehealth services. 
  • March 30 - Department of Veterans Affairs releases COVID-19 response plan
  • ​340B Audits - HRSA has issued additional information regarding the 340B program. Click here to view HRSA's COVID-19 resources webpage.
    • If a covered entity has specific questions regarding an audit once they have been engaged, please contact the Bizzell Group (the 340B audit contractor) at 340baudit@thebizzellgroup.com, who will coordinate with HRSA based on the specifics of the request. 
    • For additional concerns, please contact Molly Collins Offner, AHA director of policy, at mcollins@aha.org or Aimee Kuhlman, AHA senior association director of federal relations at akuhlman@aha.org .
  • ODH Notifications - Hospitals or other facilities that choose to voluntarily and temporarily close a service need to notify the Ohio Department of Health (ODH) of this decision in writing and notify the department again when the facility is preparing to reopen. A facility’s licensure status will not be affected by this notification to ODH. This process would apply to services such as ambulatory surgery centers, dialysis centers, diagnostic imaging centers, inpatient rehab facilities and others governed by ODH. Send temporary closure notifications to: Bureau of Regulatory Operations, Attention – Temporary Closure, at LICCERT@ODH.OHIO.GOV or by fax at 614-564-2426.
  • Price Gouging - ​OHA has heard reports from members concerned about vendors engaging in price gouging for supplies, equipment, and staff necessary for addressing the COVID-19 crisis. If you believe you are dealing with an unscrupulous vendor who is engaging in price gouging or other unconscionable business practices, please take the brief time necessary to file a complaint here.
  • GME Surveys - The Accreditation Council for Graduate Medical Education announced it is suspending routine GME operations to allow organizations and faculty members to focus on the needs of patients with COVID-19 and "the careful and appropriate integration of residents and fellows into that process." The following accreditation activities are suspended: self-study activities, accreditation site visits, Clinical Learning Environment Review program site visits, and resident/fellow and faculty surveys. For more details, visit www.acgme.org.
  • BWC - ​The Ohio Bureau of Workers' Compensation released a FAQ to provide information regarding COVID-19's impact on BWC operations. Click here to view the FAQ. Click here to view BWC's announcement that insurance premium installment payments due for March, April and May for the current policy year may be deferred until June 1, 2020, at which time the matter will be reconsidered. 

Questions? Please contact Andy White.