COIPA April Advocate
COVID - 19 Preparedness 4/22/2020
In this issue:


  • Draft Plan To Reopen The State
  • PacificSource Payments Went Out This Week
  • Phase 3.5 Relief
  • COIPA CARES Act Webinar
  • Additional Allocations of Provider Relief Funds Announced
  • Gorge Outreach
  • Clinics Open & Here To Help
  • Clinics Offering Telemedicine
  • Telehealth Updates From CMS 4/10/20
  • Technical Assistance For EHR's
  • Staying Informed On COVID-19
  • CORD (Central Oregon Resource Directory): Central Oregon Health Council
  • Washington State Department Of Health
  • Oregon Health Authority
  • Homemade Masks From COIPA
  • Patient Gives Back To VIM
  • Job Postings For COIPA Members
  • Funding Options: First Interstate Bank
  • At Home Work Stations: Pacific Office Automation

 
DRAFT PLAN FOR REOPENING OREGON CONSIDERS COUNTY-BY-COUNTY LIFTING OF COVID-19 RESTRICTIONS
A draft version of Oregon's still-evolving plan for gradually lifting coronavirus restrictions,  outlined in a PowerPoint presentation on Monday , includes criteria for a county-by-county reopening of the state if certain goals and commitments are met.
The document follows Governor Kate Brown's  announcement of a framework for reopening the state  last Tuesday, but is largely informed by  a three-phase White House plan that was released on Thursday.

PacificSource OHP Payments Arriving soon!
Checks distributing 70% of the Withhold and Surplus resulting from the PacificSource OHP contract with the IPA went out in the mail on Monday, April 20 th . You should receive your check by the end of the week.

Phase 3.5 Relief Plan

This is a difficult time for many of us and Business Oregon appreciates the opportunity to support your work.
We understand that Congress is finalizing Phase 3.5 of the relief bill that proposes to recapitalize the PPP and EIDL programs that will be available on a first come, first serve basis. Although it has yet to pass, we are recommending that small businesses take steps to prepare to apply as soon as possible as it is likely funding will again be exhausted within a matter of days. 
The best and most current information will be posted on the SBA website. Please check the links below frequently as program requirements and guidelines are constantly evolving and some features of the programs may have changed.
In the meantime, we are suggesting that small businesses with interest in SBA funding programs take the following steps to minimize issues and ensure the fastest processing possible by the SBA and/or your bank:
  • Be current – check the SBA website for the most recent guidance and forms.
  • Be aligned – clearly know how you arrived at your average monthly payroll costs & loan amount.
  • Be thorough – follow all the steps outlined in the forms and checklists.
  • Be yourself – put the borrower’s name on the application as your company’s legal name. It ought to match the name that is registered with the Secretary of State.
  • Be prepared – collect your supporting documents and have them ready when you apply.
  • Be consistent – make sure to provide consistent information on all documentation (inconsistencies slow down the process by necessitating additional verification).
  • Be in touch – contact your banker or local SBDC office with questions.
Please know that until the new law is passed and the regulations written, we are unable to provide specific guidance but we are confident that taking the steps above will increase your likelihood of securing funds.
 
Stay connected through the State of Oregon’s Small Business Navigator website.
 

Applicants wanting to check in with SBA as to the status of their application can send an  email   to the disaster relief team.
COIPA CARES Act
COIPA hosted a webinar on the CARES Act to give our members the chance to learn about business resources that can be a benefit to your business:
  • on federally funded programs through the CARES Act by Lisa Kyles, Small Business Development Center,
  • on employer and employee resources available through Worksource Oregon by Dana Dunlap , Worksource Oregon, and
  • on resources available to Oregon businesses by Tom Schnell, State of Oregon Finance Office.

The webinar can be accessed from COIPA's website .
Additional Allocations of Provider Relief Funds Announced
 
Earlier today, the Department of Health and Human Services (HHS) announced its newest allocation of funds from the Public Health and Social Services Emergency Fund (PHSSEF) for healthcare providers to provide reimbursement for COVID-19 related expenses and lost revenue from the pandemic. Four separate allocations of direct interest for our members will be distributed as described below:

1. General Allocations
  • $20 billion will be distributed to facilities and providers impacted by COVID-19, based on eligible providers’ 2018 net patient revenue from all payor sources.
  • A portion of providers will automatically be sent an advanced payment based off the revenue data they submit in Centers for Medicare & Medicaid Services (CMS) cost reports
  • These providers will still need to submit their 2018 net patient revenue information through a portal opening this week so that it may be verified
  • Other providers (like practices) without cost report data on flle will need to submit their 2018 net patient revenue information to the portal
  • Payments will go out weekly on a rolling basis with the first wave being delivered Friday, April 24
  • Providers who receive funds must also sign an attestation confirming receipt of funds, agree to the terms and conditions of payment, and confirm the CMS cost report
  • Surprise billing for presumptive and actual patients that is greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider is prohibited
2. Targeted Allocations
  • $10 billion will be distributed for targeted distribution to hospitals and providers in hot spots that have been particularly impacted by the COVID-19 outbreak. Initially, the fund was for just hospitals but through APG advocacy efforts practices will now be able to access a portion of this fund 
  • Hospitals should apply for a portion of the funds by providing the following four pieces of information via the live authentication portal before 12:00 am PDT, Thursday April 23 so that HHS can better informed where to target funds:
  • Tax Identification Number
  • National Provider Identifier
  • Total number of Intensive Care Unit beds as of April 10, 2020
  • Total number of admissions with a positive diagnosis for COVID-19 from January 1, 2020 to April 10, 2020
  • Hospitals have already been contacted directly to provide this information

APG is currently working with HHS to obtain more information on what practices must submit in order to received funds from the targeted allocations. Stay tuned for more info.

3. Allocation for Rural Providers
  • $10 billion will be allocated for rural health clinics and facilities
  • Funds will be distributed as early as next week on the basis of operating expenses, proportionately to each facility and clinic

APG is awaiting further details on how these funds will be allocated.

4. Allocation for Care for the Uninsured
  • Providers who have provided treatment for uninsured COVID-19 patients on or after February 4, 2020 can request claims reimbursement and will be reimbursed at Medicare rates, subject to available funding
  • In order to receive funds, providers must follow the steps below:
  • Enroll as a provider participant
  • Checking patient eligibility and benefits
  • Submit patient information
  • Submit claims
  • Receive payment via direct deposit 
  • Providers may register for the program on April 27, 2020 and begin submitting claims in early May 2020. Due to the limitation on these funds, we would recommend that you submit ASAP.

APG will continue to advocate for the adequate and complete funding for providers throughout this process and keep you up to date as the COVID-19 pandemic continues to unfold. Please email us with any questions.
We are here to serve as a resource for you. Please don’t hesitate to contact me here with any questions you may have or any situations within your practice that you want me to be aware of.
You can find more resources on our COVID-19 web page . As always, please know that we are in constant contact with federal and agency officials and will share any additional news with you as soon as possible.
Valinda Rutledge
Senior Vice President of Federal Affairs
America's Physician Groups
Gorge Outreach
A program of Community Action Partnership of Oregon in response to the COVID-19 State of Emergency.

Primary objective of Gorge Outreach is to provide emergency shelter through use of hotel vouchers to support unsheltered individuals and families in the Mid-Columbia counties of Wasco, Sherman and Hood River to follow CDC guidelines to practice social distancing and decrease vulnerability to infection and transmission of COVID-19. Priority for hotel vouchers will be individuals or households with a member who are in a high risk category per current CDC guidelines and individuals with disabilities and/or underlying health conditions. Secondary objective will be to provide linkage to emergency shelter, community healthcare, and social service resources to promote improved health and social outcomes and decrease impact of high utilization of emergency services and contacts with Law Enforcement Agencies and First Responders.

For referral call: 971-238-4438 A GO Program Coordinator will contact you with 24 hours for an initial eligibility screening. 

COVID-19 Lab Testing


Note:  Clinicians throughout the community can order COVID-19 testing at their discretion through commercial labs WITHOUT approval by public health.
​
Quick links to the labs are housed online at COIPA's website.
Clinics spreading the word that they are open and here for you.
Telemedicine: The following COIPA clinics have announced that they are currently offering televisits to their patients
4/10/20 Telehealth Updates from CMS
The Centers for Medicare & Medicaid Services (CMS) announced that organizations, including those in Medicare Advantage (MA), that submit diagnoses for risk adjusted payment are now able to submit diagnoses for risk adjustment that are from telehealth visits. APG has been vigorously advocating for this modification and we applaud CMS for taking this meaningful action.
Submission for these visits are allowed when they meet all criteria for risk adjustment, which include:
  • The visit is from an allowable inpatient, outpatient, or professional service, and
  • A face-to-face encounter
  • This requirement is met when the services are provided using an interactive audio and video telecommunications system that permits real-time interactive communication
The use of diagnoses from telehealth services applies to submissions to the Risk Adjustment Processing System (RAPS) and those submitted to the Encounter Data System (EDS). For EDS, MA organizations (and other organizations as required) report all the services they provide to enrollees to the system and CMS will then identify those diagnoses that meet risk adjustment filtering criteria. In order to report services to the EDS that have been provided via telehealth, providers are advised to use place of service code “02” for telehealth or use the CPT telehealth modifier “95” with any place of service.


Technical Assistance for EHR's
COIPA will continue to provide health IT assistance free of charge to help members incorporate virtual visits and telemedicine into their practice workflows. As we shift into a “new normal”, remember that we are available to help with many areas of COVID-related HIT including making sure you have the current codes, are exchanging data with the community, updating lab interfaces for new testing options, patient messaging, ad hoc reporting, etc.

If you would like assistance with EHR features or health IT solutions, please don’t hesitate to contact James McCormack, COIPA’s Director of Informatics, directly at  jmccormack@coipa.org  or by cell phone at 503-307-7994. In addition to extensive experience with eClinicalWorks, COIPA has access to an expert Athena consultant, Jensina Hawkins, who is also standing by to help. For users of Epic and other EHRs, COIPA recognizes that you may already have strong health IT support from your internal IT and/or vendors, but we stand ready to help in any way we can.
Caravan's guides to adapting AWVs & E/M visits to a telehealth format:

Staying informed on COVID-19
The Department of Health for Washington has created a web page dedicated to keeping our community up to date and informed on the current state of COVID-19. Click the link below for the most current information.

Central Oregon Health Council has created a web page dedicated to keeping our community up to date and informed on the most impactful COVID-19 communications. Below is link to the new site.

Oregon Health Association has a dedicated site to keep you update on the pressing COVID-19 impacts. Below is a quick link to the site.

To help stay on top of the surge here is a useful link for reference
If your clinic(s) needs PPE urgently, COIPA has a supply of homemade masks ready for our members.
COIPA Clinics in need of CE & FDA Approved disposal medical masks can contact Kira to place an order.


Patient Gives Back to VIM

Three years ago Mariana found herself in a distressing situation. As an uninsured small business owner her options for care seemed limited when she considered her breast, which had enlarged to 3x its normal size, had become hard, and was now very painful and causing her chills. With no other options available to her, she called Volunteers in Medicine, and she was asked to come to the clinic for testing asap.
Job Postings for COIPA Members
 COIPA is updating our web site to add available staff resources (“help available”) in our community in addition to open positions (“help wanted”). We recognize the current crisis is already having an impact on our clinical and administrative workforce and will post and update announcements submitted by email .
 
Please be sure to indicate whether you have staff available to other members, or your own needs for additional staff.
 
Note: While COIPA will providing this space, we are not responsible for connecting and vetting individuals. Postings must include contact information and any specifications for “help available” or “help wanted”.
Clinics Needing Additional Funding During This Time

For our clinics needing information regarding obtaining a loan from First Interstate to assist with operations during the COVID-19 outbreak please reach out to:

Dawn Cofer
541-330-7555


Remote Workstation Assistance To POA Clients
The team at Pacific Office Automation can help with setting up at home workstations to help keep your office and staff going.

Sean Walsh
Doug Judish
541-388-1276

Mission
COIPA is committed to our members' success by:
  • Providing sustainable support services
  • Incentivizing quality care
  • Engaging individuals for improvement
  • Partnering with the community
We want to hear all of the exciting changes, new services, promotions, and events that our members have scheduled in 2020 and share it monthly in the Advocate.

To submit your announcements call or email Autumn Wilson