Coronavirus Update #27

Webinar Education Programs, Senate Passes Stimulus Package,

New Series from AHCA/NCAL, and More

HFAM Webinar Education Programs

We thank you for all you are doing to provide care while keeping your residents and employees safe and well. The HFAM Team is focusing on helping our members and the sector navigate compliance, quality care, workforce, and other issues as we together work through the COVID-19 pandemic. HFAM/MCAL and AHCA/NCAL have many currently scheduled webinars, live and on demand, that you can access to educate staff and earn CEUs to maintain compliance with licensure.

April HFAM/MCAL Webinar Series or Single Sessions

Compliance with Administrators and Social Work Boards

As of this writing, the Maryland Board of Examiners of Nursing Home Administrators “strongly encourage all licensees to obtain all 40 CEU's through online courses, use online renewals and pay via credit card versus mailing in a check or money order.”

The Maryland Board of Social Work Examiners has indicated that all education requires remain in effect. If Social Workers obtain Category 1 CEUS via webinar or online programs, the Certificate of Attendance must indicate the type of program.

HFAM / MCAL education webinars, whether live or on demand, meet the educational requirements for Maryland Administrators and Social Workers.

Senate Passes Stimulus Package

Yesterday, March 25, the Senate passed the Coronavirus Aid, Relief, and Economic Security Act (H.R. 748), which now goes to the House of Representatives for consideration. Of note to skilled nursing facilities and assisted living facilities, the stimulus includes:



We expect the House to pass this bill later this week, and once it passes, we will offer a more detailed summary of the various provisions specific to long term care. 

AHCA/NCAL Video Series with Mark Parkinson

Our AHCA/NCAL partners have released their first video in a new series where President & CEO Mark Parkinson gives a national update on the COVID-19 pandemic. In this first video, Mark talks with Chief Medical Officer Dr. David Gifford about what to do if your staff or residents are potentially COVID-19 positive ( view more detailed guidance ), and if you’re running low on PPE. 

Emotionally Supporting Staff

The COVID-19 pandemic has taken a mental and emotional toll on Americans across the country. Health care workers especially feel the burden of this crisis. Providers must take steps to ensure the health and well-being of their staff as they navigate this challenging time. AHCA/NCAL has compiled resources to help providers prevent burnout and ensure staff feel supported at work.

Also, as we previously shared, please see this  communications document to help guide staff in answering difficult questions that may come up. It is very informative and written in easy language that is honest and simple. Please review and share with your teams in order to learn from and help others.

Status of Medicare Hearings and Appeals During COVID-19

Although the Office of Medicare Hearings and Appeals (OMHA) office space is closed to the general public, OMHA hearings and appeals processing measures are proceeding as scheduled. Unless an appellant is notified directly that a hearing has been postponed or canceled, appellants should continue to appear for hearings by telephone as scheduled. The office will demonstrate flexibility with regard to reasonable requests to reschedule hearings. Additional information and updates will be provided as the situation evolves.

UnitedHealthcare and Cigna Suspend Prior Authorizations for SNF Admissions

UnitedHealthcare (UHC) has issued a press release that they have suspended requiring Prior Authorizations (PAs) for all SNF admissions through May 31, 2020. According to UHC, the admitting provider must give notification within 48 hours of transfer and penalties still apply. Further, length of stay reviews still apply, including denials for days that exceed approved length. This is a national release and appears to cover all UHC plans. Providers who are in network with UHC should check their provider manual or with their local UHC representative to confirm this policy change applies, and any other specific requirements related to PAs. If a provider is not in network with UHC, providers should continue to get and document PAs to protect their ability to bill claims.

Cigna has also announced it is waiving PAs for the transfer of its patients to in-network subacute facilities, including skilled nursing facilities. Providers who are in network with Cigna should check their provider manual or with their local Cigna representative to confirm this policy applies, and any other specific requirements related to PAs. 

See the AHCA/NCAL template letter requesting similar administrative relief from other Managed Care Organizations (MCOs).

CMS Delays Release of SNF PEPPER Report

The Centers for Medicare and Medicaid Services (CMS) has announced another measure to free up the attention of providers as they respond to the COVID-19 pandemic. To this end, the release of the Q4FY19 PEPPER schedule for an April release has been delayed for SNFs and other providers.

Providers will be notified about the rescheduled release date for the Q4FY19 PEPPERs when determined.

DEA Permits Prescribing Across State Lines in Certain Cases

The Drug Enforcement Administration has granted an exception to allow practitioners in states that have granted reciprocity with other states for medical licensing to prescribe controlled substances in another state. Under the exception, DEA-registered practitioners are not required to obtain additional registration(s) with DEA in the additional state(s) where the dispensing (including prescribing and administering) occurs, if authorized to dispense controlled substances by both the state in which a practitioner is registered with DEA and the state in which the dispensing occurs. 

Practitioners, in other words, must be registered with DEA in at least one state and have permission under state law to practice using controlled substances in the state where the dispensing occurs. This applies to prescription of controlled substances via telemedicine in states where they are not registered with DEA. This is effective March 23, 2020 through the during of the public health emergency. 

Please note that some states may also require state-specific registration for narcotic prescribing. Practitioners should be certain to comply with any additional steps required for state compliance.



Additional COVID-19 related information from the DEA is available here . 

Special Thank You Audio Message

HFAM has recorded a special thank you to those of you working in Maryland skilled nursing and rehabilitation centers and on assisted living campuses. Please distribute broadly to your teams.

We are all navigating together in these uncharted waters of the COVID-19 pandemic. Now more than ever, it is important that we recognize we are in this together, and that we are stronger together.

The names in the recording are real and from some of our HFAM member centers.

COVID-19 Case Study (Not Maryland)

Please see this Case Study that HFAM very recently wrote after being contacted by a SNF provider in another part of the country.

Please review this case study and share with your teams -- it includes critical insight and real time experience.

Child Care for Essential Personnel

Maryland Family Network (MFN) is partnering with the Maryland State Department of Education (MSDE) to make it fast and easy for essential personnel to find safe quality child care during the State of Emergency.

Maryland’s child care providers are essential to stemming the spread of and finding a cure for the COVID-19 pandemic. Our region is teeming with the Nation’s top researchers, doctors, and policy makers. As the Coronavirus continues to spread and demands on these and other essential personnel grows, they need to know their children are safe in order to stay focused on keeping the rest of us safe and healthy.

Visit this site to learn more or call 877-261-0060 to locate child care.

Additional Resources and Guidance

AHCA/NCAL

Centers for Disease Control and Prevention

Centers for Medicare and Medicaid Services

Maryland Department of Health

AMDA Guidance

Please email [email protected] for additional questions, and visit

www.ahcancal.org/coronavirus for additional information and resources.