Coronavirus Update #57
Medicaid FAQ, CARES Act FAQ, CMS Calls Today, Additional Reminders
Medicaid FAQs 

CMS recently released guidance to states on Medicaid-related COVID-19 issues. Although the guidance covers a range of topics, including implementation of coverage for COVID-related services for the uninsured and benefits and cost sharing for COVID-19-related testing and diagnostic services, below are some highlighted items important to long term care providers:

Treatment of Relief Payments in CARES Act
CMS clarifies that the relief payments eligible people receive from the CARES Act may not be counted as income when making Medicaid and CHIP eligibility determinations. In addition, these payments may not be counted as resources for 12 months (Question 54). 

Eligibility Considerations for States to Receive Enhanced Federal Matching Rates
To continue to receive the temporary FMAP increase, the state must not cut eligibility for benefits during the public health emergency, even if that person no longer meets the existing eligibility criteria. Several questions in the FAQ document address targeted questions states have raised related to people using long term services and supports, or who become eligible for Medicare as well as Medicaid. These include: 

  • When a Person no Longer Meets Level of Care (LOC) or Other Requirements of a 1915(c) Waivers: If a person is participating in a 1915(c) home and community-based services (HCBS) waiver and they are determined to no longer meet the LOC requirements (or other requirements) for the waiver, the state should maintain an individual’s participation in a 1915(c) waiver for which the individual is enrolled during the emergency period, even if the individual is determined to no longer meet the LOC or other requirements for waiver participation (Question 25). 

  • When a Person’s Medicaid Eligibility Is Connected to Need for 1915(c) Waiver Services and They No Longer Meet LOC Requirements: If a person’s Medicaid eligibility is connected to their need for and receipt of 1915(c) waiver services, and they are determined to no longer meet the LOC requirements, to continue to receive the enhanced federal matching rate, the state must maintain the individual in this eligibility group and continue to provide coverage for 1915(c) services, unless they are now eligible for a different eligibility group that provides the same amount, duration, and scope of benefits (Question 26). 

  • Medicaid beneficiaries who become eligible for Medicare: If a person enrolled in Medicaid turns 65 and becomes eligible for Medicare during this time, CMS clarifies steps the state would have to take to ensure that their services are not reduced so that the state can continue to receive the 6.2% federal matching bump (Question27). 

  • Changes in SSI eligibility when this is the basis for Medicaid eligibility: If a person who is eligible for Medicaid based on their receipt of SSI benefits were to become ineligible for SSI during the public health emergency, they may not be terminated from Medicaid before the end of the month when the public health emergency ends. If the person is eligible for a different Medicaid eligible group that offers at least the same benefits available to SSI beneficiaries, the state is able to move them to that new group (Question 33). 

  • Moving between Medicare Savings Program (MSP) groups: During the public health emergency, states must maintain a person’s eligibility for at least the same amount, duration, and scope of benefits as are covered for the group in which the individual is enrolled. This includes paying for Medicare Part A and Part B premiums through MSPs and other Medicaid categories. This means that a person could not be moved to a different MSP group that offers less assistance with Medicare premiums and cost sharing during the emergency (Question 34). 

1915(k) Clarification and EFMAP 
CMS addressed an incorrect statement in a previous FAQ document, clarifying that Community First Choice 1915(k) service expenditures are in fact eligible for the enhanced federal matching rate of 6.2 percent under this public health emergency (Question 36). 
CARES Act Provider Relief Funds FAQs 

On Friday, April 10, the U.S. Department of Health and Human Services (DHHS) released the first round of the $100 billion in relief funds to hospitals and other health care providers on the front lines of the coronavirus response. This funding will be used to support health care-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get testing and treatment for COVID-19.  

AHCA/NCAL has developed some FAQs specific to long term and post-acute care providers.

Find these FAQs on the ACHA COVID-19 website under Financial & Reimbursement Issues > CARES Act Provider Relief Fund.
CMS CALLS TODAY
Nursing Homes

Please join the Centers for Medicare and Medicaid Services (CMS) for a call on COVID-19 with Nursing Homes , Wednesday, April 15 at 4:30 PM EDT.

CMS leadership will provide updates on the agency’s latest guidance and we will be joined by leaders in the field interested in sharing best practices with their peers. The call will be recorded if you are unable to join.

Conference lines are limited, so it is highly encouraged you to join via audio webcast, either on your computer or smartphone web browser.

Wednesday, April 15
4:30 – 5:00 PM EDT 
Attendee Dial-In : 833-614-0820 
Conference ID : 3770227 

Dialysis Facilities

Please join the Centers for Medicare and Medicaid Services (CMS) for a call on COVID-19 with Dialysis Facilities, Wednesday, April 15 at 5:30 PM EST.

CMS leadership will provide updates on the agency’s latest guidance and we will be joined by leaders in the field interested in sharing best practices with their peers. The call will be recorded if you are unable to join.

Dial-in details below. Conference lines are limited, so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser.

Wednesday, April 15
5:30 – 6:00 PM EST
Attendee Dial-In: 833-614-0820
Conference ID: 3689246

Recommendations for When a Resident Wants to Leave the Building
 
AHCA/NCAL has developed recommendations to help you address when a resident wants to leave the building to go into the surround community and then return. This could introduce COVID-19 into the building and endanger others. Our recommendations include communicating with the resident and family, requiring isolation, and contacting the ombudsman and the local health department.  
Marriott Community Caregivers Rate 

Marriott is offering a “ Community Caregivers Rate ” to expedite the booking process for healthcare and relief professionals and support staff. This rate will be available from March 26, 2020 through June 30, 2020 at participating hotels. 

Find this resource on the AHCA COVID-19 website under AHCA/NCAL Guidance and Resources > Workforce 
Reminders
SNF & Hospital Partner Call - Friday, April 17 at 2:00 PM

Along with the Maryland Hospital Association (MHA), the University of Maryland Medical System (UMMS), Johns Hopkins Medicine, LifeBridge, and other hospital partners, we will be hosting our fourth call to connect our sectors. HFAM will invite broadly and work with partners and other associations to make all post-acute providers aware of this call.

The purpose of that call will be to discuss topics of mutual interest such as transfers between hospitals and post-acute facilities, post-acute capacity, models to expand capacity, and other priorities amid the COVID-19 pandemic.


This call will take place   Friday, April 17 from 2:00 - 3:00 PM

Dial-in: 1-415-655-0001
Passcode: 316 561 900 #
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.
National Healthcare Decisions Day — April 16

National Healthcare Decisions Day exists to inspire, educate and empower the public and providers about the importance of advance care planning.

The Conversation Project has been continuing to put together new COVID-19 specific resources to help you, your loved ones and your communities during this difficult time. We encourage you to check out this  new COVID-19 specific conversation guide.  
Additional resources to help you and your teams:

  • This blog post by Joanne Lynne about what long term care and assisted living facilities should be doing now to prepare for a surge of COVID-19 deaths.

  • Healthcare professionals can learn more about the Maryland MOLST form HERE.





Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.