COVID-19 Update – March 31
Statement attributable to:
Art Fougner, MD
President, Medical Society of the State of New York
“As the Legislature and Governor work to finalize a State Budget in the next 2 days amid the extraordinary crisis we are facing in our health care system right now due to the coronavirus outbreak, we strongly urge the State Legislature to reject problematic proposals that had been advanced by the Medicaid Redesign Team.
“These problematic proposals include imposing enormous new costs on the nearly 17,000 physicians participating in the Excess Medical Malpractice Insurance Program, and changes to scope of practice for numerous health care practitioners including nurse anesthetists, pharmacists and nurse practitioners. The Excess program provides a critical additional layer of malpractice insurance for New York physicians who already incur the highest liability costs in the country.
“While we realize that the COVID-19 pandemic requires an ‘all hands-on deck’ approach, we would also urge that the temporary changes to the scopes of practices of numerous health care practitioners revert to the previous status as soon as possible. It is imperative to maintain stability as well as patient safety in our health care system as we manage this current crisis and its aftermath.”
Gov. Asking Hospitals to Adopt “Statewide “Approach” to Optimize Capacity
New York is asking hospitals to adopt a statewide approach to the coronavirus pandemic to prevent overcrowding, staffing strains and equipment shortages seen at New York City facilities in recent days. Gov. Andrew Cuomo, who previewed the coordinated approach on Monday, said he has asked private and public hospitals across New York to share staff, patient loads and medical equipment so the state can optimize its capacity to respond to the virus before it reaches its apex in the coming weeks.
The coordinated effort will initially send nurses, doctors and other medical professionals from upstate facilities to New York City, which has become the new epicenter for Covid-19, Cuomo said. It will also allow for transfers of patients, staff and supplies among all hospitals in the state, as well as new temporary federal health facilities. The governor said the state Department of Health will lead a central coordinating team with Westchester, New York City and Long Island hospitals, as well as the Greater New York Hospital Association and Healthcare Association of New York State.
Gov. Announces 60-Day Deferment for Malpractice Payments
Governor Cuomo announced on Friday that, for a 60-day period, consumers and small businesses experiencing financial hardship due to COVID-19 may defer paying premiums for property and casualty insurance, including medical malpractice, auto, homeowners, renters and workers compensation. No late fees will be assessed and no negative data will be reported to credit bureaus during this time, and late payments will be payable over a one-year period. https://www.governor.ny.gov/news/amid-ongoing-covid-19-pandemic-governor-cuomo-announces-completion-first-1000-bed-temporary
13 NY Medical Schools Allow Early Graduation during Pandemic
Thirteen medical schools in New York state intend to allow students to graduate early to join the fight against COVID-19, the disease caused by the novel coronavirus, Associated Medical Schools of New York President and CEO Jo Wiederhorn told The Wall Street Journal.
The medical schools in New York City, Long Island and Westchester County include New York University’s medical school, which is allowing students to graduate a few months early to begin working in NYU’s internal medicine or emergency medicine departments amid the pandemic.
They also include Valhalla-based New York Medical College, one of the nation’s largest private health sciences colleges. For the past month, Chancellor and CEO Edward Halperin, MD, has been in contact with hospital and health officials, and more than 400 New York Medical College students have been placed at local facilities, such as Westchester Medical Center, the Journal reported.
“Any good doctor learns really fast when you get thrown into a situation,” Dr. Halperin told the newspaper. “Would it have been better if they had more time? Yes. But extraordinary times call for extraordinary solutions.” (Becker’s Hospital, March 31)
NYS DOH: Physicians, Take these Precautions
Based on the NYS Department of Health webinar on March 13, 2020 physicians should take the following precautions:
- Triage patients over the phone or via telehealth so that your office can be prepared and avoid exposure to other patients, it is also recommended that you suspend walk-ins. Please be aware, as noted below, that the NYS DFS and DOH have taken a number of steps to ensure that physicians will be paid for telehealth and telephone visits with patients.
- Advise any patient to self-quarantine/self-isolate until COVID-19 is ruled out. Patients who have been exposed to the virus or traveled to affected international locations must continue quarantine for 14 days even if their test is negative.
- Notify the county health Department of any patient you advise to self-quarantine, even if the patient is considered low risk. A list of county health departments can be found at: https://www.health.ny.gov/contact/contact_information/ For location of testing sites, please contact the county department of health.
- Keep plenty of ear-loop face masks on hand for physicians and staff. If you need more masks or other PPE equipment in response to COVID-19, please contact your county Emergency Management Office (EMO) and indicate that you are having difficulty obtaining PPE and request their assistance in acquiring these items.
CMS Adds 85 More Medicare Services Covered under Telehealth
CMS on March 30 issued various regulatory changes to further support hospitals’, physicians’ and other healthcare organizations’ capabilities during the COVID-19 pandemic, including expanding Medicare coverage of telehealth visits.
On March 17, the Trump administration announced CMS will temporarily pay clinicians to provide telehealth services for beneficiaries during the pandemic. CMS is now expanding Medicare coverage of 85 additional services provided via telehealth, including emergency department visits and initial nursing facility and discharge visits.
Here are the 85 additional services, and their respective codes, that CMS will cover when provided via telehealth through the duration of the pandemic:
- 77427: radiation management
2. 90853: group psychotherapy
3. 90953: end stage renal disease, one visit per month, ages 2 and younger
4. 90959: end stage renal disease, one visit per month, ages 12-19
5. 90962: end stage renal disease, one visit per month, ages 20 and older
6. 92057: speech/hearing therapy
7. 92521: evaluation of speech fluency
8. 92522: evaluation speech production
9. 92523: speech sound language comprehension
10. 92524: behavioral quality voice analysis
11. 96130: psychological test evaluation phys/qhp 1st
12. 96131: psychological test evaluation phys/qhp ea
13. 96132: neuropsychological testing evaluation phys/qhp 1st
14. 96133: neuropsychological testing evaluation phys/qhp ea
15. 96136: psychological and neurological testing phy/qhp 1s
16. 96137: psychological and neurological testing phy/qhp ea
17. 96138: psychological and neurological tech phy/qhp ea
18. 96139: psychological and neurological testing tech ea
19. 97110: therapeutic exercises
20. 97112: neuromuscular re-education
21. 97116: gait training therapy
22. 97161: physical therapy evaluation low complexity, 20 min
23. 97162: physical therapy evaluation moderate complexity, 30 min
24. 97163: physical therapy evaluation high complexity, 45 min
25. 97164: physical therapy re-evaluation establish plan care
26. 97165: occupational therapy evaluation low complexity, 30 min
27. 97166: occupational therapy evaluation moderate complexity, 45 min
28. 97167: occupational therapy evaluation high complexity, 60 min
29. 97168: occupational therapy re-evaluation establish plan care
30. 97535: self care management training
31. 97750: physical performance test
32. 97755: assistive technology assessment
33. 97760: orthotic management and training 1st en
34. 97761: prosthetic training 1st enc
35. 99217: observation care discharge
36. 99218: initial observation care
37. 99219: initial observation care
38. 99220: initial observation care
39. 99221: initial hospital care
40. 99222: initial hospital care
41. 99223: initial hospital care
42. 99234: observation/hospital same date
43. 99235: observation/hospital same date
44. 99236: observation/hospital same date
45. 99238: hospital discharge day
46. 99239: hospital discharge day
47. 99281: emergency department visit
48. 99282: emergency department visit
49. 99283: emergency department visit
50. 99284: emergency department visit
51. 99285: emergency department visit
52. 99291: critical care first hour
53. 99292: critical care additional 30 mins
54. 99304: nursing facility care initial
55. 99305: nursing facility care initial
56. 99306: nursing facility care initial
57. 99315: nursing facility discharge day
58. 99316: nursing facility discharge day
59. 99327: domiciliary or rest home visit new patient
60. 99328: domiciliary or rest home visit new patient
61. 99334: domiciliary or rest home visit established patient
62. 99335: domiciliary or rest home visit established patient
63. 99336: domiciliary or rest home visit established patient
64. 99337: domiciliary or rest home visit established patient
65. 99341: home visit new patient
66. 99342: home visit new patient
67. 99343: home visit new patient
68. 99344: home visit new patient
69. 99345: home visit new patient
70. 99347: home visit established patient
71. 99348: home visit established patient
72. 99349: home visit established patient
73. 99350: home visit established patient
74. 99468: neonatal critical care initial
75. 99469: neonatal critical care subsequent
76. 99471: pediatric critical care initial
77. 99472: pediatric critical care subsequent
78. 99473: self measurement of blood pressure at home education/training
79. 99475: pediatric critical care ages 2-5 initial
80. 99476: pediatric critical care ages 2-5 subsequent
81. 99477: initial day of hospital care for neonatal care
82. 99478: ic low-birthweight infant < 1500 gm subsequent
83. 99479: ic low-birthweight infant < 1500-2500 g subsequent
84. 99480: ic infant pbw 2501-5000 g subsequent
85. 99483: assessment and care plan cognitive impairment
Click here to view the full list of services payable under Medicare when provided via telehealth. (Becker’s Hospital Review, March 31)
Stakeholders on Budget Watch After Medicaid Redesign Proposals
As health care providers, insurers and advocates await Gov. Andrew Cuomo’s budget, concerns over Medicaid redesign recommendations may be more heightened than ever.
Though long-term care is slated for the largest number of potential cuts—$715 million—physicians and community health centers are among the groups concerned.
Dr. Art Fougner, president of the Medical Society of the State of New York, said in a statement that, as the Legislature and the governor work to finalize a budget during the Covid-19 pandemic, the society urges them to “reject problematic proposals” advanced by the Medicaid redesign team. insurance for local physicians who incur high liability costs compared to the rest of the country.
“It is imperative to maintain stability as well as patient safety in our health care system as we manage this current crisis and its aftermath,” Fougner said.
Community health centers are also concerned. They say the Medicaid redesign recommendation—valued at $125 million in savings—that would shift the Medicaid pharmacy benefit from managed care to fee for service would result in a loss of 340b rebate revenue to community health centers and hospitals.
As for long-term care providers and advocates, their message has gotten even stronger during the coronavirus outbreak.
Bryan O’Malley, executive director of the Consumer Directed Personal Assistance Association of New York State, told Crain’s he thinks the cuts make even less sense now than they did just weeks ago.
Emergency Adoption of Amendment to 12 NYCRR 355.9 making a COVID-19 Diagnosis a Serious Health Condition
The Chair of NYS Workers Compensation Board announced the the board has adopted, on an emergency basis, an amendment to clarify that employees may take family leave to care for a family member diagnosed with the COVID-19 virus. The amendment is to section 355.9 of Title 12 NYCRR. A Notice of Emergency Adoption will be published in the April 15, 2020 edition of the State Register. This emergency rulemaking is effective for 90 days upon filing March 27, 2020. (March 31, 2020)
Small Business & Non-Profit Relief | Rep. Joseph Morelle
If you are a government contractor, there are a number of ways that Congress has provided relief and protection for your business. Agencies will be able to modify terms and conditions of a contract and to reimburse contractors at a billing rate of up to 40 hours per week of any paid leave, including sick leave. https://morelle.house.gov/coronavirus/smallbusiness
CAIPA Foundation “CAIPA Task Force on COVID-19” Donation and Supplies Drive
CAIPA, CAIPA MSO and CAIPAFoundation greatly appreciate your support and donations during this challenging time.
The Task Force Committee and Leadership sincerely ask for your continued support to this donation drive effort due to the increasing and pressing needs of our frontline healthcare providers. For your information, in the past weeks, we have already delivered protective supplies to our partner hospitals, including NY Presbyterian-Queen, NYU Langone Brooklyn, Maimonides Medical Center, Northwell Health, Stony Brook University Hospital, NYP-Brooklyn Methodist Hospital, The Brooklyn Hospital Center and Interfaith Hospital to help ease the needs of our frontline heroes who are fighting COVID-19 for our communities.
We want to assure you that the monetary donations and protective suppliers received will be put to the best use for our partner hospitals in the communities throughout the city, which we jointly take good care of our patient population. The money and supplies will also be used to support CAIPA’s initiatives in assisting our staff and provider-members in our fight against COVID-19.
CAIPA has dedicated a webpage, “CAIPA Task Force on COVID-19”, on CAIPA.net , where you can see our weekly update, media activities, donation report, educational materials, and resources to keep you, our providers and community posted on the progress and milestones that we achieved so far on this campaign.
FOR MONETARY DONATIONS:
Please kindly make check payable to:
CAIPA FOUNDATION, INC.
202 CANAL ST STE 500
NEW YORK, NY 10013
Or use PAYPAL and pay to email@example.com.
FOR PROTECTIVE SUPPLIES:
Please kindly contact Task Force Project Lead Lisha Xiang at firstname.lastname@example.org, who will make arrangements to be delivered to the following locations:
· Manhattan: 202 Canal St., Suite 500, New York, NY 10013 (entrance on Mulberry St.)
· Brooklyn: 5721 6th Ave., Brooklyn, NY 11220
· Queens: 136-33 37th Ave., Flushing, NY 11354
AMA summary of the CARES Act
Small businesses, including physician practices, with no more than 500 employees are eligible to apply for the Small Business Administration’s (SBA) section 7(a) Payroll Protection Program. The AMA is in the process of developing more in-depth resources for physicians on Medicare advance payments, SBA loans, and medical liability that will be available soon. The attached summary is available online at: https://www.ama-assn.org/system/files/2020-03/summary-H.R.%20748-cares-act.pdf.
Andrew Saul, Commissioner of Social Security, reminds the public that Social Security and Supplemental Security Income (SSI) benefit payments will continue to be paid on time during the COVID-19 pandemic. The agency also reminds everyone to be aware of scammers who try to take advantage of the pandemic to trick people into providing personal information or payment via retail gift cards, wire transfers, internet currency, or by mailing cash, to maintain Social Security benefit payments or receive economic impact payments from the Department of the Treasury.
For more information, please visit https://www.ssa.gov/news/press/releases/.