COVID-19 Update April 9, 2020

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April 9, 2020 Latest COVID-19 Statistics

Notes from the Governor’s briefing:

• 18 days of NY PAUSE / 39 days since first COVID case in NY / 80 days
since first COVID case in US
• Current trend is below all projected models: 90,000 bed capacity,
18,279 beds occupied, currently.
• Numbers showing that the social distancing measures are flattening the
curve, so far.
• Hospitalizations, ICU admissions and intubations is continuing to
decrease.
• “We are flattening the curve by our efforts and actions.”
• 799 lives lost yesterday, according to state. Media reports that NYC
issued 824 as the total numbers for NYC-only deaths yesterday.
• State total, according to state is 7,067 deaths.
• State bringing in additional funeral directors to help.
• State plans to open more testing sites in downstate minority
communities (SUNY Albany, DOH and Northwell collaborative effort).
• Governor on past Federal legislation:
– Not $6B in Medicaid funding, actual about $1.3B, and disqualified
about 1.3 of NYS Medicaid recipients.
• Mental Health is a growing problem (domestic violence cases rising)
• State watching Rockland, Nassau, and Suffolk as new hotspots.

Racial Disparities in Deaths from COVID-19
Gov. Cuomo on Wednesday vowed to ramp up coronavirus testing in minority communities and investigate the racial disparities in deaths from COVID-19, the disease caused by the virus. He noted that black New Yorkers comprise 28 percent of deaths in New York City and 18 percent of deaths in New York state, despite being 22 percent and 9 percent of the population, respectively.

Hispanics, meanwhile, are 29 percent of the population in New York City and 11 percent of the population statewide, but represent 34 percent and 14 percent of deaths, respectively.

Experts have pointed to underlying conditions that are more likely to affect minority communities and lack of access to medical care has factors which account for the differences. Cuomo vowed to step up testing in majority-nonwhite communities, adding that there should also be more research into whether the number of Latino and African American public workers “who don’t have a choice but to go out every day and drive the train” were putting those communities at particular risk.

Cuomo said he would ask Havidan Rodriguez, president of the University of Albany SUNY, to head an effort to collect more comprehensive data on the spread of the virus in minority communities.

CMS OKs $34B for Providers with Accelerated/Advance Payment Program in One Week
CMS has delivered near $34 billion in the past week to the healthcare providers on the frontlines battling the 2019 Novel Coronavirus (COVID-19). The funds have been provided through the expansion of the Accelerated and Advance Payment Program to ensure providers and suppliers have the resources needed to combat the pandemic.

The streamlined process implemented by CMS for COVID-19 has reduced processing times for a request of an accelerated or advance payment to between four to six days, down from the previous timeframe of three to four weeks.  In a little over a week, CMS has received over 25,000 requests from health care providers and suppliers for accelerated and advance payments and have already approved over 17,000 of those requests in the last week.

The payments are available to Part A providers, including hospitals, and Part B suppliers, including doctors, non-physician practitioners and durable medical equipment (DME) suppliers. While most of these providers and suppliers can receive three months of their Medicare reimbursements, certain providers can receive up to six months.

The advance and accelerated payments are a loan that providers must pay back. CMS will begin to apply claims payments to offset the accelerated/advance payments 120 days after disbursement. Part A providers and Part B suppliers will have up to 210 days to complete repayment of accelerated and advance payments, respectively.

It is important to note, this funding is separate from the $100 billion provided in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act appropriation is a payment that does not need to be repaid. The Department of Health and Human Services (HHS) will be providing additional information on how healthcare providers and suppliers can access CARES Act funds in the coming weeks.

The fact sheet on the accelerated/advance payment process and how to submit a request can be found here: Fact Sheet Providers can also contact their Medicare Administrative Contractor for any questions.

UnitedHealth Group Accelerates Nearly $2 Billion in Payments and Support to Health Care Providers to Help with COVID-19 Financial Challenges
UnitedHealth Group, through UnitedHealthcare and Optum, has announced it is taking steps immediately to accelerate payments and other financial support to health care providers in the U.S. to help address the short-term financial pressure caused by the COVID-19 emergency.

UnitedHealth Group’s move to accelerate claim payments to medical and behavioral care providers applies to UnitedHealthcare’s fully insured commercial, Medicare Advantage and Medicaid businesses. Other financial support currently includes the provision for up to $125 million in small business loans to clinical operators with whom OptumHealth is partnered.

The decision to accelerate claims and incentive payments builds on previously adopted measures taken by the company to streamline processes for health care professionals and facilities, as well as to help members more easily access the care they need. This includes:

·       Suspension of prior authorization requirements to a post-acute care setting

·       Suspension of prior authorization requirements when a member transfers to a new provider

·       Extension of timely filing deadlines for claims during the COVID-19 public health emergency period for Medicare Advantage, Medicaid, and Individual and Group Market health plans

·       Implementation of provisional credentialing to make it easier for out-of-network care providers who are licensed independent practitioners to participate in one or more of our networks

Physicians should go to www.UHCprovider.com for specifics on UnitedHealthcare policies and guidelines.

Communities of Color at Higher Risk for Health and Economic Challenges Due to COVID-19
The COVID-19 outbreak presents potential health and financial challenges for families, which may disproportionately affect communities of color and compound underlying health and economic disparities. A new KFF brief analyzes data on underlying health conditions, health coverage and health care access, and social and economic factors by race and ethnicity to provide insight into how the health and financial impacts of COVID-19 may vary across racial/ethnic groups. (KFF news release)

Nursing Homes Have Ventilators That Hospitals Desperately Need
As the number of COVID-19 patients climbs and health officials hunt for ventilators to treat them, nursing homes across the  U.S. have a cache ― about 8,200 of the lifesaving machines, according to data from CMS. Most of the machines are in use, often by people who’ve suffered a brain injury or stroke. Some of those residents are in a vegetative state and have remained on a ventilator for years. State officials are working to consolidate ventilators where they are most urgently needed. But so far, the supply in nursing homes has not drawn the same attention. (KHN, Los Angeles Times)

Less than 2% of COVID-19 Cases Involve Children
Less than 2% of U.S. COVID-19 coronavirus cases have been in children, with infants more likely to be hospitalized than older children, researchers found. From February 12 to April 2, individuals under age 18 accounted for 1.7% of the nearly 150,000 overall U.S. COVID-19 cases with data on age — far fewer than might be expected from their representation in the population as a whole (24%), reported Lucy McNamara, PhD, of the CDC’s COVID-19 Response Team, and colleagues in an early Morbidity and Mortality Weekly Report release.

The findings are similar to data from China, which indicated more severe COVID-19 cases, or those requiring hospitalization, tended to be in younger children, and prevalence decreased as children got older.

Of the pediatric cases, over half were from New York, 15% from New Jersey, and just under 30% from other jurisdictions. They added the first pediatric U.S. case was reported to CDC on March 2. Median age of patients was 11, and nearly a third of cases occurred in teens ages 15-17, with 27% of cases among children ages 10-14, and 15% apiece among children ages 5 to 9, and infants younger than age 1.

Data on hospitalizations was available for 745 pediatric cases, with the authors estimating a range of 5.7% to 20% of cases were hospitalized, with an estimated range of 0.58% to 2% admitted to an ICU. These figures were lower than adults ages 18-64, who had an estimated 10%-33% of patients hospitalized.

Infants accounted for the largest proportion of hospitalized children, ranging from 15% to 62% of pediatric COVID-19 admissions. Of 95 children younger than age 1, 59 were hospitalized and 5 were admitted to an ICU. Children ages 1-17 had a lower estimated range of hospitalization, from 4.1%-14%.

They added, clinicians should “maintain a high degree of suspicion” for infection in children and monitor the progression of illness, especially among those with underlying conditions.

“Because persons with asymptomatic and mild disease, including children, are likely playing a role in transmission and spread of COVID-19 in the community, social distancing and everyday preventive behaviors are recommended for persons of all ages to slow the spread of the virus,” McNamara and colleagues wrote. Morbidity and Mortality Weekly Report Source Reference: CDC COVID-19 Response Team “Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020″ MMWR 2020; Published April 6, 2020.