COVID-19 Update May 26, 2020

CORONAVIRUS COUNT — There were 362,764 confirmed cases in New York as of Monday. (NYSDOH MAP)

Notes from Governor Cuomo’s COVID-19 Briefing TODAY
– Hospitalizations down, net change down, intubations down. New COVID
cases in hospitals down.

Lives lost on May 26th: 73 – 52 in hospitals, 21 in nursing homes

Monitor the Re-openings
– Mid-Hudson Region opens today
– Long Island opens tomorrow
– Regional Control Groups monitor and respond to the numbers
– NYC is not ready to reopen
– Focus on data to get NYC reopened
– Focus on neighborhoods within NYC that are suffering the most

Supercharge Reopening
– Gov believes the economy bounces back differently
– Top end will be fine
– American workers and small businesses will be hurt
– Government can stimulate the economy
– Provides examples
– Hoover Damn
– Lincoln Tunnel
– Overseas Highway
– Have major infrastructure work to do that is long overdue
– Gov will travel to DC tomorrow to meet with President
Financial Situation for State and NYC:
– Asked about legislation allowing NYC to borrow $7 billion and
whether raising taxes on the wealthy was an option
– Reiterates without funding from feds the state will have a financial
– Gov says Borrowing for operating expenses “fiscally questionable”

New York Forward Loan Fund Supports NYS Small Businesses
New York Forward Loan Fund (NYFLF) is a new economic recovery loan program aimed at supporting New York State small businesses, nonprofits and small landlords as they reopen after the COVID-19 outbreak and NYS on PAUSE.

NYFLF targets the state’s small businesses with 20 or fewer full-time equivalent (FTE) employees (90% of all businesses), nonprofits and small landlords that have seen a loss of rental income.

NYFLF is providing working capital loans so that small businesses, nonprofits and small landlords have access to credit as they reopen. These loans are available to small businesses, nonprofits, and small landlords that did not receive a loan from either the U.S. Small Business Administration (SBA) Paycheck Protection Program (PPP) or SBA Economic Injury Disaster Loans (EIDL) for COVID-19 in 2020.  The loans are not forgivable in part or whole.  The loans will need to be paid back over a 5-year term with interest.

The working capital loans are timed to support businesses and organizations as they proceed to reopen and have upfront expenses to comply with guidelines (e.g., inventory, marketing, refitting for new social distancing guidelines) under the New York Forward Plan.


NY1: Why Independent Physician Practices are Devastated by COVID-19 Pandemic

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Trump Administration Announces Changes to Medicare Advantage and Part D to Provide Better Coverage and Increase Access for Medicare Beneficiaries

Final Rule continues to strengthen the popular private Medicare health and drug plans

CMS today finalized requirements that will increase access to telehealth for seniors in Medicare Advantage (MA) plans, expand the types of supplemental benefits available for beneficiaries with an MA plan who have chronic diseases, provide support for more MA options for beneficiaries in rural communities, and expand access to MA for patients with End Stage Renal Disease (ESRD). Together, the changes advance President Trump’s Executive Orders on Protecting and Improving Medicare for Our Nation’s Seniors and Advancing American Kidney Health as well as several of the CMS strategic initiatives.

Due to the upcoming June 1, 2020, MA and Part D bid deadlines for the 2021 plan year, CMS is finalizing a subset of the proposed policies before the MA and Part D plans’ bids are due. CMS plans to address the remaining proposals for plans later in 2020 for the 2022 plan year.

We understand that the entire healthcare sector is focused on caring for patients and providing coverage related to coronavirus disease 2019 (COVID-19), and we believe this approach provides plans with adequate time and information to design the best coverage for Medicare beneficiaries.

“CMS’s rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home,” said CMS Administrator Seema Verma. “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”

Building on actions that the Trump Administration has taken to expand access to telehealth so beneficiaries can get care at home instead of traveling to a healthcare facility, today’s rule encourages MA plans to increase their telehealth benefits and increase plan options for beneficiaries living in rural areas.

CMS is giving MA plans more flexibility to count telehealth providers in certain specialty areas (such as Dermatology, Psychiatry, Cardiology, Ophthalmology, Nephrology, Primary Care, Gynecology, Endocrinology, and Infectious Diseases) towards meeting CMS network adequacy standards. This flexibility will encourage plans to enhance their benefits to give beneficiaries access to the latest telehealth technologies and increase plan choices for beneficiaries residing in rural areas.

Today’s rule gives beneficiaries with ESRD more coverage choices in the Medicare program. Previously, beneficiaries with ESRD were only allowed to enroll in MA plans in limited circumstances. The rule implements the changes made by the 21st Century Cures Act to give all beneficiaries with ESRD the option to enroll in an MA plan starting in 2021. This will give beneficiaries with ESRD access to more affordable Medicare coverage options that may include extra benefits such as health and wellness programs, transportation, or home-delivered meals that are not available in Medicare Fee-For-Service.

CMS is also finalizing proposals to enhance the MA and Part D Star Ratings system to further increase the impact that patient experience and access measures have on a plan’s overall Star Rating. The Star Ratings system helps people with Medicare, their families, and their caregivers compare the quality of health and drug plans being offered.

One of the best indicators of a plan’s quality is how its enrollees feel about their coverage experience. This decision reflects CMS’s commitment to put patients first and improves incentives for plans to focus on what patients value and feel is important. Additionally, CMS adopted a series of changes in the March 31, 2020, Interim Final Rule with Comment Period (CMS-1744-IFC) for the 2021 and 2022 Star Ratings to accommodate challenges arising from the COVID-19 public health emergency.

For a fact sheet on the Contract Year 2021 Medicare Advantage and Part D Final Rule (CMS-4190-F1), please click here.

The final rule can be downloaded from the Federal Register here.

About 35 Percent of COVID-19 Patients Do Not Show Symptoms, the CDC Estimates
In a new guidance that outlines five pandemic planning scenarios, according to CNN. The scenarios are designed to inform decisions by mathematical modelers and public health officials.

In its “best estimate” the CDC states 40 percent of coronavirus transmission is happening before people start to feel sick, and 0.4 percent of those who contract COVID-19 and show symptoms will die. (Becker’s Hospital Report)

Flu, Pneumonia, COVID-19 Deaths Drop and other CDC Updates
Deaths attributed to pneumonia, influenza or COVID-19 dropped by about 6 percentage points for the week ending May 16 compared to the week prior, but were still high compared to previous flu seasons, according to the CDC’s weekly COVID View report.

Four things to know:

  1. The percentage of respiratory specimens testing positive for the new coronavirus decreased at public, commercial and clinical laboratories for the week ending May 16. Public labs reported the biggest drop — from 10.7 percent during the week ending May 9 to 8.5 percent during the week ending May 16.
  2. About 12 percent of deaths across the country were attributed to pneumonia, flu or COVID-19 in the week ending May 16, down from 18.5 percent the week before. The percentage remains high compared with any flu season before the pandemic and may change as additional death certificates are processed, the CDC said.
  3. The cumulative COVID-19-associated hospitalization rate for all age groups is 67.9 hospitalizations per 100,000 population, with the highest rates in people ages 65 years and older (214.4 hospitalizations per 100,000 population).
  4. Visits to outpatient providers and emergency departments for symptoms linked to COVID-19 continue to decline, and outpatient visit for flu-like illness was 1.1 percent the week ending May 16, below the national baseline of 2.4 percent. (CDC)

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Gilead Releases Full Results of Remdesivir Trial
Remdesivir quickened the recovery time for COVID-19 patients but did little to benefit patients on ventilators, according to study results from Gilead’s clinical trial of the drug, the first given emergency approval to treat COVID-19, STAT reports.

The full data from Gilead’s clinical trial, being run by the National Institute of Allergy and Infectious Diseases, was released May 22 in the New England Journal of Medicine

The trial included 1,063 patients, with 538 receiving remdesivir and 521 being given a placebo. The patients given remdesivir recovered in a median of 11 days, compared to 15 days for the placebo group, STAT reported. Mortality in the remdesivir group was 7.1 percent, compared to 11.9 percent for the placebo group, slightly better than previous results.

“It’s a very safe and effective drug,” Eric Topol, MD, founder, and director of the Scripps Research Translational Institute, told STAT. “We now have a definite first efficacious drug for COVID-19, which is a major step forward and will be built upon with other drugs [and drug] combinations.”

There was no sign of benefit for patients who began taking remdesivir while on ventilators or who were receiving extracorporeal membrane oxygenation, a treatment in which oxygen is added to the blood outside the body, according to STAT. Knowing which patients benefit from remdesivir the most could be important for deciding who gets the drug, as it has been in short supplySTAT reports. In the full study results, the benefit of remdesivir appeared to be much larger for patients who were less sick.

The study was stopped after a data safety and monitoring board told NIAID that there was a statistically significant benefit of remdesivir, and critics have said the study should have continued to better discern if remdesivir reduces the death rate, STAT reports. (May 26)

Survey: Consumers Still Feel Comfortable Picking Up Scripts at Pharmacies
The pandemic has not significantly shaped Americans’ feelings about in-person pharmacy visits, according to survey responses released May 21 by the Alliance of Community Health Plans.

The survey, which involved 1,263 adults from ages 18 to 74, found that 41 percent of respondents had delayed nonemergency healthcare appointments and 42 percent felt uncomfortable visiting the hospital for treatment.

However, the survey also revealed the following insights about respondents’ attitudes toward pharmacies during the pandemic:

  • Forty-nine percent reported feeling “very comfortable” picking up prescriptions at their pharmacy and speaking with their pharmacists.
  • Forty-seven percent received a new prescription in the last 90 days.
  • Ninety percent of respondents who received a new prescription in the last 90 days did so at a local retail pharmacy.
  • Thirty-nine percent of respondents reported feeling comfortable undergoing COVID-19 testing at a pharmacy.
  • Twenty-four percent used a mail-order pharmacy service in the last 90 days.
  • Nine percent used their local pharmacy’s home delivery service in the last 90 days.