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COVID-19 regulatory updates — June 5

By AOA Staff


COVID-19 regulatory updates for this week are provided below.

This was a busy week, with new information coming out on CMS value-based payment models, modifier usage and lab reporting for COVID-19, along with new CDC guidance for clinicians, and additional funding for health care entities.

New laboratory data reporting guidance for COVID-19 testing

The Department of Health and Human Services (HHS) announced new guidance and frequently asked question (FAQs) that specifies what additional data must be reported to HHS by laboratories along with COVID-19 test results. Laboratories are required to report to state and local public health authorities in accordance with applicable state or local law. The new reporting requirements will provide information needed to better monitor disease incidence and trends by initiating epidemiological case investigations, assisting with contact tracing, assessing availability and use of testing resources, and anticipating potential supply chain issues.

When to use CR Modifier and DR Condition Code for COVID-19

The Centers for Medicare & Medicaid Services (CMS) revised the Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) to clarify when to use the “CR” modifier (catastrophe/disaster related) and the “DR” condition code (disaster related) when submitting claims to Medicare. The update includes a chart of blanket waivers and flexibilities that require the modifier or condition code.

New CMS Innovation Center COVID-19 flexibilities

In response to the COVID-19 public health emergency (PHE), CMS is providing new flexibilities and adjustments for current and future Innovation Center value-based payment models, including Medicare Track 1+ and Next Generation accountable care organizations (ACOs), the Primary Care First Serious Illness Component, and the Oncology Care Model. The new changes are outlined in a table focusing on model adjustments related to financial methodologies, quality reporting, and model timelines.

Impact of COVID-19 on emergency department visits

The Centers for Disease Control and Prevention (CDC) released a new study on the impact of the COVID-19 pandemic in emergency department visits, showing a 42% decline during the early COVID-19 pandemic from of 2.1 million per week (March 31–April 27, 2019) to 1.2 million (March 29–April 25, 2020) per week, with the steepest decreases in persons aged ≤14 years, females, and the Northeast.

New CDC clinical care guidance

The CDC updated the interim guidance for clinicians caring for patients with confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). The guidance includes clinical presentation, clinical course, laboratory and radiographic findings, discontinuation of transmission-based precautions or home isolation and additional resources.

Health care systems receive additional funding to respond to COVID-19

The HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) is providing an additional $250 million authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act to aid health care systems treating patients and responding to the COVID-19 pandemic. The funds will support hospitals and other health care entities to train workforces, expand telemedicine and the use of virtual healthcare, procure supplies and equipment, and coordinate effectively across regional, state and jurisdictional, and local health care facilities to respond to COVID-19.

Addiction workforce expanded in underserved communities

HHS awarded $20.3 million to expand the addiction workforce in underserved communities through HRSA. This money was awarded to 44 recipients throughout the U.S. to increase the number of fellows at accredited addiction medicine and addiction psychiatry fellowship programs. The awardees will train addiction specialists at facilities in high need communities that integrate behavioral and primary care services. This new funding addresses a serious need that could be exacerbated by the COVID-19 pandemic.

New nursing home enforcement actions

CMS announced new enforcement measures for nursing homes with violations of longstanding infection control practices. The enhanced enforcement actions include increasing penalties for facilities with persistent infection control violations, and imposing enforcement actions on lower level infection control deficiencies to ensure they are addressed with increased gravity. CMS also posted state-by-state data COVID-19 nursing home cases and deaths for residents and staff. This information is based on new data collected by CDC’s National Healthcare Safety Network and shows survey collection information across states.