CMS End of PHE Roadmap

CMS Prepares Providers and Suppliers for the End of the Public Health Emergency:

CMS Issues Updates on the End of Emergency Waivers and Flexibilities Issued during the PHE

By Kathy Lester, J.D., M.P.H.

 

Even though it appears that the Biden-Harris Administration will extend the COVID-19 Public Health Emergency (PHE) for at least another 90 days, CMS has begun the process of preparing for the termination of waivers and flexibilities that have been in effect during the pandemic.  During the PHE, the American Ambulance Association has worked closely with CMS and Congress to make sure that ground ambulance services were prioritized and provided with waivers and flexibilities to support their integral role as a front-line medical response during the pandemic.

 

CMS announced its roadmap for the end of the PHE on August 18.  The roadmap includes a summary of the policies that will terminate at the end of the PHE, but also notes that CMS intends to keep some policies in place even after the PHE ends. Examples of policies that will continue after the PHE is allowed to expire include certain morbidity and mortality reporting requirements on long-term care facilities and certain telehealth services expanded by Congress.

 

In its announcement, CMS indicated particular concern about patient safety.  “As mentioned by Lee A. Fleisher, M.D.; Michelle Schreiber, M.D.; Denise Cardo, M.D.; and Arjun Srinivasan, M.D., in February 17, 2022, New England Journal of Medicine Perspective, ‘Safety has also worsened for patients receiving post-acute care, according to data submitted to the Centers for Medicare and Medicaid Services (CMS) Quality Reporting Programs…’”

 

As part of this announcement, CMS released a fact sheet detailing the current status of the Medicare waivers and flexibilities for ambulance providers and suppliers.  Some of the policies highlighted in this fact sheet include:

 

  • Vaccine Reimbursement Rates: CMS will continue to pay approximately $40 per dose for administering COVID-19 vaccines in outpatient settings for Medicare beneficiaries through the end of the calendar year that the COVID-19 PHE ends.  Effective January 1 of the year following the year that the COVID-19 PHE ends, CMS will set the payment rate for administering COVID-19 vaccines to align with the payment rate for administering other Part B preventive vaccines.  CMS plans to continue to pay a total payment of approximately $75 per dose to administer COVID-19 vaccines in the home for certain Medicare patients through the end of the calendar year that the COVID-19 PHE ends.

 

  • Alternative Destination: CMS indicates that it will include this issue in future rulemaking.

 

  • Treat in Place: CMS indicates that the waiver will end with the end of the PHE.

 

  • Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization: CMS notes that it has already returned to the full model operations including post-payment reviews of claims submitted during the PHE.

 

  • Signature Requirements: Absent indications of potential fraud and abuse, CMS will not review claims for dates of service during the COVID-19 PHE for compliance with the signature requirements.

 

  • Appeal Flexibilities: CMS will allow some of the flexibilities related to the timing of appears to continue consistent with existing authority for appeals once the PHE ends.

 

The AAA will continue to monitor the PHE and any changes in the waivers and flexibilities specific to ground ambulance services.  We encourage members to reach out to our team if concerns or questions arise as CMS winds down the PHE.

EMS.Gov | Know the Signs of Monkeypox

EMS News

Recognize Monkeypox
In Prehospital Settings

EMS and healthcare clinicians should know the signs of Monkeypox

The National Emerging Special Pathogens Training and Education Center (NETEC) is providing updates about the recently evolving situation regarding the spread of Monkeypox, a rare but potentially serious viral disease. Monkeypox has emerged in countries in which it is not normally found, including the United States. To ensure early detection and isolation of the infected, EMS/prehospital and hospital clinicians should be on alert for signs of the disease.

Monkeypox can spread between humans via contact with skin lesions and infected respiratory droplets. It is important to recognize and report cases of the disease to the local public health department for surveillance purposes.

Visit the link above or review these EMS strategies for preventing the spread of monkeypox:

If you suspect a case of Monkeypox, contact your state health department for possible initiation of special pathogen transport protocols.

More Information

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us

1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

HRSA eNews | Expanding Health Care Access and Resources in Underserved Populations,

HRSA eNews March 3, 2022

March 3, 2022

Administrator Carole Johnson on HRSA’s Commitment to President Biden’s National Mental Health Strategy

douglas-emhoff-carole-johnson-nationwide-childrens-hospitalIn his State of the Union address, President Biden announced an ambitious strategy to address our national mental health crisis. At the Health Resources and Services Administration, we stand with the President in his call for unity in our national response and know that for the millions of Americans living with a mental health condition or caring for a loved one with a mental health condition, the time for action is now.

Yesterday, Administrator Johnson and HRSA Chief of Staff Jordan Grossman joined the Second Gentleman Mr. Emhoff and Assistant Secretary for Health Admiral Levine in Columbus, Ohio, to visit HRSA grantees addressing youth mental health care needs and providing mental health supports for the health care workforce.

Read Administrator Johnson’s full statement on the President’s National Mental Health Strategy.


HRSA Works to Expand Health Care Access and Resources in Underserved Populations

physicianIn February, HRSA announced the winners of the Promoting Pediatric Primary Prevention Challenge, $66.5 million to support community-based vaccine outreach efforts, more than $560 million in pandemic relief payments to health care providers, funding to increase virtual care quality and access, and new funding to support primary care residency programs.

Read our announcements.


HHS Distributing $560 Million in Provider Relief Fund Payments to Health Care Providers Affected by the COVID-19 Pandemic

Clipart of health professionalsWith this funding, nearly $19 billion will have been distributed from the Provider Relief Fund and the American Rescue Plan Rural provider funding since November 2021 

February 24 – The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4,100 providers across the country this week.

“Provider Relief Funds have been living up to its name, providing much-needed relief to our nation’s health care providers,” said Health and Human Services Secretary Xavier Becerra. “From expanding life-saving services to tackling workforce challenges, these funds will continue to help weather the pandemic’s continued impact. The Biden-Harris Administration remain committed to ensuring our providers with the necessary support and tools to keep our families safer and healthier.”

Read the press release.


National Health Service Corps: 50 Years of Commitment, Compassion and Community

nhsc anniversary social media cardOur National Health Service Corps (NHSC) is gearing up to celebrate its 50th anniversary, and you’re invited to join in. Established with the Emergency Health Personnel Act of 1970, the NHSC placed its first clinicians – which included physicians, dentists and nurses – in 20 communities in 13 states. Learn how you can engage with, promote, and celebrate this historic milestone with our largest class of participants yet!


New Report on Children’s Mental Health Features Key Data from National Survey of Children’s Health

children lined upnew report featuring data from HRSA’s 2016-2019 National Survey of Children’s Health, shows that children’s mental health was a substantial public health concern even before the COVID-19 pandemic started.

This report is an update to one first published in 2013 in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. The 2013 report was the first ever cross-agency children’s mental health surveillance report, and includes input from HRSA, the Substance Abuse and Mental Health Services Administration and the National Institute of Mental Health. HRSA’s Reem Ghandour and Jesse Lichstein are co-authors.

The current report found that attention-deficit/hyperactivity disorder and anxiety among children of all ages, and symptoms related to depression among adolescents, are the most common concerns. It also features data on behavioral problems, autism, Tourette syndrome, as well as treatment received and signs that children are doing well. The report concludes that we need further research on positive indicators of mental health such as emotional well-being and resilience to provide the fullest picture of children’s mental health.


Climate Change and Health: The Risks to Community Health and Health Care Utilization

climate change Climate change influences human health and diseases in numerous ways. Underserved communities stand to bear the brunt of these climate-induced risks (e.g., extreme heat, poor air quality, flooding, extreme weather events). HRSA and CDC’s Climate and Health Program invite you to consider the impacts of climate change on the U.S. health care system. CDC will share its work to build resilience to these public health effects.

Webinar Date: Thursday, March 17, 1-2 p.m. ET. 

Register.


Patient Safety Awareness Week Event: Harnessing Individual Power to Effect Positive Change

webcast iconPatient Safety Awareness Week is March 13-19. We are hosting an event in partnership with the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS), the Food and Drug Administration (FDA), the Indian Health Service (IHS), and the National Institutes of Health (NIH).

Amelia Brooks from Safe and Reliable Healthcare will provide strategies that health care organizations can implement immediately to improve the safety culture in their organizations. She will share:

  • How to focus on safety in the context of global health and staffing crises
  • How to reduce burdens on frontline providers
  • Implementing practical strategies to support staff

There will also be a virtual exhibit hall at the end of the session.

Webinar Date: Thursday, March 17, 2-3:30 p.m. ET. 

Register.


States Take Action to Address Children’s Mental Health in Schools

teens against locker in schoolChildren’s mental health continues to be a top priority for state leaders across both legislative and executive branches of state government. With COVID-19 exacerbating the challenges children are facing, there is much more work to be done.

This National Academy for State Health Policy (NASHP) blog post summarizes the actions many states have taken from March 2020 through December 2021 to support school mental health systems, while many more states continue to consider legislation during the 2022 session.

HRSA’s National Organizations of State and Local Officials Cooperative Agreement provided support for this blog post.


image of a calendar

March

  • National Colorectal Cancer Awareness Month
  • National Poison Prevention Week (20-26)
  • National Women and Girls HIV/AIDS Awareness Day (10)
  • National Native American HIV/AIDS Awareness Day (20)
  • National Drug and Alcohol Facts Week (21-27)

Funding Opportunities

 

Health Workforce


Dental Faculty Loan Repayment Program – apply by March 22

Teaching Health Center Graduate Medical Education (THCGME) Program – apply by March 31

Area Health Education Centers Program – apply by April 6

State Loan Repayment Program (SLRP) – apply by April 8

Health Workforce Research Center Cooperative Agreement Program – apply by April 14

HIV/AIDS Bureau


Ryan White HIV/AIDS Program Part F Dental Reimbursement Program – apply by March 11

Ryan White HIV/AIDS Program Part D Coordinated HIV Services and Access to Research for Women, Infants, Children, and Youth (WICY) Limited Existing Geographic Service Areas – apply by March 31

Telehealth Strategies to Maximize HIV Care – apply by April 8

Ryan White HIV/AIDS Program Part B States/Territories Supplemental Grant Program – apply by May 9

Maternal and Child Health


Enhancing Systems of Care for Children with Medical Complexity (Coordinating Center) – apply by March 7

Enhancing Systems of Care for Children with Medical Complexity (Demonstration Projects) – apply by March 7

Maternal and Child Environmental Health Network (MCEHN) – apply by March 28

MCH Adolescent and Young Adult Health Research Network (AYAH-RN) – apply by March 29

Children and Youth with Special Health Care Needs Research Network – apply by April 4

Autism Single Investigator Innovation Program (Autism-SIIP) – Autism Transitions Research Project (ATRP) – apply by April 4

Autism Single Investigator Innovation Program (Autism-SIIP) – Autism Longitudinal Data Project (ALDP) – apply by April 4

American Rescue Plan Act – Pediatric Mental Health Care Access – New Area Expansion – apply by April 5

Home Visiting Collaborative Improvement and Innovation Network 3.0 (HV CoIIN 3.0) – apply by April 6

Autism CARES Act National Interdisciplinary Training Resource Center – apply by April 7

Catalyst for Infant Health Equity – apply by April 19

Infant-Toddler Court Program – National Resource Center – apply by May 4

Infant-Toddler Court Program – State Awards – apply by May 4

Early Childhood Developmental Health Systems: Evidence to Impact – apply by May 10

Federal Office of Rural Health Policy


Medicare Rural Hospital Flexibility Program- Emergency Medical Services Competing Supplement – apply by March 4

Rural Health and Economic Development Analysis – apply by March 8

Rural Communities Opioid Response Program-Behavioral Health Care Technical Assistance – apply by March 9

Rural Public Health Workforce Training Network Program – apply by March 18

Small Health Care Provider Quality Improvement Program – apply by March 21

Rural Maternity and Obstetrics Management Strategies Program – apply by April 5

Rural Communities Opioid Response Program – Behavioral Health Care Support – apply by April 19


View All Funding Opportunities

NAEMT | Quick Survey on EMS Utilization of COVID-19 Waivers

EMS Utilization of COVID-19 Waiver Survey

TAKE SURVEY
Please help our industry understand how EMS has utilized the current COVID-19 waivers. The results of this survey will be used to educate federal regulators and elected officials on EMS reimbursement reform. The survey will take no longer than five (5) minutes to complete and will ask how your ambulance agency has utilized the waivers throughout the COVID-19 pandemic.

 

During the ongoing Public Health Emergency (PHE), CMS issued four waivers to assist ambulance agencies. Separate from the CMS ET3 project, these waivers allowed for reimbursement for transporting to alternate destination of care, treatment in lieu of transport, hospital at home utilizing community paramedics, and telehealth facilitation.

 

We kindly ask that ONE leader from your agency take the survey before March 14. No identifiable information will be shared or distributed. NAEMT will share the results of the survey with its members and participants.

Thank you for taking time to participate in this survey to advance EMS!

TAKE SURVEY

CMS Releases Medicare COVID-19 Vaccine Data Analysis and PUF

From CMS on August 25, 2021

Today, the Centers for Medicare & Medicaid Services (CMS) released two new resources with information on Medicare beneficiaries on whose behalf at least one fee-for-service (FFS) claim for the administration of the COVID-19 vaccine has been submitted to the Medicare program.

First, we released a paper titled Assessing the Completeness of Medicare Claims Data for Measuring COVID-19 Vaccine Administration. This paper presents preliminary findings on the count of individuals ages 65 and older with at least one COVID-19 vaccine administration claim in the Medicare data compared to the count of people 65+ with at least one COVID-19 vaccine dose in the data reported by the Centers for Disease Control and Prevention (CDC). Using data as of June 4th, 2021, we estimate that CMS received a claim for COVID-19 vaccine administration for roughly half of Medicare beneficiaries who have received at least one COVID-19 vaccine dose as compared to the estimated counts based on adjusted CDC figures (17.5 million out of 36.6 million). As a result, we recommend that the public apply significant caution when analyzing COVID-19 vaccine administration trends using Medicare claims data.

Second, we released the Medicare COVID-19 Vaccine Public Use File (PUF) which presents a high-level and preliminary overview of Medicare utilization and spending information from Medicare FFS claims for the administration of the COVID-19 vaccine. The PUF shows that between December 11, 2020 and June 30, 2021, Medicare payments for administration of the COVID-19 vaccine were over $1.1 billion.  The PUF is based on Medicare FFS claims CMS received by August 6, 2021.

[Note: The Medicare FFS program is paying for COVID-19 vaccine administration on behalf of MA beneficiaries as well as for FFS beneficiaries receiving COVID-19 vaccinations in 2020 and 2021.]

Read Now

EMS.gov | Information About COVID-19 for EMS Systems and Clinicians

From EMS.gov

Resources include guidance documents, links to the latest from the CDC, and information about vaccine safety and administration

With cases of COVID-19 surging again across the country, EMS clinicians and leaders may once again be responding to increased numbers of PUIs, have questions about handling exposures, and be looking for information about coronavirus vaccines.

The EMS.gov COVID-19 Resources for EMS page continues to provide a number of helpful tools, on topics ranging from crisis standards of care to first responder mental health. The source of each resource is clearly identified, including documents created by the Federal Healthcare Resilience Working Group EMS/Prehospital Team.

The NHTSA Office of EMS once again would like to thank EMS clinicians and our public safety and healthcare colleagues across the country for your dedicated service. What you do is vital to our communities and our nation. We urge you to take steps to ensure the health and safety of you, your patients and your families and protect yourself from COVID-19, stress, and other dangers.

Please contact nhtsa.ems@dot.gov with questions or comments.

Letter to Senate HELP Committee Leadership on Provider-Type Equity

The Honorable Patty Murray
Chair, United States Senate Committee on Health, Education, Labor and Pensions

The Honorable Richard Burr
Ranking Member
United States Senate Committee on Health, Education, Labor and Pensions

Dear Chairwoman Murray and Ranking Member Burr:

The American Ambulance Association (AAA) appreciates the opportunity to provide suggestions for bipartisan legislation to improve medical preparedness and response programs. The AAA is the primary association for ground ambulance service suppliers/providers, including governmental entities, volunteer services, private for-profit, private not-for-profit, and hospital-based ambulance services. Our members provide emergency and non-emergency medical transportation services to more than 75 percent of the U.S. population. AAA members serve patients in all 50 states and provide services in urban, rural, and super-rural areas. As the National Highway Transportation Safety Administration identified in its 2013 report on emergency services, EMS-only systems – such as our members – provide the vast majority of emergency ambulance services throughout America.

Our members are often the first health care teams to encounter patients who are sick and/or suspect they might have COVID-19. In addition to responding to 911 emergencies and transporting patients to appropriate destinations, they are also being asked to provide health care services within their existing State-defined scope of practice without transporting patients to help reduce hospital surge, as well as to protect high-risk patients from potential exposure to COVID-19. State and Local governments and public health authorities are also enlisting ground ambulance organizations to assist with testing suspected COVID-19 patients. In addition, ground ambulances provide important medical transitional care for patients moving between facilities in both emergency and non-emergency situations.

During this pandemic, our members have experienced first-hand the gaps in the public health infrastructure and the medical preparedness and response systems and programs. One of the most frustrating aspects of the current system has been the lack of recognition and support for communities that contract with non-governmental ground ambulance providers/suppliers in everything from federal grant programs to the distribution of personal protective equipment for EMTs and paramedics.

Many of the federal grant programs triggered during the pandemic have fallen short of their promise because the statutes and regulations governing them do not recognize non-governmental ground ambulance providers/suppliers as eligible entities. This distinction remains confusing because in other areas of health care, federal grant programs are accessible by private, for-profit health care providers and suppliers.

Outdated statutes and regulations often assume that first responders are governmental or not-for-profit entities and ignore the decisions of State and Local governments to contract with private ground ambulance providers/suppliers to provide 911 or equivalent services. As others have recognized, “State and Local officials know what works best in their communities – what works best in New York City may be much different than what works in rural Tennessee.”1 The federal government should respect these local decisions and support all first responders.

An example of this problem arose early during the COVID-19 pandemic. The FEMA public assistance grant program reimburses first responders for PPE and other expenses related to the response to COVID-19. When public and private non-profit emergency ambulance providers/suppliers sought direct reimbursement under the program, they were turned away. Private emergency ambulance providers/suppliers were required to have a State or Local government agency apply on their behalf. As State and Local governments responded to the public health emergency, it was understandably difficult for them to allocate resources to work through the application process on behalf of their contractors.

This differential treatment impacts communities across the United States, including those in Arkansas, California, Colorado, Florida, Georgia, Indiana, Louisiana, Massachusetts, Mississippi, Nevada, New York, Oregon, Texas, and Wisconsin, among others.

In contrast to statutes like the one government FEMA allocations, the Homeland Security Act of 2002 (6 U.S.C. § 101) includes language that recognizes the decision of State and Local governments to contract with private not-for-profit and for-profit ground ambulance providers/suppliers within the definition of “emergency response providers.”

The AAA urges the Congress to adopt the Homeland Security Act definition of “emergency response providers” throughout the U.S. Code as applicable. Such language will help to make sure that when funding is available to help State and Local governments prepare and respond, the allocation mechanisms governing the funding permit all types of first responders, including non-governmental ground ambulance providers/suppliers, to access the dollars quickly and with minimal burden.

Recommendation

The Committee should carefully review federal public health programs and revise them as necessary to ensure that the funds may be used to support both non-governmental and governmental ground ambulance providers/suppliers to ensure that all communities, regardless of their individual decisions related to the entities operating their EMS systems, have federal funds to support their response efforts during public health emergencies.

On behalf of the AAA, I want to thank you for your ongoing support of EMS and ground ambulance providers/suppliers, as well as the leadership demonstrated by your work to prepare for the next pandemic. Over the years, the Congress has consistently recognized the vital and unique role that ground ambulance providers/suppliers play in protecting their communities and providing mobile health care services. In light of the lessons learned during this pandemic, we encourage you and your colleagues to revise antiquated language that no longer represents the innovations and progress that have led to State and Local governments to rely upon ground ambulance providers/suppliers, including non-governmental organizations.

The AAA and its volunteer leaders would welcome the chance to discuss this recommendation. We would also be pleased to participate in any fact-finding discussion or hearing that the Congress plans to host to better understand how the problems experienced during the current pandemic can be avoided in the future. Please do not hesitate to reach out to Tristan North at (202) 486-4888 or tnorth@ambulance.org, or Kathy Lester at (202) 534-1773 or klester@lesterhealthlaw.com to schedule a time for further discussion.

Sincerely,

Shawn Baird
President, American Ambulance Association
Vice President of Rural Services, Metro West Ambulance

1The Honorable Lamar Alexander, “Preparing for the Next Pandemic” White Paper” 4 (June 9, 2020).

EMS.gov | On-Demand Webinar | Experts Address the Next Phase of the Pandemic

From EMS.gov on April 21

EMS and Public Health Experts Address the Next Phase of the Pandemic

In last month’s EMS Focus webinar, “What the Vaccine Means for EMS Operations,” Florida’s State EMS Medical Director, Kenneth Scheppke, MD, and Commander Bryan Christensen, PhD, with the US Public Health Service and the Centers for Disease Control and Prevention, tackled topics ranging from PPE to quarantine rules to the long-term impacts of the pandemic on EMS.

Download Slide Deck

Millions of EMS clinicians and members of the public across the nation have now received a COVID-19 vaccine. But exactly what does that mean for EMS systems and organizations? In this webinar, learn what we know, and what we don’t know yet, about how the vaccines are changing our approach to the coronavirus pandemic. You’ll hear from experts helping to create and implement guidance for EMS services during these unprecedented times. They’ll address topics such as:

  • Testing and quarantine implications
  • EMS clinicians who have not been vaccinated
  • Vaccines and coronavirus variants
    Lessons learned for the next pandemic

Presenters:

  • Bryan E. Christensen, PhD, is an epidemiologist and industrial hygienist with the Division of Healthcare Quality Promotion (DHQP) in the National Center for Emerging and Zoonotic Infectious Diseases at the US Centers for Disease Control and Prevention (CDC). He is also an environmental health officer in the U.S. Public Health Service. During the COVID-19 response, Bryan has been deployed in several capacities and has served on the Prehospital/EMS Team as part of the Federal Healthcare Resilience Working Group.
  • Kenneth A. Scheppke, MD, FAEMS, is Florida’s State EMS medical director. A board-certified EMS and emergency physician, he also serves as chief medical officer for several fire-rescue agencies in southeast Florida, and has been a leader in the state’s response to coronavirus.
  • Jon Krohmer, MD, director of NHTSA’s Office of EMS and team lead for the Federal Healthcare Resilience Working Group EMS/Prehospital Team, will moderate.

ASPR TRACIE Newsletter April 2021

From HHS ASPR TRACIE Healthcare Emergency Preparedness Information Gateway

This issue of The Express highlights the following new/updated resources:

Please continue to access our Novel Coronavirus Resources Page, the National Institutes of Health Coronavirus Disease 2019 (COVID-19) Treatment Guidelines, and CDC’s Coronavirus webpage, and reach out if you need technical assistance (TA).

New: COVID-19 and the Changing Healthcare Delivery Landscape (Speaker Series)
Paul Biddinger, MD, FACEP, Medical Director, Emergency Preparedness, Mass General Brigham; Mark Jarrett, MD, MBA, MS, Chief Quality Officer, SVP & Deputy Chief Medical Officer, Northwell Health; and Meghan Treber, MS, ICF TRACIE Program Director, HHS ASPR highlight the impact of COVID-19 on healthcare delivery (e.g., supply chain, patients delaying emergency care, the delay of elective procedures, and financial impacts to the healthcare system) in this brief recording. Access the rest of the Healthcare Operations during the COVID-19 Pandemic speaker series for more information.
Updated: Healthcare Delivery Impacts Tip Sheet and Summary Document
This updated tip sheet describes the short- and long-term effects of COVID-19 related community mitigation measures on the healthcare system, including morbidity and mortality from chronic health conditions and lack of access. The accompanying summary document can help healthcare system planners prepare to mitigate these potential healthcare delivery impacts.
New: Acute Care Delivery at Home Tip Sheet
Some healthcare providers and systems have been providing hospital-level care in patient’s homes for years; others have implemented acute care delivery at home models in response to overcrowding at hospitals due to COVID-19. This tip sheet provides an overview of characteristics of various types of acute care delivery at home programs to help healthcare providers better understand this care model.
Issue 12: COVID-19 and Healthcare Professional Stress and Resilience
The articles in Issue 12 of The Exchange focus on three categories: understanding acute and chronic stressors in the healthcare worker population, identifying at-risk employees, and promising practices in building resilience. Be on the lookout for Issue 13, which will focus on the significant contributions made by supportive care providers and healthcare engineering representatives during the COVID-19 pandemic.
Mind Over Matter: Strategies to Help Combat the Coronavirus Blues
This document (created by the COVID-19 Schools Task Force, FEMA Region VII, and HHS Region 7) summarizes the contents of the Mind Over Matter Resource Guide, which can be used to support messaging for college and university campus communities to help combat COVID-19 fatigue and promote general wellness, both during and after the pandemic.
UCSD Health Medical Cyber Disaster Preparedness Study
The University of California San Diego (UCSD) is interested in better understanding how cybersecurity and cyber attacks impact our hospital systems and how we can better prepare in the future. This brief survey will provide a basic understanding of where we stand nationally on healthcare cyber preparedness. Your responses will be kept confidential and all data will be deidentified and reported in FEMA regions. The survey should take approximately five minutes to complete. You will receive no compensation for your participation and participation in this research is voluntary. The principal investigator of this study can be contacted at:

 

Dr. Christian Dameff, MD

University of California San Diego

Department of Emergency Medicine

200 W. Arbor Dr. #8676

San Diego, CA 92103

 

COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice are a collaborative effort between ASPR, the National Emerging Special Pathogen Training and Education Center (NETEC), and Project ECHO. These interactive virtual learning sessions aim to create a peer-to-peer learning network where clinicians from the U.S. and abroad who have experience treating patients with COVID-19 share their challenges and successes; a generous amount of time for participant Q & A is also provided. These webinar topics are covered every week:

  1. EMS: Patient Care and Operations (Mondays, 12:00-1:00 PM ET)
  2. Critical Care: Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM ET)
  3. Emergency Department: Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM ET)

Access previous webinars and special topic sessions and sign up today to receive information on upcoming events.

CMS Increases Medicare Payment for COVID-19 Vaccinations

CMS Increases Medicare Payment for COVID-19 Vaccinations

 

                                                                        By Brian S. Werfel, Esq.

On March 15, 2021, the Centers for Medicare and Medicaid Services (CMS) announced that it would be increasing the Medicare payment amount for administrations of the COVID-19 vaccines.

The original Medicare reimbursement rate depended, in part, on whether the vaccine being administered required a two-dose regimen (as is the case for the Pfizer-Biontech and Moderna vaccines), or a single dose (Johnson & Johnson vaccine).  For vaccinations that require a two-dose regime, CMS initially paid: (1) $16.04 for the administration of the first dose and (2) $28.39 for the administration of the second dose.  For vaccines that require only a single dose, Medicare paid $28.39 for the administration of that single dose.

Effective for vaccinations administered on or after March 15, 2021, CMS has increased these payments to $40 per administration.  Thus, the total reimbursement for a vaccine requiring a single dose will be $40, while the total reimbursement for a vaccine requiring a two-dose regimen will be $80.

CMS | Increased Medicare Payment for Life-Saving COVID-19 Vaccine

From CMS on March 15

Biden-Harris Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine

On March 15, CMS increased the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff. At a time when vaccine supply is growing, CMS is supporting provider efforts to expand capacity and ensure that all Americans can be vaccinated against COVID-19 as soon as possible.

Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished.

These updates to the Medicare payment rate for COVID-19 vaccine administration reflect new information about the costs involved in administering the vaccine for different types of providers and suppliers, and the additional resources necessary to ensure the vaccine is administered safely and appropriately.

CMS is updating the set of toolkits for providers, states, and insurers to help the health care system swiftly administer the vaccine with these new Medicare payment rates. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries, and make it clear that no beneficiary, whether covered by private insurance, Medicare, or Medicaid, should pay cost-sharing for the administration of the COVID-19 vaccine.

Coverage of COVID-19 Vaccines:

As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers are prohibited from charging patients any amount for administration of the vaccine. To ensure broad and consistent coverage across programs and payers, the toolkits have specific information for several programs, including:

Medicare: Beneficiaries with Medicare pay nothing for COVID-19 vaccines and there is no applicable copayment, coinsurance, or deductible.

Medicare Advantage (MA): For calendar years 2020 and 2021, Medicare will pay providers directly for the COVID-19 vaccine (if they do not receive it for free) and its administration for beneficiaries enrolled in MA plans. MA plans are not responsible for paying providers to administer the vaccine to MA enrollees during this time. Like beneficiaries in Original Medicare, Medicare Advantage enrollees also pay no cost-sharing for COVID-19 vaccines.

Medicaid: State Medicaid and Children’s Health Insurance Program agencies must provide vaccine administration with no cost sharing for nearly all beneficiaries during the Public Health Emergency (PHE) and at least one year after it ends. Through the American Rescue Plan Act signed by President Biden on March 11, 2021, the COVID vaccine administration will be fully federally funded. The law also provides an expansion of individuals eligible for vaccine administration coverage. There will be more information provided in upcoming updates to the Medicaid toolkit.

Private Plans: CMS, along with the Departments of Labor and Treasury, is requiring that most private health plans and issuers cover the COVID-19 vaccine and its administration, both in-network and out-of-network, with no cost sharing during the PHE. Current regulations provide that out-of-network rates must be reasonable, as compared to prevailing market rates, and reference the Medicare reimbursement rates as a potential guideline for insurance companies. In light of CMS’s increased Medicare payment rates, CMS will expect commercial carriers to continue to ensure that their rates are reasonable in comparison to prevailing market rates.

Uninsured: For individuals who are uninsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by the Health Resources and Services Administration (HRSA).

More Information:

 

Webinar 3/25 | What the Vaccine Means for EMS Operations

From EMS.gov

What the Vaccine Means for EMS Operations

Tune in on Thursday, March 25, at 1 pm ET for the latest edition of EMS Focus, a federal webinar series hosted by NHTSA’s Office of EMS

Register Now

Millions of EMS clinicians and members of the public across the nation have now received a COVID-19 vaccine. But exactly what does that mean for EMS systems and organizations? In this webinar, learn what we know, and what we don’t know yet, about how the vaccines are changing our approach to the coronavirus pandemic. You’ll hear from experts helping to create and implement guidance for EMS services during these unprecedented times. They’ll address topics such as:

  • Testing and quarantine implications
  • EMS clinicians who have not been vaccinated
  • Vaccines and coronavirus variants

Register Now

Panelists Include:

Bryan E. Christensen, PhD, is an epidemiologist and industrial hygienist with the Division of Healthcare Quality Promotion (DHQP) in the National Center for Emerging and Zoonotic Infectious Diseases at Centers for Disease Control and Prevention (CDC). He is also an environmental health officer in the U.S. Public Health Service. During the COVID-19 response, Bryan has been deployed in several capacities and has served on the Prehospital/EMS Team as part of the Federal Healthcare Resilience Working Group.

Kenneth A. Scheppke, MD, FAEMS, is Florida’s State EMS medical director. A board-certified EMS and emergency physician, he also serves as chief medical officer for several fire-rescue agencies in southeast Florida, and has been a leader in the state’s response to coronavirus.

Jon Krohmer, MD, director of NHTSA’s Office of EMS and team lead for the Federal Healthcare Resilience Working Group EMS/Prehospital Team, will moderate the webinar.

Attendees will be encouraged to submit questions during any point of the discussion. The webinar and Q&A will last approximately one hour.

About EMS Focus

EMS Focus provides a venue to discuss crucial initiatives, issues and challenges for EMS stakeholders and leaders nationwide. Be sure to visit ems.gov for information about upcoming webinars and to view past recordings.

EMS.gov | Training Resources for Vaccination Programs Using EMTs

From EMS.gov on February 10

These resources can serve as just in time training for vaccination programs utilizing emergency medical technicians:

Training video on COVID-19 intramuscular vaccine administration
This video created by the Maryland Institute of Emergency Medical Services Systems (MIEMSS) can be used to provide EMTs with didactic knowledge to administer IM injections. With the exception of the MIEMSS link referenced in the video, it can be used by EMTs in any state or territory. It should be accompanied by a skills assessment, which is discussed below.

Intramuscular Injection Skill Checklist
A clinical skills assessment checklist for EMTs preparing to administer IM injections.

SARS-CoV-2 Vaccine Training for EMTs
A written description of the skills required of EMTs to administer the vaccine.

Moderna and Pfizer Vaccine Comparison
A simple side-by-side comparison of the Pfizer and Moderna SARS-CoV-2 vaccines

Vaccine Update Video
In this presentation from late January 2021, Florida State EMS Medical Director Kenneth Scheppke, MD, provides an overview of the latest science related to COVID vaccines.

COVID-19 Vaccination Training Programs and Reference Materials for Healthcare Professionals
CDC recommended resources to prepare healthcare workers to administer COVID-19 vaccines.

EMS Vaccine Administration Program Manual
This guide from the State of Indiana can serve as a resource to help state and local officials and EMS organizations with the creation and implementation of EMS vaccination programs.

CDC | Essential Workers Vaccine Communication Toolkit

CDC has designed a COVID-19 Vaccination Communication Toolkit for Essential Workers to help employers build confidence in this important new vaccine. The toolkit will help employers across various industries educate their workforce about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns.

Access Toolkit

The toolkit contains a variety of resources including:

  • key messages,
  • an educational slide deck,
  • FAQs,
  • posters/flyers,
  • newsletter content,
  • a plain language vaccine factsheet (available in several different languages),
  • a template letter for employees,
  • social media content, and
  • vaccination sticker templates.

This toolkit will help your organization educate employees about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns.
Access Toolkit

LODD Grants | Brave of Heart Fund

The Brave of Heart Fund provides monetary grants to eligible family members of frontline healthcare workers, healthcare volunteers and healthcare support staff who have lost their lives because of COVID-19. A spouse or domestic partner, a dependent child, or dependent parent are eligible. The Fund also offers behavioral and emotional support services from Cigna and grief coping resources from New York Life.

Established by the Foundations of New York Life and Cigna, the Brave of Heart Fund is owned and administered by E4E Relief, a disaster relief-focused subsidiary of Foundation For The Carolinas, a Section 501(c)(3) public charity.

Learn More & Apply

Eligible Healthcare Workers

For the purpose of the Brave of Heart Fund, an eligible healthcare worker is a person who lived in the U.S. at time of death and who worked or volunteered in or for a:

  • Licensed hospital
  • Medical center or clinic
  • Nursing home
  • Medical transport vehicle
  • Triage center
  • Other licensed medical facility, provider or setting

Also those who worked or volunteered as an emergency medical technician, ambulance technician or paramedic and who died from COVID-19-related causes any time through May 15, 2021.

Grants Description

There are two phases of grants available. Eligible expenses vary based upon which grant phase the eligible family member is applying . You may be eligible for both a Phase 1 and Phase 2 grant.

Phase 1

Phase 1 assistance is intended to cover expenses related to funeral and burial costs.

The family member who is eligible for a Phase 1 grant is the family member who is responsible for the funeral/burial expenses. Only one family member is eligible for a Phase 1 grant.

Phase 1 grants are $15,000. Only one Phase 1 grant is available in connection with each eligible healthcare worker or healthcare volunteer.

Phase 2

Phase 2 assistance is intended to cover long-term expenses such as food, clothing, housing, basic essential utilities, daycare/ childcare expenses, educational expenses, counseling, medical expenses for deceased healthcare worker, and transportation.

The family member(s) who is eligible for a Phase 2 grant is the family member(s) who was dependent on the deceased healthcare worker’s income for those expenses.

Phase 2 grants range up to $60,000 per eligible healthcare worker.
The exact amount will depend on a variety of factors including the applicant’s demonstration of financial need and the number of
eligible beneficiaries.

Learn More & Apply

For answers to frequently asked questions, including questions about eligibility, visit braveofheartfund.com/FAOs. Grant awards are discretionary and e final determination of grant eligibility and amounts will be made by E4E Relief, which is the public charity that owns and administers the Fund.

Questions about the Fund: (855) 334-7932 or email: questions@replyemail.braveofheartfund.com
Learn More & Apply

CDC ACIP | Reccs for Allocating Initial COVID-19 Vaccines

From the CDC’s Morbidity and Mortality Weekly Report

The Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020

What is already known about this topic?

Demand is expected to exceed supply during the first months of the national COVID-19 vaccination program.

What is added by this report?

The Advisory Committee on Immunization Practices (ACIP) recommended, as interim guidance, that both 1) health care personnel and 2) residents of long-term care facilities be offered COVID-19 vaccine in the initial phase of the vaccination program.

What are the implications for public health practice?

Federal, state, and local jurisdictions should use this guidance for COVID-19 vaccination program planning and implementation. ACIP will consider vaccine-specific recommendations and additional populations when a Food and Drug Administration–authorized vaccine is available.

Continue Reading

Dooling K, McClung N, Chamberland M, et al. The Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020. MMWR Morb Mortal Wkly Rep. ePub: 3 December 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6949e1

ASPR | The Exchange | COVID-19 December Update #2

From the US Department of Health and Human Services Assistant Secretary for Preparedness and Response (ASPR)

Download The Exchange Newsletter PDF

This issue of The Express highlights the following new/updated resources:

Please continue to access our Novel Coronavirus Resources Page and CDC’s Coronavirus webpage and reach out if you need technical assistance (TA).

New! The Exchange, Issue 12–Special Edition: COVID-19 and Healthcare Professional Stress and ResilienceIn the months that have passed since a pandemic was declared, we have witnessed our nation’s healthcare providers working tirelessly to care for patients, with surges testing their facilities’ and their own personal resilience. This kind of work is grueling and can take a significant toll on physical and mental health. The resources developed for/highlighted in this issue can help individuals identify and address risk and the negative mental health effects of stress in themselves, their colleagues, and their staff.New: Crisis Standards of Care and COVID-19: What’s Working and What Isn’t?Speakers in this webinar discussed clinical consultation versus triage support, systems-level information sharing, coalition-level coordination activities, and recent publications/resources to help with planning efforts. Access those and the set of resources referenced during the webinar in our COVID-19 Crisis Standards of Care Resource Collection.New: Support for Overstretched Clinicians During the Ongoing PandemicIn this video, Dr. Eileen Barrett, Director of Continuous Medical Education and Graduate Medical Education Wellness Initiatives from the University of New Mexico, discusses proactive programs available to support staff during stressful times. Check out the related article in Issue 12 of The Exchange and the entire COVID-19 Healthcare Professional Stress and Resilience speaker series.New: Emergency Responder Self-Care Plan: Behavioral Health PPETaking care of oneself is difficult during a pandemic, where responders experience additional stressors related to home and personal circumstances as well as those brought on by challenging mission demands. This fillable form includes steps people can take to stay healthy and fit for duty while caring for others. The form can be completed before each mission/event and keep handy to help apply coping strategies when things get tough.New: Lessons Learned by a COVID-19 Designated HospitalThe speakers in this brief video share lessons learned when The University Hospital of Brooklyn, the primary teaching hospital for the State University of New York Downstate Health Sciences University, became the only COVID-19 designated hospital in Brooklyn.New: Armed Intruder/Active Shooter Training Module

This free short training module provides healthcare providers and other staff with an overview of strategies and protocols for an armed intruder/active shooter incident. Speakers describe the “run-hide-fight” and “secure-preserve-fight” approaches and share “Stop the Bleed” basics, a video for how to apply a tourniquet, and resources for managing stress. Though this training was created by the Mount Sinai Health System, it is applicable to other healthcare providers and healthcare systems.

 

COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice are a collaborative effort between ASPR, the National Emerging Special Pathogen Training and Education Center (NETEC), and Project ECHO. These interactive virtual learning sessions aim to create a peer-to-peer learning network where clinicians from the U.S. and abroad who have experience treating patients with COVID-19 share their challenges and successes; a generous amount of time for participant Q & A is also provided. These webinar topics are covered every week:

  • EMS: Patient Care and Operations (Mondays, 12:00-1:00 PM ET)
  • Critical Care: Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM ET)
  • Emergency Department: Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM ET)

Access previous webinars and sign up today to receive information on upcoming webinars.

 

The Healthcare & Public Health Sector Partnership led by ASPR’s Division of Critical Infrastructure Protection is actively engaged in responding to COVID-19. Register here to receive regular response bulletins.