The Centers for Medicare & Medicaid Services (CMS) issued updated guidance to healthcare providers “on providing essential non-COVID-19 care to patients without symptoms of COVID-19 in regions with low and stable incidence of COVID-19.” This guidance is a part of Phase 1 of the Trump Administration’s Guidelines for Opening Up America Again.
CMS recognizes the need to be flexible and to allow facilities in regions with low and stable COVID-19 incidences to provide non-emergent, non-COVID-19 healthcare to patients who need this care. When states or regions meet Opening Up America’s Gating Criteria for COVID-19 symptoms, cases, and hospital capacity they can begin to enter Phase I of the Administration’s Plan.
CMS encourages providers and patients to use virtual-care services, such as telehealth when appropriate, to limit COVID-19 exposure.
Stay connected by visiting NAMSS COVID-19 Response Page.
Tuesday, April 28, 2020
Guidelines for Reopening the Government
In mid-April, President Donald Trump recently released Guidelines for Opening Up America Again. The initiative provides gating criteria that states and regions can use to determine the appropriate time for states to begin taking steps to reopening businesses, schools, and public spaces. The plan enables state governors to decide when their states and regions within their states should begin reopening. Each phase of the Administration’s reopening plan includes guidelines for states, individuals, and employers.
The Opening Up America Gating Criteria requires states to meet the following milestones before beginning the phased re-opening process:
Stay connected by visiting NAMSS COVID-19 Response Page.
The Opening Up America Gating Criteria requires states to meet the following milestones before beginning the phased re-opening process:
- A downward trajectory in flu-like and COVID-like syndromic cases for 14 days;
- A downward trajectory in COVID-19 cases over a 14-day period; and
- Hospital capacity to provide crisis care and implement/activate
Stay connected by visiting NAMSS COVID-19 Response Page.
Friday, April 24, 2020
HHS Launches Telehealth Resource Site
HHS has launched a Telehealth
site to provide guidance to patients and providers during the COVID-19
Public Health Emergency. The HHS Telehealth site’s patient page includes
telehealth definitions, policies, and tips on navigating telehealth options. The
provider page includes
recommendations on integrating telehealth into practice, updates on COVID-19-related
policy changes, and assistance on shifting processes to accommodate telehealth
appointments.
Stay connected by visiting NAMSS COVID-19 Response Page.
HHS Workforce Toolkit and Preparedness Gateway for Stakeholders
This week, the Health and Human Services Assistant Secretary
of Preparedness and Response (ASPR) launched a COVID-19 Workforce
Virtual Toolkit to help state and local healthcare decision makers expand
workforce flexibilities during the COVID-19 pandemic. The Toolkit
provides guidance for states on funding flexibilities, liability protections,
workforce training, best practices, and peer-to-peer communication. It also helps
states administer these flexibilities to increase frontline medical staff and
care for patients at local hospitals, clinics, and other healthcare facilities.
This effort is part of the ASPR Technical
Resources, Assistance Center, and Information Exchange (TRACIE), a
healthcare emergency preparedness information gateway that provides information
and resources for stakeholders through participation in a public-private
information sharing exchange that requires registration and approval.
Stay connected by visiting NAMSS COVID-19 Response Page.
Thursday, April 16, 2020
HRSA Temporarily Waives NPDB Query Fees
Effective immediately, HRSA will waive National Provider
Data Bank (NPDB) query fees through May 31, 2020 to help facilities respond to,
and prepare for, the COVID-19 emergency. HRSA will host two teleconferences to provide
more information about the fee waiver on Thursday, April 16 and Thursday, April
23, 2020—both at 1pm EDT.
This fee waiver is retroactive from March 1, 2020. HRSA will
issue query credits to entities that have paid querying fees between March 1,
2020 and April 15, 2020. The Federal
Register will post this official notice on Friday, April 17, 2020.
Stay up to
date on NAMSS’ COVID-19 Response.
Wednesday, April 15, 2020
ECFMG/FAIMER Provide a Critical Role in Verifying IMGs
As states continue to waive certain licensure requirements
and licensure renewal requirements to respond to the COVID-19 emergency,
efforts to provide streamlined and appropriate verification are critical. To
help verify international medical school certifications and has passed
components of the U.S. Medical Licensing Examination, the Education Commission
for Foreign Medical Graduates (ECFMG) is working
to provide verification information on international physicians to states as
quickly as possible.
ECFMG and its non-profit arm, the Foundation for Advancement
of International Medical Education and Research (FAIMER), stands by as a
resource for providing state medical licensing personnel information on IMG.
Upon request, ECFMG will verify an IMG’s certification, provide basic identity
verification and primary-source verification for a physician’s medical
education credentials. The ECFMG/FAIMER can also verify provide previously
verified credentials, as well as verify new credentials such as medical
diplomas, transcripts, medical licenses, and registration certificates.
Contact ECFMG/FAIMER (casemanager@ecfmg.org)
for verification assistance, USMLE exams, IMG credentials, and other inquires
related to IMGs. ECFMG does not issue physician licenses and does not have
information on physician eligibility for credentialing and/or privileging.
Learn more
about ECFMG/FAIMER’s
COVID-19 Resources.
Stay up to
date on state licensure waivers from FSMB.
Stay connected
by visiting NAMSS COVID-19 Response
Page.
Friday, April 10, 2020
The Joint Commission Provides a Follow-Up FAQ to its Homemade Face Masks Statement
On April 6, The Joint Commission posted an FAQ
in response to their statement
on homemade PPE. The FAQ provides
background and additional protocol for the Joint Commission’s position on healthcare
workers using homemade PPE and on hospitals prioritizing N95 masks and N95 respirators for high-risk staff exposed to aerosolized viral particles.
The FAQ also provides additional prioritization guidance to
help hospitals conserve N95 masks and other PPE for high-risk personnel.
Thursday, April 9, 2020
Healthcare Groups Call Upon Federal Government to Address PPE and Medical Equipment Shortages
In late March, the Joint Commission, American College of
Physicians, American Hospital Association, American College of Surgeons,
American Medical Association, and the American Dental Association called upon
the federal government to drastically increase PPE and other medical equipment
production and distribution. In a public
statement these groups state their concern with PPE, ventilators, swab
kits, shortages, as well as overall testing capacity for COVID-19. These
organizations represent frontline caregivers, institutions, and personnel who
are at greater risks for COVID-19 exposure
and need more critical PPE immediately.
The lack of PPE poses an additional risk to patients and caregivers compounded
by the lack ventilators and other life-saving medical equipment, places
healthcare facilities at a dangerous disadvantage against COVID-19. Efforts to
increase PPE and medical-equipment production and distribution, as well as
expands telehealth services are critical to preserving PPE and stopping the
COVID-19 spread.
Tuesday, April 7, 2020
Joint Commission Issues Statement on Homemade Personal Protective Equipment
On March 31, the Joint Commission released a statement
supporting policies that permit healthcare workers to bring their own facemasks
or respirators to work if their healthcare facilities cannot provide enough PPE
to protect them from COVID-19 risks. The Joint Commission statement recognizes that:
- Hospitals must conserve PPEs during shortages for workers who perform high-risk procedures.
- Privately owned PPE’s full ability to protect hospital workers from COVID-19 is unknown, but may provide some degree of protection.
- The Joint Commission does not have standards or regulations prohibiting hospital staff from using homemade PPE.
- Hospital workers should only use homemade masks when standard PPE is unavailable.
Friday, April 3, 2020
CMS Provides Hospitals Flexibilities to Support COVID-19 Efforts
The Centers for Medicare and Medicaid Services (CMS) recently issued a series of waivers and modifications to help prepare and equip healthcare systems and workers to meet patient-demand resulting from COVID-19. These efforts seek equip hospitals for COVID-19 surges, expedites healthcare practitioner onboarding, and expands telehealth services, increases site-based COVID-19 testing, and reduces paperwork requirements.
These issuances will remain in effect throughout the COVID-19 Public Health Emergency. The following may affect your medical staffs:
• CMS Hospital without Walls (Temporary Expansion Sites)
o
Conditions of Participation Modifications
§
Enables ambulatory surgery centers to provide
hospital services to help meet patient volume.
§
Grants freestanding emergency departments a
pathway for treating patients during the declared emergency.
o
Paperwork Reduction
§
Waives certain paperwork requirements for
hospitals facing significant strain from COVID-19.
§
See CMS guidance for the specific waived
requirements.
o
Physical Environment
§
Allows designated health systems to use offsite,
non-hospital buildings such as hotels and community facilities for patient
care, room and board, and other patient services.
§
Enables facilities to separate non-COVID-19
patients to reduce exposure.
o
Temporary Expansion Sites
§
Waives certain COP requirements to allow
provider-based departments to establish and operate as a hospital.
§
Enables hospitals to change their provider-based
department location status to meet patient needs in a specific area.
o
Critical Access Hospital Length-of-Stay
§
Waives the 25 CAH-bed requirement.
§
Lifts the 96-hour length-of-stay requirement.
o
CAH Status and Location
§
Lifts the CAH rural-area stipulation to help
meet patient surge.
§
Removes location parameters so CAHs can help
with surge capacity.
o
Hospital Acute-Care Patients in Excluded
Distinct Part Units
§
Allows acute-care facilities to house acute-care
patients in excluded distinct-part units, as appropriate.
§
Provides documentation guidance via the applicable
patients’ medical records.
o
Telemedicine
§ Modifies
hospital and CAH telemedicine conditions to expand telehealth services.
§
Enables patients to receive telehealth care
through agreements with off-site hospitals.
Patients over Paperwork
• Verbal Orders
o
Grants facilities flexibility for verbal orders.
o
Maintains read-back verification requirements
but extends the authentication requirement to 48 hours.
• Reporting Requirements
o
Extends the time period hospitals have to report
intensive-care patient deaths who required soft-wrist restraints.
o
Increases the reporting period to close of the
next business day.
• Limit Discharge Planning for Hospital and CAHs
o
Waives certain requirements regarding discharge
planning and care goals.
o
Facilities should work with patients, families,
or patient representatives to select post-acute care providers by using and
sharing data with post-acute entities.
• Emergency Preparedness Policies and Procedures
o
Waives requirements to establish emergency preparedness
communication policies.
o
Lifts requirements to provide contact
information for staff, entities providing services under arrangement,
practitioners, and volunteers.
• Provider Enrollment
o
Makes available toll-free hotlines for
providers.
o
Waives certain screening requirements, postpones
all revalidation actions, and expedites pending or new provider applications.
Workforce
• Medical Staff Requirements
o
Waives COPs to allow physicians with expiring
privileges to continue practicing at their current facilities.
o
Enables new physicians to start practicing in a
hospital before medical staff or governing body approval to help meet patient
surges.
• Physician Services
o
Lifts requirements that Medicare patients be
under a physician’s care.
o
Enables physician’s assistants and nurses to
help meet patient surges.
• Anesthesia Services
o
Lifts current nurse anesthetist supervision
requirements and permits facilities to set temporary supervision parameters, in
accordance with applicable state law.
o
Allows nurse anesthetists to function at the
fullest extent of their licenses, as it complies with facilities’ activated
emergency plans.
• Respiratory Care Services
o
Waives requirement that facilities designate in
writing qualified personnel to perform specific respiratory-care procedures and
their appropriate supervision levels.
o
Requires state and activated emergency plan
alignment.
• CAH Personnel Qualifications
o
Waives federal minimum personnel qualifications
for clinical nurse specialists, nurse practitioners, and physician assistants.
o
The above practitioners must still meet state-licensure
requirements and scope parameters.
• CAH Staff Licensure
o
Defers all staff licensure, certification, or
registration to state law by waiving COP requirements that staff be licensed,
certified, or registered in compliance with federal, state, and local laws.
o
Defers all licensure, certification, and
registration requirements for CAH staff to the state.
The CMS COVID-19 site provides more information on the above modifications, as well as other facility modifications.
Additional CMS Guidance:
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