Updates from your ACE team
We are officially more than halfway through the year and quickly approaching the new school year, which has several concerned. We are still patiently waiting for a vaccine and seeing a surge of COVID-19 cases in young adults across the nation. With cases increasing in young adults, concern is increasing when it comes to them and pediatric patients.

This month we're talking about how excited one of the fearless generations (the millennials) were when bars reopened and how we're paying a price for their excitement... and parties. College students in Alabama threw parties with the intent to spread and be infected by COVID-19 . If an attendee tested positive after the party, that person would collect the pot of money from the party.

Since the pandemic's mandatory quarantine we've seen an increase in domestic violence cases that aren't being reported to the authorities. Instead, the victims are going straight to medical professionals to get their injuries treated. We're also talking about America's pediatric patient base and how it was affected by stay-at-home orders (a decrease in receiving regular vaccinations) and what it will mean for the upcoming school year.
Milliennials trade couch surfing for partying and U.S. sees an increase of COVID-19 and domestic violence cases
Miley Cyrus might have written the song Party In The USA, but Florida's governor is suspending its state's bar's liquor licenses because millennials decided it was time to have some fun and party with a lack of social distancing practices. The entire nation is seeing a surge of cases within one of the generations that seems to be the least fearful of the pandemic. The surge has been within millennials "where bars, stores and restaurants have reopened. In Florida, people ages 15 to 34 now make up 31 percent of all cases, [an increase] from 25 percent in early June." Health experts are concerned that the elderly are next because of their compromised immune systems and millennials are still spending time with their parents and grandparents that are not in nursing homes.

With an increase of COVID-19 cases, the country is also seeing an increase of domestic violence and child abuse cases, but not in the normal channels. Most cases are being treated by providers, not the authorities. According to Health Resources and Services Administration (HRSA)'s blog post, The Hidden Pandemic Behind COVID-19 , nonprofits funded by HRSA and the U.S. Department of Health and Human Services (HHS) have been getting creative in reaching people that may need some help by slipping business cards in grocery bags and on pizza boxes. Leiana Kinnicutt with Futures Without Violence, said the volume of "domestic violence hotline calls [has increased] from March and April, and about 50 percent are minors asking for help and information." Telehealth may be useful for those in these circumstances; victims are able to use the telehealth platform to discretely report domestic abuse and seek treatment.
COVID-19's toll on pediatric patients
Pediatric patients stopped receiving vaccinations

When COVID-19 made landfall on the United States and the government and health officials knew about it in the middle of March, everyone went home and stayed home. State governments issued stay-at-home orders, the education systems sent students home to continue school virtually and canceled graduations and other end of the year social events (prom, seniors days, etc.), businesses either furloughed, laid off or transitioned their workforce to work from home, nursing homes and hospitals closed their doors to visitors, non-essential surgeries were pushed and hospitals moved to an all hands on deck approach where different specialties rotated in the emergency rooms for incoming cases and potential COVID patients.

The pandemic affected several people, regardless of their age, income and ethnicity. Some of those that were affected, were unfortunately children who are not old enough or wise enough to take their own healthcare into their own hands. Interestingly enough, even though the pandemic had and still has enough buzz about a cure because the majority of people want to get back to normal, children's vaccines were left as an afterthought.

The following data comes from the CDC's article, Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration - United States, 2020. The article's findings are that all children ages 2 to 18 saw a decrease in vaccinations from the time COVID-19 was announced in and reacted to by America. Children ages 3-18, while still receiving vaccinations, have received more vaccinations than those between the ages of 0 and 2.
The CDC will need to collect further data in order to know how to appropriately intervene with vaccinations. It's possible that there will be a measles outbreak in children between the ages of 0 and 2, especially when everyone comes back together in the fall.
Pediatric patients see an increase of behavioral health needs and telehealth usage

The pediatric specialty has grown over the years. It was only a few years ago that more children were diagnosed with Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD). Last year, we discussed the types of life events that have an effect on pediatric patients. According to the Kaiser Family Foundation (KFF), 3 million adolescents (ages 12-17) reported having a major depressive disorder.

The article, Children's Mental Health Emergency Department Visits: 2007-2016 , published in June 2020, compiles data from 2007 to 2016 and shows that while the number of pediatric visits have remained stable, the number of pediatric patients needing behavioral health treatments have increased. According to the article, pediatric "visits for deliberate self-harm increased by 329 percent and visits for mental health disorders [increased] by 60 percent."

When academia of all levels sent their students home, telehealth's popularity has been increasing among pediatric patients and patients that are young adults, especially in rural areas . Since the pandemic, students are still reaching out to the school's health care facility via texting, calling, emailing and video conferencing their counselors for sessions. Anne Fisher, a clinical psychiatrist and head of the wellness center at the New College of Florida believes telehealth "is going to change campus healthcare, especially mental healthcare."

Are you prepared for the steady increase of pediatric and young adult behavioral health patients?
What's the real cost of the COVID-19 vaccine?
It's not a surprise or a secret that we've been patiently waiting for a vaccine. Experts now are questioning how affordable that vaccine will be. The vaccine will allow life to get back to normal, boost the economy, allow furloughed employees to go back to work, allow employers that sent their employees home to come back to the office, which is arguably invaluable. We live in a world where patents are fought after and where high preventative costs are weighed in when pricing a drug; for example, the cost of a liver transplant is significantly higher than the drug. The drug could be priced higher and still cost significantly less than the transplant.

The United States' government has always favored business and with a businessman for a president, no one is sure how this will work. According to KFF's News article, Analysis: How a COVID-19 Vaccine Could Cost Americans Dearly , released on July 8, 2020, several companies - including ones that have never produced vaccines before - have been funded by taxpayer money and are racing for the vaccine and the patent. Investors are excited about the financial possibility gains. Companies like Baicker believe "public scrutiny will prevent outrageous pricing." Johnson & Johnson, also in the race to make a vaccine, has said "it would make the vaccine on a 'not for profit basis' at $10 for 'emergency pandemic use.'" KFF questions, if that is how the pandemic is handled, how will the annual vaccine (like the flu's) work until there is a bi-similar? KFF argues that the pricing conversation should start now, not later.
HRSA's reimbursement for COVID-19 testing and treatment for uninsured patients
Providers that have been treating COVID-19 cases or testing uninsured patients for COVID-19 on or after February 4, 2020 may now receive reimbursement from HRSA.
Eligible services for reimbursement through the portal:

  • Specimen collection, diagnostic and antibody testing
  • Testing-related visits - from an office, urgent care, emergency room or telehealth
  • Treatment - from an office, using telehealth, emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), acute inpatient rehab, home health, DME, emergency ambulance transportation, non-emergent patient transfers via an ambulance and (when available) FDA approved drugs for COVID-19 treatment and are provided as part of an inpatient stay
  • FDA approved vaccine (when available)
Services not eligible for reimbursement through the portal:

  • Services not covered by Medicare
  • Any treatment without a COVID-19 primary diagnosis, except for pregnancy when the COVID-19 code may be listed as secondary
  • Hospice services
  • Outpatient prescription drugs
Important things to note:
Claims are subject to Medicare's timely filing requirements and all claims that are submitted must be complete and final.

More good news! The COVID-19 claims reimbursement to health care providers and facilities for testing and treatment of the uninsured is now available!

Telehealth has a bright future
Telehealth has made significant advancements throughout the pandemic and experts believe this trend will continue well after the pandemic . Xtelligent Healthcare Media's article Experts are starting to weigh in on Post-COVID-19 Telehealth Rules and Policies published on 15, 2020 discusses some of the experts' opinions on the advancements that still need to be addressed and changed for telehealth. Some payers, like BlueCross BlueShield of Tennessee have made telehealth payments permanent for the future. Additionally, "29 Senators sent a letter to Congressional leadership asking telehealth provisions in the CONNECT for Health Act and recent COVID-19 emergency measures [become] permanent. Nadia de la Houssaye, a partner with the Jones Walker law firm, [would like to see] Congressional action on Centers for Medicare and Medicaid Services (CMS') telehealth coverage. CMS guidelines limit telehealth to rural areas and don't allow coverage for telehealth in clinics, health centers or the patient's home." We know this is a problem because rural America started seeing an increase in COVID-19 cases when social distancing measures first started relaxing. A bill was introduced to Congress the week of June 12, 2020. The goal of the bill is to improve telehealth coverage for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) . If the bill is approved, it will "mandate Medicare coverage for telehealth services and remove the originating site facility and location requirements for distant telehealth services delivered."
Media watch and other useful info
The United States' government bodies have been busy reacting to and releasing funds in the battle against COVID-19 and other medical social issues, such as the opioid crisis .

HHS, through HRSA, awarded $8 million to organizations that will provide training and technical assistance (T/TA) to HRSA-funded health centers across the nation . Together the Primary Care Associations (PCAs) and National Training and Technical Assistance Partners (NTTAP) will provide critical COVID-19 resources to health centers, including support and expertise to advance health centers' ability to prevent, prepare and respond to the pandemic, which will benefit more than 28 million patients.

As of June 2, 2020, HHS, through HRSA, awarded $20.3 million to 44 recipients to increase the number of fellows at accredited addiction medicine and addiction psychiatry fellowship programs. The recipients will train addiction specialists at facilities in high need communities that integrate behavioral and primary care services.

Stay updated with HRSA's latest information about COVID-19 HERE .

CMS has some exciting news! "More than 85 percent of Medicare fee-for-service beneficiaries are traveling to receive their treatments." The treatments are typically 12 hours and are split over 3 days. CMS has been working to let these patients, some of the most vulnerable of the Medicare patient population, stay home for their treatments.
This action would stand after the pandemic.
Read the full press release here .

CMS is tracking and following COVID-19. Stay updated with the latest information HERE .

The National Association of Community Health Centers (NACHC) is calling on additional Medicaid funding for states, territories, counties, cities and towns for the next bipartisan COVID-19 relief bill . NACHC believes that increasing "the Federal Medical Assistance Percentages (FMAP), which is the [key to] the federal-state partnership that provides health care for more than 70 million Americans." Read the full press release here .

NACHC is following COVID-19. Stay updated with their COVID-19 information for community health centers HERE .