COVID 19: New and Updated Information and Resources
NJAASC has curated authoritative information and a list of resources for our Membership’s reference. We will continue to update this as more information becomes available.


NJAASC & COALITION PETITION GOVERNOR FOR ASF TAX RELIEF - 4/27/20
As you know, I have been talking to NJDOH regarding the ASF Tax.  The Director of the Assessment Department understands and indeed is on our side on this one.

However his attempts to get relief only resulted in the postponement of the filing deadline- which quite honestly does not do a thing for us, that is unless there would have been a corresponding postponement of the payment schedule.  

I had our Government Affairs people get a special meeting of the Coalition (of which NJAASC is a member) and we hashed out a  letter that was delivered directly to the Governor .

I am especially concerned with the June 15 th  payment as it is the last quarterly payment for the FY declared, and failure to completely pay your assessment would result in non- renewal of your license.
 
Jeff

INSURANCE DENIALS DUE TO EXECUTIVE ORDER 109 - 4/27/20
As you know EO 109 limited the types of cases to be performed at ASCs.

NJAASC outlined all of this in our webinar (please view it on our website if you have not done so-free, for everyone), and in numerous e-blasts to all ASCs.

I have heard that some MVA carriers are denying pre-cert requests based on:  ‘The proposed procedure is found to be elective and non-compliant with Governor Murphy’s March 23, 2020 Executive Order 109’

I have doubts as to if said carriers have any legal right/ability to do this, but they have so it will get played out in arbitration.
 
NJAASC had circulated to all ASCs and strongly recommended that they have their doctors wishing to perform procedures, fill out an attestation-  The Confirmation of Non-Elective Form,  for just such a reason as this.

Centers must be careful (and you need to protect yourself), and the doctors themselves as well- which is the reason for the form, which would be kept in your chart.

You could as well send it as part of your pre-cert request.

$20B in Grants to Eligible Healthcare Providers, including ASCs, Available Tomorrow - 4/27/20
The US Department of Health & Human Services (HHS) will allocate an additional $20 billion in grants to Medicare providers, including ambulatory surgery centers, starting tomorrow, April 24. These grants are part of the $100 billion in relief funds included in the  Coronavirus Aid, Relief, and Economic Security (CARES) Act  of 2020 that was signed by President Donald Trump on March 27, 2020.

Fifty billion dollars of the Provider Relief Fund is being allocated for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers' 2018 net patient revenue. As you are aware, HHS started distributing an initial $30 billion on April 10. In the interest of getting funds to providers as quickly as possible, the $30B was distributed using a different formula based on information HHS already had—providers’ share of Medicare fee-for-service (FFS) reimbursements in 2019.

On April 24, providers that submit Centers for Medicare & Medicaid Services (CMS) cost reports will automatically be sent an advance payment based off the revenue data they submit. Providers without adequate cost report data on file will need to submit their revenue information to a portal opening this week linked on  this page  in order to obtain additional general distribution funds.  Since ASCs do not submit cost data, facilities that wish to obtain additional grant money through this program will have to submit revenue information to the portal.  Visit the  Provider Relief Fund page  to apply beginning tomorrow, April 24.

Payments will go out weekly, on a rolling basis, as information is validated.


ECONOMIC IMPACT STUDY FOR NEW JERSEY- YOU MAY WANT TO FILL IT OUT- 4/27/20
On Thursday, NJBIA started soliciting responses from members for our new Recovery Survey. The second part of the survey questions mirror many from the Recovery and Reinvention Framework document. We invite you to share the survey with your members to insure we get as much feedback as possible. Please do not elicit responses via social media as we want to ensure we have legitimate businesses/nonprofits only answering this.

As we discussed, the goal of this survey is to have businesses/nonprofits inform us of the economic impacts resulting from the COVID-19 response, and to shed light on what it will take to bring them back online when the state reopens. We will, of course, use this data to help inform our policymakers as they contemplate a reopening, as well as to advocate for appropriate policies and actions on behalf of our collective members.

Please let your members know that they can fill out the survey  here  for a limited time.

Thank you for your continued collaboration!

NEW YORK TO RELAX ELECTIVE PROCEDURES BAN IN SOME COUNTIES- 4/23/20
Be aware that NY, NJ, CT, PA Governors are part of a regional task force that regularly meet and communicate. There is talk of NJ opening up as well, but nothing definitive yet.


CARES FUND PORTAL NOW LIVE – 4/23/30
The CARES Act Provider Relief Fund Portal is now live. It can be accessed here:
 
For additional details about the program from the
U.S. Department of Health & Human Services:

Brach Eichler Coronavirus Mini-Update - 4/23/20
Governor Murphy held a press conference this afternoon providing an update on positive COVID-19 cases and announced an additional 3,551 cases which brings the statewide total to 95,865. He also announced an additional 314 deaths which brings the statewide total to 5,063.
 
The Governor mentioned a significant flattening of the curve thus far, with statistics showing that the growth rate is steadily decreasing. Despite the positive data, Governor Murphy emphasized that New Jersey is still not close to claiming victory over COVID-19. He said that the curve must continue to flatten before reopening the State. The Governor mentioned that the social distancing policies must stay in place for the next several weeks.
 
This morning, Governor Murphy spoke with New York Governor Cuomo in regards to tri-state cooperation on contact tracing with Connecticut. The discussion is in early stages and it is vital to the reopening of New Jersey. The broader 7-state regional coalition met this morning for the first time and will continue to meet twice a week. New Jersey, New York, Delaware, Connecticut, Pennsylvania, Rhode Island, and Massachusetts are all a part of the regional coalition to coordinate plans to reopen their economies.
 
Yesterday, the NJ Office of Emergency Management received a shipment of 500 additional ventilators that the State purchased. Governor Murphy explained that this will put our State in a position to be better prepared as we reopen and expect a spike in positive cases.
 
The Governor is signing legislation today that requires all NJ hospitals to report demographic and racial data for all individuals who have tested positive for COVID-19 to the NJ Department of Health. Governor Murphy said that this is a critical step in fully understanding how COVID-19 has impacted our diverse NJ communities.
 
NJ Department of Health Commissioner Judith Persichilli reported that 6 hospitals were on divert last night. The Commissioner reported that there has been a flattening of cases in the northern region of the State, but an increase in the central region. The counties in the central region are Somerset, Middlesex, Mercer, Monmouth, and Ocean.


Healthcare News

AMBULATORY ASSESSMENT REPORTING DEADLINE FOR 2019 POSTPONED - 4/21/20
NJDOH has agreed to postpone the filing date for calendar year 2019 until July 15 th .
This brings the assessment in line with State and Federal tax filings.

Facility Administrator,

In accordance with the state and federal income tax filing extensions granted by State of New Jersey, and the U.S. Department of the Treasury, Internal Revenue Service related to COVID-19  https://covid19.nj.gov , the New Jersey Department of Health (Department) has extended the due date of your Calendar Year 2019, State Fiscal Year SFY 2021 HFEL-5 Annual Financial Report to  July 15, 2020  .

Click here to download a copy of the Calendar Year (CY) 2019 Annual Financial Report (HFEL-5), the form required for each licensed facility offering certain types of ambulatory care services to submit an annual financial report for (SFY) State Fiscal Year 2021.

Registered users may complete Form HFEL-5 using the Department’s web-based portal at  https://dohlicensing.nj.gov   . Detailed instructions for registered users on how to submit the HFEL-5 can be found at  https://dohlicensing.nj.gov/helpHFEL5 . If you are unregistered, you may request registration at  aap@doh.nj.gov .

If you have any questions about ambulatory assessment reporting requirements, or the completion of the HFEL-5 Financial Form, please contact the Department at  (609) 913-5970  or email us at  aap@doh.nj.gov .

Thank you,

David Preston, Director
Ambulatory Assessment Program
NJ Department of Health


CARES Grant Attestation Portal Now Live – 4/21/20
Healthcare providers can now attest that they wish to keep the grants the US Department of Health & Human Services (HHS) began distributing last Friday. This grant fund is part of the $100 billion in relief included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 that was signed by President Trump on March 27, 2020.

ADDITIONAL DIRECTION FROM ASCA ON RE-OPENING ASCS -4/21/20
CMS Releases Recommendations for Reopening Healthcare Facilities
The Centers for Medicare & Medicaid Services (CMS)  released guidance  yesterday on restarting non-emergent non-COVID-19 healthcare. If states or regions have passed the  Gating Criteria  (symptoms, cases and hospitals) the White House announced on April 16, 2020, then they may proceed to Phase I. These recommendations can guide healthcare systems and facilities as they consider resuming in-person care of non-COVID-19 patients in regions with a low incidence of COVID-19 disease.

Decisions must be consistent with public health information and in collaboration with state public health authorities. All facilities should continually evaluate whether their region remains at a low risk of incidence and should be prepared to cease non-essential procedures if a surge occurs. Adhering to the following recommendations can allow for safely extending in-person, non-emergent care in select communities and facilities.

General Considerations
  • In coordination with state and local public health officials, evaluate the incidence and trends for COVID-19 in the area where restarting in-person care is being considered.
  • Evaluate the necessity of the care based on clinical needs.
  • Consider establishing Non-COVID Care (NCC) zones that would screen all patients for symptoms of COVID-19, including temperature checks. Staff would be screened routinely as would others who work in the facility (physicians, nurses, housekeeping, delivery and all people who would enter the area).
  • Sufficient resources should be available to the facility across phases of care, including personal protective equipment (PPE), healthy workforce, facilities, supplies, testing capacity and post-acute care, without jeopardizing surge capacity.

In addition to the general considerations, CMS outlines the following recommendations:
  • PPE for staff and patients;
  • workforce availability and staff screening;
  • facility considerations, including social distancing in waiting areas and maintaining low patient volumes;
  • sanitation protocols, including an established plan for thorough cleaning and disinfection prior to using spaces;
  • adequate equipment, medication and supplies must be ensured and must not detract from the community’s ability to respond to a potential surge;
  • all patients must be screened for potential symptoms of COVID-19 prior to entering the NCC facility, and staff must be routinely screened for potential symptoms; and
  • when adequate testing capability is established, patients should be screened by laboratory testing before care, and staff working in these facilities should be regularly screened by laboratory testing as well.

In addition to CMS, ASCA and other healthcare organizations have each identified potential pathways for healthcare providers, including ASCs, to provide care to more patients as the COVID-19 pandemic recedes.

The  ASCA Statement on Resuming Elective Surgery as the Pandemic Recedes , the Society for Ambulatory Anesthesia (SAMBA)  Statement on Resuming Ambulatory Anesthesia Care as Our Nation Recovers from COVID-19 , supported by the American Society of Anesthesiologists (ASA) and ASCA, and the  Roadmap for Resuming Elective Surgery after COVID-19 Pandemic , prepared by the American College of Surgeons, ASA, the Association of periOperative Registered Nurses and the American Hospital Association, can all be found in ASCA’s  COVID-19 Resource Center .

As always, we recommend visiting ASCA's  COVID-19 Resource Center  for valuable resources for ASCs and to find the latest information on the pandemic.
Questions? Contact Jeff Shanton at  jshanton@jssurgctr.com