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.


GOINGS ON – 6/2/20

Productive conference call with DOH today.
We again brought up issues- primarily with testing. 
The Department gave us facts about lab usage and availability, which is contrary to what we are hearing from all of you. This of course makes it even more imperative for you to get us the data we have been requesting from you.
We told them that they (or whomever would do this at the state level), need to reach out to pharmacies and others and tell them that they need to test pre-op patients that are not symptomatic, as right now all the chain drug stores for instance will not do that.

Upon our questioning, the Department opined that any MOLECULAR test is OK to use for pre-op testing- thus for instance the Rutgers Saliva Test.
This after we pointed out the wording of the guidelines, and mixed messages we and centers were getting from the CLIA area. They admitted that they need to change it, better describe what is allowed.

They also stated unequivocally : ALL CASES REQURE TESTING.
This is what we have been advising you from the beginning.

They also reiterated: The Guidelines are not a suggestion or discretionary. They are part of EO 145 and are to be obeyed. 
This too is what we have been advising you from the beginning.
They also told us that enforcement guidelines would be forthcoming as regards the ASC guidelines for those who do not follow them.

PPE/Staff Reporting:
The Hospital Association has created a portal for ASCs to use, so the Department will not use a survey as they stated yesterday.
In fact today we went over all the questions to be answered for the portal. Per our suggestions and mutual discussion, the Department is rewording/changing/amending all of them.
All ASCs will receive in the mail a letter from the Department asking for the primary contact (we had them add- and back-up) information as to who will be responsible for reporting, so they can give out passwords for the portal, so watch for that letter.
NJAASC will also forward via our e-blasts that letter when it comes out.

There will also be testing of staff who come in contact with patients- not just for ASCs, but across the board. Right now the Guidelines do not make this mandatory. That is because this mandatory testing was in the works when the Guidelines were issued, and not ready for publication.
All health care providers affected will be notified by the Department. We have no other details as of this moment.  

We sent out a data collection/reporting tool this AM to all centers.
Please fill it out and return.
This is extremely important, as we need a lot of hard data to be able to use to show the Department that in our opinion testing is not working the way it should, or they expected.

The Department is going to use a survey for reporting PPE & Staffing, as opposed to sharing the hospital portal, see below:
We will use a novi survey. We found that there have been too many errors from other facilities entering data on that portal. We should have the survey ready by mid-week. And we can work on frequency and making sure we have all the emails for each facility to log in.’
More to come.

HHS Provides Guidance on Balance Billing Restriction to Retain Provider Relief Payment - 6/1/20
The Department of Health & Human Services (HHS) has issued guidance on the balance billing restriction to which providers must agree in order to keep their Provider Relief Fund grant payments. The guidance, which clarifies that a balance billing prohibition applies only to treatment of patients for a diagnosis of COVID-19 even without a positive test, is contained in an updated  Frequently Asked Questions document  (FAQs) linked on the HHS Provider Relief Fund  webpage .

The Terms and Conditions to which providers must attest in order to keep both the first and second round of Provider Relief payments require that for care for a presumptive or actual case of COVID-19, the Recipient must certify that the practice “will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.” Questions have been raised regarding the definition of a “presumptive” case of COVID-19, i.e., whether the ban on balance billing applies to all patients and/or all care. The source of the confusion stems from one of the Terms and Conditions, which make providers eligible for grant payments only if they did not balance bill for patients treated after January 31, 2020, with “possible” or actual cases of COVID-19 and HHS previous guidance that HHS broadly views every patient as a “possible” case of COVID-19.
To continue reading this Alert on Balance Billing Restriction, click  here .

HHS Issues Guidance on Calculation of Provider Relief Fund Payments and Handling Suspected Overpayments/Underpayments - 6/1/20
In addition to the first Provider Relief Fund payments that providers received automatically during the week of April 10, 2020, HHS began offering on April 24, 2020, a second round of Provider Relief payments for which most providers would need to submit an application. HHS explains in its updated  Frequently Asked Questions  how the second payment amount is calculated. (Some of you may have noticed that a calculation briefly appeared on the Provider Relief Fund Attestation Portal a couple of weeks ago but was taken down.) The purpose of the second payment is to augment a provider’s initial payment so that the total of the two payments combined would be proportional to the provider’s share of 2018 net patient revenue from all sources. HHS clarifies that the allocation methodology is designed to provide relief to providers (who bill Medicare fee-for-service) with at least 2% of that provider’s net patient revenue regardless of the provider’s payer mix. Payments are determined based on the lesser of a) 2% of a provider’s 2018 (or most recent complete tax year) net patient revenue, or b) the sum of incurred losses for March and April which a provider must report in the attestation for the first payment. 
To continue reading this Alert on Calculation of Provider Relief Fund Payments, click  here .

HHS Issues Press Release on Timeline to Apply for Second Relief Payment - 6/1/20
HHS issued a press release on May 20, 2020, reminding providers that they have until June 3, 2020 to apply for the second payment from the Provider Relief Fund. The press release states that all providers who automatically received the second payment prior to 5:00 p.m. on April 24, 2020 must submit by June 3rd their tax forms or financial statements to HHS via the General Distribution Portal. (The automatic payments were sent to providers who had cost reports on file with CMS). For those providers who did not automatically receive a second payment, submission of tax forms or financial statements will serve as an application for the second payment. Providers who do not submit revenue information by June 3rd will not be eligible to receive the additional payment.
Questions? Contact Jeff Shanton at