Coronavirus Update #171
New MDH Orders, Indoor Visitation Guide, MDH Webinar Recap, MD Think Updates, Conference Calls Today, Provider Relief Fund Resources, Continuing Appropriations Act, 2021 and Other Extensions Act, CDC Flu Summary and Key Points
New Orders from MDH

As we shared yesterday evening, the Maryland Department of Health (MDH) has released updated orders on health care matters, nursing home matters, assisted living matters, and guidance on visitation and point of care testing. While there is still much to review in greater detail, these are very positive steps forward with much work by many behind the scenes. Governor Hogan’s announcements yesterday and these new initiatives are deeply appreciated and are to be applauded. Please click the links below to view the updated orders and guidance, as well as our August 17 letter on testing recommendation:

Indoor Visitation Explainer for Families

Along with our partners at LeadingAge Maryland and Lifespan, we wanted to share this quick guide to help families understand the full scope of what “indoor visitation” resuming really means. Please feel free to share this document with your teams, families, and communities.
MDH Webinar Recap

Yesterday, the Maryland Department of Health held a webinar call to update the long-term care sector on COVID-19 developments and best practices. The call was recorded, in case you were unable to join or would like to review the topics discussed, which included:

You can also view the webinar's Powerpoint presentation here.

If you have any questions, please email
MD Think Updates

As we shared earlier this week, a new MD Think update is scheduled for release on Tuesday, October 13, 2020. There will be a weekly training hosted by the MD Think team every Thursday from 1:00 - 3:00 PM. Click here for a memo from MDH with more details on the changes and training.

Decommission of the Office of Long Term Care Dedicated Email Account: Beginning Tuesday, December 1, 2020, DHS will decommission the Office of Long Term Care ( dedicated email account that some facilities use to submit applications, redeterminations or documentation. Click here for the memo from MDH for more information.
Federal Updates
President Trump Announces Call with Long Term/Post-Acute Care Providers Today

The White House has invited long term, post-acute, and assisted living providers to join a conference call with President Donald J. Trump and Administration Officials TODAY, Friday, October 2, 2020 at 12:15 PM ET.  

Interested parties can register for the call using the link below. Upon registration, you will receive a unique dial-in number. 
Conference Call Registration
Date: Friday, October 2, 2020
Time: 12:15 pm Eastern Time (please note the time for your specific time zone)
Call-In Registration: CLICK HERE
FRIDAY, OCT. 2: AHCA/NCAL Office Hours on Provider Relief Fund Reporting Requirements

Today at 3:00 pm EST, AHCA/NCAL will host an “office hour” to provide up-to-date answers to your questions about provider relief fund reporting requirements based upon available information and interpretationRead More

Provider Relief Fund Reporting Requirements Office Hours 
Friday, Oct 2, 2020 3:00 pm | 1 hour | Eastern Time 
Join by video HERE

HHS Announces New Opportunity to Apply for Provider Relief Fund Resources 

Yesterday, the Department of Health and Human Services (HHS) announced a new opportunity for providers to seek funding through the HHS Provider Relief Fund. HHS will be accepting applications from October 5, 2020 through November 6, 2020.
What It Means

Congress allocated $175 billion to HHS for the CARES Act Provider Relief Fund. As of September 24, HHS had allocated $122.9 billion of those funds. That funding has been divided between:

  • General distributions: two General Distributions – Phase 1 ($50 billion) and Phase 2 ($18 billion) – distributed through a combination of proactive distributions and application-based awards, and
  • Targeted Distributions: proactive distributions to specific provider types – primarily hospitals and nursing homes.

Yesterday, HHS has allocated an additional $20 billion for another General Distribution, which they have deemed “Phase 3 General Distribution.”
HHS encourages providers to apply early. The new distribution methodology will take into account other applicants, so HHS will not be able to calculate full awards until it has received and reviewed all applications. Virtually all health care providers should be eligible to apply for funding in this distribution. Even those providers who received funding previously may be newly eligible for consideration. 

Key parameters of the new distribution

The new distribution is application-based. Interested providers will be required to apply as opposed to receiving a proactive distribution from HHS. HHS will accept applications from October 5 through November 6. The application will be open to: 

  • providers who have previously received, accepted, or rejected funding through the Provider Relief Fund,

  • behavioral health providers (some had previously been excluded for methodological reasons), and

  • providers newly practicing in 2020 (previously excluded for methodological reasons).

Distribution methodology

2% of Patient Care Revenue – HHS will review each application to ensure providers have received 2% of their annual patient care revenue, taking into account previous distributions from the Provider Relief Fund. This methodology is consistent with the most recent General Distribution Phase 2, for which applications closed on September 13. 

“Equitable Add-On Payment” – HHS indicates it will use the remainder of the $20 billion (after ensuring all applicants have 2% of annual patient care revenue) to calculate an “equitable add-on payment” for all applicants, reflecting:

  • A provider’s change in operating revenues from patient care,

  • A provider’s change in operating expenses from patient care, including expenses incurred related to coronavirus, and

  • Payments already received through prior Provider Relief Fund distributions.

For updates and to learn more about the Provider Relief Program, visit:
President Trump Signs into Law Continuing Appropriations Act, 2021 and Other Extensions Act

Yesterday morning, President Trump signed into law H.R.8337: Continuing Appropriations Act, 2021 and Other Extensions Act. The Senate passed the bill by a vote of 84-10 and the House passed the same measure by a vote of 359-57-1. 

This continuing resolution (CR) provides continued FY2021 appropriations to federal agencies through December 11, 2020 and extends several programs. Of particular interest to our sector, this bill modifies the Accelerated and Advance Payment Programs under Medicare parts A and B during the COVID-19 pandemic. Below are specific details of the modifications.

Congress changed the terms of loan repayment in the following ways: 

  • Subsection C of the bill makes clear that Part A providers, in addition to hospitals now have an extension from 120 days of the loan to 29 months from the date of the first payment. 

  • One year delay – Repayments for both Part A and Part B providers will not begin until at least a year from the date of the original payment from CMS. 

  • Staggered recoupment – Rather than seizing the entire amount of claims until that is repaid, CMS would put limits on the total amount deducted from new claims during the recoupment period: 

  • During the first 11 months in which any such payment offsets are made, 25 percent of the amount is due. 

  • During the succeeding six months, 50% percent of the amount is due. 

  • Longer recoupment period – Providers would have 29 months from the date of the first Advance/Accelerated payment to repay funds before a bill is sent for the balance, including interest. 

  • Lower interest rate – The legislation would lower the interest rate for payments due after the recoupment period from ten percent to four percent. 

CDC Releases Influenza Summary and Technical Key Points

During the 2020-2021 cold and flu season, getting an influenza vaccine is more important than ever to protect yourself, your loved ones, the residents you care for, your community, and the global community from flu. It’s estimated that between 70-85 percent of seasonal flu-related deaths have occurred in older adults, according to the Centers for Disease Control and Prevention (CDC).  Read More
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from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.