March 31, 2020
Stay Connected - LeadingAge Illinois COVID-19 Resources
Stay up to date on state and federal COVID-19 information and updates by accessing the LeadingAge Illinois COVID-19 Resources page. You can also engage with other Illinois members through our listservs, connecting you with your peers by provider type. We have now added a COVID-19 listserv . Contact LeadingAge Illinois if you’d like more information about the listservs or would like to join one.

MUST READ - CMS Releases COVID-19 Emergency Declaration Blanket Waivers
Late last night, CMS released a package of more “sweeping regulatory changes to help the U.S. healthcare system address the COVID-19 patient surge.” The CMS release reflects a huge advocacy win for LeadingAge and VNAA. They included almost every blanket waiver that LeadingAge asked for. Nursing home, hospice and home health waivers granted, linked to those requested, are summarized below:
Everything in the release is contained in an interim final rule with comment period. Also, click here for the recent CMS Memo on Reprioritization of PACE, Medicare Parts C and D Program, and Risk Adjustment Data Validation (RADV) Audit Activities. 
Source: CMS
Federal Coronavirus Response Increases Medicaid Funding for States
This article summarizes key provisions related to Medicaid in the legislation signed on March 18, the Families First bill, as well as the third coronavirus stimulus bill. 
Increases to Share of Medicaid Spending
Each state has its own Medicaid matching rate, or the percent of Medicaid spending the federal government covers. By law, the federal government covers at least 50% of Medicaid costs in each state, with poorer states receiving a higher match rate. 
The Families First bill increases each state’s matching rate by 6.2 percentage points for 2020. So, if a state’s matching rate for 2020 were to be 50%, under Families First its matching rate is now 56.2%. The increased federal share of Medicaid does not apply to the expansion population.
Researchers have estimated this will increase federal funding for Medicaid by $35.7 billion. You can see an estimate for how many federal dollars are estimated to go to states here .
The idea behind increasing the federal share of Medicaid spending is to help free up state budget dollars during the pandemic. Throughout the pandemic most states will see significant decreases in revenue due to decreased economic activity. While the federal government likely will too, many state governments have balanced budget laws that will require significant cuts to spending as a result of the loss of revenue. The federal government does not. Raising the federal share of Medicaid spending allows states to take their budgets further and help stave off cuts within Medicaid and to other programs.
It is important to note that this increased federal Medicaid spending is made to states. Increases in the federal Medicaid share do not go directly to providers or, in states with managed care in Medicaid, managed care organizations. State agencies will receive these funds as they typically do from the federal government and provider reimbursement will not change unless states take steps to make changes. There is no requirement that states do that.
States Must Maintain Eligibility Criteria
The new federal funding for Medicaid is conditioned on states maintaining the current eligibility criteria and premium policies they had set as of January 1.
In other words, states are not allowed to impose more restrictive eligibility criteria (e.g., functional eligibility) or charge higher premiums (or introduce premiums if they did not have them before January 1). In addition, the funds are conditioned on continuous eligibility for all enrollees as of March 18. If a person was enrolled in Medicaid on that date, their state cannot dis-enroll them from Medicaid until the national emergency period ends.
The increased funds do not prevent states from expanding Medicaid or making it easier for people to qualify. Current eligibility criteria serve as a floor, not a ceiling, for the purposes of these funds.
Medicaid Coverage for COVID-19 Services
The increased federal match rate for Medicaid is also conditioned on COVID-19 services. Specifically, states must not impose any Medicaid cost sharing for any services related to COVID-19, including testing and treatment. States also have the option to extend Medicaid coverage to their uninsured populations solely for COVID-19 testing. The federal government will pay the full bill for this testing.
Support for Home and Community-Based Services
The third coronavirus bill includes provisions supporting Medicaid, including home and community-based services. The bill extends the Money Follows the Person (MFP) program through November 2020. Previously scheduled to expire in May, MFP provides enhanced federal dollars to support people transitioning from nursing homes to home and community-based settings.
In addition, the bill extends federal protections for spouses of people receiving Medicaid HCBS through November 2020. These were also going to expire in May. Such protections exist permanently for spouses of people in nursing homes, and exist at the state level in most, but not all, states.
Stimulus Funds and Medicaid Eligibility
A key provision of the third coronavirus response bill provides direct payments to individuals and families. Under the bill, those payments will not count towards Medicaid income eligibility thresholds. People receiving Medicaid, including in nursing homes and in home and community-based settings, will not lose their services because of the funds these payments will deliver.
Source: LeadingAge
CMS Announces Expansion of Accelerated and Advance Payments for Medicare Providers
The Centers for Medicare & Medicaid Services (CMS) recently put out an announcement that it is expanding its accelerated and advance payment for Medicare providers, to help fight the Coronavirus. The expansion of this program is only for the duration of the public health emergency. Details on the eligibility, and the request process are outlined in the CMS Fact Sheet.  
Source: CMS
Family Medical Leave Under the Families First Bill
LeadingAge has updated their Question and Answer document on the Family Medical Leave Act (FMLA) provisions of the second stimulus bill. 
LeadingAge Live Online Coronavirus Daily Member Update
Today – April 26 (7 days/week)
2:30 p.m. daily
Everyone must register again for this new series of live online updates. When you register, you will be automatically signed up for every update through April 26. After you register, you will receive an email confirmation with your unique weblink, which you can use every day. There will be no telephone option.

Due to overwhelming response—and in light of the added strain on virtual meeting platforms—members may still have connection problems with live call-ins. Recordings will be available, should you experience access problems.
Also, if you’re a member of both LeadingAge Illinois and LeadingAge National, stay connected with other LeadingAge National Members and share information and resources through the MyLeadingAge Member Community: COVID-19 . This is a place to connect with your peers to share and discuss everyday practices related to the coronavirus. Take a moment now to log into your account and join the group to stay connected. LeadingAge also has a COVID-19 webpage with the latest updates, information and resources for members.
Update from LeadingAge Illinois and Value First
LeadingAge Illinois and Value First continue to stay in contact with our vendors in for updates in PPE and other supplies for you.  
At this time we have heard from many of our vendors that our communities should put in an order for the equipment that they need as soon as possible. Back orders are being filled in the order in which they have been received from the majority of our vendors. 
Value First members:
We are aware that there are some “gray” vendors sending out information that they can provide you with your PPE equipment, please be cautious of these vendors. If you have any questions, please contact your States Attorney General’s office. 
If you are a Value First member and you have any questions, please do not hesitate to reach out to Terry Romin , our Value First advisor, at 224-230-7265 . If you are NOT a Value First member, but still have questions regarding supplies. Please do not hesitate to reach out to Terry she will assist as best as possible. 
How RESIDE Helps Protect Long-Term Care Facility Residents During COVID-19
As COVID-19 continues its global spread, states and cities across the country are taking serious measures, including stay-at-home orders to prevent more infections. With the recent CMS guidance prohibiting all visitors to long-term care facilities, how are you expected to remain compliant? With RESIDE, admissions can be completed, managed, and overseen REMOTELY. This gives residents the unique ability to submit their contract wherever they choose, keeping current residents and facility staff safe during COVID-19. Click here for the full article.

Author : Holly Kasnetz is the VP of Strategy and Implementation at RESIDE Admissions.