The Pennsylvania Liquor Control Board (PLCB) today began accepting orders by phone for curbside pickup at 176 locations. Phone orders can be placed between 9 a.m. and 1 p.m., or until reaching a store’s maximum order capacity each day. Curbside pickups will be scheduled from 9 a.m. to 6 p.m. within a few days of order placement. Callers will be guided through each store’s unique inventory. There is a limit of six bottles per order, and credit cards are the only accepted form of payment. At pickup, customers will be required to present identification before the order is delivered.

The PLCB website lists the stores offering curbside pickup. PLCB anticipates expanding the service at more locations in the future. The PLCB website, FineWineAndGoodSpirits.com, is also increasing order capacity.

 

USDA is launching a new “Buy Fresh” program to purchase $100 million per month in fresh produce from regional and local distributors whose workforce has been significantly impacted by the closure of restaurants, hotels, and other food service entities. USDA also will buy similar quantities of dairy products and meat. The program is expected to continue for six months.

An informational webinar for interested participants will be held at 2 p.m. EDT on Tuesday, April 21, 2020, to provide an overview of the program and instructions for submitting offers. Register in advance for this webinar here. If you are unable to participate in the webinar, a recording will be available.

You can email questions to USDAFoodBoxDistributionProgram@usda.gov.

With many industries in the U.S. ground to a halt because of the coronavirus social distancing restrictions, the personal-finance website WalletHub today released its report on the States Slowing Down the Most During the COVID-19 Pandemic, as well as accompanying videos.

In order to find out which states are slowing down most during the COVID-19 pandemic, WalletHub used Google data to compare the 50 states across six key metrics. Each metric measures the percentage point increase or decrease in visits to various types of places due to coronavirus. Below, you can see highlights from the report, along with a WalletHub Q&A.

States Slowing Down the Most	States Slowing Down the Least
1. Hawaii	41. West Virginia
2. New York	42. Tennessee
3. New Jersey	43. Indiana
4. Vermont	44. Ohio
5. Nevada	45. Alabama
6. Florida	46. Iowa
7. California	47. Kentucky
8. Montana	48. Arkansas
9. Michigan	49. Kansas
10. Massachusetts	50. Nebraska

To view the full report and your state’s rank, please visit:
https://wallethub.com/edu/states-slowing-down-the-most-during-the-covid-19-pandemic/73432/

Improved availability of data key to driving improvement in patient care and development of innovative practices

The Centers for Medicare & Medicaid Services (CMS) is encouraging clinicians who participate in the Quality Payment Program (QPP), such as physicians, physician assistants, nurse practitioners, and others, to contribute to scientific research and evidence to fight the Coronavirus Disease 2019 (COVID-19) pandemic. Clinicians may now earn credit in the Merit-based Incentive Payment System (MIPS), a performance-based track of QPP that incentivizes quality and value, for participation in a clinical trial and reporting clinical information by attesting to the new COVID-19 Clinical Trials improvement activity. This action will provide vital data to help drive improvement in patient care and develop innovative best practices to manage the spread of COVID-19 within communities.

“The best scientific and medical minds in the world are working night and day to find treatments to combat Coronavirus,” said CMS Administrator Seema Verma. “But without solid data, their efforts are liable to run up against a brick wall. At the direction of President Trump, CMS is supporting efforts of researchers to obtain solid, actionable data to accelerate the development of new treatments and our understanding of the coronavirus.  Today’s action encourages clinicians to report data that will help us monitor the spread of the virus, find innovative medical solutions, and unleash scientific discovery as we seek to overcome this terrible disease.”

In order to receive credit for the new MIPS COVID-19 Clinical Trials improvement activity, clinicians must attest that they participate in a COVID-19 clinical trial utilizing a drug or biological product to treat a patient with a COVID-19 infection and report their findings through a clinical data repository or clinical data registry for the duration of their study.

The new improvement activity provides flexibility in the type of clinical trial, which could include the traditional double-blind placebo-controlled trial to an adaptive or pragmatic design that flexes to workflow and clinical practice. It also carries a high weight from a scoring perspective. This means that clinicians who report this activity will automatically earn half of the total credit needed to earn a maximum score in the MIPS improvement activities performance category, which counts as 15 percent of the MIPS final score.

For example, clinical trials could include those conducted by the National Institute of Health (NIH). Clinicians could also report through a clinical data repository, such as Oracle’s COVID-19 Therapeutic Learning System. Oracle has developed and donated a system to the U.S. government that allows clinicians and patients at no cost to record the effectiveness of promising COVID-19 drug therapies. Having clinicians use an open source data tool to submit their findings will bring the results of their research to the forefront of healthcare much faster, leading to improvements in care delivery and the ability to treat COVID-19 patients.

This action, along with the unprecedented regulatory flexibilities recently introduced, is just one part of the agency’s efforts to address the COVID-19 pandemic. CMS, in coordination with the White House Coronavirus Task Force, remains committed to  reducing regulator burden and supporting clinicians, stakeholders, and the health care community to identify unique solutions that enhance care for patients and further mitigate the spread of the virus.

This action, and earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov.  For information specific to CMS, please visit the Current Emergencies Website.

To view a database of privately and publicly funded clinical studies currently being conducted on corona virus visit:  https://clinicaltrials.gov/

Dr. Rachel Levine, under her authority as Secretary of the Department of Health to take any disease control measure appropriate to protect the public from the spread of infectious disease, signed an order directing protections for critical workers who are employed at businesses that are authorized to maintain in-person operations during the COVID-19 disaster emergency.

The entire press release can be found here.

 

On April 17, 2020, Pennsylvania Governor Tom Wolf announced a Plan for Pennsylvania that will provide citizens and businesses relief, allow for a safe and expedient reopening, and lay a road to recovery from the challenges and hardships created by the 2019 novel coronavirus.

The proposal includes plans for food insecurity, student loan debt, individuals who have been furloughed, laid off, or have reduced hours, individuals who are uninsured or underinsured, students and families, relief for businesses, and standards for reopening.

MLN Matters Number: SE20016

Article Release Date: April 17, 2020

Related CR Transmittal Number: N/A

Related Change Request (CR) Number: N/A

Effective Date: N/A

Implementation Date: N/A

PROVIDER TYPES AFFECTED

This MLN Matters® Special Edition Article is for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) during the COVID-19 Public Health Emergency (PHE) for services provided to Medicare beneficiaries.

WHAT YOU NEED TO KNOW

To provide as much support as possible to RHCs and FQHCs and their patients during the COVID-19 PHE, both Congress and the Centers for Medicare & Medicaid Services (CMS) have made several changes to the RHC and FQHC requirements and payments. These changes are for the duration of the COVID-19 PHE, and we will make additional discretionary changes as necessary to assure that RHC and FQHC patients have access to the services they need during the pandemic. For additional information, please see the RHC/FQHC COVID-19 FAQs at https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf.

BACKGROUND

New Payment for Telehealth Services

On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) was signed into law. Section 3704 of the CARES Act authorizes RHCs and FQHCs to furnish distant site telehealth services to Medicare beneficiaries during the COVID-19 PHE. Medicare telehealth services generally require an interactive audio and video telecommunications system that permits real-time communication between the practitioner and the patient. RHCs and FQHCs with this capability can immediately provide and be paid for telehealth services to patients covered by Medicare for the duration of the COVID-19 PHE.

Distant site telehealth services can be furnished by any health care practitioner working for the RHC or the FQHC within their scope of practice. Practitioners can furnish distant site telehealth services from any location, including their home, during the time that they are working for the RHC or FQHC, and can furnish any telehealth service that is approved as a distant site telehealth service under the Physician Fee Schedule (PFS). A list of these is available at https://www.cms.gov/files/zip/covid-19-telehealth-services-phe.zip.

The statutory language authorizing RHCs and FQHCs as distant site telehealth providers requires that CMS develop payment rates for these services that are similar to the national average payment rates for comparable telehealth services under the PFS. Payment to RHCs and FQHCs for distant site telehealth services is set at $92, which is the average amount for all PFS telehealth services on the telehealth list, weighted by volume for those services reported under the PFS.

For telehealth distant site services furnished between January 27, 2020, and June 30, 2020, RHCs and FQHCs must put Modifier “95” (Synchronous Telemedicine Service Rendered via Real-Time Interactive Audio and Video Telecommunications System) on the claim. RHCs will be paid at their all-inclusive rate (AIR), and FQHCs will be paid based on the FQHC Prospective Payment System (PPS) rate. These claims will be automatically reprocessed in July when the Medicare claims processing system is updated with the new payment rate. RHCs and FQHCs do not need to resubmit these claims for the payment adjustment.

For telehealth distant site services furnished between July 1, 2020, and the end of the COVID-19 PHE, RHCs and FQHCs will use an RHC/FQHC specific G code, G2025, to identify services that were furnished via telehealth. RHC and FQHC claims with the new G code will be paid at the $92 rate. Only distant site telehealth services furnished during the COVID-19 PHE are authorized for payment to RHCs and FQHCs. If the COVID-PHE is in effect after December 31, 2020, this rate will be updated based on the 2021 PFS average payment rate for these services, weighted by volume for those services reported under the PFS.

Costs for furnishing distant site telehealth services will not be used to determine the RHC AIR or the FQHC PPS rates but must be reported on the appropriate cost report form. RHCs must report both originating and distant site telehealth costs on Form CMS-222-17 on line 79 of the Worksheet A, in the section titled “Cost Other Than RHC Services.” FQHCs must report both originating and distant site telehealth costs on Form CMS-224-14, the Federally Qualified Health Center Cost Report, on line 66 of the Worksheet A, in the section titled “Other FQHC Services”.

Since telehealth distant site services are not paid under the RHC AIR or the FQHC PPS, the Medicare Advantage wrap-around payment does not apply to these services. Wrap-around payment for distant site telehealth services will be adjusted by the MA plans.

During the COVID-19 PHE, CMS will pay all of the reasonable costs for any service related to COVID-19 testing, including applicable telehealth services, for services furnished beginning on March 1, 2020. For services related to COVID-19 testing, including telehealth, RHCs and FQHCs must waive the collection of co-insurance from beneficiaries. For services in which the coinsurance is waived, RHCs and FQHCs must put the “CS” modifier on the service line.

RHC and FQHC claims with the “CS” modifier will be paid with the coinsurance applied, and the Medicare Administrative Contractor (MAC) will automatically reprocess these claims beginning on July 1. Coinsurance should not be collected from beneficiaries if the coinsurance is waived.

Expansion of Virtual Communication Services

Payment for virtual communication services now include online digital evaluation and management services. Online digital evaluation and management services are non-face-to-face,

patient-initiated, digital communications using a secure patient portal. The online digital evaluation and management codes that are billable during the COVID-19 PHE are:

• CPT code 99421 (5-10 minutes over a 7-day period)
• CPT code 99422 (11-20 minutes over a 7-day period)
• CPT code 99423 (21 minutes or more over a 7-day period)

To receive payment for the new online digital evaluation and management (CPT codes 99421, 99433, and 99423) or virtual communication services (HCPCS codes G2012 and G2010), RHCs and FQHCs must submit an RHC or FQHC claim with HCPCS code G0071 (Virtual Communication Services) either alone or with other payable services. For claims submitted with HCPCS code G0071 on or after March 1, 2020, and for the duration of the COVID-19 PHE, payment for HCPCS code G0071 is set at the average of the national non-facility PFS payment rates for these 5 codes. Claims submitted with G0071 on or after March 1 and for the duration of the PHE will be paid at the new rate of $24.76, instead of the CY 2020 rate of $13.53.

MACs will automatically reprocess any claims with G0071 for services furnished on or after March 1 that were paid before the claims processing system was updated.

Revision of Home Health Agency Shortage Requirement for Visiting Nursing Services

RHCs and FQHCs can bill for visiting nursing services furnished by an RN or LPN to homebound individuals under a written plan of treatment in areas with a shortage of home health agencies (HHAs). Effective March 1, 2020, and for the duration of the COVID-19 PHE, the area typically served by the RHC, and the area included in the FQHC service area plan, is determined to have a shortage of HHAs, and no request for this determination is required. RHCs and FQHCs must check the HIPAA Eligibility Transaction System (HETS) before providing visiting nurse services to ensure that the patient is not already under a home health plan of care.

Consent for Care Management and Virtual Communication Services

Beneficiary consent is required for all services, including non-face-to-face services. During the PHE, beneficiary consent may be obtained at the same time the services are initially furnished. For RHCs and FQHCs, this means that beneficiary consent can be obtained by someone working under general supervision of the RHC or FQHC practitioner, and direct supervision is not required to obtain consent. In general, beneficiary consent to receive these services may be obtained by auxiliary personnel under general supervision of the billing practitioner; and the person obtaining consent can be an employee, independent contractor, or leased employee of the billing practitioner. For RHCs and FQHCs, beneficiary consent to receive these services may be obtained by auxiliary personnel under general supervision of the RHC or FQHC practitioner; and the person obtaining consent can be an employee, independent contractor, or leased employee of the RHC or FQHC practitioner (see: https://www.cms.gov/files/document/covid-final-ifc.pdf).

 Accelerated/Advance Payments

In order to increase cash flow to providers and suppliers impacted by COVID-19, CMS has expanded our current Accelerated and Advance Payment Program. An accelerated/advance payment is a payment intended to provide necessary funds when there is a disruption in claims

 20016Related CRN/A submission and/or claimsprocessing. CMS is authorized to provide accelerated or advancepayments during the period of the PHE to any RHC orFQHC who submitsa requestto theirMACand meets the required qualifications.Each MACwillwork to review requestsand issuepayments within seven calendar days of receiving the request. Traditionallyrepayment ofthese advance/accelerated payments begins at 90 days; however,forthe purposes of the COVID-19 pandemic, CMS has extended the repayment ofthese accelerated/advance payments to begin 120 days after the date of issuance of the payment. Providers can get more information on thisprocessathttps://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf.

ADDITIONALINFORMATION

View the complete list of coronaviruswaivers.

Review information on the current emergencies webpage athttps://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page.If you have questions, your MACs may have more information. Find their website at http://go.cms.gov/MAC-website-list.

With COVID-19 turning home into the workplace nationwide, the personal-finance website WalletHub today released its report on the Best States for Working from Home, as well as accompanying videos, in order to highlight which areas are thriving and which are struggling in this pandemic economy.

To identify which states are most conducive to working from home, WalletHub compared the 50 states and the District of Columbia across 12 key metrics. The data set ranges from the share of workers working from home before COVID-19 to internet cost and cybersecurity. We also considered factors like how large and how crowded homes are in the state. Together, these metrics show how feasible working from home is in terms of cost, comfort and safety. Below, you can see highlights from the report, along with a WalletHub Q&A.

Best States for Working from Home	Worst States for Working from Home
1. Delaware	42. District of Columbia
2. Washington	43. Wyoming
3. New Hampshire	44. Iowa
4. Colorado	45. Rhode Island
5. Georgia	46. North Dakota
6. Arizona	47. Oklahoma
7. Utah	48. Arkansas
8. Oregon	49. Mississippi
9. North Carolina	50. Hawaii
10. South Dakota	51. Alaska

Key Stats

• Colorado has the highest share of the labor force working from home, 7.70 percent, which is 3.3 times higher than in Mississippi, the state with the lowest at 2.30 percent.
• New Hampshire has the highest share of households with a broadband internet subscription, 78.80 percent, which is 1.7 times higher than in Mississippi, the state with the lowest at 46.80 percent.
• Connecticut has the highest share of households with access to broadband speeds over 25 Mbps, 98.70 percent, which is 1.5 times higher than in Mississippi, the state with the lowest at 65.40 percent.
• South Dakota has the fewest cybercrime victims per 100,000 residents, 54.73, which is four times fewer than in Nevada, the state with the most at 218.31.
• Indiana has the lowest amount lost per victim as a result of internet crime, $2,465.73, which is 11.5 times lower than in Ohio, the state with the highest at $28,394.32.
• North Dakota has the lowest residential retail price of electricity, 9.01 cents per kWh, which is 3.5 times lower than in Hawaii, the state with the highest at 31.70 cents per kWh.

To view the full report and your state’s rank, please visit:
https://wallethub.com/edu/best-states-for-working-from-home/72801/

The Pennsylvania Department of Community and Economic Development (DCED) Secretary Dennis Davin announced the creation of the Business-to-Business Interchange Directory to connect organizations and businesses directly to manufacturers producing COVID-19-related products and supplies.

Company and product information provided in the directory were gathered in good faith as a means of connecting Pennsylvania businesses and organizations that are seeking various PPE and other related items to combat the COVID-19 crisis. The information made available is from those entities who voluntarily contacted the commonwealth through the Manufacturing Call to Action Portal or the Pennsylvania Critical Medical Supplies Procurement Portal.

Currently included in the directory are manufacturers of N95 masks, fabric and other masks, and surgical masks. Additional supplies and materials will be added to the directory as DCED identifies potential manufacturers. Businesses that would like to be added to the directory or those with questions should contact RA-DCEDPAMCTAP@pa.gov.