- Rural Hospitals Built During Baby Boom Now Face Baby Bust
- Food Stamps Go Further in Rural Areas — Until You Add Transportation Costs
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Texas
- CMS Proposes New Payments for Digital Health Under CY2025 PFS Draft Rule
- Improving Public Health by Strengthening Community Infrastructure
- Biden Harris Administration Proposes Policies to Reduce Maternal Mortality, Advance Health Equity, and Support Underserved Communities
- Nearly Half of U.S. Counties Don't Have a Single Cardiologist
- Randolph County, Ill. Turns Unused Part of Nursing Home Into State-Of-The-Art Behavioral Health Center
- Rural RPM Program Is a Lifeline for Pregnant Women
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Expert: Rural Hospitals Are Particularly Vulnerable to Increasing Cyberattacks Targeting Healthcare Facilities
- Biden-Harris Administration Invests Over $200 Million to Help Primary Care Doctors, Nurses, and Other Health Care Providers Improve Care for Older Adults
- AJPH Call for Papers Special Section on Intersections of Public Health And Primary Care
- NIH HEAL Initiative Turns Attention to Pragmatic Trials in Rural Communities
- Limited Continuing-Care Options in Rural Virginia Create Challenges for an Aging Population
Penn State Releases COVID-19 Strategic Planning Report
The Institute of State and Regional Affairs at Penn State Harrisburg has released a report to help guide strategic planning in response to the COVID-19 outbreak in Pennsylvania. The report compares counties in Pennsylvania based on medical risk factors relating to COVID-19. The institute found that the three Pennsylvania counties with the highest relative risk, Sullivan, Northumberland and Juniata, are not yet showing high rates of infection.
“Efforts to mitigate the spread of COVID-19 in Pennsylvania have been strong and grounded in the best available evidence. This analysis provides new information that may aid strategic efforts to promote the health and safety of communities at greatest risk,” said Institute Director Philip Sirinides.
Rather than mapping current hot spots of COVID-19, this report’s purpose is to highlight areas where the outcomes from COVID-19 may be more severe. To highlight which Pennsylvania counties have the most vulnerable populations, the institute collected data relating to age, prevalence of cardiovascular disease and diabetes, available hospital staff and beds, and nursing home populations, all factors associated with COVID-19 risk identified by the Centers for Disease Control and Prevention.
Click here to read the report on medical risk and COVID-19 in Pennsylvania.
Dispatch From A Country Doctor: Seeing Patients Differently In The Time Of Coronavirus
![](https://khn.org/wp-content/uploads/sites/2/2020/04/Hahn_1350.jpg?w=1024)
Patients would often stop by River Bend Family Medicine just to gab with staff at the front desk or bring baked goods to Dr. Matt Hahn.
“I’m a simple country doctor,” said Hahn, who has practiced in Hancock, Maryland, for 20 years ― the past decade at his River Bend office. “Our waiting room is like a social network in and of itself.” Hahn is also a candidate for West Virginia’s 2nd Congressional District though he has backed away from campaigning because of the coronavirus threat.
His waiting room is now closed for the same reason. But Hahn’s practice in this small town — pinned hard up against the borders with West Virginia and Pennsylvania, about 100 miles northwest of Washington, D.C. ― is not.
Patients who need an in-office appointment call when they get to the parking lot and wait there instead. A staff member escorts them in, opening all the doors, telling patients not to touch anything. Those who are ill use one specific entrance, which leads them upstairs where they are met by staff who follow strict infection-control measures. The rest, such as those coming in with a wound or a diabetes checkup, are treated downstairs.
COVID-19: Expanded Use of Ambulance Origin/Destination Modifiers
During the COVID-19 Public Health Emergency, Medicare will cover a medically necessary emergency and non-emergency ground ambulance transportation from any point of origin to a destination that is equipped to treat the condition of the patient consistent with state and local Emergency Medical Services (EMS) protocols where the services will be furnished. On an interim basis, we are expanding the list of destinations that may include but are not limited to:
- Any location that is an alternative site determined to be part of a hospital, Critical Access Hospital (CAH), or Skilled Nursing Facility (SNF)
- Community mental health centers
- Federally Qualified Health Centers (FQHCs)
- Rural health clinics (RHCs)
- Physicians’ offices
- Urgent care facilities
- Ambulatory Surgery Centers (ASCs)
- Any location furnishing dialysis services outside of an End-Stage Renal Disease (ESRD) facility when an ESRD facility is not available
- Beneficiary’s home
CMS expanded the descriptions for these origin and destination claim modifiers to account for the new covered locations:
- Modifier D – Community mental health center, FQHC, RHC, urgent care facility, non-provider-based ASC or freestanding emergency center, location furnishing dialysis services and not affiliated with ESRD facility
- Modifier E – Residential, domiciliary, custodial facility (other than 1819 facility) if the facility is the beneficiary’s home
- Modifier H – Alternative care site for hospital, including CAH, provider-based ASC, or freestanding emergency center
- Modifier N – Alternative care site for SNF
- Modifier P – Physician’s office
- Modifier R – Beneficiary’s home
For the complete list of ambulance origin and destination claim modifiers see Medicare Claims Processing Manual Chapter 15, Section 30 A.
Guidance for Processing Attestations from Ambulatory Surgical Centers (ASCs) Temporarily Enrolling as Hospitals during the COVID-19 Public Health Emergency
CMS is providing needed flexibility to hospitals to ensure they have the ability to expand capacity and to treat patients during the COVID-19 public health emergency. As part of the COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers CMS is allowing Medicare-enrolled ASCs to temporarily enroll as hospitals and to provide hospital services to help address the urgent need to increase hospital capacity to take care of patients.
Families First Coronavirus Response Act Waives Coinsurance and Deductibles for Additional COVID-19 Related Services
The Families First Coronavirus Response Act waives cost-sharing under Medicare Part B (coinsurance and deductible amounts) for Medicare patients for COVID-19 testing-related services. These services are medical visits for the HCPCS evaluation and management categories described below when an outpatient provider, physician, or other providers and suppliers that bill Medicare for Part B services orders or administers COVID-19 lab test U0001, U0002, or 87635.
Cost-sharing does not apply for COVID-19 testing-related services, which are medical visits that: are furnished between March 18, 2020 and the end of the Public Health Emergency (PHE); that result in an order for or administration of a COVID-19 test; are related to furnishing or administering such a test or to the evaluation of an individual for purposes of determining the need for such a test; and are in any of the following categories of HCPCS evaluation and management codes:
- Office and other outpatient services
- Hospital observation services
- Emergency department services
- Nursing facility services
- Domiciliary, rest home, or custodial care services
- Home services
- Online digital evaluation and management services
Cost-sharing does not apply to the above medical visit services for which payment is made to:
- Hospital Outpatient Departments paid under the Outpatient Prospective Payment System
- Physicians and other professionals under the Physician Fee Schedule
- Critical Access Hospitals (CAHs)
- Rural Health Clinics (RHCs)
- Federally Qualified Health Centers (FQHCs)
For services furnished on March 18, 2020, and through the end of the PHE, outpatient providers, physicians, and other providers and suppliers that bill Medicare for Part B services under these payment systems should use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services and should NOT charge Medicare patients any co-insurance and/or deductible amounts for those services.
For professional claims, physicians and practitioners who did not initially submit claims with the CS modifier must notify their Medicare Administrative Contractor (MAC) and request to resubmit applicable claims with dates of service on or after 3/18/2020 with the CS modifier to get 100% payment.
For institutional claims, providers, including hospitals, CAHs, RHCs, and FQHCs, who did not initially submit claims with the CS modifier must resubmit applicable claims submitted on or after 3/18/2020, with the CS modifier to visit lines to get 100% payment.
Additional CMS actions in response to COVID-19, 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, visit www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.
New Video Available on Medicare Coverage and Payment of Virtual Services
CMS released a video providing answers to common questions about the Medicare telehealth services benefit. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.
Strategies for Disseminating and Implementing COVID-19 Public Health Prevention Practices in Rural Areas
By Beth Prusaczyk, PhD, Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri
The rapid spread of COVID-19 across the United States (US) demands a similarly rapid scientific response to mitigate the impact. While the initial scientific discourse about the virus appropriately focused on virology, clinical features, and therapeutics, there is now equal, if not greater, attention on the public health practices that are immediately needed to slow the spread as the response shifts from―containment‖ to―mitigation.
To mitigate the spread of the virus, numerous states have enacted policies that restrict their residents statewide, such as closing all schools, limiting gatherings over a certain amount, or issuing ―shelter in place/stay at home‖ orders for all non-essential activities. These―social or physical distancing‖ practices are seen by many public health experts as the most effective tools currently available to slow the transmission of the virus.
Updated: Most Aggressive States Against the Coronavirus – WalletHub Study
With nearly all of the 50 states in some form of lockdown to fight the spread of COVID-19, WalletHub today released updated rankings for the Most Aggressive States Against the Coronavirus, as well as accompanying videos.
To identify which states are taking the most aggressive actions to combat coronavirus, WalletHub compared the 50 states and the District of Columbia across 51 key metrics. The data set ranges from tested cases of COVID-19 per capita to school closures, ICU beds, and shelter-in-place policies. Below, you can see highlights from WalletHub’s report, along with a summary of the largest changes in rank from our previous report and a Q&A with WalletHub analysts.
States with Most Aggressive Measures |
States with Least Aggressive Measures |
1. New York | 42. Texas |
2. District of Columbia | 43. Utah |
3. Alaska | 44. Florida |
4. Hawaii | 45. Mississippi |
5. New Jersey | 46. Arkansas |
6. Rhode Island | 47. Wyoming |
7. Washington | 48. Alabama |
8. Massachusetts | 49. Nebraska |
9. New Hampshire | 50. South Dakota |
10. West Virginia | 51. Oklahoma |
Note: Rankings reflect data available as of 1 p.m. ET on April 6, 2020.
National Public Health Week 2020
The week of April 6-12, 2020 is National Public Health Week. Join the American Public Health Association in recognizing the contributions of public health and highlighting issues that are important to improving overall health. Use the hashtag “#NPHW2020” on social media and consider joining the Twitter Chat on April 8 at 2 p.m.
Click here for more information.
Click here to register for the Twitter Chat.
Free Oral Health Educational Curriculum: Smiles for Life
Smiles for Life (SFL) is a free online oral health curriculum. The curriculum consists of 60-minute modules covering core areas of oral health relevant to health professionals. The topics are: The Relationship of Oral Health & Systemic Health, Child Oral Health, Adult Oral Health, Acute Dental Problems, Pregnancy & Woman’s Oral Health, Caries Risk Assessment Fluoride Varnish & Counseling, The Oral Exam, and Geriatric Oral Health.