Appalachia’s first COVID-19 cases were confirmed in early March. 143 days later, on July 26, Doddridge County, West Virginia became the final of Appalachia’s 420 counties to report a confirmed COVID-19 case. Drawing on data from the Johns Hopkins University, COVID-19 Cases in Appalachia maps COVID-19’s spread in the region in relation to the rests of the country.  

More county-level information regarding COVID-19 cases can be found using the searchable database offering demographic data snapshots of confirmed cases and deaths in relation to hospital bed counts, population and businesses, and categories of people at risk for COVID-19. By hovering over each statistical icon, users can learn more about the supporting data. COVID-19 related data is updated daily.

Trump’s announcement comes as his administration has rolled out multiple health care announcements in recent weeks.

President Donald Trump is expected to sign an executive order on August 3, 2020 aimed at boosting health care in rural areas, where struggling hospitals have faced worsening economic conditions during the pandemic, according to five individuals familiar with the planned announcement.

The order will focus on an administration effort to create new ways of financing rural health care, as well as propose a permanent extension for some telehealth policies that helped fuel virtual care’s explosive growth amid stay-at-home orders.

Trump’s announcement comes as his administration has rolled out multiple health care announcements in recent weeks, in a pre-election effort to bolster the president’s record on an important issue to voters. These actions have included executive orders aimed at slashing drug prices, though the ambitious plans have limitations and are not expected to take effect before Election Day. Last week, the administration also released a report on surprise medical bills, as it urged Congress to revive bipartisan efforts to pass consumer protections.

Pressed about his lack of a replacement for Obamacare, Trump also has spent days promising to unveil a health plan of his own, though he declined to detail exactly what that plan would do.

“We’re signing a health-care plan within two weeks, a full and complete health-care plan,” Trump said on “Fox News Sunday” on July 19 — just over two weeks ago.

One federal health official said the rural health changes are limited and should not be viewed as a replacement for the health care law. Three officials also said the administration does not have plans to imminently produce an Obamacare alternative.

Some elements of the rural health plan have been under consideration for more than two years, but the White House budget office balked at proposals to reform hospital payments, fearing that they would be unworkable in practice. Federal health officials retooled the proposals to demonstrate they would save the federal government money.

Under the new plan, the federal Medicare agency will leverage its authority to test new pilot projects that offer financial incentives for providers who deliver higher-quality care to patients. Administration officials believe its new financial model will help keep rural hospitals open, after about 130 have closed in the past decade. The program will be optional, according to three sources.

However, officials have debated the risks of overhauling rural hospital payments, given that the industry is already are under considerable financial pressure and the administration could face political backlash if more hospitals shutter after the White House’s plan takes effect. It’s unclear if any of the changes could be finalized before the election.

On telehealth, the administration will issue a proposed rule to make permanent Medicare payment of the technology for certain health care providers, in an effort to ensure the expansion of virtual care outlasts the pandemic, said two officials. However, a more sweeping extension of pandemic telehealth policies would likely have to come from Congress, which is just beginning to review the issue.

During the height of nationwide shutdowns, Medicare telehealth visits grew from just a few thousand per week to more than 1 million. Trump himself has often remarked about the technology’s rapid rise during the pandemic.

The White House and HHS declined to comment. A CMS spokesperson did not immediately respond to a request for comment. A White House announcement is expected at 5 p.m., two sources said.

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

• Increase Hospital Capacity – CMS Hospitals Without Walls;
• Rapidly Expand the Healthcare Workforce;
• Put Patients Over Paperwork; and
• Further Promote Telehealth in Medicare

Next Office Hours:

Tuesday, August 11^th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 3498643

Audio Webcast link: https://protect2.fireeye.com/url?k=6f7db93e-3329a042-6f7d8801-0cc47adc5fa2-ed718e46a02e4dc1&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2361

Weekly COVID-19 Care Site-Specific Calls

CMS hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.

Home Health and Hospice (twice a month on Tuesday at 3:00 PM Eastern)

Tuesday, August 11^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5097566
Audio Webcast Link: https://protect2.fireeye.com/url?k=b4723cca-e827351a-b4720df5-0cc47a6a52de-e4916e2be973d447&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2386

Nursing Homes (twice a month on Wednesday at 4:30 PM Eastern)

Wednesday, August 12^th 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7857618
Audio Webcast Link: https://protect2.fireeye.com/url?k=2884bdb1-74d1b4a2-28848c8e-0cc47adb5650-5b54c104cb155c28&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2411

Dialysis Organizations (twice a month on Wednesday at 5:30 PM Eastern)

Wednesday, August 12^th at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1027088
Audio Webcast Link: https://protect2.fireeye.com/url?k=6b0af8ba-375ff16a-6b0ac985-0cc47a6a52de-6400b78b7f9a7c65&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2401

Nurses (twice a month on Thursday at 3:00 PM Eastern)

Thursday, August 13^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7844289
Audio Webcast Link: https://protect2.fireeye.com/url?k=666e39a3-3a3b30b0-666e089c-0cc47adb5650-9c83dad655df67f4&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2421

 Lessons from the Front Lines: COVID-19 (twice a month on Friday at 12:30 – 2:00 PM Eastern)

 Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.

This week’s Lessons from the Front Lines:

Friday, August 7^th at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 4695240

Audio Webcast Link: https://protect2.fireeye.com/url?k=c441afa6-9814a6b5-c4419e99-0cc47adb5650-c14a30d0298b73f0&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2376

 For the most current information including call schedule changes, please click here

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.

On July 29, CMS announced the average basic premium for Medicare Part D prescription drug plans, which cover prescription drugs that beneficiaries pick up at a pharmacy. Under the leadership of President Trump, for the first time seniors that use insulin will be able to choose a prescription drug plan in their area that offers a broad set of insulins for no more than $35 per month per prescription.

The average basic Part D premium will be $30.50 in 2021. The 2021 and 2020 average basic premiums are the second lowest and lowest, respectively, average basic premiums in Part D since 2013. This trend of lower Part D premiums, which have decreased by 12 percent since 2017, means that beneficiaries have saved nearly $1.9 billion in premium costs over that time. Further, Part D continues to be an extremely popular program, with enrollment increasing by 16.7 percent since 2017.

“At every turn, the Trump Administration has prioritized policies that introduce choice and competition in Part D,” said CMS Administrator Seema Verma. “The result is lower prices for life-saving drugs like insulin, which will be available to Medicare beneficiaries at this fall’s Open Enrollment for no more than $35 a month. In short, Part D premiums continue to stay at their lowest levels in years even as beneficiaries enjoy a more robust set of options from which to choose a plan that meets their needs.”

In addition to the $1.9 billion in premium savings for beneficiaries since 2017, the Trump Administration has produced substantial Part D program savings for taxpayers. With about 200 additional standalone prescription drug plans and 1,500 additional Medicare Advantage plans with prescription drug coverage joining the program between 2017 and 2020, and that trend expected to continue in 2021, increased market competition has led to lower costs and lower Medicare premium subsidies, which has saved taxpayers approximately $8.5 billion over the past four years.

Earlier this year, CMS launched the Part D Senior Savings Model, which will allow Medicare beneficiaries to choose a plan that provides access to a broad set of insulins at a maximum $35 copay for a month’s supply. Starting January 1, 2021, beneficiaries who select these plans will save, on average, $446 per year, or 66 percent, on their out-of-pocket costs for insulin. Beneficiaries will be able to choose from more than 1,600 participating standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage, all across the country this open enrollment period, which runs from October 15 through December 7. And because the majority of participating Medicare Advantage plans with prescription drug coverage do not charge a Part D premium, beneficiaries who enroll in those plans will save on insulin and not pay any extra premiums.

In January 2020, CMS, through the Part D Payment Modernization Model, offered an innovative new opportunity for Part D plan sponsors to lower costs for beneficiaries, while improving care quality. Under this model, Part D sponsors can better manage prescription drug costs through all phases of the Part D benefit, including the catastrophic phase. Through the use of better tools and program flexibilities, sponsors are better able to negotiate on high cost drugs and design plans that increase access and lower out-of-pocket costs for beneficiaries. For CY 2021, there will be nine plan options in Utah, New Mexico, Idaho and Pennsylvania that participate in this model.

In Medicare Part D, beneficiaries choose the prescription drug plan that best meets their needs, and plans have to improve quality and lower costs to attract beneficiaries. This competitive dynamic sets up clear incentives that drive towards value. CMS has taken steps to modernize the Part D program by providing beneficiaries the opportunity to choose among plans with greater negotiating tools that have been developed in the private market and by providing patients with more transparency on drug prices. Improvements to the Medicare Part D program that CMS has made to date include:

• Beginning in 2021, providing more information on out-of-pocket costs for prescription drugs to beneficiaries by requiring Part D plans to provide a real time benefit tool to clinicians with information that they can discuss with patients on out-of-pocket drug costs at the time a prescription is written
• Implementing Part D legislation signed by President Trump to prohibit “gag clauses,” which keep pharmacists from telling patients about lower-cost ways to obtain prescription drugs
• Beginning in 2021, requiring the Explanation of Benefits document that Part D beneficiaries receive each month to include information on drug price increases and lower-cost therapeutic alternatives
• Providing beneficiaries with more drug choices and empowering beneficiaries to select a plan that meets their needs by allowing plans to cover different prescription drugs for different indications, an approach used in the private sector
• Reducing the maximum amount that low-income beneficiaries pay for certain innovative medicines known as “biosimilars,” which will lower the out-of-pocket cost of these innovative medicines for these beneficiaries
• Empowering Medicare Advantage to negotiate lower costs for physician-administered prescription drugs for seniors for the first time, as well allowing Part D plans to substitute certain generic drugs on plan formularies more quickly during the year, so beneficiaries immediately have access to the generic, which typically has lower cost sharing than the brand
• Increasing competition among plans by removing the requirement that certain Part D plans have to “meaningfully differ” from each other, making more plan options available for beneficiaries

For More Information:

• Part D Senior Savings Model webpage
• Ratebooks & Supporting Data webpage: View the 2021 Part D base beneficiary premium, the Part D national average monthly bid amount, the Part D regional low-income premium subsidy amounts, the de minimis amount, the Medicare Advantage employer group waiver plan regional payment rates, and the Medicare Advantage regional PPO benchmarks

With the emergence of Coronavirus Disease 2019 (COVID-19) and the new treatments that have followed, it is critical to be able to track the use of these treatments and their effectiveness in real-time. CMS responded to this need, and in record time is implementing new procedure codes to allow Medicare and other insurers to identify the use of the therapeutics remdesivir and convalescent plasma for treating hospital in-patients with COVID-19. These new codes, which go into effect August 1, will enable CMS to conduct real-time surveillance and obtain real-world evidence in how these drugs are working and provide critical information on their effectiveness and how they can protect patients. These codes can be reported to Medicare and other insurers may also use the codes to identify the use of COVID-19 therapies and help facilitate monitoring and data collection on their use.

These new codes are being implemented into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS). ICD-10-PCS is the Health Insurance Portability and Accountability Act (HIPAA) designated code set for reporting hospital inpatient procedures, which is developed and maintained by CMS and can be used by other health insurers.

The implementation of these new procedure codes is part of the Trump Administration’s ongoing efforts to protect the health and safety of COVID-19 patients across the country during the public health emergency.

For more information, see ICD-10 MS-DRGs Version 37.2 Effective August 1.

On July 30, CMS and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to counsel patients, at the time of Coronavirus Disease 2019 (COVID-19) testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms.

The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic, and asymptomatic individuals emphasizing the importance of education on self-isolation as the spread of the virus can be reduced significantly by having patients isolated earlier, while waiting for test results or symptom onset. The CDC models show that when individuals who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86 percent reduction in the transmission of the virus compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.

Provider counseling to patients, at the time of their COVID-19 testing, will include the discussion of immediate need for isolation, even before results are available, the importance to inform their immediate household that they too should be tested for COVID-19, and the review of signs and symptoms and services available to them to aid in isolating at home. In addition, they will be counseled that if they test positive, to wear a mask at all times, and they will be contacted by public health authorities and asked to provide information for contact tracing and to tell their immediate household and recent contacts in case it is appropriate for these individuals to be tested for the virus and to self-isolate as well.

CMS will use existing evaluation and management payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals, and community drive-thru or pharmacy testing sites.

For More Information:

• Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) MLN Matters Special Edition Article SE20011
• Counseling Check List, including resource links