06.22.2020

Post-Acute Care Improvements, Telemedicine, and more ...

State Steps Up to Assist Post-Acute Care

The Executive Office of Health & Human Services (EOHHS) has announced a plan to address placement challenges to post-acute care and to support long-term care providers with new funding during the COVID-19 emergency. MHA and its members, through MHA’s Post-Acute Care Transitions Workgroup, have been in close contact with the state over the past month and more in an attempt to resolve the challenges in the post-acute care continuum. Capacity and transfer issues, along with inadequate funding for the post acutes, have at times hampered the COVID-19 response.

The state’s plan is detailed in this one-page summary. Included among the actions are an increased capacity for chronic ventilator-dependent patients and trach-dependent patients in specialized nursing homes. An add-on to the MassHealth nursing facility rate will support this expansion. The state is also providing additional funding of up to $4 million for LTCH/IRFs through MassHealth supplemental payments and temporarily lifting the non-payment for Administratively Necessary Days policy. And supply and demand data for LTCH/IRF beds will be tracked and triaging will be set up to assist in transitioning difficult-to-place cases during the state of emergency. Additional materials will be forthcoming, including a bulletin to formalize the Family Assistance expansion, an escalation form for patients who are "stuck" awaiting discharge, and details for the supplemental payments and the administrative day payment change.

MHA’s Vice President of Clinical Affairs Patricia Noga, R.N and Senior Director of State Government Finance and Policy Dan McHale, who both spearheaded the MHA response, said, “We very much appreciate the Baker Administration’s recognition of the unique role long-term care hospitals have in helping COVID-19 patients recover, as well as their efforts to protect and care for all patients at their facilities during these difficult times.”

State Senate to Consider Major Reforms

With an eye toward a post-COVID healthcare system – and a probable second wave of the virus – the State Senate will consider legislation this week that would make significant changes to the way care is delivered. The bill, An act putting patients first, draws on the system’s COVID-19 experience and would solidify several of the innovations that have helped providers weather the storm.

The Senate bill would require insurers to permanently cover any telehealth visit that has an in-person equivalent. The widespread coverage for telemedicine services, originally mandated by a March 15 executive order, has resulted in a sharp uptick of necessary virtual visits among patients in Massachusetts.

“Telemedicine has empowered clinicians to treat patients without interruption during this public health crisis and prevented our facilities from being overwhelmed throughout the surge, as hospitals exceeded their pre-COVID bed capacity,” said MHA President & CEO Steve Walsh. “It is critical that these services are preserved, especially as a COVID-19 resurgence remains a looming concern for the healthcare community.”

Separately, the MHA-convened tMED Coalition sent this letter to state leaders last week to advocate for long-term telemedicine reforms.

The proposed law would also allow qualified caregivers – including nurse practitioners, nurse anesthetists, and psychiatric nurse mental health specialists – to continue practicing without unnecessary and burdensome oversight. The increased responsibility for these healthcare professionals afforded organizations much-needed flexibility during a time of persistent uncertainty, and expanded scope of practice is a promising way to boost the healthcare workforce moving forward.

The Senate is scheduled to debate the bill on Thursday.

MHA On-Demand Course Helps Caregivers Fulfill Alzheimer’s Requirement

Massachusetts Chapter 220 of the Acts of 2018 requires all physicians, physician's assistants, registered nurses, and practical nurses who serve adult populations to complete a one-time course on the diagnosis, treatment, and care of patients with cognitive impairments including, but not limited to, Alzheimer's disease and dementia.

MHA has produced an on-demand webinar course to help the affected caregivers attest to meeting the state requirements. The course is one hour long and may be downloaded and reviewed at the individual’s convenience. Its expert faculty provides succinct, detailed considerations for caregivers and clinicians who serve aging adult populations.

Today, more than 5.8 million Americans are living with Alzheimer's disease. The MHA course will review important topics in Alzheimer's and related dementias, including guidelines for diagnosis and treatment as well as care management best practices. 

MassHealth Alternative Payment Opportunity for Physicians

The Executive Office of Health and Human Services (EOHHS) has announced a new opportunity for physicians to request cash advances from MassHealth. Eligible physicians’ practices must have billed at least 20% of their calendar year 2019 charges to MassHealth. Individual physicians and group practices are eligible to apply. EOHHS states the amount of funding a practice can request is the lesser of $500,000 or two months of the provider’s average monthly calendar year 2019 MassHealth payments for physician services. The total amount of funding dedicated to these payments is capped at $20 million for all providers and EOHHS will adjust requested amounts pro rata if the funding requests exceed this amount. Reconciliation of these cash advances will begin on January 1, 2021. MassHealth will begin by withholding 50% of the amount reimbursed through MassHealth MMIS claims until the cash advance is repaid. Providers seeking an interim payment must submit an Alternative Interim Payment Application and Attestation Form no later than 5 p.m. on June 23, 2020.

Transition

Jatin K. Dave, M.D., starts with UMass Medical School/Commonwealth Medicine (CWM) and MassHealth on July 1 as chief medical officer for MassHealth and director of CWM’s Office of Clinical Affairs. He comes to his new post from New England Care Alliance. Dave will be the primary clinical liaison between MassHealth and CWM. He is the current chair of MHA’s Physician/Hospital Integration Collaborative (PHIC).

MHA WEBINAR: The Evolving Landscape
and Implications of COVID-19 Testing

Tuesday, June 23 from 12:30 to 1 p.m.

COVID-19 testing is a rapidly evolving and vital tool in controlling the spread of coronavirus. Expanding testing capacity, establishing guidelines and protocols, and ensuring accuracy and rapid results are all critical goals. Dr. Helen W. Boucher, chief of the Division of Geographic Medicine and Infectious Diseases at Tufts University School of Medicine, leads this webinar to discuss COVID-19 testing, and the opportunities, challenges, and implications for healthcare. Register by clicking here.

John LoDico, Editor