COVID-19 Informational Resource Page (Updated 6/26/20; 10:00A)

The Virginia MGMA has created this page as a resource for medical practice management professionals regarding COVID-19. It includes current information, webinars, articles, documents, links, etc. we are receiving on this rapidly changing situation. Our Corporate Sponsors have also submitted helpful information. Please check this page often for updates.
NOTE: VMGMA has not vetted these resources and recommends you consult your attorney or CPA before making any changes to how you conduct business. This page is for information only.             

WEBINARS


ON DEMAND WEBINARS

DATE:
TOPIC:
Getting Practices Back to ‘Normal’: HR Best Practices and Legal Compliance Issues  
Presented by Curi, VMGMA Bronze Corporate Sponsor.
Provided by RxVantage, VMGMA Bronze Corporate Sponsor
Click HERE
In this succinct, 15-minute webinar, we share trends, protocols, and sample policy changes thousands of medical practices have made in response to COVID-19.
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How to "See" Patients during a Pandemic - and Get Paid For It  LINK
Presented by SR Health. Questions or comments? Contact Erik Kingston at: [email protected]
SPEAKER: Elizabeth Woodcock, MBA, FACMPE, CPC is the principal of Woodcock & Associates
COVID-19 has facilitated sweeping changes to the healthcare system; overnight, healthcare organizations have been forced to pivot their ambulatory enterprises from office-based care sites to treating patients remotely. Innovation, speed, and dedication have been embraced for this successful transformation. Join Elizabeth Woodcock for advice about ensuring that your successful operations incorporate the financial aspects of remote care. You’ll learn about:

- Necessary alterations to your scheduling and registration workflows
- Reimbursement opportunities for remote care
- Differences between telemedicine and virtual services
Don’t miss your chance to get these expert insights and ask your questions about providing virtual care and how to get paid for it.
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Webinar Series: Healthcare Practice Comeback
Presented by SolutionReach. Questions or comments? Contact Lori Curtis <[email protected]>
How does your practice bounce back from COVID-19? Here's our plan to get you back in the game - ideas for communication, preparation, and things you can do RIGHT NOW. Everyone loves a good comeback story. Let's start writing yours.

The Practice Comeback Plan webinar series includes four one-hour sessions.
Series Breakdown: Link
Session 1: Practice Comeback Plan Overview
Session 2: Urgent - "Do This Now"
Session 3: Recovery - "Ready to Reopen"
Session 4: Growth "Thrive Going Forward" 
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Staying Connected in an Isolated World
SPEAKER: Greg Peters, The Reluctant Networker
Shared by IL / MI MGMA
Recording /
Access Password
: @connect1 / PPT
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Leading Change Through Turmoil & Turbulence for Practice Managers
SPEAKER:
Mary Kelly, Productive Leaders
Webinar Recording
Handouts: 5 Minute Brainstorming Plan; 5 Minute Daily Productive Plan; 5 Minute Focus Plan
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VMGMA 2020 Corporate Sponsor Resources

McKesson Medical Surgical
-  Webinar: COVID-19 Trends Impacting Providers, powered by Avalere
-  Webinar: Preparing for the New Normal: Virtualizing Medical Care Post Pandemic, brought to you by Amwell
Webinar Wednesday Page: Complete form on right of screen to be alerted to upcoming webinars
-  McKesson Medical-Surgical Covid-19 Support Portal
Coverys
- FAQ For Policy Holders & Helpful Information
- COVID-19 Article
RxVantage
- Safely Re-Opening Amid COVID-19 Vendor Rep. Visitation Protocol Update
- Sample Policy: COVID-19 Vendor/Rep Visitation Protocol Update
- Insight/Guidance on Vendor/Rep Visitation
Article
(5/18/20) Contain Costs By Addressing Financial Barriers to Medication Adherence
(5/18/20) Building a Clinical Education Strategy
(5/18/20) 5 Ways to Boost Practice Efficiency on a Shoestring Budget
(5/18/20) COVID-19 & Medical Practices Updating Protocols For Rep Engagement
(5/18/20) Life Science Companies & Healthcare Providers Partnering for Value Based Patient Care
(5/18/20) 7 Free or Low Cost Ways to Increase Practice Efficiency
RCM&D

- Click HERE for COVID-19 information.
MSVIA / MSV
- Click HERE for MSVIA COVID-19 information.
- Click HERE for MSV COVID-19 information.
HandCraft Linen & Uniform Specialists
- Article: How To Reduce Contamination in Patient Rooms
Curi
- COVID-19 Resource PAGE
The Doctors Company
- COVID-19 Malpractice Coverage FAQ Page. Although it is written for TDC members, there is general information included as well.
- COVID-19 Resource Center
LabCorp
- Link to LabCorp Informational Page

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Virginia Department of Health: Click HERE
CDC
: Click HERE
US Department of Labor / Wage & Hour Division
   - Employee Rights Poster
   - Paid Sick Leave & Expanded Medical Leave Under FFCRA

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Centers For Medicare & Medicaid Services (Philadelphia Regional Office)

To keep up with the important work the Task Force is doing in response to COVID-19, please click HERE. For a complete and updated list of CMS actions, guidance and other information in response to COVID-19, please visit the Current Emergencies Website.

(6/26/20) Hospital Outpatient Departments: Prior Authorization Begins July 1
For dates of service beginning July 1, 2020, you must request prior authorization for the following hospital Outpatient Department (OPD) services:
Blepharoplasty
Botulinum toxin injections (when paired with specific procedure codes)
Panniculectomy
Rhinoplasty
Vein ablation
Medical necessity documentation requirements remain the same and hospital OPDs will receive a decision within 10 days.
While only the hospital OPD service requires prior authorization, CMS wants to remind other providers that perform services in the hospital OPD setting that claims related to/associated with these services will not be paid if the service requiring prior authorization is not eligible for payment. These related services include, but are not limited to, anesthesiology services, physician services, and facility services. Only associated services performed in the hospital OPD setting are affected. Depending on the timing of claim submission for any related services, claims may be automatically denied, reviewed, or denied on a postpayment basis.
For botulinum toxin injections, consult the list of codes that require prior authorization for more details. Generally, the use of botulinum toxin injection codes paired with procedure codes other than 64612 or 64615 will not require prior authorization under this program.
For More Information:
List of codes that will require prior authorization (PDF)
Prior Authorization for Certain Hospital OPD Services webpage
Operational Guide (PDF)
FAQs (PDF)
Final Rule: Page 61446
Send questions to: [email protected]
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(6/17/20) CMS Issues Proposed Rule to Empower Commercial Plans and States to Negotiate Payment for Innovative New Therapies Based on Patient Outcomes (Proposed rule updates provisions to promote value-based payment for prescription drugs.)
Today the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would start to remove barriers to the development of payment models based on value for innovative new therapies.  Therapies are coming to market today that fight disease in an entirely new way, including at the genetic level.  While the impact of these therapies can be transformative, their costs are unprecedented.  New approaches to payment are needed to allow the market room to adapt to these types of curative treatments while ensuring that public programs like Medicaid remain sustainable.  Several proposals will also enhance CMS’s efforts to combat the opioid epidemic and make sure that opioid outpatient drug coverage is appropriate, medically necessary, and avoids adverse medical events.
“CMS’s rules for ensuring that Medicaid receives the lowest price available for prescription drugs have not been updated in thirty years and are blocking the opportunity for markets to create innovative payment models,” said CMS Administrator Seema Verma.  “By modernizing our rules, we are creating opportunities for drug manufacturers to have skin in the game through payment arrangement that challenge them to put their money where their mouth is.”
Under current regulations, prescription drug manufacturers face challenges reporting payments under value-based arrangements to CMS.  Current regulations hinder payers and manufacturers from designing new payment arrangements based on the value provided to a patient, which leads to price negotiations based on quantity of drugs sold instead of the quality of a drug product, as well as efforts by payers to limit access to emerging treatments through utilization management practices like prior authorization and step therapy.  Today’s proposals seek to modernize these regulations, encouraging innovation and empowering states, private payers, and manufacturers to pay for prescription drugs based on clinical outcomes.  Basing payment on the effectiveness of a given therapy can foster innovation in the treatments that are most impactful to patients, while reducing overall healthcare spending and hospital visits.  
These proposals would support the healthcare system’s move to paying on the basis of value instead of volume and increasing accountability for outcomes, as insurers would be able to better negotiate discounts based on a drug’s effectiveness.  In addition, more widespread adoption of payment arrangements based on value could lead to the collection of more evidence on clinical outcomes for a given therapy.  This type of real-world, real-time evidence could help providers use new medications and treatments in a more targeted fashion.  Increasing the link between reimbursement and drug effectiveness will also encourage payers to facilitate patients’ access to new therapies by easing more traditional utilization management practices.
By offering more flexibility for payers and manufacturers to enter into value-based agreements while still ensuring that Medicaid always gets the best deal, CMS is continuing our efforts to foster innovation, increase access to the latest technologies, and ensure that the Medicaid program is sustainable and can continue to serve our most vulnerable populations.
These proposals build on the steps that the Trump Administration has already taken to lower drug prices including the following actions:
•    In Medicare Part D, which covers prescription drugs that beneficiaries pick up at the pharmacy, the average
     basic premium for Medicare Part D prescription drug plans was projected to decline 13.5 percent since 2017
     to the lowest level in seven years, saving beneficiaries about $1.9 billion in premium costs over that time.
•    Announced the Senior Savings Model where, starting in 2021, participating enhanced Part D prescription drug
     plans across the country will provide Medicare beneficiaries access to a broad set of insulins at a maximum $35
     copay for a month’s supply, saving beneficiaries on average $446 for their insulins.
•    Allowing Part D plans to substitute certain generic drugs to onto plan formularies more quickly during the year, so
     beneficiaries immediately have lower cost sharing for these drugs.
•    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.
•    Providing more information on out-of-pocket costs for prescription drugs to beneficiaries by requiring Part D plans to
     adopt tools that provide 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.
•    Approved state plan amendments from eight states to negotiate supplemental rebate agreements involving innovative
     value-based payment arrangements with drug manufacturers, so states can demand results from manufacturers in
     exchange for payment.
•    Issued guidance intended to help states monitor and audit Medicaid and CHIP managed care plans to identify spread
     pricing when calculating their medical loss ratio (MLR).
The changes CMS is proposing also furthers the Trump Administration’s efforts to combat the opioid crisis.  The proposed rule would implement provisions under the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act to promote safe prescribing of opioids and other medications, which is essential to prevent and reduce opioid misuse and abuse.  These proposals include standards that would enhance a states’ ability to identify or limit inappropriate prescribing of opioids if a beneficiary is already receiving medication assisted treatment for substance use disorder (SUD).
CMS is also seeking input on proposals for future rulemaking that would require additional review of opioid prescribing, medication assisted treatment, and naloxone prescribing.  CMS is requesting comments on potential new standards that would enhance states’ ability to identify or limit inappropriate prescribing of opioids if a beneficiary is already receiving medications that can be unsafe when taken with opioids.  These proposals are key to addressing the misuse and overuse of opioids in order to help reduce hospitalizations, emergency department visits, and family crises associated with the epidemic.
A Fact Sheet on the Proposed Rule can be viewed HERE.
The Proposed Rule can be viewed HERE.

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MGMA RESOURCES

(6/26/20) 2020 MIPS: Hardship exception available due to COVID-19
The Centers for Medicare & Medicaid Services (CMS) announced flexibilities for clinicians participating in the Merit-based Incentive Payment System (MIPS) in 2020. Clinicians significantly impacted by the COVID-19 public health emergency may submit an Extreme & Uncontrollable Circumstances application to reweight any or all of the MIPS performance categories by logging into their HARP account at qpp.cms.gov. If a group practice or individual clinician submits 2020 MIPS data for one or more performance categories, that data submission will override an approved application on a category-by-category basis.
(6/26/20) Updated PPP forgiveness guidance released
The Small Business Administration (SBA) released further guidance on Paycheck Protection Program (PPP) loan forgiveness. The Interim Final Rule updates previous loan forgiveness guidance to reflect the changes made under the recently enacted Paycheck Protection Program Flexibility Act. In the guidance, SBA clarifies that a borrower may submit a loan forgiveness application before the end of the covered period if he or she has used all the loan proceeds for which he or she is requesting forgiveness. For more information on the PPP, you can access MGMA’s recently updated resource.
(6/26/20) CMS updates COVID-19 coverage FAQ
CMS released new FAQs regarding COVID-19 coverage issues included in the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act. FFCRA requires insurers to cover COVID-19 tests without patient cost-sharing, but this new guidance clarifies that the requirement for coverage does not extend to tests conducted for general workplace health and safety (such as screening for employees to come back to work) or for any purposes not primarily intended for individualized diagnosis or treatment of COVID-19 or another health condition.
(6/26/20) New Medicare prior authorization requirements go into effect July 1
The Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule issued by CMS established nationwide prior authorization requirements for certain hospital outpatient department services. The following Medicare services will require prior authorization when provided on or after July 1, 2020:
•    Blepharoplasty
•    Botulinum toxin injections
•    Panniculectomy
•    Rhinoplasty
•    Vein ablation
CMS is, however, removing HCPCS code 21235 (Obtaining ear cartilage for grafting) from the list of codes that require prior authorization as a condition of payment, as it is more commonly associated with procedures unrelated to rhinoplasty that are not likely to be cosmetic in nature. The full list of HCPCS codes requiring prior authorization is available here.  

- MGMA COVID Action Center

- Article: 12 Steps For Keeping Your Medical Practice Running Amid COVID-19

- Article: Coronavirus Test Tracker - Commercially Available COVID-19 Diagnostic Tests

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ADDITIONAL RESOURCES

Virginia Department of Health: Click HERE
CDC
: Click HERE
US Department of Labor / Wage & Hour Division
   - Employee Rights Poster
   - Paid Sick Leave & Expanded Medical Leave Under FFCRA
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AAD COVID-19 Reopening Guidelines
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Politico Article: Health Care Workforce is Recession Proof. Is it "Pandemic Proof?"
 *VMGMA Legislative Liaison Gerard Filicko, CMPE, contributed to this article.
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(4/8/20) Daily Labor Report Article - INSIGHT: Managing Health-Care Workers During Coronavirus
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(4/6/20) PayCheck Protection Program (PPP) Information Sheet
Website
(https://www.sba.gov/funding-programs/loans/paycheck-protection-program-ppp#sectionheader-4)
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Total Medical Compliance COVID-19 Resource Page
(5/6/20)
Virginia is working to get practices back in business, and there is a strong emphasis to do it safely. Total Medical Compliance (TMC) would like to assist in that effort by providing an addendum to an OSHA manual to address Respiratory Protection Plan protocols and procedures. We are providing this download free to TMC OSHA clients until 7/1/20 and at a discount for VMGMA members. Please go to our website (https://www.totalmedicalcompliance.com/written-respiratory-protection-plan/) and use the following code to get your VMGMA member discount:  DSM30
If you have questions, call TMC at 1-888-862-6742. Bill Fivek, President & CEO ([email protected])
Respiratory Protection Plan
With the recent events surrounding the COVID - 19 crisis, Total Medical Compliance (TMC) anticipates that there will be additional focus on how employers protect their workers from exposure to diseases spread in an airborne manner. Based on CDC guidance, practices that perform procedures which generate aerosols will require a higher level of respiratory protection, such as the N95 respirator. When implementing the use of respirators, a written plan and training must be in place to ensure the safety of the worker.  TMC has developed this written plan and in conjunction with appropriate equipment and practice involvement, your practice will have the tools needed for success.
Package Includes:
    A written Respiratory Protection Plan, customizable by the practice.  
    A webinar on completion and implementation of the plan. We plan on doing a live webinar initially, and the recorded session will be made available afterwards.
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(3/21/20) Virginia Board of Nursing - To All Board Of Nursing Licensees
On March 12, 2020, Governor Northam issued Executive Order No. 51 declaring a state of emergency for the Commonwealth due to the novel COVID-19. In response to that Order, on March 19, 2020, Dr. David Brown, Director of the Department of Health Professions, waived certain Board of Nursing regulations with the goal of removing certain regulatory barriers to assist with education, testing, practice and workforce issues. Information regarding these waivers is located HERE.

 

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VMGMA 2020 CORPORATE SPONSORS

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