IHA Daily Briefing: May 20

Wednesday, May 20, 2020
Update on COVID-19 Private Payer Guidance
HHS Provides $11.8 Million to IL RHCs
Governor Announces Phase 3 Modifications
Illinois COVID-19 Update
National COVID-19 Update
CDC Releases COVID-19 Guide
IHA Quality Improvement Opportunities Post-HIIN

Update on COVID-19 Private Payer Guidance
To assist members in navigating private payer policies, IHA has created a table that summarizes COVID-19 coverage of testing/screening and treatment for health plans offered by health insurance issuers operating in Illinois. The COVID-19 treatment information generally applies to private fully-insured, individual, and group health plans. It does not address policies for self-funded group health plans (ERISA), Medicare Advantage plans, or Medicaid managed care plans.

Federal law requires most health insurance issuers offering individual and group health plans, including self-funded employer-based health plans (ERISA) to waive cost-sharing, prior authorization and other medical management policies, and network requirements for COVID-19-related testing and screening services; however, there are currently no federal or state mandates regarding treatment of COVID-19.  Coverage flexibilities for treatment are generally at the discretion of the health insurance issuer based on plan type and benefit design and typically limited to in-network services.

See IHA’s memo for additional information.


HHS Provides $11.8 Million to IL RHCs
On May 20, the U.S. Department of Health and Human Services (HHS) distributed $225 million for COVID-19 testing in rural communities, $11.8 million of which went to 239 rural health clinics (RHCs) in Illinois. This funding came through the April 24 Paycheck Protection Program and Health Care Enhancement Act, which specifically directed these monies to be allocated to RHCs.

“The funding may be used for a wide range COVID-19 testing and related expenses including planning for implementation of a COVID-19 testing program, procuring supplies to provide testing, training providers and staff on COVID-19 testing procedures, and reporting data to HHS on COVID-19 testing activities,” said Health Resources and Services Administration (HRSA) Administrator Tom Engels.

HHS also awarded $500,000 for COVID-19 testing technical assistance, such as providing guidance for the implementation and management of testing programs. IHA will publish additional information on the receipt and use of these funds as it is released.


Governor Announces Phase 3 Modifications
Today at his daily press conference, Governor J.B. Pritzker announced modifications to phase 3 of the Restore Illinois plan. After consulting with scientific experts, the Governor said that more activities can resume and additional business can reopen than originally designated.

In May 29, bars and restaurants will now be able to reopen with outdoor seating, while following social distancing and utilizing face mask and abiding by Illinois Dept. of Public Health safety guidance. Also numerous outdoor activities, such as boating, camping, tennis and golf, among others, can also resume with a 10-person limit. All state parks will be allowed to open in phase 3. Health clubs, retail stores and personal care services can reopen under IDPH guidelines.

The Governor indicated that he will continue to roll out additional Phase 3 guidance and information in the coming days.


Illinois COVID-19 Update
The Illinois Department of Public Health (IDPH) today announced 2,388 new COVID-19 cases and 147 deaths. The total number of cases in the state is 100,418 in 100 counties, with a total of 4,525 deaths. IDPH says that in the past 24 hours, 21,029 specimens have been processed. Statewide COVID-19 hospitalizations in the past 24 hours have decreased from 4,002 patients to 3,914 patients. Of that figure, 1,005 patients are in ICU with 554 patients on ventilators. The statewide seven-day rolling COVID-19 positivity rate is 14%.

Today, Governor JB Pritzker and the Illinois Department of Human Services (IDHS) announced the state's plan to enable 1.8 million SNAP recipients to purchase food from participating grocery retailers online has been approved by the federal government. This new purchasing option will begin on June 2. All Link customers will be alerted when they can use their card to make food orders online. This change was developed due in-person grocery shopping difficulties brought on by COVID-19 restrictions.

IDPH and the Chicago Department of Public Health will provide an overview of the EmResource system and updates to definitions as it relates to bed availability and capacity reporting on Tues., May 26 from 3:30-4:30 p.m. Register here.  


National COVID-19 Update
Current Centers for Disease Control and Prevention (CDC) figures show more than 1.5 million confirmed and presumptive positive cases of COVID-19 in the U.S. in 55 states and U.S. territories, with 90,340 deaths. New York state leads the nation with more than 356,000 cases, followed by New Jersey which has more than 149,000 cases. There are 29 states reporting more than 10,000 cases of COVID-19.

The latest WHO situation report shows more than 4.78 million COVID-19 cases globally, with over 318,000 deaths. The Region of the Americas (includes the U.S.) now leads the world with more than 2.1 million cases and over 125,000 deaths. The European Region, is second with more than 1.9 million cases and more than 169,000 deaths.

The Centers for Medicare & Medicaid Services (CMS) has COVID-19 calls scheduled for Thursday and Friday. CMS encourages attendees to register for the webcast rather than calling in. Thurs., May 21: Nurses, 2-2:30 .pm CT; Dial: 833-614-0820; Passcode: 2874976; Webcast and CMS COVID-19 Office Hours, 4-5 p.m. CT; Dial: 833-614-0820; Passcode: 9984433; Webcast. Fri., May 22: Lessons from the Front Lines: COVID-19, 11:30 a.m.-1 p.m. CT; Dial: 877-251-0301; Passcode: 6086125; Webcast.


CDC Releases COVID-19 Guide
The Centers for Disease Control and Prevention (CDC) yesterday released its detailed guide for reopening America. The document, “CDC Activities and Initiatives Supporting the COVID-19 Response and the President’s Plan for Opening America Up Again,” covers: COVID-19 surveillance, healthcare system surveillance, infection control and contact tracing, testing, surveillance assessment and setting guidance. Included in the guide is a “three-phased approach” addressing social distancing measures and outlines the use of six “gating” measures to identify the progression of movement through phases.  


IHA Quality Improvement Opportunities Post-HIIN
Illinois hospitals prevented 23,000 incidents of patient harm and reduced healthcare costs by $226 million by participating with IHA in the Hospital Engagement Network (HEN) from 2012-2016 and Hospital Improvement Innovation Network (HIIN) from 2017-2020.

While federal funding for HIIN ended in March, IHA is committed to continuing the momentum with members—and quality and patient safety achievements—through a variety of programs.

For the HIIN, IHA joined forces with the Michigan and Wisconsin hospital associations in the Great Lakes Partners for Patients, the third largest HIIN in the U.S. Now, along with the Minnesota Hospital Association, our four hospital associations are working together to provide resource-filled webinars on key quality improvement topics.

Registration is now open for the following webinars, each from 1-2 p.m. and complimentary for IHA members:

IHA members also can enhance care delivery through the Midwest Alliance for Patient Safety (MAPS) Patient Safety Organization (PSO), an IHA company. With over 95 members to date, MAPS PSO supports patient safety work through:

  • Educational programming;
  • Peer collaboration and shared lessons;
  • Resources and tools on patient safety culture and high reliability;
  • Legal privileges for adverse events; and
  • Secure adverse event data collection solutions.

By joining MAPS PSO, Illinois hospitals with more than 50 beds can satisfy the Affordable Care Act mandate to join a PSO.