IHA Daily Briefing: May 3

Monday, May 3, 2021
ACA Marketplace Plan Costs to Drop in 2022 
Governor Re-Issues COVID-19 Executive Orders 
IDPH Revised Guidance for Elective Surgeries/Procedures 
State, National, Global COVID-19 Updates 
AARP Teletown Hall on Telehealth This Wednesday 
MMAI Expansion Effective Date: July 1, 2021 
HSSC Survey Deadline Extended to Friday



ACA Marketplace Plan Costs to Drop in 2022 
On Friday, the Centers for Medicare & Medicaid Services announced that it has adopted new provisions to lower maximum out-of-pocket costs by $400, while increasing competition and improving the consumer experience for people who will rely on the Federal Health Insurance Marketplaces in plan year 2022.
 
The second 2022 Notice of Benefit and Payment Parameters final rule finalizes a maximum annual limitation on cost-sharing that is $400 below what CMS proposed in November 2020. The rule also includes several provisions to help consumers more easily distinguish between plan options and increase opportunities to qualify for future special enrollment periods (SEPs), when consumers are eligible to enroll in marketplace plans outside annual open enrollment. These SEP policies will offer greater flexibility for those who need coverage—particularly those communities hardest hit by COVID-19. An additional 800,000 Americans have enrolled in the ACA under the current SEP.
 
For more information on provisions in the second 2022 payment notice final rule, see a CMS fact sheet.




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Governor Re-Issues COVID-19 Executive Orders 
On Friday, Governor J.B. Pritzker issued a new COVID-19 disaster proclamation and re-issued a series of executive orders, including those related to telehealth, healthcare worker background checks, actions by the Illinois Dept. of Financial and Professional Regulation for licensed professionals engaged in disaster response, hospital capacity, and Illinois Dept. of Public Health regulatory activities. The proclamation and executive orders are in effect through May 29.



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IDPH Revised Guidance for Elective Surgeries/Procedures
The Illinois Dept. of Public Health (IDPH) has issued revised guidance for elective surgeries and procedures. The new guidance was distributed via SIREN alert on Friday afternoon. 
 
The revised guidance provides some relief from pre-operative COVID-19 testing requirements for elective surgeries and procedures for fully vaccinated patients and patients who have recovered from COVID-19 within 90 days of the scheduled procedure. Additional flexibility is provided in the types of testing that may be used for patients undergoing low to moderate risk procedures. 







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State, National, Global COVID-19 Updates 
The third COVID-19 surge appears to have stalled for now. In Illinois, cases have stopped rising, test positivity is flat to down, and hospitalizations are back below 2,000.
 
The Illinois Department of Public Health (IDPH) announced today 2,049 new confirmed and probable COVID-19 cases and 28 deaths. The total number of cases in the state is 1,341,777 with a total of 22,047 deaths. IDPH says that in the past 24 hours, 49,473 test specimens have been processed, with a positivity rate of 4.1%. The preliminary 7-day statewide positivity rate for cases as a percent of total tests from April 26- May 2 is 3.4%, and the seven-day test positivity rate is 4.0%.
 
Statewide COVID-19 hospitalizations in the past 24 hours increased from 1,916 patients to 1,963 patients. Of that figure, 479 were in the ICU, with 249 patients on ventilators.
 
The state continues to make progress with vaccinations, although momentum is slowing. So far, 4.1 million people in Illinois have been fully vaccinated or 32% of the population and 40% of everyone over age 16. The average number doses administered per day has dropped significantly, from more than 130,000 per day two weeks ago, to 78,000 per day as of yesterday (see chart).
 
Yesterday, 16,920 doses were reported administered in Illinois. Data from this weekend from several pharmacies (Walgreens, Albertsons, CVS) is not yet available so the doses administered yesterday are likely to be low. The missing doses from this weekend will be reflected in numbers in the next couple days.
 
Today’s Centers for Disease Control and Prevention (CDC) figures showed more than 32.2 million confirmed and presumptive positive cases of COVID-19 in the U.S. (a daily increase of more than 32,000 cases), with 574,220 deaths (a daily increase of 423).
 
Today’s WHO Coronavirus Disease Dashboard showed more than 152.5 million COVID-19 cases globally (a daily increase of more than 721,000 cases), with more than 3.1 million deaths. The Region of the Americas (includes the U.S.) continues to lead the world with more than 62.4 million cases and more than 1.5 million deaths.




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AARP Teletown Hall on Telehealth This Wednesday 
AARP Illinois will hold a telephone town hall on telehealth this Wednesday, May 5, starting at 6:05 p.m. The event will feature state Rep. Deb Conroy (46th District), House sponsor of House Bill 3498, major telehealth parity legislation that is now pending in the Senate; IHA President & CEO A.J. Wilhelmi; Marvin Lindsey, CEO, Community Behavioral Healthcare Association of Illinois; and Lori Hendren, Associate State Director, AARP Illinois.
 
To participate, dial 866-495-1089 or join AARP Illinois on Facebook at https://www.facebook.com/AARPIllinois/.



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MMAI Expansion Effective Date: July 1, 2021 
On Friday (April 30), the Illinois Dept. of Healthcare and Family Services (HFS) issued a Provider Notice to remind providers that the previously delayed statewide expansion of the Medicare-Medicaid Alignment Initiative (MMAI) is scheduled to begin July 1, 2021. HFS also announced that CountyCare health plan is seeking approval from the Centers for Medicare & Medicaid Services (CMS) and the state to offer an MMAI plan in Cook County only, effective January 1, 2022. Currently, MMAI plans are offered by Aetna Better Health of Illinois, Blue Cross Blue Shield of Illinois, Humana, MeridianHealth, and Molina Healthcare of Illinois
 
The MMAI program provides managed care coverage for the state’s Medicare-Medicaid dually covered population. The MMAI program is designed to bring together Medicare, Medicaid and prescription drug benefits into one health plan. Many MMAI health plans also offer extra benefits such as expanded dental care and lower prescription co-pays. All MMAI health plans are to provide care coordination to manage the healthcare and long-term services and supports of covered individuals.
 
Questions regarding the HFS provider notice may be directed to the Department’s Bureau of Managed Care at 217-524-7478 or HFS.MMAI@Illinois.gov.




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HSSC Survey Deadline Extended to Friday 
IHA is working with the Illinois Dept. of Public Health (IDPH) on the Centers for Disease Control and Prevention (CDC) cooperative agreement, “Improving the Lives of Illinoisans through Chronic Disease Prevention” (DP18-1815) grant, to provide education and resources to our members. As part of the grant, we are working with IDPH to encourage data collection on primary care and the outpatient setting for the CDC quality improvement assessment tool called the Health Systems Scorecard (HSSC). The deadline to complete the survey has been extended to this Friday, May 7.
 
Information collected by the HSSC will help your hospital/health system determine opportunities to strengthen implementation of evidence-based policies and systems that can improve care for patients with chronic conditions. The survey will also be used to identify what evidence-based strategies are being used in your hospital/health system and the extent to which you are delivering care in ways to improve health outcomes.
 
Members are asked to convene your quality improvement (QI) leaders/groups/committees to complete the survey – click here – by this Friday. Required modules for completion are outlined in the document “2021 HSSC Required Modules.” Additional modules may be completed at each respondent’s discretion. A PDF version of the scorecard for your review and planning purposes can be accessed by clicking here. For a video that provides an overview of the HSSC and instruction on its completion please click here.
 
If you have any questions or concerns, contact Patrick Harper, IDPH CDC Assignee, at patrick.harper@illinois.gov.
 
Please note: Responses will only be accessible by IDPH Division of Chronic Disease and the grant-funded evaluation team at University of Illinois-Chicago. Respondents may request their individual raw data from IDPH. All other data sharing will be in deidentified, aggregate form. IHA Critical Access Hospital members who are also Illinois Critical Access Hospital Network (ICAHN) members are asked to only complete the scorecard using the link that was sent from ICAHN.