CMS Posts Vaccine Order Guidance for Surveyors
On December 28, 2021, CMS posted a memorandum to State Survey Agency Directors, providing guidance and survey procedures for assessing and maintaining compliance with the vaccine mandate regulatory requirements. The memo can be read at:
Guidance for the Interim Final Rule - Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination (QSO-22-07-ALL)
Enforcement remedies for home health and hospice agencies include civil monetary penalties, payment denials and – as a final measure- termination of participation in Medicare and Medicaid programs.
State, Federal, Accreditation, and CMS-contracted surveyors will begin surveying for compliance as part of initial certification, recertification, reaccreditation, and complaint surveys beginning on January 27, 2022 (30 days after issuance of the memo). Facilities failing to maintain compliance with the 100% standard may be subject to enforcement action within 90 days of the memo.
The memo includes attachments for provider-specific expectations and guidance. |
US Sets Shorter COVID-19 Isolation Rules for Healthcare Workers
Modern Healthcare
Worried that a new COVID-19 wave could overwhelm understaffed U.S. hospitals, federal officials, last Thursday, loosened rules that call on healthcare workers to stay out of work for 10 days if they test positive.
Those workers now will be allowed to come back to work after seven days if they test negative and don't have symptoms. Isolation time can be cut to five days, or even fewer, if there are severe staffing shortages, according to the new Centers for Disease Control and Prevention guidance.
"As the healthcare community prepares for an anticipated surge in patients due to omicron, CDC is updating our recommendations to reflect what we know about infection and exposure in the context of vaccination and booster doses," CDC Director Rochelle Walensky said in a statement.
"Our goal is to keep healthcare personnel and patients safe, and to address and prevent undue burden on our healthcare facilities," she added.
Isolation is designed to keep infected people away from uninfected people, to prevent further spread of the virus.
CDC officials have advised that in calculating the 10-day isolation period, the first day should be the first full day after symptoms first developed or after a positive test. If a person develops symptoms sometime after a positive COVID-19 test, the quarantine period must restart, beginning one day after the symptoms develop. |
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LAN Survey: 40% of Health Payments Tied to Alternative Payment Models in 2020
Fierce Healthcare
Roughly 40% of U.S. healthcare payments were tied to alternative payment models (APMs) last year, with Medicare Advantage claims representing the largest amount, a new survey found.
The survey, published Wednesday by the Health Care Payment Learning & Action Network, showed that more work needs to be done as most healthcare payments were still tied to a fee-for-service model.
“The survey shows we have made limited progress in moving away from fee for service between 2019 and 2020,” said Mark McClellan, M.D., Ph.D., director of Duke University’s Margolis Center for Health Policy and co-chair of the LAN CEO forum, during the LAN Summit Wednesday. “Most payments are still in fee-for-service, especially outside of Medicare.”
The report found that 38.2% of healthcare payments in 2019 and 40.9% of payments in 2020 were tied to an APM. The percentage of payments tied to value increased from 35.8% in 2018.
However, the percentage is below the network’s goal of 50% by 2018.
The network surveyed 73 health plans, five Medicaid states and traditional Medicare, representing 80% of the national market.
LAN also looked at the percentage of healthcare payments along payer types. Medicare Advantage had the highest amount of dollars tied to an APM, with 50% in 2019 and 58% in 2020.
Meanwhile, the commercial insurance business had 32% of its dollars in an APM for 2019 and only slightly increased to 35% the next year.
Traditional Medicare payments stayed relatively flat from 2019 to 2020, with nearly 42% in 2019 and 42.8% last year. But payers broadly support shifting toward value-based care. LAN found that 92% of respondents believe APMs can lead to better quality of care, and 85% think it can lower costs.
However, key challenges are a willingness among providers to take on financial risk and the ability to operationalize those risks…
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Omicron Variant Will Dominate in U.S. Within Weeks, Fauci Says
Bloomberg
The omicron variant of the Covid-19 virus will assume a dominant role in the U.S. “very soon,” possibly within a few weeks, said Anthony S. Fauci.
“We’re looking over our shoulder at omicron,” Fauci, President Joe Biden’s chief medical adviser for Covid-19, said at a U.S. Chamber of Commerce Foundation event. The latest variant of concern, which scientists in South Africa first identified around Thanksgiving, will start to dominate in the U.S. “I would imagine within a period of a few weeks as we go into January,” he said.
The delta variant remains the main source of infections in the U.S., accounting for 96% of cases, Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Wednesday during a White House press briefing. That means delta is largely responsible for the latest surge to 117,900 cases per day. Cases were down to less than 60,000 per day back in July.
“Delta is still a serious problem,” Fauci said. With the uptick of delta-related infections, the country getting into “the depths of winter,” and “with omicron breathing down our back, things could get really bad, particularly for the unvaccinated.”
But he said that those who are vaccinated and boosted will be relatively well protected against severe disease.
The omicron variant represents about 3% of the cases in the U.S, but it has a doubling time of about three days. By comparison, the delta variant doubled at a rate of about two weeks.
“It is the most transmissible virus of Covid-19 that we’ve had to deal with thus far,” Fauci, who’s also the director of the National Institute of Allergy and Infectious Diseases, said about omicron.
South Africa has already been overtaken with the variant and the U.K. also expects the omicron variant to dominate soon. “If things go in the United States the way they’ve gone in other countries—and there’s no reason to believe that that won’t be the case—it will soon become dominant here,” he said. |
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