CDC encourages employers to permit workers to voluntarily use filtering facepiece respirators like N95s. These policies allowed for audio-only modalities to initiate buprenorphine prescribing. Facemask:OSHA defines facemasks as a surgical, medical procedure, dental, or isolation mask that is FDA-cleared, authorized by an FDA EUA, or offered or distributed as described in an FDA enforcement policy. The studies used to inform this guidance did not clearly define severe or critical illness. If being transported outside of the room, such as to radiology, healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient. The vast majority of current Medicare telehealth flexibilities that Americansparticularly those in rural areas and others who struggle to find access to carehave come to rely upon over the past two years, will remain in place through December 2024 due to the bipartisan Consolidated Appropriations Act, 2023 passed by Congress in December 2022. S.J.Res.32 - 117th Congress (2021-2022): A joint resolution providing 304 0 obj <> endobj NIOSH-approved particulate respirators with N95 filters or higher used for: All aerosol-generating procedures (refer to. 497 0 obj <>stream References related to aerosol generating procedures: Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J (2012) Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers: A Systematic Review. This guidance applies to all U.S. settings where healthcare is delivered, including nursing homes and home health. e.B]e|M4EY ) &(6DGm2m Based on current COVID-19 trends, the Department of Health and Human Services (HHS) is planning for the federal Public Health Emergency (PHE) for COVID-19, declared under Section 319 of the Public Health Service (PHS) Act, to expire at the end of the day on May 11, 2023. chlorhexidine gluconate, povidone-iodine) have been shown to reduce the level of oral microorganisms in aerosols and spatter generated during dental procedures. FROM: Directors . 0 However, coverage may continue if plans choose to continue to include it. The waiver of this requirement ends upon the conclusion of the PHE. Temporary changes through the end of the COVID-19 public health emergency . CDC twenty four seven. After that, coverage and cost sharing may vary by state. As previously reported, CMS will begin requiring residents to have a PASARR prior to admitting to facilities when the PHE expires. CDC hasinformation and resources for older adults and for people with disabilities. Moderate Illness: Individuals who have evidence of lower respiratory disease by clinical assessment or imaging, and a saturation of oxygen (SpO2) 94% on room air at sea level. AHA does not claim ownership of any content, including content incorporated by permission into AHA produced materials, created by any third party and cannot grant permission to use, distribute or otherwise reproduce such third party content. CMS Announces Impact of PHE Ending on COVID-19 Waivers, Today, the Centers for Medicare & Medicaid Services (CMS) released a new regulatory memo. If possible, discontinue AGPs prior to entering the destination facility or communicate with receiving personnel that AGPs are being implemented. The top developments in COVID-19 litigation since our last post are: the Supreme Court's decisions to stay enforcement of OSHA's private-sector employer vaccine-or-test mandate, and to deny a stay of a similar mandate for healthcare facilities that receive Medicare and Medicaid funding; an investor lawsuit against a pharmaceutical company . This will continue until that time as a requirement to support national efforts to control the spread of COVID-19. However, these patients should NOT be cohorted with patients with confirmed SARS-CoV-2 infection unless they are confirmed to have SARS-CoV-2 infection through testing. endstream endobj startxref The definition of higher-risk exposure and recommendations for evaluation and work restriction of these HCP are in the. 0 However, COVID-19 testing remains important and is a nationally recognized standard to help identify and prevent the spread of COVID-19. Depending on the carrier and state, you may be able to compliantly hold a virtual education event for Medicare prospects or enrollees during the 2023 AEP. CMS waived the requirements in 42 CFR 483.10(e)(5) and (7) solely for the purposes of grouping or cohorting residents with respiratory illnesses. What personal protective equipment (PPE) should be worn by environmental services (EVS) personnel who clean and disinfect rooms of hospitalized patients who have SARS-CoV-2 infection? Information discussed during the call is available at: . During the COVID-19 PHE, Congress has provided critical support to state Medicaid programs by substantially increasing the federal matching dollars they receive, as long as they agreed to important conditions that protected tens of millions of Medicaid beneficiaries, including the condition to maintain Medicaid enrollment for beneficiaries until the last day of the month in which the PHE ends. Facemasks may also be referred to as medical procedure masks. Facemasks should be used according to product labeling and local, state, and federal requirements. Clinical judgement regarding the contribution of SARS-CoV-2 to clinical severity might also be necessary when applying these criteria to inform infection control decisions. This includes those LTC care facilities, or facilities in states that were granted an extension of the waiver after October 6, 2022. Testing is recommended immediately (but not earlier than 24 hours after the exposure) and, if negative, again 48 hours after the first negative test and, if negative, again 48 hours after the second negative test. When performing an outbreak response to a known case, facilities should always defer to the recommendations of the jurisdictions public health authority. Dedicated means that HCP are assigned to care only for these patients during their shifts. Uncertified nurse aides working in a LTCfacility covered by a waiver granted to a State or individual facility will have 4 months from the date the PHE ends (or from the termination date of the facilitys or states waiver, if earlier) to complete a state approved NATCEP program. FDA is in the process of addressing which policies are no longer needed and which should be continued, with any appropriate changes, and the agency will announce plans for each guidance prior to the end of the PHE. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Currently, the amended PREP Act declaration provides liability immunity to manufacturers, distributors, public and private organizations conducting countermeasure programs, and providers for COVID-19 countermeasure activities related to a USG agreement (e.g., manufacturing, distribution, or administration of the countermeasures subject to a federal contract, provider agreement, or memorandum of understanding). Access to COVID-19 vaccinations and certain treatments, such as Paxlovid and Lagevrio, will generally not be affected. Still, others will expire. Please enable scripts and reload this page. The codes and allowances are shown below. Coverage for COVID-19 testing for Americans will change. Physical barriers between patient chairs. Establish a process to make everyone entering the facility aware of recommended actions to prevent transmission to others if they have any of the following three criteria: 3) close contact with someone with SARS-CoV-2 infection (for patients and visitors) or a. Source control devices should not be placed on children under age 2, anyone who cannot wear one safely, such as someone who has a disability or an underlying medical condition that precludes wearing one safely, or anyone who is unconscious, incapacitated, or otherwise unable to remove their source control device without assistance. Stand-alone Vaccine Counseling-specific HCPCS codes (Posted 6/8/2022) SHO: Medicaid and CHIP Coverage of Stand-alone Vaccine Counseling (Posted 05/12/2022) Vaccine Counseling for Medicaid and CHIP Beneficiaries (PDF, 318.37 KB) Overview of Strategic Approach to Engaging Managed Care Plans to Maximize Continuity of Coverage as . Then they should revert to usual facility source control policies for patients. g%^e4}$&T!|= [i}wh6XU=c!Di6pc4s=f-]{H 54 Stay tuned for updates and new resources once they are available. This guidance is not intended for non-healthcare settings (e.g., restaurants) and not for persons outside of healthcare settings. Clarified the recommended intervals for testing asymptomatic HCP with a. Evidence from recent studies suggest that some PPMR solutions are efficacious and may temporarily decrease the viral load of SARS-CoV-2 in the oral cavity. When should healthcare facilities make changes to interventions based on changes in community transmission levels? %PDF-1.6 % FAQs on Reporting COVID-19 Vaccination Data | NHSN | CDC In general, it is recommended to restrict HCP and patients without PPE from entering the room until sufficient time has elapsed for enough air changes to remove potentially infectious particles. Communicate information about patients with suspected or confirmed SARS-CoV-2 infection to appropriate personnel before transferring them to other departments in the facility (e.g., radiology) and to other healthcare facilities. CDCs main landing page for COVID-19 content will help readers navigate to information regarding modes of transmission, clinical management, laboratory settings, COVID-19 vaccines and CDC guidance on other COVID-19-related topics. However, people in this category should still consider continuing to use of source control while in a healthcare facility. The amount of time that the air inside an examination room remains potentially infectious depends on a number of factors including the size of the room, the number of air changes per hour, how long the patient was in the room, if the patient was coughing or sneezing, and if an aerosol-generating procedure was performed. For strategies to mitigate healthcare personnel staffing shortages, see Contingency and crisis management. Place a patient with suspected or confirmed SARS-CoV-2 infection in a single-person room. Disease severity factors and the presence of immunocompromising conditions should be considered when determining the appropriate duration for specific patients. Empiric use of Transmission-Based Precautions for residents and work restriction for HCP who met criteria can be discontinued as described in Section 2 and the. All information these cookies collect is aggregated and therefore anonymous. Select IPC measures (e.g., use of source control, screening testing of nursing home admissions) are influenced by levels of SARS-CoV-2 transmission in the community. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Secure .gov websites use HTTPS If additional cases are identified, strong consideration should be given to shifting to the broad-based approach if not already being performed and implementing quarantine for residents in affected areas of the facility. This pertains to the requirement associated with F885. To provide the greatest assurance that someone does not have SARS-CoV-2 infection, if using an antigen test instead of a NAAT, facilities should use 3 tests, spaced 48 hours apart, in line with. CMS updates COVID-19 vaccination guidance for health care providers Public Readiness and Emergency Preparedness (PREP) Act liability protections for may be impacted. Symptoms (e.g., cough, shortness of breath) have improved, Results are negative from at least two consecutive respiratory specimens collected 48 hours apart (total of two negative specimens) tested using an antigen test or NAAT. If transport personnel must prepare the patient for transport (e.g., transfer them to the wheelchair or gurney), transport personnel should wear all recommended PPE(gloves, a gown, a NIOSH-approved particulate respirator with N95 filters or higher, and eye protection [i.e., goggles or disposable face shield that covers the front and sides of the face]). Dental healthcare personnel (DHCP) shouldregularly consulttheir. They should minimize their time spent in other locations in the facility. This requirement will resume when the PHE expires. The test-based strategy as described for moderately to severely immunocompromised patients below can be used to inform the duration of isolation. Instruct HCP to report any of the 3 above criteria to occupational health or another point of contact designated by the facility so these HCP can be properly managed. Our response to the spread of SARS-CoV-2, the virus that causes COVID-19, remains a public health priority, but thanks to the Administrations whole of government approach to combatting the virus, we are in a better place in our response than we were three years ago, and we can transition away from the emergency phase. Below is a list of some of the changes people will see in the months ahead. Because dental patients cannot wear a mask, in general, those who have had close contact with someone with SARS-CoV-2 infection should also postpone all non-urgent dental treatment until they meet the healthcare criteria to end quarantine. Before entering the isolated drivers compartment, the driver (if they were involved in direct patient care) should remove and dispose of PPE and perform hand hygiene to avoid soiling the compartment. CMS-CDC Fundamentals of COVID-19 Prevention for Nursing Home Management CMS Updates Testing and Visitation Guidance, Aligning with Latest CDC Guidance COVID-19; CMS Published:September 26, 2022 Crystal Bowens Rollup Image Page Content CMS released revised QSO memos QSO-20-38-NH(Testing) and QSO-20-29-NH(Visitation). Hepatitis B isolation rooms can be used if: 1) the patient is hepatitis B surface antigen-positive or 2) the facility has no patients on the census with hepatitis B infection who would require treatment in the isolation room. AGPs should take place in an airborne infection isolation room (AIIR), if possible. H|N@sn6 Jo apIB Such a unit can be used to increase the number of air changes per hour. *Non-skilled personal care consists of any non-medical care that can reasonably and safely be provided by non-licensed caregivers, such as help with daily activities like bathing and dressing; it may also include the kind of health-related care that most people do themselves, like taking oral medications. Encourage use of alternative mechanisms for patient and visitor interactions such as video-call applications on cell phones or tablets, when appropriate. Examples of when empiric Transmission-Based Precautions following close contact may be considered include: Patients placed in empiric Transmission-Based Precautions based on close contact with someone with SARS-CoV-2 infection should be maintained in Transmission-Based Precautions for the following time periods. After May 11, 2023: Medicare will continue to cover vaccines without cost sharing. HCP and healthcare facilities might also consider using or recommending source control when caring for patients who are moderately to severely immunocompromised. Performance of expanded screening testing of asymptomatic HCP without known exposures is at the discretion of the facility. After arrival at their destination, receiving personnel (e.g., in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE. References Coronavirus COVID-19 information COVID-19 Frequently Asked Questions (FAQs) on Medicare-Fee-for-Service (FFS) Billing Medicare Administrative Contractor (MAC) COVID-19 Test Pricing 3XZLm CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. The Centers for Medicare & Medicaid Services today released additional guidance and resources to help states maintain Medicaid and Children's Health Insurance Program coverage for individuals after the COVID-19 public health emergency ends, or transition them to other affordable coverage options. Executive Summary This SHO letter is part of a series of guidance and tools that outlines how states may address the Certain Medicare and Medicaid waivers and broad flexibilities for health care providers are no longer necessary and will end. FDA published several dozen guidance documents to address challenges presented by the COVID-19 PHE, including limitations in clinical practice or potential disruptions in the supply chain. Certain FDA COVID-19-related guidance documents for industry that affect clinical practice and supply chains will end or be temporarily extended.