This page contains resources you need to stay updated on the coronavirus. This is a resource page for VGM & Associates and all communities, including complex rehab (U.S. Rehab), Women's Health (Essentially Women), Orthotics & Prosthetics (OPGA), and Home Modifications (Live at Home).
Please click an icon below for specific COVID-19 resources, or scroll down for the most recent updates.
House Passes Coronavirus Stimulus Plan- HME Legislation Included! Heading to the President’s Desk.
Today, the Coronavirus Stimulus package, H.R. 748 passed the House. The bill will now head to President Trump’s desk for his signature. Much needed reimbursement relief will be coming to home medical equipment suppliers! The bill includes language from H.R. 2771, relief for areas deemed rural and non-rural by CMS.
See the bill language here, page 383 Sec. 3172 Revising Payment Rates for Durable Medical Equipment Under Medicare Program Through Duration of Emergency Period
Rural and contiguous areas: This will extend the reimbursement rates for beyond 2020, for the duration of the COVID-19 Public Health Emergency (PHE).
Non-Rural and noncontiguous: will get the 75/25 blended rate. That is 75% of the regional competitive bid rates and 25% of the 2015 unadjusted rates. See the sample below with current reimbursement examples.
The rates will be will be retroactive as of March 6, 2020, through the remainder of the duration of emergency period. While we can’t predict the future, if we look at the history of other PHEs (Public Health Emergencies), like H1N1, it extended over a year long.
Additionally, this bill will temporarily lift the automatic 2% Medicare payment cuts imposed by what is known as federal sequestration and will increase pay for hospitals treating Medicare patients with Covid-19 by 20%. Each of those measures are estimated to be worth about $10 billion, according to a Republican Senate Finance Committee aide. The bill also delays a scheduled cut in Medicaid funding to certain hospitals that was to have gone into effect on May 22.
Industry champions, Sen. John Thune (R-SD) and Sen. Chuck Grassley (R-IA) both played a large part in getting this legislation included. Rose Schafhauser and the MAMES state association along with VGM members were directly reaching out to these senate offices encouraging the legislation. We also want to thank industry leaders Jay Witter of AAHomecare who worked tirelessly on the hill to ensure this language was included. Thanks also go out to other industry leaders like CQRC and NCART.
Grassroots activities were happening all throughout the country these past few weeks. There are too many to name. But thank you to all who encourage your members of Congress and Senators to include and support this language in the bill.
Senate Passes $2 Trillion Stimulus Plan. HME Relief Included!
The massive Coronavirus Stimulus package passed the Senate just before midnight last night with a 96-0 vote. The bill will now head over to the House and has to be voted on by Unanimous Consent in order to pass. Since the House members will not likely fly back to Washington D.C. for a vote, the House announced they plan to vote on Friday by a voice vote.
The bill includes language from H.R. 2771, relief for areas deemed rural and non-rural by CMS.
See the bill language here, page 383 Sec. 3172 Revising Payment Rates for Durable Medical Equipment Under Medicare Program Through Duration of Emergency Period
Rural and contiguous areas- This will extend the reimbursement rates for beyond 2020, for the duration of the COVID-19 Public Health Emergency (PHE).
Non-Rural and noncontiguous- will get the 75/25 blended rate. That is 75% of the regional competitive bid rates and 25% of the 2015 unadjusted rates. See the sample below current reimbursement examples.
Additionally, this bill will temporarily lift the automatic 2% Medicare payment cuts imposed by what is known as federal sequestration and will increase pay for hospitals treating Medicare patients with COVID-19 by 20%. Each of those measures are estimated to be worth about $10 billion, according to a Republican Senate Finance Committee aide. The bill also delays a scheduled cut in Medicaid funding to certain hospitals that was to have gone into effect on May 22.
While we can’t predict the future, if we look at the history of other PHEs (Public Health Emergencies), like H1N1, it extended over a year long.
Our team as well as other industry stakeholders have been in contact with CMS in regard to the how COVID-19 will effect the Round 2021 competitive bidding program. CMS is aware of the concerns of the industry and is hoping to provide a response in the near future.
The Families First Coronavirus Response Act (FFCRA) and what you need to know as an employer
Here is an overview of how FFCRA works.
CMS Approves Medicaid Section 1135 Waivers for 11 Additional States
A total of 13 states are now included. Click here for details.
U.S. Small Business Administration Offers Low-Interest Rate Loans
The U.S. Small Business Administration (SBA) is offering designated states and territories low-interest federal disaster loans for working capital to small businesses suffering substantial economic injury as a result of the Coronavirus (COVID-19). Click here for an overview of eligibility, filing, and how to apply.
FEMA Heads Says Administration Will Use Defense Production Act to Obtain 60,000 Coronavirus Tests
As posted on the nationalreview.com, the Trump administration is invoking the Defense Production Act as part of the COVID-19 pandemic response. Read More....
[Webinar] COVID-19 & HME: A Dialogue — What we know and what we don’t know
March 23, 2020
Join The van Halem Group, Brown & Fortunato, AAHomecare, and Lieber Consulting for their webinar on Thursday March 26, 2020 from 1:00-2:00 pm EDT.
As everyone knows, in today’s COVID-19 emergency, things are changing by the minute. HME providers are on the front line of patient care and are serving an invaluable role in keeping patients out of hospitals. Join industry leaders to get the latest information at the federal level, as well as the state and local levels. In this webinar, you will get the latest facts to help you and your employees effectively manage through this COVID-19 pandemic. You’ll also learn what changes will be coming soon. Join us for a lively discussion!
Click here to read more and to register.
Industry Matters Podcast Episode 49: COVID-19 Updates for DMEPOS Providers
March 23, 2020
VGM's Payer Relations experts Ronda Buhrmester and Craig Douglas team up to give an update on COVID-19 for DMEPOS providers. Ronda and Craig discuss COVID-19 hot topics, address some frequently asked questions and provide the most recent updates we have. Topics include telehealth visits related to DMEPOS, proof of delivery requirements, oxygen testing, essential business interpretations and more.
Listen here or click here.
CPAP devices can be used as ventilators during coronavirus outbreak, FDA guidance says
March 22, 2020
In a recent update from Politico Pro, new temporary guidance from the FDA allows hospitals to re-purpose existing products such as CPAP devices as ventilators, an effort to meet major shortages in the United States during the coronavirus outbreak.
The guidance, issued today, allows hospitals and manufacturers to make certain modifications to existing devices, or to production lines, to create more respiratory devices.
Ventilators normally used in other environments, such as ambulances, could be used for long-term care, the guidance says. It covers devices that aren't traditionally used for long-term care.
The guidance also would allow non-medical device companies, such as auto manufacturers, to start making ventilator parts.
The agency plans to use "enforcement discretion" for modifications to FDA-cleared devices. Traditionally manufacturers' modifications to ventilators would trigger an additional pre-market review, which could delay deployment.
The guidance means "America can make more ventilators during this crisis,” Health and Human Services Secretary Alex Azar said in a release.
The guidance also aims to create "maximum regulatory flexibility" while "still providing crucial FDA oversight," FDA Commissioner Stephen Hahn said in a release.
FDA is also encouraging manufacturers, including foreign ones, to contact the agency about emergency authorizations to distribute ventilators in the United States.
See also: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enforcement-policy-ventilators-and-accessories-and-other-respiratory-devices-during-coronavirus
Q&A: Are DME companies (providers / manufacturers) considered "essential business" during COVID-19?
A: (note: VGM is seeking further clarification from expert sources)
The short answer it typically yes, they are considered essential and allowed to remain open and continue working. Many of them are carrying their ID badges for work (not sure whether you have those or not), or are carrying emergency travel exemption letters to show to authorities if/when they are questioned as to why they are out and about. Unfortunately, none of the guidance that has been issued has come out and named DME providers and manufacturers specifically as “essential,” but we have seen examples of where DME was approved as essential at a local level, and have not seen examples of them being told they can’t continue operations.
All that said, we suggest that you reach out to your local Public Health officials to get clarity from them at your local level. Certain cities/municipalities may be treating things a little differently than others. They may even go as far as to say that providers who supply oxygen and ventilators and other life-sustaining equipment can continue operations, but those that do not must close.
Home Delivery, Billing, and Sales in a COVID-19 Environment Webinar
March 20, 2020
Presenters: Ronda Buhrmester (VGM & Associates), Ty Bello (Team At Work Coaching), Laura Williard (AAHomecare)
Just like supply chain preparedness, medical equipment suppliers that go to homes need to be prepared and take steps to maintain best practices for home delivery, billing, and sales in a COVID-19 Environment.
What do external stakeholders need to know about our cleaning policies and procedures? What are the precautions we need to take to mitigate exposure and compromised scenarios for our delivery and clinical staff that are in the homes of patients?
We must also be prepared for limited access to the medical referral community. How will we stay top of mind, while adhering to closed access? What best practices can our sales team execute during this time? What can be done to ensure the submission of claims continues so the cash flow isn’t impacted?
Click on the webinar links below to listen to Ronda Buhrmester, Ty Bello, and Laura Williard as they answer these.
What HME Suppliers Need To Know About Personal Protective Equipment (PPE)
March 19, 2020
Yesterday, states reached out to President Trump asking to empty the federal stockpile of PPE and medical supplies. See the full article here. We need to ensure home medical equipment suppliers receive priority access to critical supplies during this crisis to assist patients in healing at home.
It is crucial that HME suppliers reach out to their county and state health departments today, letting them know what your company is doing to help during this crisis and your PPE supply needs to ensure patient and employee safety.
What Steps Should I Take?
- Today, call your state and county health departments. You can find a list of county and state health departments in each state by clicking on this link, www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=IA#card-filter.
- Have a personal contact with your county health department and state health departments.
- Let them know your information and company’s information. Explain your business model and the importance of home medical suppliers during this crisis. They may not understand how HMEs work.
- Let them know you need assistance with necessary supplies such as PPE in order to keep your patients and employees safe.
Please Take These Necessary Steps Today!
Industry Matters Podcast Episode 48: Preparedness Beats Panic…Pandemic Planning and COVID-19
March 18, 2020
VGM Group's Information Security Officer, Jay Bracken, outlines a framework for pandemic planning in the midst of the COVID-19 pandemic in this latest podcast episode. Listen here or click here.
President Trump Expands Telehealth Benefits for Medicare Beneficiaries
March 17, 2020
According to CMS communications, the Trump Administration announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility. This will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.
Click here for additional information.
CMS Releases Coronavirus Partner Virtual Toolkit
March 17, 2020
The Centers for Medicare & Medicaid Services (CMS) release an email today with their Virtual ToolKit to help you stay up-to-date on CMS materials available on COVID-19.
For more information from the CDC on COVID-19 visit: Coronavirus.gov
VGM Requests Congressional Support
March 16, 2020
VGM Government recently sent letters to the offices of Secretary of HHS, Alex Azar and CMS Administrator, Seema Verma. The letters were also sent to the offices of Sen. Chuck Grassley and Sen. Ron Wyden (Chairman and Ranking Member of Senate Finance Committees).
The letter contains the following requests:
- CMS to suspend adding NIV to the 2021 competitive bidding program.
- CMS to extend the current blended rate in rural non-CBAs and initiate a blended rate for non-rural CBAs in 2021 to protect access to critical home medical equipment.
- Leniency with home medical suppliers to be able to accept and submit claims when telehealth visit is performed
- CMS to reduce burdensome paperwork on physicians and suppliers (CMNs)
- Coverage and reimbursement for necessary home medical equipment, supplies and services provided to patients confirmed with COVID-19
- CMS to prioritize the provision of PPE for HME suppliers
We encourage state associations and all members to send letters to their congressional offices. Each state may have specific questions and issues to address based on your area and region. Create your own letter that has requests and data based on your state and county. Click here to find your congressional offices contact information.
We encourage you to continue to be in contact with your local hospitals and health departments for updates in your areas.
Pandemic Planning and Preparedness
March 13, 2020
VGM Group just released a Pandemic Planning and Preparedness document to offer tips on pandemic preparedness planning that will allow your organization to respond quickly and efficiently to a pandemic situation. Click here to read the document.
CMS Releases More Information Regarding Coronavirus
March 11, 2020
Today, CMS sent out more information regarding safety amidst the coronavirus pandemic. The three articles and links below include more guidance about COVID-19 for healthcare workers, as well as more guidance about the Medicare Advantage and Part D plans. The guidance expands on the types of face masks that healthcare works can use.
What should you/the provider community be doing right now?
It is important to remain in contact with your state and county departments of health. Also, based on the information provided in these articles, we recommend you reach out to your local hospitals for additional guidance specific to your area.
See new articles below:
The Coronavirus and Workplace Readiness
March 9, 2020
We’ve had a lot of members and customers reaching out to us lately to ask for advice about dealing with the recent outbreak of COVID-19, more commonly known as the “coronavirus.” As with every other challenge that our customers face, we’re here to help! While we aren’t experts at dealing with viral outbreaks, we’ve put together a comprehensive library of resources for you from organizations like the CDC and the World Health Organization, and you can find those materials in the right-hand column of this page. We’ll continue to keep this site up to date as things continue to develop.
In the meantime, we’re also prepared to share with you the steps that we’ve been taking to keep our people safe and ensure the continuity of our business operations. The article that you’re reading is the first of a planned series that we’ll be writing in collaboration with leaders throughout our organization. We want to emphasize that these are the steps that we’re taking, but they may not necessarily be the best steps for your organization or practice. Members are encouraged to consider reaching out to their local and state health officials for expert advice on how the virus is impacting their area and what they can do to protect themselves.
What We’re Doing
VGM has created a taskforce of individuals from our Human Capital, Security & Compliance, and Project Management teams. This taskforce is responsible for monitoring the situation using resources released by the CDC, WHO, and our state and county health officials. They are also responsible for developing and implementing our communication plan to make sure that VGM’s leaders and employees are kept informed. Under their guidance, VGM is currently taking the following steps:
- We’re asking all of our employees to follow proper coughing/sneezing etiquette, wash their hands often, and avoid touching their eyes, noses, and mouths with unwashed hands. We’ve supplied plenty of alcohol-based hand sanitizer in all of our common spaces and break rooms, and we’re actively encouraging people to use it. We’ve also posted signage in all of our restrooms and kitchenettes outlining proper hand-washing techniques.
- We’re actively encouraging our sick employees to stay home until they’re free of fever and all other symptoms for at least 24 hours without the use of any medication, over-the-counter or otherwise. We’re also encouraging our leaders to actively monitor their work areas for employees who don’t appear to be feeling well, especially if they’re coughing or showing signs of respiratory illness, and send them home immediately.
- We’re being especially flexible about our sick leave and work-from-home policies while this situation develops so that sick employees don’t feel pressured to return to work early. We’re also directing our leaders to be flexible with employees requesting to take time off to care for sick family members, especially if they have young children.
- For those employees who plan to travel internationally, we’re requesting that they report their travel plans to HR and provide us with a full itinerary that includes all connecting airports and destinations. We’re then asking that those whose travel plans include stops in parts of the world that the CDC has classified with an alert level of 2 or higher stay home for a minimum of fourteen days after they return, and supplying them with any equipment necessary to work from home during that period if they don’t already have it.
- For those whose work normally requires them to travel domestically, we’re giving them the option to conduct their business using video conferencing for the duration of the outbreak. We’re also encouraging them to cancel or reschedule their business trips if they’re at all uncomfortable about the risk of travelling to certain parts of the country. Just like international travel, if any of our employees travel to a part of the country that the CDC classifies with an alert level of 2 or higher, we’re asking them to self-quarantine by working from home for two weeks after their return.
Hopefully these tips and the resources that we’re putting together for you will be helpful to you as you prepare. In next week’s article, we’ll have some tips for you on preparing your own BCDR plan. If you have any questions, or if you have a topic that you’d like us to address in a future article, please reach out to your RAM or MAM and let us know!
CMS Announces Actions to Stem Spread of Coronavirus
March 5, 2020
The Centers for Medicare & Medicaid Services (CMS) has called on health care providers to implement mandated infection control procedures in response to novel Coronavirus, or COVID-19. CMS is also issuing new requirements for state survey agencies and accrediting organizations for inspecting Medicare-participating health care providers across the country in response to the virus.
Click here to read more.
Risk Insights - Protecting Workers From Coronavirus
March 4, 2020
VGM Insurance recently shared in the Risk Insights the examination of what coronavirus is, how it spreads, and what employers can do to protect their workforce
According to the World Health Organization (WHO), coronavirus is a family of viruses that cause illnesses ranging from the common cold to more severe diseases.
According the Centers for Disease Control and Prevention (CDC), the spread of COVID-19 from person-to-person most likely occurs among close contacts who are within about 6 feet of each other. It’s unclear at this time if a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes.
Best practices employers should consider to help prevent the spread of COVID-19 include:
- Educate employees on the signs and symptoms of COVID-19 and the precautions that can be taken to minimize the risk of contracting the virus, without causing panic.
- Appoint a single individual or department as the point of contact within your organization for employee questions about COVID-19.
- Review safety programs and emergency action plans to ensure that they include infectious-disease protocols.
- Implement travel guidelines and procedures for approving travel to and from China.
Click here to read the original Risk Insights from VGM Insurance.
What Do You, As An Employer, Need To Do About The Coronavirus?
February 28, 2020
The Center for Disease Control (CDC) is closely monitoring the outbreak of COVID-19 (Coronavirus), and with a total of 15 confirmed cases in the United States as of February 28 and more than 450 tested, your employees may start asking questions about work, travel, how to help customers, etc.
In the article, “Coronavirus Outbreak Causes Employers to Consider Precautionary Steps,” Emma Follansbee covers best practices for employers:
- Communication and education
- Reinforce sick leave policies
- Consider a temporary travel opt-out policy
- Offering medical opinions and misinformation
- Employee medical examinations and quarantines
- Do not prevent certain employees from traveling over others
Click here to read the full article.
And for up-to-date information from the CDC, click here.
The CDC and OSHA Recommend:
- Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Avoid close contact with people who are sick
- Stay home when you are sick
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If a tissue isn’t available, cough or sneeze into your elbow.
- Clean and disinfect frequently touched objects and surfaces
- If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.
- Practice social distancing