Submit your vaccine administration claims for reimbursement by the April 5, 2022, deadline

The COVID-19 Coverage Assistance Fund, which reimburses for the claims for testing, treatment, and vaccine administration, is running out and the deadline to submit for vaccine administration claims is quickly approaching. Claims will be accepted through April 5, 2022, at 11:59 pm via the COVID-19 CAF portal. Claims submitted to the portal after the April 5, 2022, deadline will not be adjudicated. The Health Resources and Services Administration (HRSA) notes that claims submitted by the deadline will be paid subject to their eligibility and the availability of funds. The AMA has urged Congress to appropriate more money to support the COVID-19 efforts.

The dedicated Coverage Assistance Fund customer support may be reached at 833-967-0770 (TTY number 888-970-2920) Monday through Friday from 8:00 am – 8:00 pm EST or at [email protected].

Important Information for Providers Serving Virginia Medicaid Patients

During the Public Health Emergency (PHE), the Commonwealth of Virginia has maintained coverage for the Medicaid patient population thanks to the flexibilities and waivers afforded by state emergency orders and federal legislation. When Virginia is no longer under the PHE, the Department of Medical Assistance Services will begin their normal monthly practice of renewing Medicaid recipients. This means some patients previously enrolled may no longer be eligible or ensured covered.

Although Medicaid recipients cannot renew their coverage yet, they can begin updating their address and contact information now to make the renewal process more efficient. When talking with your patients who have Medicaid, encourage them to make sure their contact information, especially their address, is current and correct with the Department of Medical Assistance Services.

DMAS is also asking all Medicaid providers to familiarize their staff with the items that will remain active under the federal public health emergency and which items have now expired at the state level.

More Information and DMAS Updates for Medicaid Providers

National Nutrition Month: Help Patients Make Healthy Eating a Priority — Even On the Go

“I want to eat healthy, but I just don’t have the time.”

Sound familiar?

For National Nutrition Month, it’s important to recognize that time is the one thing we never have enough of. Just like you, your patients have long to-do lists and busy schedules. Unfortunately, when time is short, healthy eating often goes out the window.

You know diets high in saturated fat, sodium, and sugar can lead to conditions like obesity, high blood pressure, high cholesterol, and heart disease. In fact, most of the sodium we consume comes from restaurant, processed, packaged, and store-bought food — the very things we reach for when we’re in a hurry.

It’s important to help patients make healthy eating a priority — even on the go. Beyond informing them about health risks and encouraging them to make better choices, this list offers specific tips you can share to help patients eat healthy, or at least healthier, when time is tight and they’re on the move.

Healthy Eating Tips on the Go for National Nutrition Month

Make sure being busy isn’t an excuse for your patients to ignore their healthy eating goals, from what they choose to eat and even how they prepare it. Share these healthy eating tips to give them actionable ways to make better choices, even on the go:

Work, Activities, and More

  1. Keep fresh fruit handy as a snack. Oranges, bananas, and apples don’t need constant refrigeration.
  2. Pack lunch, dinner, and/or snacks to stay in control of options.
  3. Avoid or limit sugar-loaded fancy coffee drinks.
  4. Stay hydrated — thirst often disguises itself as hunger.
  5. Pack last night’s healthy dinner leftovers for lunch.
  6. Beware of mindless munching.
  7. Travel with smart nonperishable options for snacks or even lunch in a pinch. Try low-sugar, high protein energy bars or single-serve whole grain cereal packs.
  8. Choose foods high in protein and fiber to stay fuller longer.
  9. Don’t skip meals.
  10. Sip water.
  11. Avoid the sugar load of office cake or pastries, which can decrease your energy. Take one bite, say, “No thank you,” or leave it on the table.

Home

  1. Drink water with every meal.
  2. Canned and frozen veggies are speedy sides and can be more nutritious than fresh.
  3. Don’t skip breakfast! Grab-and-go choices include low-fat cheese sticks, fresh fruit, and low-fat yogurt tubes or smoothies.
  4. Do meal prep like chopping in advance so meals come together faster.
  5. Use prewashed, precut veggies to save time.
  6. Purchase low fat and low sugar frozen desserts.
  7. Freeze leftovers from healthy meals, they’re perfect for heating up in a pinch.
  8. Use leftover, prepped, or precut veggies to make a quick at-home salad bar.
  9. Weekends are a good time to batch cook for the week or stock the freezer.
  10. Bake potatoes ahead of time so they’re ready to heat and serve.

Fast Food

  1. Go for grilled menu choices.
  2. Only eat a few fries or skip them all together.
  3. Adults can order a kid-sized meal.
  4. Drink water or unsweet tea instead of sweet tea or soda.
  5. Skip the cheese and bacon on a burger.
  6. Choose wheat over white.
  7. Load up the veggies on sandwiches and burgers.
  8. Don’t double patties or super-size anything.
  9. Order thin crust instead of thick and skip pizza toppings like pepperoni.
  10. Choose low-fat salad dressing like vinaigrettes instead of creamy options.

Restaurants & Takeout

  1. Choose a veggie-heavy entrée.
  2. Avoid creamy or cheesy sauces.
  3. Opt for broiled, grilled, or baked instead of fried.
  4. Start with a salad to fill up more before the main course.
  5. Control portions — take extra food to go or split a meal with someone.
  6. Order chicken or fish instead of beef.
  7. Select smart sides, like a salad instead of mac and cheese.
  8. Ask for sauces and dressings on the side and control the amount.
  9. Put down the salt — restaurant food is usually already high in sodium.
  10. Skip the freebies like chips or bread.

We hope this list of specific tips helps you help patients make healthy eating a priority — even on the go. Bonus: We encourage you to use National Nutrition Month as an opportunity to apply these healthy eating tips to your own busy lifestyle!

Written By:
Mary Schmidt, MD, FIDSA, MPH

The information contained in this article is for educational purposes only and does not constitute health care advice.

Telephone Communication for Healthcare Providers: Safety Strategies

Nicole Franklin, MS, CPHRM, Patient Safety Risk Manager II, The Doctors Company

When casually or carelessly conducted, telephone communications can lead to diagnostic errors and misunderstandings that may culminate in professional malpractice claims.

Mitigate Malpractice Risk: Telephone Communication with Patients

Creating comprehensive, clear guidelines for telephone encounters with patients is critical in mitigating risk. Establish practice guidelines and ensure that all office and clinical staff are trained on their roles in communicating with patients by telephone. Protect yourself from potential liability by following these general practices:

  • Smile when greeting patients. Research has shown that people are able to tell if you are smiling by the tone of your voice.
  • Triage and refer all critical calls to emergency services. For more information on this topic, read the article Telephone Triage and Medical Advice Protocols.
  • Obtain as much information as possible about the patient’s presenting complaint. Listen carefully and allow the caller both the time and opportunity to ask questions.
  • Use easy-to-understand language that avoids medical terminology.
  • Obtain the services of an interpreter if you encounter a language difficulty. For more information, see ADA Requirements: Effective Communication.
  • Avoid distractions, such as checking email or attending to other duties, when speaking with patients.
  • Adhere to HIPAA rules and regulations to maintain patient privacy when communicating over the telephone, both inside and outside the office.
  • Develop written protocols for front office/unlicensed personnel to help them respond to patient questions and concerns.
  • Prescribe or advise by telephone only when you have reviewed the patient’s allergies, medications, and medical and surgical history. For more information on this topic, read our article Rx for Patient Safety: Use Ask Me 3 to Improve Patient Engagement and Communication.
  • Accept a third party’s description of a medical or dental condition only when you have confidence in that person’s competence to describe what he or she sees.
  • Make prompt referrals if the patient’s call concerns a medical or dental problem that is outside your expertise.
  • Confirm that pharmacists understand all dosages and instructions for drug prescriptions given by telephone.
  • Verify and document the patient’s adherence with telephone advice through a follow-up contact to ensure continuity of care.

Document All Telephone Communication to Mitigate Malpractice Risk

Disagreements about what was said during telephone conversations can be a major problem in professional malpractice cases. Follow these documentation processes to mitigate potential miscommunication and risk:

  • Document all patient telephone conversations in the medical or dental record—including those received and returned after hours. Include the date and time of each contact and when follow-up is completed.
  • Record all details immediately about the information you received, what you advised, and the orders you gave.
  • Implement an office process for calls received during office hours. Office staff should tell the caller when the provider is most likely to return the call. Include tracking and follow-up to ensure that the caller’s questions and problems are resolved and documented.
  • Document a patient’s hospital medical record with telephone conversations about the hospitalized patient—including any conversations with nurses or other providers.

Health Care Expenditures Attributable to Primary Care Physician Overall and Burnout-Related Turnover: A Cross-sectional Analysis

Abstract

Objective

To estimate the excess health care expenditures due to US primary care physician (PCP) turnover, both overall and specific to burnout.

Methods

We estimated the excess health care expenditures attributable to PCP turnover using published data for Medicare patients, calculated estimates for non-Medicare patients, and the American Medical Association Masterfile. We used published data from a cross-sectional survey of US physicians conducted between October 12, 2017, and March 15, 2018, of burnout and intention to leave one’s current practice within 2 years by primary care specialty to estimate excess expenditures attributable to PCP turnover due to burnout. A conservative estimate from the literature was used for actual turnover based on intention to leave. Additional publicly available data were used to estimate the average PCP panel size and the composition of Medicare and non-Medicare patients within a PCP’s panel.

Results

Turnover of PCPs results in approximately $979 million in excess health care expenditures for public and private payers annually, with $260 million attributable to PCP burnout-related turnover.

Conclusion

Turnover of PCPs, including that due to burnout, is costly to public and private payers. Efforts to reduce physician burnout may be considered as one approach to decrease US health care expenditures.

One of the more pervasive and prevent-able sources of disruptions to patient care is the occupational syndrome of burnout. The consequences of physician burnout are wide-ranging and include…

Read the Full Article

Why America Has So Few Doctors

As a matter of basic economics, fewer doctors means less care and more expensive services. | By Derek Thompson via The Atlantic

The U.S. is one of the only developed countries to force aspiring doctors to earn a four-year bachelor’s degree and then go to medical school for another four years. (Most European countries have one continuous six-year program.) Then come the years of residency training. Many graduates have $200,000 to $400,000 in outstanding student loans when they enter the workforce. Medical education is a necessary good; nobody wants charlatans in the OR and snake-oil salesmen prescribing arthritis medication. What I’m asking is: What advantage do these additional years and loans get us?

Keep Reading

Dr. Lorna Breen Heroes’ Foundation Hails Senate Passage of Legislation Protecting Healthcare Workers’ Mental Health

The Dr. Lorna Breen Heroes’ Foundation today praised the U.S. Senate for passing the Dr. Lorna Breen Health Care Provider Protection Act. The legislation is named after Dr. Lorna Breen, a New York City emergency room physician who tragically died by suicide in Spring 2020 after treating confirmed COVID-19 patients, aims to reduce the stigma of seeking mental health assistance among health care professionals.

Jennifer Breen Feist and Corey Feist, co-founders of the Dr. Lorna Breen Heroes’ Foundation released a video praising the bill’s passage.

“We want to take a moment with you to pause and let all those health care professionals know that we heard you and we have been working diligently to support you,” said Jennifer Breen Feist, co-founder of the Dr. Lorna Breen Heroes’ Foundation. “We owe each of you our deepest gratitude for all you’ve done for us and for this country.”

Read the Full Article

Looking for confidential support in Virginia? SafeHaven™ was founded in 2020 after recognizing a greater need to provide physicians and PAs the support they need to stay well and prevent burnout. Learn more here.

Health Commissioner Update: COVID-19 Update for Virginia | February 17, 2022

Dear Colleague:

Thank you for your continued partnership in responding to the COVID-19 pandemic.  Please visit the Virginia Department of Health (VDH) website for current clinical and public health guidance, epidemiologic data, and other information.  Updates on the following topics are included in this correspondence:

  • CDC Updates Vaccine Recommendations for Immunocompromised Individuals and Those Who Received Passive Antibody Products
  • FDA Grants Emergency Use Authorization to Bebtelovimab
  • New Isolation and Quarantine Calculators
  • National Blood Shortage

Read the Full Update

Health Commissioner Update: COVID-19 Update for Virginia | February 10, 2022

via VDH

Dear Colleague:

Thank you for your continued partnership in responding to the COVID-19 pandemic.  Please visit the Virginia Department of Health (VDH) website for current clinical and public health guidance, epidemiologic data, and other information.  Updates on the following topics are included in this correspondence:

  • State Health Commissioner Issues Interim Guidelines for the Prioritization of the Use of Rapid COVID-19 Tests
  • CDC Recommends FDA-Approved Moderna COVID-19 Vaccine
  • Therapeutics Updates
  • CDC and CMS Updates for Infection Prevention in Healthcare Settings
  • Keeping Up With COVID Video Series

State Health Commissioner Issues Interim Guidelines for the Prioritization of the Use of Rapid COVID-19 Tests

In response to Governor Youngkin’s COVID-19 Action Plan, VDH recently issued new Interim Guidelines for the Prioritization of the Use of Rapid COVID-19 Tests.  Due to nationwide challenges in the supply chain, combined with a surge in demand for testing due to the Omicron surge of cases, there is a strain on the COVID-19 testing system in the Commonwealth.  Testing remains an important tool to guide the care of individuals and to prevent transmission to others.  In general, testing should be prioritized for people who have symptoms and/or have had a known exposure.  Additionally, healthcare providers should review the guidelines and prioritize available rapid tests in accordance with the guidance to the extent possible.  As cases decline and demand for testing decreases, providers are advised to expand testing as appropriate.  As a reminder, a negative test is not required to be released from isolation and quarantine.

Additionally, the U.S. Food and Drug Administration (FDA) recently updated its Molecular Diagnostic Tests for SARS-CoV-2 page to specify which authorized tests are designed with single or multiple viral targets.  Tests with single targets are more susceptible to changes in performance due to viral mutations because they are more likely to fail to detect new variants.   In contrast, tests with multiple targets are more likely to continue to perform well with the emergence of new variants.

CDC Recommends FDA-Approved Moderna COVID-19 Vaccine

FDA granted full approval to the Moderna COVID-19 vaccine on January 31 and the Centers for Disease Control and Prevention (CDC) recommended the vaccine for people 18 years of age and older on February 4. The vaccine, which will be marketed as Spikevax, will be the country’s second fully approved vaccine to protect against COVID-19 and will be administered as a two-dose primary series.  FDA’s Emergency Use Authorization (EUA) for Moderna COVID-19 vaccine will continue to cover the two-dose primary series for individuals aged 18 years and older, the administration of a third dose to certain immunocompromised individuals aged 18 years and older, and a single booster dose for individuals aged 18 years and older at the recommended interval following the completion of a COVID-19 vaccine primary series.  The FDA-approved vaccine and the FDA-authorized vaccine have the same formulation, and the two can be stored, handled, and used interchangeably.  The FDA has updated its Spikevax and Moderna fact sheets for healthcare providers administering vaccines and for recipients and caregivers and should continue to be distributed at the time of vaccination. CDC will be updating their Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States to reflect these changes.

The FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) will also be meeting on Tuesday, February 15 to discuss Pfizer-BioNTech’s data on its COVID-19 vaccine for children aged 6 months to 4 years.  The VRBPAC meeting will be able to be viewed via live stream, and additional meeting information will be available on their site.

Therapeutics Updates

On January 24, 2022, the FDA revised the EUA fact sheets for REGEN-COV and bamlanivimab/etesevimab (bam/ete) to limit their use to only when the patient is likely to be exposed or infected with a COVID-19 variant susceptible to these treatments.  REGEN-COV and bam/ete are highly unlikely to be effective against Omicron.  Due to the Omicron surge, HHS has paused allocations of REGEN-COV and bam/ete until further notice.

Demand for Sotrovimab is decreasing, following a decrease in case rates as well as increased availability of oral antivirals.  Molnupiravir is available for providers to order in Vaxmax.  Please note that providers should only order Molnupiravir through Vaxmax if the dispensing site is a pharmacy or if the facility has a “Physician Selling Controlled Substances Facility Permit,” issued by the Board of Pharmacy.  Paxlovid will become available for ordering through Vaxmax when supply is more readily available.

CDC and CMS Updates for Infection Prevention in Healthcare Settings

On February 2, 2022, CDC updated Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic and descriptions are provided regarding “up to date” COVID-19 vaccination status for healthcare personnel, patients, and visitors.  CDC continues to emphasize that anyone with even mild symptoms of COVID-19, regardless of vaccination status, should receive a viral test as soon as possible.  Asymptomatic patients in any healthcare setting with close contact with someone with SARS-CoV-2 infection, regardless of vaccination status, should have a series of two viral tests immediately (but not earlier than 24 hours after the exposure) and, if negative, again 5–7 days after the exposure.

In areas with substantial to high community transmission, CDC recommends a NIOSH-approved N95 or equivalent or higher-level respirator when caring for patients not known or suspected to have SARS-CoV-2 infection in the following higher-risk situations: all aerosol-generating procedures; higher-risk surgical procedures; and in situations where additional risks for infection are present.  These situations include caring for a patient who is not up to date with their vaccines, the patient is not able to wear source control, or the area is poorly ventilated.

On February 2, 2022, CDC updated Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes and the Centers for Medicare and Medicaid Services updated their nursing home visitation FAQs.  In nursing homes, residents who are not up to date with all recommended COVID-19 vaccine doses and are new admissions or readmissions should be placed in quarantine, even if they have a negative test upon admission; COVID-19 vaccination should also be offered.  VDH Recommendations for Hospitalized Patients Being Discharged to a Long-Term Care Facility During the COVID-19 Pandemic were updated February 9, 2022.

VDH Presents Keeping Up With COVID Video Series

VDH’s Health Professionals page is excited to announce the Keeping Up With COVID video series.  Each Monday, the page will feature a new short video on a topic of interest to keep providers up to date on new COVID-19 information.

Thank you for your continued partnership as we respond to the COVID-19 pandemic.

Sincerely,

Colin M. Greene, MD, MPH
Acting State Health Commissioner

Biden-Harris Administration Will Cover Free Over-the-Counter COVID-19 Tests Through Medicare

Via cms.gov Newsroom

As part of the Biden-Harris Administration’s ongoing efforts to expand Americans’ access to free testing, people in either Original Medicare or Medicare Advantage will be able to get over-the-counter COVID-19 tests at no cost starting in early spring. Under the new initiative, Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per month for free. Tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 over-the-counter tests approved or authorized by the U.S. Food and Drug Administration (FDA).

This is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries. There are a number of issues that have made it difficult to cover and pay for over-the-counter COVID-19 tests. However, given the importance of expanding access to testing, CMS has identified a pathway that will expand access to free over-the-counter testing for Medicare beneficiaries. This new initiative will enable payment from Medicare directly to participating pharmacies and other participating entities to allow Medicare beneficiaries to pick up tests at no cost. CMS anticipates that this option will be available to people with Medicare in the early spring.

Until then, people with Medicare can access free tests through a number of channels established by the Biden-Harris Administration. Medicare beneficiaries can:

  • Request four free over-the-counter tests for home delivery at covidtests.gov.
  • Access COVID-19 tests through healthcare providers at over 20,000 free testing sites nationwide. A list of community-based testing sites can be found here.
  • Access lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost. In addition to accessing a COVID-19 lab test ordered by a health care professional, people with Medicare can also already access one lab-performed test without an order, also without cost sharing, during the public health emergency.

In addition:

  • Medicare Advantage plans may offer coverage and payment for over-the-counter COVID-19 tests as a supplemental benefit in addition to covering Medicare Part A and Part B benefits, so Medicare beneficiaries covered by Medicare Advantage should check with their plan to see if it includes such a benefit.
  • All Medicare beneficiaries with Part B are eligible for the new benefit, whether enrolled in a Medicare Advantage plan or not.

For more information, please see the FAQ Fact Sheet.