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CMS Releases Recommendations on Adult Elective Surgeries, Non-Essential Medical, Surgical, and Dental Procedures During COVID-19 Response

Earlier today at the White House Task Force Press Briefing, the Centers for Medicare & Medicaid Services (CMS) announced that all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak.

As more healthcare providers are increasingly being asked to assist with the COVID-19 response, it is critical that they consider whether non-essential surgeries and procedures can be delayed so they can preserve personal protective equipment (PPE), beds, and ventilators.

“The reality is clear and the stakes are high: we need to preserve personal protective equipment for those on the front lines of this fight,” said CMS Administrator Seema Verma.

This will not only preserve equipment but also free up our healthcare workforce to care for the patients who are most in need. Additionally, as states and the nation as a whole work towards limiting the spread of COVID-19, healthcare providers should encourage patients to remain home, unless there is an emergency, to protect others while also limiting their exposure to the virus. They should also urge patients to follow the President’s recently issued guidelines to help slow the spread of the virus.

The recommendations provide a framework for hospitals and clinicians to implement immediately during the COVID-19 response. The recommendations outline factors that should be considered for postponing elective surgeries, and non-essential medical, surgical, and dental procedures. Those factors include patient risk factors, availability of beds, staff and PPE, and the urgency of the procedure. This will help providers to focus on addressing more urgent cases and preserve resources needed for the COVID-19 response. The decision about proceeding with non-essential surgeries and procedures will be made at the local level by the clinician, patient, hospital, and state and local health departments.

The recommendations can be found here:  https://www.cms.gov/files/document/31820-cms-adult-elective-surgery-and-procedures-recommendations.pdf

These recommendations, and earlier CMS guidance and actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov for further information. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.

President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak

The Trump Administration today 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. Beginning on March 6, 2020, Medicare—administered by the Centers for Medicare & Medicaid Services (CMS)—will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.

“The Trump Administration is taking swift and bold action to give patients greater access to care through telehealth during the COVID-19 outbreak,” said Administrator Seema Verma. “These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus. Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries.”

On March 13, 2020, President Trump announced an emergency declaration under the Stafford Act and the National Emergencies Act. Consistent with President Trump’s emergency declaration, CMS is expanding Medicare’s telehealth benefits under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. This guidance and other recent actions by CMS provide regulatory flexibility to ensure that all Americans—particularly high-risk individuals—are aware of easy-to-use, accessible benefits that can help keep them healthy while helping to contain the spread of coronavirus disease 2019 (COVID-19).

Prior to this announcement, Medicare was only allowed to pay clinicians for telehealth services such as routine visits in certain circumstances. For example, the beneficiary receiving the services must live in a rural area and travel to a local medical facility to get telehealth services from a doctor in a remote location. In addition, the beneficiary would generally not be allowed to receive telehealth services in their home.

Click here to read more.

CMS Announces Actions to Address Spread of Coronavirus

CMS calls on all health care providers to activate infection control practices and issues guidance to inspectors as they inspect facilities affected by Coronavirus

Today, the Centers for Medicare & Medicaid Services (CMS) is announcing several actions aimed at limiting the spread of the Novel Coronavirus 2019 (COVID-19). Specifically, CMS is issuing a call to action to health care providers across the country to ensure they are implementing their infection control procedures, which they are required to maintain at all times. Additionally, CMS is announcing that, effective immediately and, until further notice, State Survey Agencies and Accrediting Organizations will focus their facility inspections exclusively on issues related to infection control and other serious health and safety threats, like allegations of abuse – beginning with nursing homes and hospitals. Critically, this shift in approach, first announced yesterday by Vice President Pence, will allow inspectors to focus their energies on addressing the spread of COVID-19.

As the agency responsible for Medicare and Medicaid, CMS requires facilities to maintain infection control and prevention policies as a condition for participation in the programs. CMS is also issuing three memoranda to State Survey Agencies, State Survey Agency directors and Accrediting Organizations – to inspect thousands of Medicare-participating health care providers across the country, including nursing homes and hospitals.

Click here to read more.

ESRD Proposal May Inadequately Reimburse Medicare Advantage Plans

Medicare Advantage proponents are concerned that the new CMS proposal may result in underpayment to Medicare Advantage plans for end-stage renal disease care.  While payers and Medicare Advantage proponents applauded elements of the Medicare Advantage rule that CMS proposed yesterday which will increase plans’ revenues by nearly one percent, many expressed concerns about the proposed rule’s approach to chronic disease management costs for patients with end-stage renal disease (ESRD).

Click here to read more.

ACO Care Coordination Toolkit and Beneficiary Engagement Toolkit Available

The Centers for Medicare & Medicaid Services worked with 21 Medicare Accountable Care Organizations (ACOs) and End-Stage Renal Disease Seamless Care Organizations (ESCOs) participating in the Shared Savings ProgramNext Generation ACO Model, and the Comprehensive ESRD Care Model to identify promising practices and innovative strategies for coordinating care for Medicare beneficiaries.

Specifically, the ACO Care Coordination Toolkit focuses on care coordination for Medicare beneficiaries who:

  • Recently received care in an emergency department,
  • Require treatment in a skilled nursing facility,
  • Have recently been discharged home after a hospital or emergency department visit,
  • Have been diagnosed with a chronic condition or have a complex medication regimen, or
  • Have conditions affected by the social determinants of health.

Working with the same methodology, CMS also has released the ACO Beneficiary Engagement Toolkit which highlights strategies used by ACOs and ESRD Seamless Care Organizations (ESCOs) to engage beneficiaries. Specifically, the toolkit explores how ACOs and ESCOs:

  • Engage beneficiaries in ACO governance,
  • Elicit beneficiary and family feedback,
  • Support beneficiaries in self-care management,
  • Enhance beneficiary communication in the clinical setting, and
  • Communicate with beneficiaries about the ACO as a value-based care organization.

These toolkits are part of a broader series of toolkits designed to educate the public about the strategies ACOs use to provide value-based care while also providing actionable ideas to current and prospective ACOs to help them improve or begin operations.

For more information on the toolkits and case studies please visit the ACO General Information webpage.

Kidney Care Choices Model

The Centers for Medicare and Medicaid Services (CMS) released clarifications to the Kidney Care Choices (KCC) Model’s Request for Applications (RFA) that was posted on October 24, 2019.
These clarifications were created in response to questions from applicants regarding the Kidney Care First (KCF) and Comprehensive Kidney Care Contracting (CKCC) Options. This document expands upon eligibility requirements regarding revenue calculations and practices’ Tax Identification Numbers (TINs).
The KCC Model is designed to help health care providers reduce the cost and improve the quality of care for patients with late-stage chronic kidney disease and end stage renal disease by aiming to delay the need for dialysis and encourage kidney transplantation.
The clarifications, full RFA, and additional resources can be found on the Kidney Care Choices websiteThe Model is expected to run from 2020 through December 31, 2023. The deadline to apply is January 22, 2020.

CROWNWeb New User Training

Are you new to CROWNWeb, or just need a refresher on how to use the system? CROWNWeb New User Training is for you! This informative ONE-DAY90-minute course covers all the basic information a new CROWNWeb user would need to begin using the system. January’s New User Training will be held on Tuesday, January 21, 2020 from 2:00 PM ET to 3:30 PM ET.
Click here to register.

2020 NHSN Dialysis Event Updates

The NHSN Dialysis Team will host a webinar on December 4th and December 5th at 3pm EDT that will provide updates to the NHSN Dialysis Component for 2020. These webinars are identical, but are offered on two days to reach the maximum number of NHSN users. We will only be accepting questions and comments via the webinar chat box, and will answer as many questions during the webinar as time allows. Please e-mail the NHSN helpdesk at nhsn@cdc.gov with “Dialysis” in the subject line following the webinar if we do not address your questions, and we will follow up with you directly.

Please pre-register via one of the links below:

Title: NHSN Dialysis Surveillance Call
Date: 12/4/2019
Time: 3:00 PM EST
Duration: 1 hour
Audience Listen By Phone: 706-418-5005(United States)
Passcode: 77572898#
Conference URL: https://globalmeetwebinar.webcasts.com/starthere.jsp?ei=1272194&tp_key=38d01fc74f

Title: NHSN Dialysis Surveillance Call
Date: 12/5/2019
Time: 3:00 PM EST
Duration: 1 hour
Audience Listen By Phone: 706-418-5005
Passcode: 47347711#
Conference URL: https://globalmeetwebinar.webcasts.com/starthere.jsp?ei=1272202&tp_key=d2a3e8f9bf

ESRD QIP Call: Audio Recording and Transcript

An audio recording and transcript are available for the August 20 Medicare Learning Network call on the End Stage Renal Disease (ESRD) Quality Incentive Program (QIP): CY 2020 ESRD PPS (Prospective Payment System) Proposed Rule Call. Learn about the legislative framework, the proposed rule, and methods for reviewing and commenting on the rule.

ESRD Spanish Webinar: Basic Nutrition Guide for People with Kidney Disease

Upcoming ESRD webinar on renal nutrition will be presented in Spanish, please share the information with Spanish-speaking patients, families and facilitates who might be interested.

The webinar will be presented on August 22 and will discuss information about the renal diet including sodium, protein, potassium and phosphorus and how to choose foods that are kidney-friendly. The presentation will be given in Spanish by a renal dietitian, María E Rodriguez. She has worked with dialysis patients for the past 10 years and with chronic kidney disease patients for the past 6 years.

Guía Básica de Alimentación para Personas con Enfermedad Renal

Presentado por María E. Rodríguez, MS, RD, CSR

Aprende:

  • ¿Qué es la dieta renal?
  • Lo que necesitas saber sobre proteína, sodio, potasio y fósforo
  • ¿Cómo hacer una buena selección de alimentos?

Regístrate para los detalles de la llamada: https://www.dpcedcenter.org/news-events/education-webinars/signup/

Imprima el folleto de promoción: https://www.dpcedcenter.org/wp-content/uploads/2019/07/201908_flier.pdf

The Kidney Innovation Accelerator (KidneyX) – Patient Innovator Challenge

The Kidney Innovation Accelerator (KidneyX) is a public-private partnership between the U.S. Department of Health and Human Services (HHS) and the American Society of Nephrology (ASN) seeking to improve the lives of the 850 million people worldwide currently affected by kidney diseases. KidneyX aims to accelerate breakthroughs to promising new technologies for people with kidney diseases by addressing barriers innovators commonly identify as they develop new products for the prevention, diagnosis, and treatment in kidney care. To do this, KidneyX hopes to create a better collaborative relationship among patients and innovators.

KidneyX Patient Innovator Challenge (Prize Competition)
The Patient Innovator Challenge, funded by the National Kidney Foundation, is looking for ideas and fixes that people living with kidney diseases have developed through their own experiences and ingenuity. In this competition there are two submission categories:

  • Category 1: “Solutions in Practice,” which are solutions already tried or put into practice
  • Category 2: “New Ideas,” which are solutions that have not yet been created or tried.

Anyone can apply for the competition and some key areas submissions may focus on are how to manage the side effects of dialysis or transplant treatment, ways to gain patient independence, successful diet and fluid regimens, techniques to increase physical activity, and methods which help sustain family and social life or improve overall quality of life.

Up to 25 winners will be awarded – 10 winners in Category 1 will receive $4,000 each, and up to 15 winners in Category 2 will receive $2,000.

Submissions are due by 5:00 ET on September 16, 2019. For more information, go to https://www.kidneyx.org/WhatWeDo/PrizeCompetitions/patientinnovatorchallenge

REMINDER: Register for ESRD QIP Training July 11, 2019

Thursday, July 11, 2019 at 2:00 PM ET is the first of two ESRD QIP training sessions. Each of these informative 1-hour courses will cover the information needed to begin using the ESRD QIP System. A second session will be held on Monday, July 22, 2019 at 2:00 PM ET. During these sessions, the CROWNWeb Outreach, Communication, and Training (OCT) Team will provide the basics of how to use the ESRD QIP system, including how to effectively submit a clarification question and a formal inquiry, if needed, prior to the end of the preview period.

To join the online event, click on the dates above to register.  Note, both training sessions will contain the same information, users only need to attend one event.