Policy Throughout The Pandemic

“I’ve been coming to these meetings since the mid-’90s, and I’ve a medical director for 23 years. This past year is unlike any we’ve ever experienced,” said Karl Steinberg, MD, CMD, HMDC, 2021–2022 president of AMDA – The Society Post-Acute Long-Term Care Medicine, at start second general session Society’s virtual Annual Conference. public policy update always popular program, but there no doubt that if this had live, room would have overflowing. So much has happened so ahead PALTC clinicians are eager some perspective guidance. Alex Bardakh, MPP, advocacy Society, opened by recognizing many leaders members whose efforts advocate, inform, educate during pandemic were “nothing short heroic.” He then talked about what expect with new federal administration in place as well thin Democratic majority Senate. Particularly Senate, “it means chairs key committees control hearings other actions significant. Given one-party [the legislative executive] branches, opportunity pressure push through legislation, even it not bipartisan, will be something watch,” Mr. Bardakh Elsewhere, noted, “The released nursing home priorities. Not every done this, which sign they clearly planning pay attention area.” Among things, plan calls for:•Requiring an infectious disease specialist regulated setting.•Ensuring access personal protective equipment.•Ensuring adequate staffing staff training.•Allowing LTC workers choice organize unions collectively bargain, giving them paid leave, career ladders, benefits.•Increasing frequency scope surveys data collection families sufficient information make choices.•Conducting numbers surveys, restoring levels penalties needed obtain compliance quality standards.•Reauthorizing Elder Justice Act 2010. However, added, “as right now, expert appointed Biden health care task force, clear how implement agenda.” stressed one issues ensuring experts part decision-making process on concerns, just having response process. COVID-19 Relief Bill (American Rescue Plan), signed into law before Conference, provides $450 million support skilled facilities, $250 strike teams assist clinical care, infection control, staffing, $200 protocols. legislation did include provision suspend sequestration — result across-the-board cut 2% all Medicare services Congress working separate bill said. stayed top everything happening regulatory front via weekly Centers & Medicaid Services Disease Control Prevention. Additionally, said, continue regular conversations leadership congressional staff. held Hill Day last September, Board others used meeting platforms connect legislators They focused their PALTC, reductions payments facility visits physician fee schedule, use reimbursement telehealth PALTC. State-level also was out full force year. “Decisions being made locally, state chapters great job making our voice heard,” Michele Bellantoni, associate professor medicine Division Geriatric Medicine Gerontology Johns Hopkins University School issue updates, starting vaccination. She “AMDA CMS putting together statements vaccination policies adopted federally now address vaccine hesitancy among staff.” recommended distribution prioritize residents workers. urged directives from governments reduce barriers vaccinations, flexibility Federal Partnership Program distribution/administration involve local pharmacies. On treatment side, collaborated American Consultant Pharmacists (ASCP) develop readiness document outlines steps pharmacies acquire provide monoclonal antibody treatments capable settings. eligibility, administration, monitoring requirements staffs facilities It soon became administering challenge due limited qualified necessary safe infusion treatment, overwhelming demands. five national associations united form Coalition Advance Community-Based Solutions COVID-19. coalition designed supports Infusion Support Activity launched early March facilitate interested Medical Reserve Corps volunteers infusions homes. advocating registry directors time. “We think should easy support,” Suzanne Gillespie, RD, Department Emergency Rochester Center. “It enable best possible communication regarding opportunities improve care.” worked arrange bipartisan letter asking this. At same time, she states begun level. discussions issue, we confident progress this,” Dr. Gillespie emergency (PHE) waivers went effect effective enabling practitioners promote smooth transitions. Specifically telehealth, noted PHE remain allowing After ends, however, things change. In its final rule issued end 2020 few determinations (the indicated likely least 2021).•Nursing Facility Initial Visits (99304–99306) billable telehealth.•Nursing Subsequent codes (99307–99310) once 14 days.•Home/domiciliary established patient (99341–99350) rest ends. Telehealth Workgroup continues advocate removal long-term basis. group reintroduction Reducing Unnecessary Senior Hospitalizations (RUSH Act, H.R. 6209), establish Medicare-reimbursed program practices may certain telehealth. thanked everyone audience engaged effort avoid nearly 10% facility, health, assisted living 2021. calendar 2021 proposed rule, wanted cuts complicated budget neutrality formula where get increase, must offset decreases codes. aggressive helped cut. sent more than 1,000 letters talking impact cuts. stressed, “A lot work addressing issue. We couldn’t without your support.” end, added significant money schedule delayed implementation code. Instead cut, saw or only 1% Last year, finalized Evaluation/Management (E/M) coding documentation changes office/outpatient E/M (99211–99215), beginning January 1, includes code redefinitions rely time selecting visit level, performance history examination medically appropriate, deletion level 1 code, prolonged specific visits. revised guidelines CPT Editorial Panel. Of note, do services. Looking forward, presenters expressed optimism. brought us table issues. As gets back fog pandemic, it’s hard say exactly we’ll go, I’m optimistic.”