Maine Insurance Emergency Response Order (March 27, 2020) Continuation of Group Health Coverage: Eric Cioppa, Superintendent of Insurance orders carriers, when requested by an employer, to suspend the application of any group health plan contract provision that terminates coverage when an eligible employee is no longer actively employed by the group policyholder, provided that the employer’s offer of continued coverage is made to all affected employees on a nondiscriminatory basis.
Maine Records First Death of Individual Who Tested Positive for COVID-19
March 27, 2020
The Maine Center for Disease Control and Prevention (Maine CDC) today reported the first death of an individual who had tested positive for the disease caused by the 2019 novel coronavirus (COVID-19). The individual was a man in his 80s from Cumberland County. Due to privacy laws, Maine CDC is limited in releasing further details.
US Becomes Nation With Most Confirmed Cases Of Coronavirus- USA Today (3/26) reports the US “surged past China and Italy to become the planet’s most infected nation Thursday, a stark milestone in the coronavirus era – and a reminder of its deadly, culture-changing effects on American life.” The article says that “the Johns Hopkins University dashboard showed the U.S. with 85,840” cases “as of 11 p.m., ET, moving past Italy (80,589) and China (81,782),” and “more than 1,296 people have died in the U.S.”
Governor Mills Launches New Online Resource Outlining Ways Mainers Can Help Mainers During COVID-19 Pandemic
March 27, 2020
In response to the extraordinary generosity of Maine people, businesses, and organizations looking to help during these challenging times, Governor Janet Mills today launched a new online resource, coronavirus.maine.gov/mainehelps, to outline ways in which Maine people can support efforts to combat the COVID-19 pandemic.
The new resource, which will be updated regularly, outlines four predominate ways Maine people can address immediate needs: 1) financial assistance; 2) health care and medical assistance (via Maine Responds registry: Register on Maine Responds-- Emergency Health Volunteer System; 3) small business assistance; and 4) connections with family, friends, and neighbors. Visit Maine Helps Here.
Governor Mills Extend State Income Tax Payment Deadline to July 15, 2020 (March 26, 2020)
Governor Mills Acts to Promote Access to Health Care During COVID-19
March 25, 2020
Two new orders bolster health care workforce and telehealth
First, Governor Mills has signed an Executive Order (PDF) allowing licensed physicians, physician assistants, and nurses greater flexibility to contribute to Maine’s response during the civil state of emergency. Those who are licensed and in good standing in other states can now:
- Receive an emergency license to provide health care in person or through telehealth to Maine people, with no application fee
- See Maine patients through telehealth without obtaining a Maine license, if already serving those patients at out-of-state locations
- Have their licenses automatically renewed if up for renewal during the state of emergency
- Suspend conforming to physician oversight requirements (for physician assistants and advanced practice registered nurses)
- Reactivate their license immediately with no application fee, if retired.
Additionally, all physicians, physician assistants and nurses licensed in Maine and those authorized under the order may provide services through all methods of telehealth, including video, audio and other electronic technologies to treat Maine people for all medical needs. The order expands acceptable technologies beyond only those that are compliant with patient privacy laws, to align Maine with major changes made by the federal government that provide broad coverage for telehealth services for Medicare members.
In addition to this Executive Order, the Administration’s second action also aligns Maine with federal guidance and improves the affordability of needed health care services delivered through telehealth. To implement the Governor’s initiative, Superintendent of Insurance Eric Cioppa on Friday signed an order that requires insurance companies to provide coverage for clinically-appropriate services delivered by telephone, as well as via more commonly used apps, such as FaceTime, WhatsApp and Skype, as long as they are private. This provides flexibility to patients who may not have access to web-based applications traditionally used for telehealth. The Superintendent’s order also requires insurance carriers to pay providers for telehealth services at the same rate they would pay for an in-person visit for the same service. This supports health care providers who are following national and state recommendations to postpone in-person appointments for non-urgent care and makes it more likely that patients will be able to get the care they need through telehealth visits.
MaineCare, or Medicaid, already pays the same rate for most covered services whether delivered in person or through telehealth. Last week, the Maine Department of Health and Human Services (DHHS) announced an expansion of this already robust policy through an emergency rule change that allows for prescribing through telehealth. Maine DHHS has long supported the promotion of telehealth services, as described in a new fact sheet.
The Insurance Superintendent’s authority extends only to fully-insured health plans -- not to Medicare Advantage or self-insured plans. The Governor urges all self-insured large employers in Maine to adopt the same policies to ensure their employees continue to get the care they need.
DHHS Commissioner Jeanne Lambrew and the Northeast Telehealth Resource Center will host a statewide virtual statewide Telehealth Town Hall meeting on Thursday, March 26 for health providers to explain these changes and announce a range of resources (PDF) available to support them in using telehealth services.
Executive Order Mandating all non-essential businesses and operations in Maine close public-facing contact (March 24, 2020)
Augusta, MAINE – Under the authority granted to her during a State of Civil Emergency, Governor Janet Mills today issued an Executive Order mandating that all non-essential businesses and operations in Maine close their physical locations that are public facing, meaning those that allow customer, vendor or other in-person contact. The Order also closes non-essential business sites that require more than ten workers to convene in a space where physical distancing is not possible. Non-essential businesses and operations may continue activities that do not involve these types of in-person contact and convenings, and should facilitate the maximum number of employees working remotely.
The Order is effective March 25, 2020 at 12:01 a.m. and extends for a period of 14 days through April 8, 2020 at 12:00 a.m.
- March 26th the AOA hosted a webinar along with the CDC to provide updates to the DO community on COVID-19. Watch the webinar to stay in the know.
- AOAAM and Opioid Response Network host Webinar on Telemedicine: Getting Started, Regulations and Privacy Issues-- March 27, 2020 at 3:00 PM EDT, Register here.
- Maine CDC Weekly Updates for Clinicians-- Thursdays at 12:30PM-- New Call-in: https://zoom.us/j/399715702?pwd=MmNwUUZKa2Nldm1BSmV1SHhHQWJiZz09 Meeting ID: 399 715 702, Password: 348750 Dial:+16465588656,,399715702# US (New York)
Telehealth Town Hall for Maine Healthcare Providers -- Held March 26.Nearly 1,000 participated. If you missed it, here are some key resources:
Maine COVID Sitters - UNE Students are volunteering to provide childcare, pet services, and household support to those on the front line of the COVID-19 pandemic.
A little bit about how our program works: we are a group of health care professional students (DO, MD, PA, dentistry, pharmacy, etc) in and around Portland, Maine, modeled after the MN CovidSitters. Using this intake form you can identify your needs, may they be child care, pet walking, grocery or pharmacy runs. You will then be connected with a “pod” of 1-5 students who will provide support solely to your family. This is done to distribute the responsibilities evenly among students who still have academic requirements, and promote social distancing in accordance with CDC guidelines. You will then be able to coordinate with your pod to get the services that you require. Please know that we are students and not certified childcare providers, nor are these services affiliated with our respective institutions.
We encourage you to share this information widely, so we will be able to reach any and all health care workers that need a helping hand. We are attaching a document of frequently asked questions to address any concerns you may have. If you have any additional questions or concerns, you can contact us at maineCOVIDsitters@gmail.com.
Urgent Call to Action from the Maine Association of Psychiatric Physicians
COVID-19 is an unprecedented challenge to Maine. Our front line clinicians will soon be dealing with a much greater volume of patients at a time when we have no specific vaccine, limited testing, and little to offer in the way of specific treatment. Our colleagues will soon be facing extremely difficult situations with large numbers of critically ill patients and at the same time the lack of sufficient beds, ICU capacity and shortages of medications, supplies and personal protection equipment. OUR MAINE FRONT LINE PROVIDERS ARE ALREADY FEELING STRESSED. COVID-19 WILL IMPACT OUR COLLEAGUES AND THE EFFECTIVENESS OF THE HEALTHCARE SYSTEM ON WHICH WE ALL RELY.
MAPP is partnering with Maine psychologists, social workers, Psych NP's and PA's and other mental health professionals to SUPPORT our clinical front line staff and first responders during this crisis. We will do a short training with on volunteers on the principles of Psychological First Aid. We will connect with particular clinicians or organizations that have requested assistance from us. We will be helping out 'virtually', on-line or by phone, in pairs or teams. We will stay connected with our front line providers as long as there is a need and we will all make it through this, together.
ALL OF US CAN HELP. Many of us are appropriately "sheltering in place" at home at the moment- WE CAN GIVE MUCH NEEDED SUPPORT WITHOUT LEAVING OUR HOME. Whatever amount of time you can give will make a difference.
It's easy to participate. To start, please complete the following SHORT QUESTIONNAIRE: https://www.surveymonkey.com/r/3B7X822
We will be in touch shortly with more information. Thank you for helping to make a difference!
Edward Pontius, MD, DLFAPA
Osteopathic Health Policy Fellowship
The application cycle for the Osteopathic Health Policy Fellowship Class of 2020-2021 is now open.
As you may know, the Fellowship is designed for practicing and/or teaching osteopathic physicians and osteopathic college faculty and staff who are preparing for leadership roles in the profession and positions of influence in health policy. Fellows are required to attend an intensive academic orientation and nine additional three-day seminars across the year. Between monthly seminars, Fellows are expected to devote a minimum of 20 hours to reading, research, and completing written assignments.
Graduates of the program join a cadre of health policy experts from which the profession can draw to staff committees and task forces at the federal and state levels, testify on issues relevant to osteopathic medicine and education, and develop policy positions. The AOA, AACOM, specialty groups, and state and regional associations have supported the program continuously since its beginning.
October 4-6: University of New England College of Osteopathic Medicine
Please note – all dates are confirmed at this time. COVID-19 and other circumstances may result in altering the dates of some sessions.
Working with the AACOM staff, we have revised the application to be more user friendly and to expedite the review process. The main application uses type-in-boxes, drop down lists, and radio buttons to increase efficiency and to provide more uniform information. All supporting materials (personal statement, CV/resume, and letters of reference) are uploaded electronically. Applicants are advised to review the schedule to assure full participation in the program. All application materials must be completed by April 26, 2020, with acceptance decisions made in mid-May.
Please forward this information widely and encourage applications to the Osteopathic Health Policy Fellowship Class of 2020-2021 at the following link:
If you or the applicant have questions or require additional information, please contact Al Pheley, Co-Director at firstname.lastname@example.org.
The State of Maine will hold its second annual Governor Mills Opioid Response Summit: Compassion, Community, Connection on July 23rd and 24th, 2020 at the Cross Arena in Bangor Maine.
Expanding on the success of our past conference this summit will focus on leadership, prevention, overdose rescue, treatment and recovery within the opioid epidemic. It is being designed to enlighten, inform, and assist in our strategy of reducing negative health and economic impacts of opioid use disorder on individuals, families, and the communities in Maine.
The Opioid Response Summit Committee invites you to participate in our call for presentations in a wide variety of topics to best meet the interests and learning needs of our attendees. Proposals from individuals and panels are accepted. Multidisciplinary panels are encouraged and include perspectives from physicians, nurses, psychologists, basic scientists, pharmacists, recovery support and people in recovery. Proposals that include both basic and clinical science are encouraged.
Call for abstracts deadline extended to April 18th- more information here.
ABMS Reaffirms Support for Physicians to Focus Their Priorities on Patients, Families, and the Communities They Serve
As the worldwide health care community continues to navigate and respond to the ever-changing COVID-19 landscape, the American Board of Medical Specialties (ABMS) and its 24 Member Boards are committed to supporting diplomates and trainees as they work on the front line to combat this virus by providing expert care to patients. For our residents, fellows, interns and program directors, this has translated into supportive strategies Boards can employ regarding initial board certification requirements and leave policies.
ABMS and its Member Boards are responding accordingly by allowing flexibility during this critical time for our nation’s diplomates. Examples include enhanced activities and heightened education in partnership with specialty societies focused on COVID-19, to deferment of activities or requirements and/or the extension of cycle deadlines, depending on the timing of activities in the Boards’ continuing certification programs in 2020.
Read the full notice here:https://www.abms.org/media/257941/abms-statement-on-continuing-certification-during-covid-19.pdf?utm_source=abms&utm_medium=email&utm_campaign=covid-statement&utm_content=20200326
Public Health Updates
|Maine COVID-19 Testing Data
|Updated: March 27, 2020 at 11:30 AM
View a Breakdown of Cases by County, Age, Sex on the Maine CDC Website Here.
Important Information from Maine CDC
1. Testing at state lab (HETL):
Testing at state lab (HETL) as of March 25, 2020. Maine now meets U.S. CDC’s criteria for a Moderate level of community transmission. At present, a limited national supply of laboratory materials inhibits Maine’s testing capacity. Therefore, consistent with U.S. CDC guidelines, Maine is now creating a prioritization system to test individuals in high-risk categories.
To preserve Maine’s specimen collection and testing supplies for patients who may develop severe COVID-19 illness over the coming months, effective immediately, Maine Health and Environmental Testing Laboratory (HETL) will prioritize testing to high-risk individuals and will only accept specimens for testing from symptomatic individuals who have fever or respiratory symptoms and who fall into one of the following high-risk categories:
- Those who are hospitalized
- Health care workers
- First responders (e.g., EMS Police, Fire)
- Patients living in congregate setting (e.g., LTCFs, group homes, assisted living facilities, jails, shelters)
- Patients older than 60 years
- Patients with underlying medical conditions
Testing within these categories is likely to be prioritized further based on availability of laboratory materials. Presently the emphasis will be on groups within Tier 1. This guidance is in general accordance with U.S. Department of Health and Human Services (DHHS) recommendations for prioritizing COVID-19 testing for individuals.
- Samples sent to HETL that do not have completed paperwork or that do not meet one of the above criteria will be discarded.
- Samples from individuals who do not fall into any of these six categories should be sent to a commercial laboratory.
2. Swabs for testing:
U.S. CDC now recommends collecting a single nasopharyngeal (NP) swab in viral transport media. Throat (OP) swabs are no longer required.
3. Lab Results:
HETL will send lab results only to the ordering provider. Maine CDC and HETL do not release results to individuals. U.S. CDC has stated that any positive results from a commercial or state lab will now be considered final and confirmed.
4. Discontinuation of home isolation without testing:
On March 16, 2020, US CDC released Interim Guidance on Discontinuation of Home Isolation for Persons with COVID-19. Patients have to be fever-free (without the use of fever-reducing medications) for 72 hours and have to have improvement in respiratory symptoms (cough or shortness of breath). If this timeframe means it is less than 7 days since symptom onset, they have to wait until 7 days after onset of symptoms before they can be released from isolation.
5. Scheduled Maine CDC webinars:
Maine CDC is hosting regular interactive (Zoom) webinars for the following groups
6. Keep up to date with COVID information from key state agencies and patient populations:
7. Sign up for Maine CDC’s Health Alerts (HANs) here.
Please sign up UNDER THE ORGANIZATION THAT YOU WORK FOR. The CDC receives a lot of new account requests from folks who work one place, but think they need to sign up under the CDC, DHHS, and MEMA. If you work at a hospital, you will find your facility under “Hospitals” – the same is true for FQHCs.
Maintaining Childhood Immunizations During COVID-19 Pandemic
The COVID-19 pandemic is changing rapidly and continues to affect communities across the United States differently. Some of the strategies used to slow the spread of disease in communities include postponing or cancelling non-urgent elective procedures and using telemedicine instead of face-to-face encounters for routine medical visits.
Ensuring the delivery of newborn and well-child care, including childhood immunization, requires different strategies. Healthcare providers in communities affected by COVID-19 are using strategies to separate well visits from sick visits. Examples include:
- Scheduling well visits in the morning and sick visits in the afternoon
- Separating patients spatially, such as by placing patients with sick visits in different areas of the clinic or another location from patients with well visits.
- Collaborating with providers in the community to identify separate locations for holding well visits for children.
Because of personal, practice, or community circumstances related to COVID-19, some providers may not be able to provide well child visits, including provision of immunizations, for all patients in their practice. If a practice can provide only limited well child visits, healthcare providers are encouraged to prioritize newborn care and vaccination of infants and young children (through 24 months of age) when possible. The U.S. CDC and Maine CDC are monitoring the situation and will continue to provide guidance as it becomes available. Should you have additional questions, please feel free to call the Maine Immunization Program at 207-287-3746.
CMS Announces Findings at Kirkland Nursing Home and New Targeted Plan for Health Care Facility Inspections in light of COVID-19
On March 23, the Centers for Medicare & Medicaid Services (CMS) announced the preliminary results of a recent inspection of the Life Care Center nursing home in Kirkland, Washington – the epicenter of the 2019 Novel Coronavirus (COVID-19) outbreak in that state. The inspection, which the Agency conducted with the Washington Department of Social & Health Services, has helped inform CMS’s national strategy for keeping patients safe in nursing homes and other health care facilities. In keeping with the Trump Administration’s aggressive moves to combat further spread of COVID-19, CMS is also utilizing flexibilities allowed by President Trump’s Emergency Declaration to announce an enhanced, focused inspection process, informed in part by the Agency’s experiences on the ground in Kirkland, and close coordination and input from the Centers for Disease Control and Prevention (CDC). This focused inspection process will be provided to all inspectors and facilities, and used on a national scale. Critically, this focused inspection process includes a self-assessment tool for providers to employ.
You can find a copy of the press release here: – https://www.cms.gov/newsroom/press-releases/cms-announces-findings-kirkland-nursing-home-and-new-targeted-plan-healthcare-facility-inspections. Please note that links to the guidance can be found in the press release.
You can find a copy of the fact sheet here: – https://www.cms.gov/newsroom/fact-sheets/kirkland-washington-update-and-survey-prioritization-fact-sheet.
CMS COVID-19 REGULATORY UPDATE
New Expanded Telehealth Services During COVID-19 Public Health Emergency
On March 17, the U.S. Department of Health and Human Services (HHS) used its authority granted under section 1135 of the Social Security Act and the Coronavirus Preparedness and Response Supplemental Appropriations Act to waive certain Medicare telehealth restrictions during the COVID-19 nationwide public health emergency.
Details on Centers for Medicare & Medicaid Services (CMS) policy changes and guidance are available in a new AOA practice guide.
For MaineCare Telehealth Guidance, click here.
HIPAA Enforcement Relaxed for Telehealth Platforms
Additionally, the HHS Office for Civil Rights (OCR) is exercising its enforcement discretion and, effective immediately, will not impose penalties on physicians using telehealth communication tools that are not Health Insurance Portability and Accountability Act (HIPAA) compliant. Under the OCR notice, physicians may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype. Physicians should not use Facebook Live, Twitch, TikTok or other public facing communication services.
CMS Allows State Flexibility on Telehealth Methods
States can cover telehealth using various methods of communication such as telephonic, video technology commonly available on smart phones and other devices. No federal approval is needed for state Medicaid programs to reimburse providers for telehealth services in the same manner or at the same rate that states pay for face-to-face services.
For more information on this announcement, read the HHS Fact Sheet and Frequently Asked Questions.
New CPT Code for COVID-19 Testing
CMS has adopted the new Common Procedure Coding System (HCPCS) codes to use for COVID-19 testing. Details on the new codes can be found on the AOA’s new COVID-19 resource page.
Private Practice Physicians -- Resources in time of COVID-19 Crisis:
The U.S. Small Business Administration has released information about financial relief for small businesses, including private practices.
For additional guidance related to unemployment benefits and COVID-19, visit www.maine.gov/labor/covid-19 provided by the Maine Bureau of Unemployment.
Maine Dental Association has created an FAQ document that may be useful to private practice physicians as well. Covers HR concerns, Unemployment questions, etc. View it Here.
The Committee Supported two educational sessions during the Midwinter Symposium from Edward Roche, PhD, JD and Thomas Force, Esq. on all things billing/coding, audits and recoupments. Slides for both presentations are below.
Recoupments-- Thomas Force, Esq.
Dealing with Audits, Edward Roche, PhD, JD
Quick Resource Links:
Maine Osteopathic Association
AOA Physician Services
Phone: (888) 62-MYAOA
AOA Private Payor Advocacy Page:
Sign up for the AOA's Quarterly Newsletter: https://osteopathic.org/private-payer-newsletter-