On May 11, 2023, the Centers for Medicare & Medicaid Services (CMS) officially concluded the Public Health Emergency (PHE), ushering in significant changes that impact long-term care facilities and their day-to-day infection prevention and vaccination protocol. Comagine Health has compiled some important information outlining the implications of this milestone for your facility in this post-PHE landscape.
Vaccines
The bivalent mRNA COVID-19 vaccine is now the recommended type for all indications for individuals 6 years and older. Under Medicare Part B, which covers medical services and outpatient care, vaccines that are deemed medically necessary are typically covered. This includes immunizations for influenza, pneumonia and COVID-19.
Treatments
COVID-19 treatments like Paxlovid will still be available to Medicare patients at no cost and are readily available to help manage symptoms and reduce the severity of the illness. However, the specific treatment and its suitability for an individual depend on a host of factors, including age, overall health status and underlying medical conditions. It is crucial for individuals to consult their health care provider if they suspect they have COVID-19 or experience symptoms, as the provider can assess their condition and determine the most appropriate course of action.
Reporting
Long-term care facilities will continue to be required to report COVID-19 data through the National Healthcare Safety Network (NHSN), but they are no longer required to provide notifications of COVID-19 infections to residents and families. Reporting of vaccination status will continue through May 2024 or until CMS declares otherwise. Testing for long-term care facility staff and patients will no longer be required under the updated regulation, though education and access assistance is still a stipulation. Recommendations to follow CDC guidelines are suggested but not mandatory. Be sure to check state and local health departments for guidance specific to your location.
Testing
The provision that allowed Medicare and private insurance companies to offer coverage for COVID-19 over-the-counter tests at no cost ended on May 11 at the expiration of the PHE. However, if an individual is enrolled in Medicare Part B, they will continue to have coverage with no out-of-pocket costs for appropriate laboratory-based COVID-19 PCR and antigen tests, when a provider orders them. If the individual is enrolled in a Medicare Advantage plan, they may have more access to tests depending on their benefits.
Ongoing Requirements
Per previous regulations, all facilities are required to have a resident cohorting plan, staff infection prevention training program, a visitor policy, an emergency preparedness plan (should include an all-hazards approach and have an emerging infectious disease component) and continued staff education per regulations updated in October 2022. Facilities must ensure these policies and procedures are accessible to all staff while on the job. By adapting to these evolving guidelines, long-term care centers can continue to create a safe and supportive environment for both residents and staff.
No-Cost Assistance
Comagine Health provides 1:1 technical assistance free of charge to all LTPAC facilities within our six-state region (New Mexico, Nevada, Idaho, Utah, Washington and Oregon). For more information or assistance, please contact the Comagine Health QIN-QIO LTPAC Team at LTPAC@Comagine.org.