The SCMA has compiled state and federal resources below to facilitate answers on COVID-19 for South Carolina physicians. Members receive weekly updates via email. If you are not receiving these updates, please email email@example.com
COVID-19 is changing rapidly, and we are all trying to stay on top of the latest medical information from trusted sources. Join Dr. Helmut Albrecht, Infectious Disease Specialist and Heyward Gibbes Distinguished Professor of Internal Medicine Chair, Department of Internal Medicine University of South Carolina Chair, Department of Internal Medicine Palmetto Health USC Medical Group and Society of America for a free webinar covering what he knows about the coronavirus outbreak. Recorded on Friday, April 17, 2020.
It is hard to believe that the first COVID-19 case in South Carolina occurred on March 7, 2020. The Governor closed schools on March 15, and on March 17 the Governor asked that over the next 72 hours hospitals stop non-urgent care to preserve protective gear and protect patients from infection. As COVID-19 spread, the Governor closed non-essential businesses on March 31, 2020. A lot has changed in the course of a few weeks, and physicians have been at the forefront of these issues and changes. Whether serving in the ER or weathering the slowdown in your practice, each physician has been impacted in some way.
The SCMA is here for you and has worked to help South Carolina physicians with all sorts of issues. Below we have captured some of the SCMA's work over the past two months so that you can see the SCMA's action at work. And, the SCMA appreciates the physician support in each of these endeavors - the organization cannot do it without your support, your input, and your willingness to assist us by being the physician voice. Many of you have joined late night phone calls, responded to early emails, or simply answered questions on issues we are tackling. To this we simply say thank you. Together we have done a lot:
The SCMA is still working on issues, like asking for telehealth parity on audio visits only as many patients do not have video capability, and working with the Governor and the federal delegation to find help with PPE and reagents for testing in our State. We are also asking the legislature to waive liability for physicians who treated COVID-19 patients and for situations where a physician could not see patients due to the COVID-19 restrictions. We know that we are not at the end of this.
The SCMA will continue updating telehealth resources below There are new options everyday as Medicare, Medicaid, and private insurance carriers continue to open telehealth resources.
Still struggling with telehealth?
Visit the AMA website geared to give you all of the information you need. The AMA has created a quick guide to Telemedicine in Practice along with FAQs on COVID-19 and Telemedicine. Click here to access. The AMA also has outlined coding scenarios designed to assist in coding practices. The AMA Physician Innovation Network launched a virtual panel on the use of Telemedicine to deliver care to those who need it most during COVID-19. They are taking questions related to the latest policy & payment updates, best practices and tips from experts and peers. Click here to join the AMA's virtual panel discussion. Also, the AMA has started a COVID-19 (2019 novel coronavirus) resource center for physicians.
Most providers are now following the examples set by Medicare and Medicaid and allowing Skype and FaceTime rather than requiring special telehealth programs. Check with your providers for updates on their policies as most private insurance companies are now allowing this.
If you are still looking for help gaining access to telehealth codes, the Department of Insurance is providing a page with the appropriate information of what each private insurer will cover linked here. The details are provided under each company heading, and you can click the company heading to reach even more information.
The South Carolina Department of Health and Human Services (SC DHHS) has issued a Medicaid Bulletin with all of its telemedicine codes, which you can access here.
The Health and Human Services (HHS) Office for Civil Rights (OCR) announced it will “waive potential penalties for HIPAA violations against health care providers that serve patients through everyday communications technologies during the COVID-19 nationwide public health emergency.” This is effective immediately, and applies to “widely available communications apps, such as FaceTime or Skype, when used in good faith for any telehealth treatment or diagnostic purpose, regardless of whether the telehealth service is directly related to COVID-19.” For more information, click here.
The Office of Inspector General (OIG) issued a Policy Statement to notify physicians and other practitioners that they will not be subject to administrative sanctions for reducing or waiving any cost-sharing obligations related to telehealth. You can read the statement here.
*The SCMA will continue to highlight new CMS waivers. If you are looking for past information on specific waivers or you would like to see all of the current waivers, please visit the CMS emergency site located here.
The SCMA is advocating for funding to support physicians and their practices. The SCMA has spoken with South Carolina congressional delegation members about these issues, and on March 25 signed a letter of support with the AMA and other state medical societies. The SCMA is also working with local officials about additional resources for physicians.
THE CARES ACT - FORGIVABLE LOANS, PAYMENT FOR LOST REVENUE, AND UNEMPLOYMENT BENEFITS
Below is a quick overview of provisions in The CARES Act you may be interested in pursuing for your business.
If you are a small business or solo proprietorship, you should know that the CARES Act creates a new Business Loan Program under the Small Business Act (SBA). Quick facts to see if this may assist your business short term:
The CARES Act waives the 10% additional tax for premature distributions from retirement plans and IRAs if the distribution is related to COVID-19 with a maximum distribution of $100,000 from all plans. Distributions may be repaid at any time over the next three years, beginning on the date the distribution was made. This distribution provision applies to those diagnosed with SARS-CoV-2 or COVID-19 by a test approved by the Centers for Disease Control (CDC), their spouse or dependent who has been diagnosed by such a test, or a person who experiences adverse financial consequences as a result of being quarantined, furloughed, laid off, or suffered reduced working hours, or who is unable to work due to lack of child care.
The CARES Act provides eligible employers – including tax-exempt organizations – a refundable credit against payroll tax (Social Security and Railroad Retirement) liability equal to 50% of the first $10,000 in wages per employee (including value of health plan benefits). In order to qualify, you must have had business operations fully or partially suspended due to orders from a governmental entity limiting commerce, travel, or group meetings; or experience a year-over-year (comparing calendar quarters) reduction in gross receipts of at least 50%.
$100 billion is available through the Public Health and Social Services Emergency Fund to provide immediate financial relief by covering non-reimbursable expenses attributable to COVID-19. Health care entities, including physician practices, that provide health care, diagnoses, or testing are eligible. Non-reimbursable expenses may include lost revenue due to COVID-19. HHS is reviewing applications and making payments on a rolling basis. HHS will be releasing guidance soon on the application process, which we will provide in a MedNews once posted.
The CARES Act has a provision to allow an additional $600/week for up to four months and additional 13 weeks of Unemployment benefits for states that choose to participate. States can also enter agreements with the federal government to receive funding for state-enacted “short-time compensation” programs to subsidize employees who have their hours reduced in lieu of a layoff.
The Families First Coronavirus Response Act (FFCRA) takes effect April 1, 2020 and provides new types of leave for employees. The FFCRA applies to employers with less than 500 employees. Employers may claim an exemption if they have less than 50 employees, but employers must document why providing such leave will jeopardize your business. The Department of Labor has yet to set forth the criteria for documenting this, but has promised guidance is forthcoming. The Department of Labor issued Guidance and FAQs on the new law. Also, there is a mandatory poster employers must hang in their office, found here. Read below for the key provisions.
1. Exception for Health Care Providers and Emergency Responders - An employer can choose to exempt employees who are health care providers or emergency responders from receiving such leave. But this does not mean that every person in a health care facility receives the exemption. The definitions are specific, click here for a great legal article explaining who is a qualifying health care employees. Employers may want to review exemptions with human resources personnel or legal counsel.
2. The Act provides that covered employers must provide to all employees:
The Charleston County Medical Society is coordinating a joint order of N95 masks and possibly other supplies for smaller practices. As many physicians have learned, those with large contracts can more easily get supplies. The coordination of a large order from small practices will help provide the needed supply. Keep in mind that South Carolina is expected to “peak” around the end of April/beginning of May, it is likely supplies will be limited through the end of May. Below is a link to order N95 Masks for your practice or for donating to other practices. CCMS has worked hard to vet the supplier that it has obtained through its contacts and believes that the items are from a reliable source. Information on the supplies is provided through the link. Once the order arrives, orders will be distributed to sites in Charleston, Columbia and Greenville for pick up. A big thank you to CCMS for coordinating this! Click here to purchase.
ADDITIONAL RESOURCES YOU CAN USE
Where can you find information on next steps? The CDC has published Criteria to Guide Evaluation of a Person Under Investigation for COVID-19 and Clinical Guidance for Management of Patients with Confirmed COVID-19 among other great resources. The CDC also has a latest updates button on the COVID-19 outbreak here. Current information, including the location of known cases in the U.S., are provided.
Looking for local resources? The South Carolina Department of Health and Environmental Control (DHEC) has its own site with local resources and updates here. The SCHA has a resource page for hospitals with up-to-date information here. And the AMA has a website with information here.
Tired of answering the same questions all day? The CDC has handouts and posters you can use in your office to inform the public on what to do, how best to stop the spread of germs, and the symptoms of COVID-19. The handouts are available for download in English, Spanish, and Chinese.