State Public Health Emergency Declarations
- Proclamation Number 38 JBE 2020: Additional Measures for COVID-19 Public Health Emergency that relaxes licensure requirements for physicians, nurses, APRNs, CRNAs and respiratory therapists. (03/31/20)
- CMS Approves Louisiana Waiver: CMS approved
an additional 11 state Medicaid waiver requests, including one for
Louisiana, under Section 1135 of the Social Security Act. These Section
1135 waivers are effective retroactive to March 1, 2020 and will end
upon termination of the public health emergency, including any
- LHA Letter: The LHA sent a letter on March 16 to the LDH regarding state-level flexibility for hospitals.
- LHA Letter:
The LHA sent a letter on March 16 to the Centers for Medicare &
Medicaid Services (CMS) requesting waivers under Section 1135 of the
Social Security Act.
- AHA Letter: The AHA sent a letter on March 16 to HHS requesting additional waivers
and flexibilities for hospitals.
PHE Waiver: Waiver or Modification of Requirements Under Section 1135 of the Social Security Act (03/13/20)
Healthcare Facility Notices from LDH
- Hospital Discharges to Nursing Facilities: On March 26, LDH issued a Healthcare Facility Notice
restricting hospitals from discharging patients with COVID-19, patients
who have a pending test for COVID-19, or patients with undiagnosed
active respiratory issues to nursing facilities. The hospital will have
to discharge these patients to alternative settings. These discharge
restrictions are effective for 30 days from March 26. The notice also
clarifies that nursing facilities should accept transfers of
individuals/residents for any other condition or diagnosis that is not
- Temporary PASRR Suspension: On March 24, LDH issued a Healthcare Facility Notice
to all licensed hospitals and all Medicaid-certified nursing facilities
regarding the “Temporary Suspension of Pre-Admission Screening and
Resident Review (PASRR).”
- Medical/Surgical Procedures Notice: On March 21, LDH issued Healthcare Facility Notice/Order Notice #2020-COVID19-ALL-007
ordering all medical and surgical procedures to be POSTPONED until
further notice unless the medical or surgical procedure is required to
treat an emergency medical condition as defined under EMTALA or the
medical or surgical procedure is required to avoid further harm from an
underlying condition or disease. In addition, LDH is directing
postponement of in-person healthcare services and directing healthcare
providers to transition to a telehealth mode of delivery unless the
provider makes a good faith determination that the healthcare service
could not be postponed and could not be provided through telehealth. The
new memo supersedes LDH Notice #2020-COVID19-ALL-006 dated March 18, 2020.
State Clinical Guidance
- LDH Clinical Guidance for Individuals Returning to Normal Activity: LDH
updated the clinical guidance for returning to normal activity after
being in isolation for suspected or confirmed COVID-19. The guidance,
published in a Louisiana Health Alert Network (LA HAN) message, now provides that it is acceptable to return to normal activity following a suspected or confirmed case of COVID-19 when: 1) at
least 3 days (72 hours) have passed since recovery defined as
resolution of fever without the use of fever-reducing medications; 2) improvement
in respiratory symptoms (e.g., cough, shortness of breath); and 3) at
least 7 days have passed since symptoms first appeared.
This guidance is consistent with the Discontinuation of Home Isolation Interim Guidance from the CDC. (03/17/20)
Federal Guidance for Healthcare Facilities
- Guidance: General information and guidance about COVID-19 for Healthcare Professionals (03/20/20)
- Guidance: General information and resources about COVID-19 for Hospitals and facilities (03/24/20)
- Interim Guidance: Risk Assessment and Public Health Management of
Healthcare Personnel with Potential Exposure
- CMS Data Reporting Exceptions & Extensions:
announced it is granting exceptions from reporting requirements and
extensions for clinicians and providers participating in Medicare
quality reporting programs with respect to upcoming measure reporting
and data submission for those programs. View the news release for a list of programs that have been granted exceptions or extensions. (03/22/20)
Testing & Laboratory Guidance
State Testing Guidance
- Electronic State Lab Forms: On March 25, LDH issued a LA HAN message regarding OPH State Lab Forms Now Available Electronically: Updated Guidance for COVID-19 Testing at the State Laboratory. LDH has released an online tool
that streamlines the requisition form for submitting samples for
COVID-19 testing at the Office of Public Health (OPH) State Lab.
- LA HAN Message: LDH Issues Updated Guidance for COVID-19 Testing at the State Laboratory (03/19/20)
- LA HAN Message: Updated
Testing Criteria at State and Commercial Labs (03/19/20)
- LA HAN Message: Person Under Investigation (PUI) Criteria for COVID-19
Federal Testing Guidance
- Updated CDC Testing Guidelines: The CDC has updated its COVID-19 testing priority guidance, which gives first priority to testing hospitalized patients and symptomatic healthcare workers. The agency also updated its interim guidelines
for collecting, handling and testing COVID-19 clinical specimens to
allow for self- or healthcare worker-collected nasal or nasal turbinate
swabs if nasopharyngeal swab is not possible. (03/24/20)
- CMS CLIA Laboratory Requirements: CMS announced
a relaxed enforcement policy to meet the urgent need to expand
laboratory capacity, under the CLIA during the COVID-19 public health
emergency with respect to review of pathology slides, proficiency
testing, alternate collection devices, and requirements for a CLIA
- FDA Policy Change for Test Results:
On March 15, FDA removed a requirement that labs send to the CDC
samples of their coronavirus test results to confirm positive cases,
which has reduced the number of tests needed per patient. It also is
expected to decrease turnaround time for test results, with labs granted
the authority to confirm positive COVID-19 cases.
Hospital Service Districts
- Open Meetings Law: Requirements under the Open Meetings Law have been relaxed by Executive Order JBE 30-2020 (03/16/20). The
order provides that all state agencies, boards and commissions, and
local political subdivisions of the state shall provide for attendance
at essential governmental meetings via teleconference or video
conference and such attendance shall be allowed during the period of
this emergency. All efforts shall be made to provide for observation and
input by members of the public. Before any meeting conducted pursuant
to this section, the state agency, boards and commission, or local
political subdivision of the state shall first provide a written
certification that it will otherwise be unable to operate due to quorum
requirements. On March 19, the Louisiana Attorney General has also issued guidance that is in accordance with the executive order.
Louisiana Department of Insurance (LDI)
- Emergency Rule 41: In the April 20 issue of the Louisiana Register, the Office of the State Register will publish Emergency Rule 41 from LDI regarding medical surge-related patient transfers in Louisiana, effective March 31, 2020.
- Moratorium on Policy Cancellations: LDI issued Emergency Rule 40, which “suspends
any notice of cancellation, notice of nonrenewal, nonreinstatement or
any other notice related to any of the kinds of insurance enumerated in
§4003 that was in force and effect at 12:01 a.m. on March 12, 2020, and
any such notice shall be null and void and have no force of effect.” However,
this Emergency Rule does not prevent an insurer from cancelling or
terminating an insurance policy for fraud or material misrepresentation
on the part of the insured.
- LHA Urges LDI to Take Additional Actions: Letter
- Emergency Rule 37: LDI issued Emergency Rule 37
that provides for telemedicine and network adequacy in health insurance
during the COVID-19 outbreak. Emergency Rule 37 is effective until
April 9, 2020 unless extended by the Department. (03/23/20)
Department of Labor (DOL)
- DOL Clarification on Healthcare Guidance: On March 28, the U.S. DOL Wage and Hour Division released an updated set
of “Questions and Answers” that provide additional guidance concerning
healthcare providers and emergency responders. The EMFLEA and the EPSLA
authorize the DOL to issue regulations to exempt healthcare providers
and emergency responders from eligibility for coverage under the FFCRA.
In addition, the FFCRA provides that employers of healthcare providers
and emergency responders may elect to exclude these employees from
- Workforce FAQs: The U.S. DOL released information on
common issues employers and employees face when responding to COVID-19,
and its effects on wages and hours worked under the Fair Labor
Standards Act; job-protected leave under the FMLA; and paid sick leave
and expanded family and medical leave under the FFCRA. The new law
allows employers of healthcare providers or emergency responders to
elect to exclude such employees from eligibility for the leave provided
under the FFCRA.
- FCC Telehealth Program: The Federal Communications Commission (FCC) issued a draft order that would create a program to
help eligible healthcare providers purchase telecommunications,
broadband and devices to provide telehealth services to COVID-19
patients and others at higher risk for the virus while reducing
practitioners’ exposure. Money for the proposed program came from the
recently-passed CARES Act.
Long-Term Care Nursing Homes Telehealth Toolkit: CMS issued an electronic toolkit
regarding telehealth and telemedicine for Long Term Care Nursing Home
HHS HIPAA & Telehealth: Enforcement Discretion and Waive Potential Penalties
CMS Telehealth: AHA Advisory: CMS Broadens Access to Telehealth During COVID-19 Public Health Emergency (03/17/20)
Medicare: The Trump Administration 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 will
temporarily pay clinicians to provide telehealth services for
beneficiaries residing across the entire country. Read the
Fact Sheet and Frequently Asked Questions.
Medicaid: As a companion piece to the earlier released Medicare Telehealth Guidance, CMS services released Medicaid Telehealth Guidance to states. Visit the homepage for general Medicaid Telehealth Guidance.
Medicaid Bulletin: Healthy Louisiana posted Informational Bulletin 20-7 “COVID-19 - SUD Telemedicine/Telehealth.”
- NABP Passport: LSBP issued a memo
recognizing the NABP Passport as a valid service in Louisiana to allow
pharmacists and pharmacy technicians temporary permission to practice in
states where they are not licensed. To participate, pharmacists and
pharmacy technicians should obtain an NABP Passport. There is no cost to the applicant. (03/28/20)
- Pharmacy Guidance: The Louisiana State Board of Pharmacy (LBP) has issued guidance
relaxing certain rules regarding storage space for
prescription drugs; centralized compounding capacity; and allowable
quantities of extra outpatient prescription meds and waiving the
restriction on hospital permits that limit hospital pharmacies
to dispensing medications to hospital patients only, for the
duration of the public health emergency.
- Pharmacy Emergency Rule: LBP will publish the following Emergency Rule to limit the dispensing of chloroquine and hydroxychloroquine for COVID-19 by pharmacists.
- LSBN Emergency Rules: In an emergency meeting of the LSBN Board on Thursday, Board members passed the following two emergency rules:
- Emergency rule for relaxation of collaborative practice agreements for APRNs
- Emergency rule for extension of RN applicant (new graduate nurses) temporary permit
- LSBN Emergency Relief: The Louisiana State Board of Nursing (LSBN) is granting emergency relief for
all RNs/APRNs in hospitals to allow them to do moderate clinical laboratory point of care testing. (03/17/20)
- NCSBN Update:
The National Council of State Boards of Nursing has suspended NCLEX
testing in the United States until April 16 and has made a 6-month
extension for new grads who have expired temporary licenses and who
cannot take NCLEX for the first time. Learn more on the COVID-19 Impact to NCLEX Candidates website.
- Joint Commission Accreditation and Certification Performance Measure Reporting: The Joint Commission sent an update
to state hospital associations announcing that it has made data
submission for accreditation (ORYX) and certification (with standardized
measures) optional for 4Q2019, 1Q2020 and 2Q2020 time periods.
Questions regarding these modified requirements may be directed to the ORYX Help email.
- HHS Civil Rights Protections: On March 28, HHS' OCR issued a bulletin focused
on ensuring that covered entities do not unlawfully discriminate
against people with disabilities when making decisions about their
treatment during this pandemic.
- PHI Guidance: The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) issued guidance
on how covered entities may disclose protected health information (PHI)
about an individual who has been infected with or exposed to COVID-19
to law enforcement, paramedics, other first responders, and public
health authorities in compliance with the Health Insurance Portability
and Accountability Act of 1996 (HIPAA) Privacy Rule. (03/24/20)
- 340B Audits:
HRSA announced that it is moving towards conducting 340B Program
covered entity audits remotely (virtually) for the next several months.
If a covered entity has questions regarding an audit, contact
- 340B Hospitals: FAQs
; HRSA requests all 340B hospitals that believe they are
faced with a specific circumstance that could affect their compliance or
340B eligibility to contact the 340B Prime Vendor (Apexus) at
1-888-340-2787 (Monday through Friday, 9 a.m. to 6
p.m. ET) or firstname.lastname@example.org.
Louisiana Legislative Update
- LHA Letter to Lawmakers:
The LHA sent lawmakers a letter thanking them for supporting
the healthcare community and social distancing efforts. (03/17/20)
- Louisiana Legislature Temporarily Adjourns: News: The Louisiana Legislature temporarily
adjourned the 2020 Regular Legislative Session until March 31, 2020.
- President Signs CARES Act: President Trump signed into law H.R. 748, the CARES Act. (03/27/20)
- Senate Relief for Hospitals and Healthcare Providers: By a vote of 96 to 0, the U.S. Senate approved an economic stimulus package
containing $100 billion in direct funding to hospitals and healthcare
providers to ensure they receive needed support for related expenses and
lost revenue during the COVID-19 outbreak. (03/25/20)
- CMS FMAP Increase: CMS issued an FAQ document to
address a temporary 6.2% increase to qualifying states’ and
territories’ FMAP, enacted as part of the Families First Coronavirus
Response Act signed into law on March 18. The document outlines the
requirements states must meet for eligibility for the FMAP increase.
President Signs One Relief Package: President Trump signed the Families First Coronavirus Response Act (H.R. 6201)
legislation that, among other areas, eliminates patient cost-sharing for
COVID-19 testing and related services; establishes an emergency paid
leave program; expands unemployment and nutrition assistance; provides a
temporary increase in the
Medicaid FMAP; and creates two mechanisms for coverage
of testing for the uninsured — one through the Medicaid program and
another through the Public Health and Social Services Emergency Fund.
- LHA Letter to Congress: The LHA sent Louisiana’s Congressional Delegation a letter asking for their support of comprehensive solutions regarding COVID-19. (03/17/20)
- Cyber Threat: On March 30, the FBI issued a notice to the private sector regarding the Kwampirs Remote Access Trojan, which is targeting healthcare and other sectors, and provided best practices for network security and defense.
- Cybersecurity: The AHA has released a compendium of resources
for hospitals and health systems related to cybersecurity threats
during the COVID-19 pandemic.
- HHS Hospital Inquiries: HHS announced that it has established a new email address, HospitalCOVID19@hhs.gov,
for hospitals and health systems as a one-stop resource to triage a
wide range of COVID-19 inquiries across HHS’s offices and operating
- Quality Reporting and Value-based Purchasing Programs: CMS releases a guidance memo describing specific changes to CMS provider, hospital and post-acute care quality reporting programs.
- MIPS Quality Payment Program: CMS released a factsheet outlining Merit-based Incentive Payment System (MIPS) extreme and uncontrollable circumstances policy and procedures for MIPS-eligible clinicians affected by COVID-19.
- Rural Health Care Program Deadlines: On March 26, the Federal Communications Commission (FCC) extended the Rural Health Care Program application window to June 30, 2020.
- Open Payments Program Reporting Requirements: CMS posted an announcement
regarding the deadline for submitting records to the Open Payments
Program. While CMS does not have the authority to extend the submission
window past the deadline, it has released an FAQ document that provides hospitals guidance on issues related to reporting on or before the March 31, 2020 deadline.
- Communication Card: LDH created a communication card for patients who are deaf or hard of hearing to better communicate their needs with providers.
- Chloroquine Phosphate Guidance: The CDC issued guidance on severe illness associated with using non-pharmaceutical Chloroquine Phosphate to prevent and treat COVID-19
- CMS Stakeholder Call Recordings: CMS announced that it is making COVID-19-related stakeholder calls and transcripts available. Calls from March 13 and 16 are currently available.
- National Donate Life Month (NDLM): Donate Life America will be taking an online approach for NDLM observances. Please join them on Facebook, Instagram, Twitter and DonateLife.net to help honor donors, recipients, and their families and caregivers.
- Patient Guidelines: President Trump and the White House Coronavirus Task Force issued new guidelines to help protect Americans during the global Coronavirus outbreak. (03/16/20)
- Special Hotel Rate:
Several participating Marriott Hotels in Baton Rouge, Metairie and New
Orleans have a special rate for healthcare providers and traveling
nurses starting at $60 per night. Visit www.marriott.com, and use special rate code 6SG under “Corporate/Promo/Set#.” Room rates are subject to availability.