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COVID-19: State & Federal Updates & Guidance

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)

Hospital Waivers

  • 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 extensions. (03/23/20)
  • 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 COVID-19.
  • 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: CMS 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 MessageUpdated 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 certificate. (03/26/20)
  • 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 coverage. 
  • 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.

Telehealth Guidance

  • 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.
  • CMS Long-Term Care Nursing Homes Telehealth Toolkit: CMS issued an electronic toolkit regarding telehealth and telemedicine for Long Term Care Nursing Home Facilities. (03/28/20)
  • HHS HIPAA & Telehealth: Enforcement Discretion and Waive Potential Penalties (03/18/20)

  • 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. (03/17/20)

  • 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.”


Licensure Organizations

  • 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.


Survey Updates

  • 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.

Patient Protections

  • 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 Updates

  • 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 340baudit@thebizzellgroup.com.
  • 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 apexusanswers@340bpvp.com.

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.

Congressional Update

  • 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. (03/18/20)

  • 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)

Cybersecurity:

  • 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. 

Other Resources

  • 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 divisions.
  • 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.

Louisiana Hospital Association

9521 Brookline Avenue, Baton Rouge, LA 70809  Google Map
Phone: (225) 928-0026
Fax: (225) 923-1004