Issue: July 30, 2020

Published on July 30, 2020

Articles in this issue:

MLTC Transition to FFS

Author: Carl Pucci

DOH remains on track to implement the MLTC – FFS three month benefit limitation, effective August 1, 2020. Attached is the 6/11/20 DAL as well as the NYSHFA Priority Alert which contains the “Notice of LTC Medicaid Plan Disenrollment” letters that were sent to SNF residents in early June.

Questions related to the transition should be emailed to as well as to


Carl J. Pucci
Chief Financial Officer
518-462-4800 x36

CMS and CDC Announce Provider Reimbursement Available for Counseling Patients to Self-Isolate at Time of COVID-19 Testing

Author: Lisa Volk

Today, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to counsel patients, at the time of coronavirus disease 2019 (COVID-19) testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms. 

The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic and asymptomatic individuals emphasizing the importance of education on self-isolation as the spread of the virus can be reduced significantly by having patients isolated earlier, while waiting for test results or symptom onset.  The CDC models show that when individuals who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86 percent reduction in the transmission of the virus compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.

Provider counseling to patients, at the time of their COVID-19 testing, will include the discussion of immediate need for isolation, even before results are available, the importance to inform their immediate household that they too should be tested for COVID-19, and the review of signs and symptoms and services available to them to aid in isolating at home.  In addition, they will be counseled that if they test positive, to wear a mask at all times and they will be contacted by public health authorities and asked to provide information for contact tracing and to tell their immediate household and recent contacts in case it is appropriate for these individuals to be tested for the virus and to self-isolate as well. 

CMS will use existing evaluation and management (E/M) payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals and community drive-thru or pharmacy testing sites.

Further information and resource links are available in the Counseling Check List PDF here:


Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

AHCA Point-of-Care Antigen Test Devices

Author: Lisa Volk

As the first antigen Point-of-Care (POC) test devices are making their way to nursing homes in several states, AHCA has put together a brief document summarizing some key information providers should be aware of before utilizing these test devices. Most notably, the CARES Act requires all laboratories with a CLIA certificate to report the results of every COVID-19 test that they conduct (positives and negatives) to the appropriate state or local public health department. This applies to nursing homes using these devices and is in addition to the reporting completed through the CDC NHSN website. CMS has published the list of facilities being prioritized for these test devices. 


Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

COVID-19 Impacts on Medicare Beneficiaries – Updated Data

Author: Lisa Volk

COVID-19 Impacts on Medicare Beneficiaries – Updated Data

Thursday, July 30, 2020


Claims, Pricers & Codes


MLN Matters® Articles


View this edition as PDF (PDF)

August 2020 Aware Prepare Update

Author: Lisa Volk

Welcome to the August 2020 issue of the Aware Prepare (AP) Update. The AP is your bi-monthly guide to upcoming trainings related to preparedness, readiness, and response. These trainings may be provided in one or more of the following formats, including: live webcasts, webinars and in-person training; archived webcasts, webinars and on demand eLearning on the Learning Management System.  Questions or submissions, email:

A Long Term Care Update from AHCA/NCAL

Author: Carl Pucci

CMS Releases List of Nursing Homes Prioritized for POC Testing Instrument

The Department of Health and Human Services (HHS) recently announced that it will begin providing nursing homes with a Point of Care (POC) rapid response testing instrument to bolster each facility’s ability to prevent the spread of COVID-19. The data collected through the NHSN system directly supports this initiative by helping to prioritize those nursing homes with testing needs and an increasing number of cases. CMS has also provided information about their methodology for prioritizing facilities and a listing of the facilities, as well as a list of frequently asked questions.



HHS FAQ Updates on Auditing and Funds Transfers

New AHCA/NCAL COVID-19 Trainings and Infection Prevention and Control Action Briefs

Public Health Emergency Extended

​​​​​​​Point-of-Care Antigen Tests: What SNFs Need to Know


CMS SNF PDPM Interrupted Stay Claim Issue Workaround Announcement

CMS Updates MDS RAI Contacts List​​​​​​​


Registration Is Now Open for the 71st AHCA/NCAL Virtual Convention & Expo


AHCA/NCAL’s Infection Preventionist Training Includes Bonus Covid-19 Content

Give Your Staff the Real-World Tools They Need to Improve Functional Outcomes​​​​​​​

Use the Free Test Drive of the CARES® Online Dementia Training Program to Introduce New Staff to Person-Centered Dementia Care​​​​​​​

Last Chance to Register! Long-Term Care Investigations: Critical Steps to Mitigate Risk & Protect Your Residents, Staff & Reputation Webinar

Author: * Published in Education

Last Chance to Register! Long-Term Care Investigations: Critical Steps to Mitigate Risk & Protect Your Residents, Staff & Reputation Webinar! Earn CEUs from the convenience of your office! 

Long-Term Care Investigations: Critical Steps to Mitigate Risk & Protect Your Residents, Staff & Reputation
Webinar (1.5 CEUS)
Tuesday, August 4, 2020 at 10:00am 

As widely reported, Governor Cuomo has asked the state Department of Health and Attorney General Letitia James to conduct an investigation of the state’s long-term care facilities in connection with the COVID-19 pandemic. Data shows that nursing homes consistently served as “hot zones” in the spread of the virus, despite the efforts of caregivers to keep patients safe and families fully informed.

The scrutiny of regulators and investigators could put facilities at risk of having their operating certificate suspended or revoked. In this environment, home operators must take a proactive approach. Assuming that you’re doing the best you can and that investigators will see that isn’t enough. Our attorneys will discuss best practices for mitigating risk while cooperating fully with any investigative requests.


Click here for additional program details and registration options. 

Registration Closing Soon! 39th Annual Health Care Open Golf Tournament


Registration is open but closing soon for the 39th Annual Health Care Open Golf Tournament. The tournament will be held on August 10th at the Albany Country Club.

Don’t miss out on your chance to support The Ruth E. Stafford & James D. Durante Nurse Scholarship Fund and with this being the Year of the Nurse, there is no better time to support this worthy cause! We offer many opportunities to support the event through Golf, Sponsorships & Donations!

Click here for additional details and registration/sponsorship information!

Don’t Hesitate! Submit your registration today!

Four Sessions Left! Register Now! 17th Annual Social Service & Activities Conference: Live Webinar Series

Author: * Published in Education

Four sessions remain for the 17th Annual Social Service & Activities Conference: Interactive Webinar Series Live on Zoom. Register today

Upcoming sessions:

August 5, 2020 | Using Principles Holistic Healing to Focus on Recovery for Staff and Residents as We Adjust to the “New Normal”
Ms. Sulekha Zaug, MS, ADC | SUNY Cortland & Ms. Renee Markle, MS | Consultant
This session will be moderated and facilitated by Ms. Kelli Woods, LMSW | Consultant

August 12, 2020  | What’s Love Got to do With It? How to Best Manage Intimacy Issues in Your Facility
Ms. Lynda Shrager | Consultant
This session will be moderated and facilitated by Ms. Dana Diorio-Casey, LMSW | National Healthcare Association                  

August 19, 2020 | Improving Communication, Teamwork and Person-Centered Care
Ms. Barbara Speedling | Innovations for Quality of Living
This session will be moderated and facilitated by Ms. Kelli Woods, LMSW | Consultant

August 26, 2020 | The JANUS Series…Taking the Best of What We Know and Creating the Future We Need: “If You Are Not A Little CRAZY, You Cannot Come Into My House”
Dr. Francis Battisti, LCSW | Battisti Management Affiliates


Click here for additional details and registration options. 

Upcoming NYSHFA/NYSCAL Distance Learning Opportunities

Author: * Published in Education

Join NYSHFA/NYSCAL for one or more of our upcoming Distance Learning Programs. Earn CEUs from the convenience of your office! We will host the following program approved for CEUs!

Fiscal Readiness for Long-Term Care Organizations
Webinar (1.5 CEUS)
Tuesday, August 18, 2020 at 10:00am


How to Successfully Pivot Clincal Processes in a Changing Post-Acute Environment
Webinar (1.5 CEUS)
Thursday, August 27, 2020 at 10:00am 


Click here for additional program details and registration options. 

There's Lots in Store for You at AHCA/NCAL Virtual Convention & Expo

Author: Lisa Volk

There's So Much In Store For You


This year, the virtual Convention & Expo runs from October 8-31st. That means you get 24 days of access to on-demand sessions. Topics are wide ranging and focus on what you need to deal with the challenges of today. 


The virtual Expo Hall will be available to explore 24-7 throughout the duration of convention. You can demo products, download brochures, and chat with representatives from industry-specific businesses that may just have the solution you are seeking. Join your colleagues to reflect, share, and learn.

Designated Live Chats in the Expo Hall on Get-Together Thursdays
9:00 AM – 11:00 AM, EST
October 8, 15, 22

IPRO Events and Updates: Telehealth Billing and Advance Care Conversations

Author: Lisa Volk

IPRO Events and Updates: Telehealth Billing and Advance Care Conversations 

New Webinar Series 

Implementing Telehealth During COVID-19
Eight-session series: All health care providers are invited to participate.
Alternating Tuesdays, 1-2PM EDT.
Next Session: Billing & Coding
August 11, 1-2PM EDT.
View materials from Session 1.


COVID-19 Workshop Series
July 28 through November 3, 2020
Next week's topic?
Advance care conversations during COVID-19: How to have them and are they reimbursable?
August 6, 10:30-11AM EDT

View our past workshops.

National Partner Event

HHS/ASPR COVID-19 Clinical Rounds 
Special Session: Transitions of Care: From Acute Care To Long Term Care A Peer-to-Peer Virtual Community of Practice: August 4, 12-1PM EDT

Visit the IPRO website at for Press Releases, background information, waivers and guidance, and other resources.