COVID-19 Resources for Medical Providers

The Maine Osteopathic Association continues to monitor the ongoing spread of coronavirus disease (COVID-19) and will update the resources and information below to the best of our ability, sending important updates to members individually. 

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NEW Call-In Information! Maine CDC Update for Clinicians-- Weekly on Thursdays at 12:30pm: Zoom meeting facilitated by Dr. Stephen Sears, MD.

Topic: MCDC Coronavirus Update for Clinicians

Time: Mar 26, 2020 12:30 PM Eastern Time (US and Canada)

        Every week on Thu, until Jul 30, 2020, 19 occurrence(s)

 

Join Zoom Meeting

https://zoom.us/j/399715702?pwd=MmNwUUZKa2Nldm1BSmV1SHhHQWJiZz09

Meeting ID: 399 715 702

Password: 348750

 

        +1 646 558 8656 US (New York)

 

Latest News

 

Governor Janet Mills today issued a series of substantial new mandates to protect public health and safety in the face of COVID-19, including a Stay Healthy at Home directive that requires people living in Maine to stay at home at all times unless for an essential job or an essential personal reason, such as obtaining food, medicine, health care, or other necessary purposes.

The Governor also mandated a series of other new restrictions, including:

  • For essential businesses and operations that remain open, limiting the number of customers in their buildings at any one time, implementing curb-side pickup and delivery options as much as possible, and enforcing U.S. CDC-recommended physical distancing requirements for their customers and employees in and around their facilities.
  • Prohibiting the use of public transportation unless for an essential reason or job that cannot be done from home and limiting the number of people traveling in private vehicles to persons within the immediate household unless transporting for essential activities.
  • Mandating the continued termination of classroom or other in-person instruction until at least May 1, 2020.
  • Mandating that, when out of the home or when at work at an essential business, individuals shall maintain a minimum distance of six feet from other persons.

The Executive Order takes effect at 12:01 a.m. on April 2, 2020 and will last until at least April 30, 2020. The Governor may amend, rescind, or renew this timeline at her discretion. The Governor also extended the closure of restaurants and bars statewide for dine-in customers until at least April 30, 2020 to align with today’s Executive Order.

White House Projects Grim Toll From Coronavirus-- New York Times, March 31, 2020
The scientists leading the administration’s fight estimated the virus could kill between 100,000 and 240,000 Americans. New data suggests many as 25 percent of infected people may not show symptoms.
 
The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) -- Passed into law 
Highlights of Provisions Most Relevant to Physicians and Medical Students from the AOA (see 
attached) The AOA has a running list of FAQs relating to COVID-19 on their website. Take a look here.
 
Osteopathic medical students may be graduating early to fight COVID-19
The AOA’s Commission on Osteopathic College Accreditation (COCA), which accredits the nation’s 38 osteopathic medical schools, will allow colleges of osteopathic medicine to offer early graduation to certain medical students in their fourth year to increase the health care workforce fighting the COVID-19 pandemic. Read more.
 
CMS Updates-- Courtesy of FSMB

Yesterday evening (Monday, March 30th), CMS announced the release of additional blanket waivers to address hospital staffing issues and to increase access to Medicare telehealth services during this COVID-19 national emergency. As you know, CMS had already put in place several “1135 Waivers” that have been available on the FSMB COVID-19 Website. The new CMS Fact Sheet outlines the additional blanket waivers and clarifies certain elements of waivers that had already been released – including the need for practitioners to follow state licensure laws and emergency waivers when practicing across state lines. The fact sheet released yesterday is available here.

 

CMS also released an Interim Final Rule with Comment Period (CMS-1744-IFC) that revises several Medicare and Medicaid regulations in response to the COVID-19 national emergency, including approved telehealth services. As of today, this IFC has not been published in the Federal Register, but can be viewed here.

 

Board of Osteopathic Licensure Experiencing Phone Issues-- State office phones have been having sporadic connectivity issues since Monday, March 30th. If you are trying to reach the Maine Board of Osteopathic Licensure and not able to get through, please use the Board's cell phone number cell at 207/446-4205 for urgent licensing matters/questions.

 

The DO Board also has an emergency COVID-19 locum tenens license – issued for 90 days for now. Click Here for more info. Please tell your colleagues that may be interested! 

 

Maine Responds-- Option to register as willing to provide services during a disaster or emergency situation. The registration system will collect basic information about you and your professional skills. Maineresponds.org 

 
Some Happy News... It's Census Day! Complete the Census here.
 
Proud Moment for Maine-- Lab To Release 5-Minute COVID-19 Test--Maine Public By PATTY WIGHT • MAR 30, 2020
A new 5-minute test for COVID-19 is being produced in Maine. Abbott Laboratories in Scarborough is expected to begin releasing the tests this week. They’re being lauded by President Donald Trump as a potential game changer in the fight against the coronavirus, but the director of the Maine Center for Disease Control is advising caution.

State CDC Director Dr. Nirav Shah says the new test, which promises to give results on whether someone is infected with COVID-19 in as little as five minutes, is an exciting development.
 
DO Community Coming Together
 
Using OMT to Care for COVID-19 Patients
ACOFP Provides FREE Videos of OMT techniques that address upper and lower respiratory issues and can be used to treat COVID-19 symptoms. The ACOFP Blog also shares member stories of using OMT during the Spanish Flu outbreak of 1918.

New York Governor Cuomo Urgently Seeks Qualified Health Professionals
https://coronavirus.health.ny.gov/get-involved-how-you-can-help

Maine Insurance Emergency Response Order (March 27, 2020) Continuation of Group Health Coverage:  Eric Cioppa, Superintendent of Insurance orders carriers, when requested by an employer, to suspend the application of any group health plan contract provision that terminates coverage when an eligible employee is no longer actively employed by the group policyholder, provided that the employer’s offer of continued coverage is made to all affected employees on a nondiscriminatory basis.

Maine Records First Death of Individual Who Tested Positive for COVID-19 
March 27, 2020
The Maine Center for Disease Control and Prevention (Maine CDC) today reported the first death of an individual who had tested positive for the disease caused by the 2019 novel coronavirus (COVID-19). The individual was a man in his 80s from Cumberland County. Due to privacy laws, Maine CDC is limited in releasing further details.  

US Becomes Nation With Most Confirmed Cases Of CoronavirusUSA Today (3/26) reports the US “surged past China and Italy to become the planet’s most infected nation Thursday, a stark milestone in the coronavirus era – and a reminder of its deadly, culture-changing effects on American life.” The article says that “the Johns Hopkins University dashboard showed the U.S. with 85,840” cases “as of 11 p.m., ET, moving past Italy (80,589) and China (81,782),” and “more than 1,296 people have died in the U.S.”

Governor Mills Launches New Online Resource Outlining Ways Mainers Can Help Mainers During COVID-19 Pandemic
March 27, 2020
In response to the extraordinary generosity of Maine people, businesses, and organizations looking to help during these challenging times, Governor Janet Mills today launched a new online resource, coronavirus.maine.gov/mainehelps, to outline ways in which Maine people can support efforts to combat the COVID-19 pandemic.

The new resource, which will be updated regularly, outlines four predominate ways Maine people can address immediate needs: 1) financial assistance; 2) health care and medical assistance (via Maine Responds registry: Register on Maine Responds-- Emergency Health Volunteer System; 3) small business assistance; and 4) connections with family, friends, and neighbors. Visit Maine Helps Here.

Governor Mills Extend State Income Tax Payment Deadline to July 15, 2020 (March 26, 2020)

New Testing Guidelines for Maine State Lab

Testing at state lab (HETL) as of March 25, 2020. Maine now meets U.S. CDC’s criteria for a Moderate level of community transmission. At present, a limited national supply of laboratory materials inhibits Maine’s testing capacity. Therefore, consistent with U.S. CDC guidelines, Maine is now creating a prioritization system to test individuals in high-risk categories.

To preserve Maine’s specimen collection and testing supplies for patients who may develop severe COVID-19 illness over the coming months, effective immediately, Maine Health and Environmental Testing Laboratory (HETL) will prioritize testing to high-risk individuals and will only accept specimens for testing from symptomatic individuals who have fever or respiratory symptoms and who fall into one of the following high-risk categories: 

Tier 1:

  • Those who are hospitalized

  • Health care workers

  • First responders (e.g., EMS Police, Fire)

  • Patients living in congregate setting (e.g., LTCFs, group homes, assisted living facilities, jails, shelters)

Tier 2:

  • Patients older than 60 years

  • Patients with underlying medical conditions

Testing within these categories is likely to be prioritized further based on availability of laboratory materials.  Presently the emphasis will be on groups within Tier 1.  This guidance is in general accordance with U.S. Department of Health and Human Services (DHHS) recommendations for prioritizing COVID-19 testing for individuals.

Note:

  • Samples sent to HETL that do not have completed paperwork or that do not meet one of the above criteria will be discarded.

  • Samples from individuals who do not fall into any of these six categories should be sent to a commercial laboratory.


     

March 24, 2020-- Gov. Mills Issues Executive Order -- All Non-essential Businesses to Cease Public-Facing Activities, Enforce Work from Home in Environments with More than 10 Workers in One Space Until April 8th -- Read the full Order Here. 

COVID-19 National Headlines (March 20, 2020)

The Wall Street Journal (3/19, Subscription Publication) reports on Thursday, the number of confirmed cases of coronavirus in the US passed 14,000. The article adds that the number of cases jumped in several states including New York. Younger Adults May Account for more cases than expected. And COVID-19 Appears to be killing more men than women. The Federal Government now preparing for Outbreak of 18 months or longer with multiple waves of cases, CNN said today March 20th. 

Congress has passed two legislative packages addressing issues resulting from the COVID-19 outbreak, and is hard at work on a third. As Congress works on a third legislative package to address broad economic issues, provide support for small businesses and support ongoing public health needs, sharing your voice is important (via the AOA Action Network).

The Coronavirus Preparedness and Response Supplemental Appropriations Act,  an $8.3 billion package provides funding for vaccine development, support for state and local health departments to provide personal protective equipment and supplies for medical personnel, and assistance for small businesses.

The Families First Coronavirus Response Act includes:

  • The creation of a federal emergency paid leave program;
  • A requirement that private insurers expand coverage for certain medical expenses related to COVID-19
  • A requirement that employers in the healthcare sector develop a comprehensive exposure control plan to protect workers from COVID-19; and,
  • A temporary increase in the Medicaid federal medical assistance percentage (FMAP).

Updates and Action in Maine:


US Centers for Disease Control and Prevention Resources

General Information for Healthcare Providers: Persons Under Investigation Guidelines, FAQs, Infection Control, etc.

Interim Guidance for Healthcare Facilities: Preparing for Community Transmission of COVID-19 in the United States

Resources and Fact Sheets for your patients and office

Morbidity and Mortality Weekly Report-- Severe Outcomes in US 

Updated Cleaning Procedures from EPA (March 13, 2020)

CMS Adult Elective Surgery and Procedures Recommendations (March 18, 2020)

Maine CDC

If you have not done so, please sign up for the Maine CDC Health Alert Network HERE

Maine COVD-19 Case Updates

Maine's Emergency Response System Now Activated for Public Questions on COVID-19: Dial 211, or text your zip code to 898-211


TeleHealth

Telehealth Town Hall for Maine Healthcare Providers -- Held March 26.Nearly 1,000 participated. If you missed it, here are some key resources:

Expanded Telehealth Benefits now available for patients with Medicare, MaineCare and many private plans

HIPAA Enforcement Relaxed for Telehealth Platforms
 Under the OCR notice, physicians may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype. Physicians should not use Facebook Live, Twitch, TikTok or other public facing communication services.

AOA Telehealth Guide

CMS Fact Sheet for Providers Available Here: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet

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Maine DHHS logo

MaineCare Guidance Relating to Telehealth and COVID-19--Utilize Teleheath when appropriate and necessary. Full guidance here.

 Billing for Telehealth

In general, services must be billed in accordance with applicable sections of the MaineCare Benefits Manual. Providers must submit claims in accordance with Department billing instructions. The same procedure codes and rates apply to the underlying covered service as if those services were delivered face-to-face. When billing for Interactive Telehealth Services, health care providers at the Receiving (provider) Site should bill for the underlying covered service using the same process they would if it were delivered face-to-face; with the addition of a GT modifier to the claim


Credentialing

Many states have eased licensing requirements to allow more physicians to help meet the growing healthcare needs of the pandemic. Contact the Maine Board of Osteopathic Licensure for more details.
Website: https://www.maine.gov/osteo/ Phone: (207) 287-2480 Email: osteo.pfr@maine.gov


Testing Codes

COVID-19 Testing Codes
The Centers for Medicare and Medicaid Services (CMS) has adopted two new Common Procedural Technology (CPT) codes that should be used for COVID-19 testing.  

  • U0001 - 2019 Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel should be used when specimens are sent to the CDC and CDC-approved local/state health department laboratories.
  • U0002 - 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC should be used when specimens are sent to commercial laboratories, e.g. Quest or LabCorp, and not to the CDC or CDC-approved local/state health department laboratories.

For more information and future updates, visit the CMS website and its recently issued FAQs. To view a more comprehensive list of COVID-19 codes, visit the Aetna website

MaineCare COVID-19 CPT/HCPC Codes, CR 93723 

The following codes will be updated in MIHMS with the effective dates listed in the table below. Three CPT codes will be opened temporarily to support telehealth services and we anticipate that these codes will be available in MIHMS on March 25, 2020. One new HCPC code will be available for COVID-19 testing when the second quarter coding update is available from the Centers for Medicare and Medicaid Services (CMS). 

CPT/HCPC Code

Effective for Date of Service

99441 - temporary

03/18/20

99442 - temporary

03/18/20

99443 - temporary

03/18/20

U0002

02/04/20

 

 


Financial Relief

The U.S. Small Business Administration has released information about financial relief for small businesses, including private practices.

For additional guidance related to unemployment benefits and COVID-19, visit www.maine.gov/labor/covid-19 provided by the Maine Bureau of Unemployment.

Maine Dental Association has created an FAQ document that may be useful to private practice physicians as well. Covers HR concerns, Unemployment questions, etc. View it Here.

Frequently Asked Questions – Layoffs and Unemployment Compensation in Maine (Bernstein Shur)

Newly Enacted Federal Paid Leave Law: Families First Coronavirus Response Act (Bernstein Shur)

 


Other Resources

Maine DHHS COVID-19 Resources Page

Check the Status of AOA Meetings, Conferences and certification exams 

Ways to Volunteer for Retired DOs and other Healthcare Workers:

Case Map from Johns Hopkins

DO Launches Openxmed App to Help PCPs Navigate COVID-19-- Click Here for More info.

Medical Professionals Health Program: https://www.mainemphp.org/

 National Suicide Prevention Lifeline: 1-800-273-8255 

 

Urgent Call to Action from the Maine Association of Psychiatric Physicians

MAPP is partnering with Maine psychologists, social workers, Psych NP's and PA's and other mental health professionals to SUPPORT our clinical front line staff and first responders during this crisis. We will do a short training with on volunteers on the principles of Psychological First Aid. We will connect with particular clinicians or organizations that have requested assistance from us. We will be helping out 'virtually', on-line or by phone, in pairs or teams. We will stay connected with our front line providers as long as there is a need and we will all make it through this, together.

ALL OF US CAN HELP. Many of us are appropriately "sheltering in place" at home at the moment- WE CAN GIVE MUCH NEEDED SUPPORT WITHOUT LEAVING OUR HOME. Whatever amount of time you can give will make a difference.

It's easy to participate. To start, please complete the following SHORT QUESTIONNAIRE:    https://www.surveymonkey.com/r/3B7X822

Fitness Apps with free trial periods: 

 

Maine COVID Sitters are volunteering to provide childcare, pet services, and household support to those on the front line of the COVID-19 pandemic. 

A little bit about how our program works: we are a group of health care professional students (DO, MD, PA, dentistry, pharmacy, etc) in and around Portland, Maine, modeled after the MN CovidSitters. Using this intake form you can identify your needs, may they be child care, pet walking, grocery or pharmacy runs. You will then be connected with a  “pod” of 1-5 students who will provide support solely to your family. This is done to distribute the responsibilities evenly among students who still have academic requirements, and promote social distancing in accordance with CDC guidelines. You will then be able to coordinate with your pod to get the services that you require. Please know that we are students and not certified childcare providers, nor are these services affiliated with our respective institutions. 

We encourage you to share this information widely, so we will be able to reach any and all health care workers that need a helping hand.  We are attaching a document of frequently asked questions to address any concerns you may have. If you have any additional questions or concerns, you can contact us at maineCOVIDsitters@gmail.com