HCAM/MCAL Member Update - COVID - Member Appointment to NHA Board, How to Avoid NHSN Data Reporting Errors, FLSA and FMLA FAQs, Deadline Extended: Medicaid Application for Provider Relief Fund, Licensing Update

Member Appointment to NHA Board

On Friday July 17, 2020 Governor Whitmer announced appointments to Boards and Commissions. Of particular note, an HCAM member was appointed to the Michigan Board of Nursing Home Administrators.

Paul D. Pruitt, is the Chief Operating Officer for Mission Point Healthcare Services. He holds a Master of Business Administration from Cornerstone University. Mr. Pruitt is appointed to represent nursing home administrators for a term commencing July 17, 2020 and expiring June 30, 2024.

Please join HCAM in congratulating Paul in his new appointment!

How to Avoid NHSN Data Reporting Errors

The National Healthcare Safety Network (NHSN) has identified nursing facilities that are submitting confirmed and suspected COVID-19 data incorrectly. Facilities that are receiving citations should view the NHSN LTCF COVID-19 data quality webinar to review the commonly identified errors in submission data and follow the data quality slides to check that their information is being submitted correctly.

According to NHSN, common data submission errors include:

Reporting aggregate counts for COVID-19 confirmed, suspected, and deaths. Data submitted should be newly identified since prior data submission.
COVID-19 deaths are greater than total number of deaths. Data submitted for COVID-19 deaths should never be greater than the total number of deaths reported.
Missing data for counts. Leaving blanks for numbers equaling zero (0) results in a system flag and identification of a failure to report to the NHSN system.
Missing or incomplete reporting in one or more pathways. Missing or incomplete reporting results in a system flag for failure to report data to the NHSN system. Each pathway must turn green when all data has been successfully submitted.

USDOL Wage and Hour Division: New COVID-19-related guidance - FLSA and FMLA FAQs
The US Department of Labor (USDOL) Wage and Hour Division announced additional guidance to provide information to workers and employers about how the requirements and protections of the Fair Labor Standards Act (FLSA), the Family Medical Leave Act (FMLA), and the Family First Coronavirus Response Act (FFCRA) impact the workplace as America continues to reopen from the coronavirus. The new guidance provides plain-language questions and answers addressing critical issues under all three laws.

FMLA-related questions address issues including whether telemedicine visits count as in-person visits with a health care provider and whether the FMLA restricts employers' ability to require workers to get a COVID-19 test before returning to the worksite. FFCRA-related questions address whether employers can require workers to telework or take leave until they test negative for COVID-19 after taking leave to care for someone in quarantine. FLSA-related questions address issues including how employers must count the number of hours employees work in flexible scheduling and telework situations, whether hazard pay is required for employees working during the COVID-19 pandemic, and the effect of employers' reducing salaries for exempt salaried workers during an economic slowdown.

For Covid-19 related questions on the guidance to FLSA and FMLA and the FFCRA please contact Mildred Kress, USDOL Community Outreach & Resource Planning Specialist at (313) 309-4526.

Deadline Extended: Medicaid Application for Provider Relief Fund

Last week, The US Department of Health & Human Services (HHS) extended the application deadline for the Medicaid tranche of the COVID Provider Relief Fund to Monday, August 3, 2020. The payment to each provider will be approximately 2 percent of reported gross revenue from patient care, and the final amount each provider receives will be determined after the data is submitted.

Unlike previous funding tranches, this is not a first-come, first-serve process. These funds are available to providers who have not received payment from the General Distribution to Medicare providers, and have billed Medicaid or Medicaid managed care plans for health care-related services between January 1, 2018 - December 31, 2019.

AHCA/NCAL has a tips sheet and step-by-step guide for providers on how to successfully navigate the Provider Relief Fund Payment Portal for non-SNF Medicaid providers.

Instructions for the application form can be found here. For additional information, please see the Medicaid and CHIP Distribution FAQs.

BPL Shares Licensing Update Related to Executive Order 2020-150
On Monday, July 13, 2020 the Governor signed Executive Order 2020-150 regarding licensing and certification requirements and rescinded Executive Order 2020-61, which was previously relied upon for guidance in this area. The new Executive Order remains in effect until any state of emergency or disaster related to the COVID-19 pandemic ends. Currently the state of emergency is scheduled to end on August 11, 2020.

While some provisions of EO 2020-61 were continued in EO 2020-150, many provisions were not and are therefore no longer in effect. Here are some of the key points and changes:

Many scope of practice and supervision exemption provisions that were in EO 2020-61 have been removed in EO 2020-150 and are no longer in effect. Since these changes were immediate and understanding the problems this may cause for providers, the Department of Licensing and Regulatory Affairs (LARA) will give providers through 11:59 pm, August 31, 2020 to return to normal order. If the Bureau of Professional Licensing (BPL) receives any complaints covering the timeframe under EO 2020-61 through August 31, 2020 related to scope, supervision and delegation concerns, the bureau will review each complaint on a case by case basis as it has throughout the pandemic.
The provision under EO 2020-150 allowing those licensed and in good standing in other states or territories to practice in Michigan without a Michigan license has been removed. However, they still may fall under the exemption from licensure provision under MCL 333.16171: BPL Clarification: Exemption of Michigan Licensure Time of Disaster/State of Emergency. Generally, this provision of the Public Health Code allows for licensees in good standing from other states to practice in Michigan under this type of emergency situation.
Executive Order 2020-150, continues to allow the Department to waive an exam as a condition of licensure for health professions "to the extent that the exam's administration has been canceled while the emergency declaration is in effect."
o     As noted on the web page (michigan.gov/bpl) individuals who applied after 12:00 am on July 2, 2020, or thereafter, where the entity offering the exams is scheduling exams, those professions and applicants will not be eligible for an exam waiver. Those who applied prior to that date where the exam was waived, will need to meet all the other requirements for licensure in order to be approved to receive a license.
o     BPL will continue to waive the licensing test requirement for professions where the testing center is not open or is not administering the licensing exam. Currently this is mainly dental professions, but you can contact BPL at BPLHelp@michigan.gov or 517-241-0199 to confirm.
o     BPL will not have the legal authority to waive exam requirements for applications received after EO 2020-150 or other subsequent EOs are rescinded or when the state of emergency expires.
o     Those receiving a license whose exam was waived during the state of emergency, will be required to take, and pass that exam in order to keep his/her license after the state of emergency expires. Licensees in this situation will be given six months from the end of the declared state of emergency to take and pass the exam. Failure to do this will result in the license being null and void and no longer in effect. Pursuant to the Public Health Code, MCL 333.16181(2), nurses who received Temporary Nursing Licenses have one year from the issuance date of their Temporary License to meet all the requirements for full licensure (passing the exam).
o     However, BPL encourages applicants for licensure of a health profession, including Nursing, to schedule and take the exam now versus delaying taking the exam.
o     More information can be found in this document: Examination Waiver Guidance.
Executive Order 2020-150 continues to allow the Department to waive continuing education requirements as part of the renewal process for health professionals. This provision only applies to individuals whose license renewal period occurs while the emergency is in effect. To take advantage of this provision, individuals may want to renew as soon as their license renewal period occurs during the state of emergency. Again, the state of emergency is currently scheduled to end on August 11, 2020.
While not addressed in any current Executive Orders, Executive Order 2020-82 allowed the Department to recognize hours worked by health professionals responding to the COVID-19 pandemic as hours toward continuing education courses or programs required for licensure. Since EO 2020-82 was rescinded the Department will recognize hours worked responding to COVID-19 between March 17, 2020 and June 9, 2020 as continuing education hours at your next renewal, even if that renewal is after the emergency ends. In other words, the hours need to be accumulated during the license cycle you are renewing.
Please note all Michigan health professionals are still required to renew their license before the expiration date. No Executive Order waives the license requirement and as such licensees will want to continue to renew on-time or during the 60-day late renewal grace period.
Additionally, the provision allowing those licensed and in good standing in another country is not included in EO 2020-150. If an individual was granted a license under this provision, the license will be valid for the duration of the state of emergency.

For questions or concerns please contact Cathy Sunlin at CathySunlin@HCAM.org.

July 20, 2020