In The News

Denver Mandates COVID-19 Vaccination for Healthcare Workers, Educators & Others

ORDER WHEREAS, on March 12, 2020, the Mayor of the City and County of Denver declared a state of local disaster emergency pursuant to C.R.S. § 24-33.5-701, et seq., due to the risk of spread of the COVID-19 virus.

WHEREAS, according to the federal Centers for Disease Control (“CDC”), COVID-19 continues to pose a serious risk, especially to individuals who are not fully vaccinated, and certain safety measures remain necessary to protect against COVID-19 cases and deaths.

WHEREAS, vaccination is the most effective way to prevent transmission and limit COVID-19 hospitalizations and deaths.

WHEREAS, this Order is based upon evidence of continued community transmission of COVID19, in particular the rise of Delta variant cases, within the City and County of Denver.

WHEREAS, the primary intent of this Order is to continue to protect the community from COVID19 and to increase vaccination rates to reduce transmission of COVID-19 long-term, so that the community is safer and the COVID-19 pandemic can come to an end. All provisions of this Order shall be interpreted to effectuate this intent.

Due to the recent surge of Delta variant COVID-19 cases and epidemiological evidence that shows low rates of vaccination fuel increased rates of community transmission, this Order hereby requires personnel of the following entities, or types of entities, to be fully vaccinated by September 30, 2021:

  • the City and County of Denver;
  • care facilities;
  • hospitals;
  • clinical settings;
  • limited healthcare settings;
  • shelters for people experiencing homelessness, including day and overnight shelters;
  • correctional facilities, including jails, detention centers and community corrections sites and residences;
  • schools, including post-secondary and higher education;
  • childcare centers and services;
  • any entity providing home care to patients; and
  • any entity providing first responder services.

This Order further requires the entities or types of entities listed above to ensure that all personnel are fully vaccinated by September 30, 2021, and to ensure that all personnel hired thereafter are vaccinated. Until a person’s vaccination status is ascertained, that person must be treated as not fully vaccinated. Personnel who decline to provide vaccination status must also be treated as unvaccinated. The entities, or types of entities listed above, with the exception of hospitals, must complete their initial ascertainment of full vaccination status for all personnel by September 30, 2021 and must maintain corresponding records that are available to the health authority upon request. Hospitals may meet their ascertainment of full vaccination status in conjunction with meeting their flu and other vaccination requirements.

“Personnel” means employees of the entities or types of entities listed above, as well as individuals who provide services onsite and/or in the field to or on behalf of the entities or types of entities listed above on a contractual or volunteer basis. Entities and individuals who provide onsite services to or on behalf of the Denver International Airport on a contractual basis shall not be considered “personnel” for purposes of this Order. Employers shall provide reasonable accommodations for any personnel who have medical or religious exemptions from the COVID19 vaccination.

“Employees” of the City and County of Denver shall mean all persons in the employ of the City and County of Denver, including on-call employees; interns (paid or unpaid); volunteers; appointed officers, board members and commissioners; elected officials; at-will appointees of elected officials and the Department of Aviation; hearing officers appointed by the Career Service Board; employees of the Denver County Court including judges and magistrates; and employees of the Independent Monitor’s Office, City Council, Library Commission, the Denver Public Library, and the Civil Service Commission.

“Care facilities” means nursing facilities, assisted living residences, intermediate care facilities and group homes.

“Childcare centers and services” does not include foster care.

“Clinical settings” means ambulance service centers, urgent care centers, non-ambulatory surgical structures, clinics, dentist offices, doctor offices, and non-urgent care medical structures.

“Fully vaccinated” means two weeks after a person’s second dose in a two-dose series and two weeks after a single-dose vaccine.

“Limited healthcare settings” means those locations where healthcare services are provided including but not limited to acupuncture, audiology services, services by hearing aid providers, chiropractic care, massage therapy, naturopathic care, occupational therapy services, optometry, ophthalmology, physical therapy, and speech language pathology services.

This Order shall be effective immediately and shall remain in effect until rescinded, superseded, or amended in writing by the Executive Director of DDPHE.

Issued by: Robert M. McDonald

Public Health Administrator, City & County of Denver Executive Director, Denver Dept of Public Health & Environment

 

Register for the August 4 Hospice Quality Reporting Program Forum

On Wednesday, August 4th, the Centers for Medicare & Medicaid Services (CMS) will host a webinar to share updates on the on the fiscal year (FY) 2022 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements Final Rule.

During this webinar, a CMS subject matter expert will provide information on the following topics:

  • · FY 2022 Hospice Final Rule summary
  • · Public display of quality measures and other hospice data updates

CMS will answer questions at the end of the webinar, as time permits.

Webinar Details

Title: CMS Hospice Quality Reporting Program Forum – 2022 Rulemaking Update

Date: Wednesday, August 4, 2021

Time: 2:00 - 3:00 p.m. ET

Registration Link: https://register.gotowebinar.com/register/7879279960570652687

 

Dying MA customers are switching to traditional Medicare

Modern Healthcare / Michael Brady
 
Medicare Advantage beneficiaries can't access the care they need as they get sicker, a new report from federal watchdogs suggests.
 
People enrolled in Medicare Advantage plans are switching to Medicare fee-for-service at an alarming rate during their last year of life, according to a Government Accountability Office (GAO) report published Wednesday. Medicare Advantage customers in their last year of life were more than twice as likely to drop their policies and enroll in Medicare fee-for-service than other Medicare Advantage enrollees.
 
"Among other reasons, beneficiaries in the last of year life may disenroll because of potential limitations accessing specialized care under MA," the GAO concluded.
 
In 2017, 5% of Advantage beneficiaries in their last year of life converted to traditional Medicare, compared to 2% of all other enrollees, the oversight agency reported.
 
Medicare Advantage has grown popular over decades as beneficiaries opt for insurance policies that come with extra benefits not available in traditional Medicare. But given their nature as private insurance products with limitations such as provider networks and varying benefit designs, Medicare Advantage has always drawn skeptical appraisals from those concerned about access to care.
 
"Beneficiaries in their last year of life are generally high-cost and disproportionately require specialized care, with a few studies estimating that they may account for as much as a fifth to a quarter of all [fee-for-service] spending," the GAO found. The federal government would have saved $912 million during 2016 and 2017 had fewer Medicare Advantage enrollees opted into traditional Medicare during their last year of life, the GAO estimates.
 
The watchdog recommends CMS review disenrollment by Medicare Advantage customers in their last year of life as part of the agency's broader analysis of Medicare Advantage beneficiaries in poor health who switch to fee-for-service Medicare. The agency began that evaluation after the GAO reported in 2017 that sicker beneficiaries are more likely to drop out of Medicare Advantage.
 
"Given their high costs and specialized care needs, a specific focus on disenrollments by beneficiaries in their last year of life could help CMS better identify and address potential concerns regarding their care under MA, and ensure efficient Medicare program spending," the GAO report say.
 
HHS agreed with GAO's recommendation.

 

Access to Patients in Nursing Homes

In recent days, NHPCO has been hearing some renewed concerns about hospice providers’ access to patients in nursing homes and would like to make CMS aware of this issue. Please email [email protected] to let us know about any recent experiences you have had accessing and providing care for patients in these settings. These could include access to patients, inability to do in-person assessment visits, and any other requirements from nursing homes for hospice patients residing there.

 

Hospice FY 2022 Wage Index and Quality Reporting Final Rule Published

Last Thursday, July 29, 2021, the FY 2022 Hospice Wage Index and Payment Update Final Rule were posted to the Federal Register website for public inspection. It will be published in the Federal Register on August 4, 2021, with all regulations taking effect on October 1, 2021.

This rule rebases the hospice labor shares and clarifies certain aspects of the hospice election statement addendum requirements. It also finalizes changes to the Hospice conditions of participation and Hospice Quality Reporting Program (HQRP), and finalizes a Home Health Quality Reporting Program policy that becomes effective on October 1, 2021 in preparation for public reporting beginning in January 2022.

  • The final hospice rate increase for FY 2022 is 2.0%. This is a result of the 2.7 percent market basket percentage increase reduced by a 0.7 percentage point productivity adjustment. Hospices that fail to meet quality reporting requirements receive a 2% reduction to the annual hospice payment update percentage increase for the year.
  • The final hospice cap amount for FY 2022 is $31,297.61 (an increase of 2%)
  • Technical changes and clarifications to the election statement addendum were finalized.
  • Two 1135 waivers were made permanent.
  • The Hospice Care Index was finalized.
  • Updates on the HOPE Assessment Tool were detailed.
  • Hospice CAHPS® Star Ratings were finalized.
  • A Request for Information (RFI) for Closing the Health Equity Gap and for Fast Fast Healthcare Interoperability Resources in Support of the HQRP were made

More Information:

 
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