A Summary of the Stimulus Legislation

Late Wednesday night the Senate approved a massive $2 trillion stimulus and COVID-19 relief package.

Provisions of particular interest to physicians and their practices include the following:

  1. Creates a new loan product within the Small Business Administration for loans of up to $10 million to help cover payroll and overhead costs, with expanded loan forgiveness criteria. Physician practices with not more than 500 employees may qualify.
  2. $100 billion in direct financial support to hospitals, physician practices, and other health care providers under the Public Health and Social Services Emergency Fund. This support is for costs of treating COVID-19 patients as well as to ease the financial impact on those who lose revenue due reductions in other services as a result of the pandemic. Exact eligibility criteria and application process is not yet defined pending implementation.
  3. Suspension of the 2% Medicare sequester in May through December 2020.
  4. Limitations on liability for volunteer health care professionals during COVID-19 emergency response.
  5. A temporary waiver of the face-to-face visit requirement with home dialysis patients.
  6. Authority for the Secretary of HHS to waive telehealth coverage requirements for new patients during a national emergency. Previous legislation provided flexibility only for established patients seen within the past three years.
  7. Secretary will also allow for enhanced use of telehealth under Medicare for federally qualified health centers.

Also of interest, the “health extenders” package that was set to expire on May 22 has now been extended to November 30.

House passage is expected on Friday and the President is expected to sign the bill into law.

Blood Drive at Carter BloodCare: Rosedale Donor Center

Moncrief Cancer Institute has teamed up with Carter BloodCare to host a blood drive on Sunday, March 29 from 9 a.m. to 3 p.m. at the Rosedale Donor Center. This is considered an essential activity and is approved by the City of Fort Worth. We need the community’s help to keep the blood supply ready. 

Sunday, March 29 from 9 a.m. to 3 p.m
Carter Bloodcare: Rosedale Donor Center
1263 W. Rosedale
Fort Worth, TX 76104

Click this link to sign up – must pre-register to honor social distancing! On the day of the blood drive, donors will receive a link to a short, online questionnaire to complete.

Carter BloodCare donors help provide blood for 90% of the hospitals in North, Central, and East Texas, and their supply has decreased due to drives/appointments being canceled. Blood is needed for cancer patients, transplant recipients, heart surgery, and trauma. Giving blood is safe, and Carter BloodCare is taking all precautions to ensure the safety of the donors. The team wears personal protective equipment throughout the entire blood drive and exceeds all FDA guidelines.

What Physicians and Health Care Workers Need to Know about Tarrant County’s Stay-at-Home Order

Excerpts from an article by Sean Price that was originally published on the Texas Medical Association website. Find the original here.

Texas’ largest counties and cities have issued stay-at-home orders designed to keep residents at home and away from each other as much as possible. Most of the orders exempt health care activities, but the specific language in each varies.

Most of them are set to expire in early April, though they could be revised or renewed.

Texas already is under a statewide order issued by Gov. Greg Abbott forbidding social gatherings of more than 10 people. That order also forced restaurants to close dining rooms – though they can still deliver food and provide takeout service – and closed establishments like bars, theaters, and gyms.

As of Wednesday, 18 counties have issued stay-at-home orders, including the six largest – BexarDallasEl PasoHarrisTarrant, and Travis. In many cases, large cities within these counties – including Fort Worth and San Antonio – issued joint orders along with their county governments.

The local orders have shut down all businesses except those exempted as “essential,” such as health care facilities, grocery stores, gas stations, and news media outlets. Orders typically followed guidelines on “critical infrastructure” established by the U.S. Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency, which include health care. 

 Tarrant County

Took effect March 24 and ends April 7, 2020

  1. “That this Executive Order authorizes the County to take any actions necessary to promote health and suppress disease, including quarantine, evacuation, regulating ingress and egress from a disaster area and controlling the movement of persons and the occupancy of premises, pursuant to § 418.108(f), (g) of the Texas Government Code.”
  2. “All elective medical, surgical, and dental procedures are prohibited anywhere in Tarrant County. Hospitals, ambulatory surgery centers, dental offices, and other medical facilities are directed to identify procedures that are deemed ’elective’ by assessing which procedures can be postponed or cancelled based on patient risk considering the emergency need for redirection of resources to COVID-19 response.”
  3. “That no person shall sell any of the following goods or services for more than the price the person charged for the goods or services on March 16, 2020, and continuing during the pendency of this Executive Order:
  4. groceries, beverages, toilet articles, ice;
  5. restaurant, cafeteria, and boarding-house meals; and
  6. medicine, pharmaceutical, and medical equipment and supplies.”
  7. Essential activities include:
    • “To engage in activities or perform tasks essential to their health and safety, or to the health and safety of their family or household members (for example, obtaining medical supplies or medication, visiting a health care professional, or obtaining supplies need to work from home).”
    • “Essential Businesses means:
    • Essential Health Care Services. Health care operations, including hospitals, clinics, doctors, dentists, pharmacies, pharmaceutical and biotechnology companies, other health care facilities, health care suppliers, home health care services providers, mental health providers, substance abuse providers, blood banks, medical research, or any related and/or ancillary health care services, veterinary care provided to animals. Home-based care for seniors, adults, or children. Residential facilities and shelters for seniors, adults, and children. Health care operations do not include fitness and exercise gyms and similar facilities. Health care operations do not include elective medical, surgical, and dental procedures as established in accordance with this Executive Order.”   

Tarrant County COVID-19 Activity 3/25/20

Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Wednesday, March 25, 2020 at 11:30 a.m. Find more COVID-19 information from TCPH here.

Source:http://www.tarrantcounty.com/en/public-health/disease-control—prevention/coronaviruas.html?linklocation=homecarousel&linkname=COVID-19

COVID-19 Drive Thru Testing Available for Health Care Workers

The Tarrant County Medical Society is pleased to announce that the City of Fort Worth Fire Department, in close consultation with Dr. Michael Williams, President, UNTHSC at Fort Worth and Dr. Keith Argenbright, Director, Moncrief Cancer Institute/UT Southwestern Medical Center have opened a COVID-19 testing center for 1st responders that is now available to front line health care workers. This screening resource is now available for physicians, nurses, medical assistants and other health professionals who are on the front lines fighting the COVID virus.  

If you are interested in accessing this testing, please call the Infections Disease Coordinator at the Joint Emergency Operations Center (EOC) at the City of Fort Worth at 817-714-9709. This number is answered from 8 am to 5 pm daily. The ID coordinator will conduct an environmental and clinical assessment of the health care professional and determine if COVID testing is warranted. We understand that the clinical evaluation of COVID testing is complex and changes rapidly – you can be assured that the IC coordinator is up-to-date on the current recommendations. 

If testing is indicated, the ID coordinator will collect demographic and clinical information from the health care professional and give the provider the address of the testing facility and an appointment window. The ID coordinator will inform the professional that if the result is positive, they will receive the results by phone; if negative by text or e-mail. The health care professional will be given post-test instructions, including self-quarantine until the test results are available. We are telling them to expect 5 days for results, but are hoping for a quicker turn-around. 

We appreciate your cooperation in this effort to quickly and appropriately screen our critical health care providers. This is a new program and thus will be subject to modification as it is operationalized. 

Dr. Mark Shelton responds to ‘stay at home’ order and concern over hospitals reaching capacity

Watch Pediatric Infectious Disease specialist Dr. Mark Shelton’s responses to WFAA, where he spoke about the importance of the recent stay at home order issued in Tarrant County. Originally aired on 3/24/20.

AMA releases special coding advice related to COVID-19

New guidance from the AMA provides special coding advice during the COVID-19 public health emergency. One resource outlinescoding scenarios designed to help health care professionals apply best coding practices. The scenarios include telehealth services for all patients. Examples specifically related to COVID-19 testing include coding for when a patient: comes to the office for E/M visit, and is tested for COVID-19 during the visit; receives a telehealth visit re: COVID-19 and is directed to come to physician office or physician’s group practice site for testing; receives a virtual check-in/online visit re: COVID-19 (not related to E/M visit), and is directed to come to physician office for testing; and more. There is also a quick-reference flowchart that outlines CPT reporting for COVID-19 testing. A new web page on the AMA site also outlines CMS payment policies and regulatory flexibilities related to COVID-19. Check the AMACOVID-19 resource center to stay up to date and for additional resources.

COVID-19 Testing Sites – Tarrant County

Below is information about the two COVID-19 testing sites currently available in Tarrant County:

Clinicas Mi Doctor – Seminary  La Gran Plaza

4200 South Freeway, Ste. 106

Fort Worth, TX 76115

817-566-0505

  • Currently, this is the only COVID-19 Testing Site for Clinicas Mi Doctor. No other Clinicas Mi Doctor locations will provide testing.
  • There is a drive-thru to check for COVID-19 symptoms at no-cost. 
  • Once symptoms have been verified, the individual will be given a number to call for their appointment to be tested. The number is 1-888-776-5252.
  • If the individual cannot pay, Free Testing will be provided.
  • If the individual does not have insurance but can self-pay, then the cost is $75.00.
  • If the individual has insurance, then Lab Corps will bill the insurance company.

City Hospital Emergency Care Center (Open 24 hours)

4551 Western Center Blvd.

Fort Worth, TX 76137

(817) 644-3340 

  • Pre-screenings for COVID-19 symptoms are provided at no-cost.
  • Once symptoms have been verified, the individual will be given a test at no-cost.
  • The test results take 5-7 days to return.
  • If the test is positive, the patient is called and told to self-quarantine.
  • The following fees will be billed to the patient:
  • Copay if insured or self-pay if not insured
  • Physician Fee
  • Facilities Fee
  • Assigned a billing level just like an ER in a hospital

Tarrant County COVID-19 Activity – 3/24/20

There have been a total of 71 coronavirus cases in Tarrant County. Currently, 67 of those are still active.

Source: http://www.tarrantcounty.com/en/public-health/disease-control—prevention/coronaviruas.html?linklocation=homecarousel&linkname=COVID-19