Whitmer Orders Bars, Theaters, Gyms, Most Public Spaces Closed
Governor Gretchen Whitmer issued a sweeping executive order today closing not just bars and restaurants other than for delivery and carryout, but also shuttering cafes, coffee houses, clubs, movie theaters, indoor and outdoor performance venues, gyms, fitness/exercise studios, spas and casinos.
Restaurants can still offer food and beverage through delivery, drive-through, walk-up and window service. Restaurants may allow only five people inside at a time to pick up orders and they must stay six feet apart.
These restrictions do not apply to the following locations: office buildings, grocery stores, markets, food pantries, pharmacies, drug stores and providers of medical equipment and supplies, health care facilities, residential care facilities, congregate care facilities, juvenile justice facilities, warehouse and distribution centers and industrial and manufacturing facilities. The order takes effect at 3 p.m. today and lasts until 11:59 p.m. March 30.
"This disease is a challenge unlike any we've experienced in our lifetimes," Ms. Whitmer said in a statement. "Fighting it will cause significant but temporary changes to our daily lives. By practicing social distancing and taking aggressive action now, the state is working to mitigate the spread of coronavirus so we reduce the risk that our healthcare system becomes overwhelmed. This is about saving lives. Michiganders are tough and we are going to get through this, but it will require everyone doing their part. That means making smart choices and not putting yourself or others at risk by going out in public unless it is absolutely necessary."
Several recently released Proposed Medicaid Policy Bulletins listed below aim to help improve access to behavioral health. We encourage you to review these policies so you are abreast of changes that affect you and your clients and provide comments as needed, especially during these uncertain times.
1944-Telemedicine: The purpose of this bulletin is to update program coverage of telemedicine services including the definition, consent requirements, privacy and security requirements, allowable originating sites, distant site procedures, and billing and reimbursement. It also outlines specific telemedicine considerations for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). The proposal allows for the home of the beneficiary, along with numerous other locations, to be an originating site.
2006-BHDDA - Opioid Health Home (OHH): This policy will implement the Opioid Health Homes in Michigan’s PIHP Regions 1, 2 and 9 in addition to Calhoun and Kalamazoo counties in Region 4. These Opioid Health Homes provide for comprehensive care management and coordination of services to Medicaid beneficiaries with an opioid use disorder diagnosis, directing patient-centered care across the broader health care system through the implementation of interdisciplinary teams.
1945-CoCM - Coverage of Psychiatric Collaborative Care Model Services: The purpose of this policy is to increase access for behavioral health services for those with mild-moderate behavioral health conditions within the primary care settings. The Psychiatric Collaborative Care Model (CoCM) is a model of integrated behavioral health services not typically provided within a primary care setting.
2007-BHDDA - Behavioral Health Home (BHH): Behavioral Health Homes increase access to integrated physical and behavioral health services with a goal of increasing access to coordinated care. The policy recalibrates the diagnosis to serve the highest-need beneficiaries with Serious Mental Illness/Severe Emotional Disturbances and expands the initiative to PIHP regions 1, 2 and 8.
2005-SBS - Behavioral Health Telepractice: This policy allows for telepractice for behavioral health services for the School-Based Services and Caring 4 Students programs.
Center on Medicaid and Medicare Services Expands Telehealth Services ( March 17th, 2020)
CMS has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services.
To read the Fact Sheet on this announcement visit: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet.
To read the Frequently Asked Questions on this announcement visit:https://www.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf.
Key Take-Aways for Social Workers:
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Licensed Clinical Social Workers can provide teletherapy to beneficiaries if the client is in their home.
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Licensed Clinical Social Workers can also see new or existing patients.
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Telephone/audio only does not appear to be reimbursable at this time
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Licensed Social Workers must use a video conferencing platform.
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HIPAA requirements are also eased.
OCR Announces Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency ( March 17th, 2020)
Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) announced, effective immediately, that it will exercise its enforcement discretion and will waive potential penalties for HIPAA violations against health care providers that serve patients through everyday communications technologies during the COVID-19 nationwide public health emergency.
The Notification of Enforcement Discretion on telehealth remote communications may be found at: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html.
Further Guidance on Michigan Medicaid Telemedicine Policy ( March 19th, 2020)
The current Michigan Medicaid telemedicine policy update described in MSA 20-09 recognizes telecommunication systems that utilize both audio and visual connections together and ensure privacy and security of Medicaid beneficiaries.
Systems limited to telephonic connection are not supported within this policy. Some Medicaid and Behavioral Health programs may temporarily consider telephonic connections acceptable as the Centers for Disease Control discourages non-essential in-person services to prevent the spread of 2019 Novel Coronavirus Disease (COVID-19).
Refer to recently released MSA 20-12 for further guidance on limiting face to face services.
The current telemedicine policy described in MSA 20-09 includes a range of telemedicine services including CPT 90837. For a complete list of services and billing codes covered within this policy, please see the telemedicine fee schedule on the MDHHS website and use the following navigation to access >> Billing and Reimbursement >> Provider Specific Information >> Physicians/Practitioners/Medical Clinics >> Telemedicine Services.”
Additional resources
SBA offers disaster assistance loans for small businesses impacted by coronavirus
Resources for Michigan Employers and Workers
Loom
Loom is a video messaging platform
available to businesses and schools connecting remotely.
They are currently addressing the COVID-19 situation by offering free access.
Showbie and Socrative
Showbie and Socrative are distant learning tools designed to support interactive education, with tools for parental access, school administration and oversight, communication and assessment in place. These platforms work together to setup the educational environment best suited for your classroom and are free through July 31, 2020.
TechSmith Snagit
and TechSmith Video Review
TechSmith is offering its screen recording tool, TechSmith Snagit, and asynchronous collaboration platform, TechSmith Video Review, for free through the end of June 2020 to any organization that needs it. These tools help create and record interactive training materials while providing opportunities for collaborative feedback and communication.
Again, we hope you all stay healthy and safe. Please be sure to care for your well-being and follow guidelines put forth by the CDC. For more updates and information regarding COVID-19, we recommend the CDC’s website, accessing the National Association of Social Workers Coronavirus resource list and for Michigan-related updates, the state of Michigan’s website directly addressing COVID-19. For additional questions regarding state Medicaid and Children’s Health Insurance Programs (CHIP), please view the Center on Medicaid Services FAQs ensuring that individuals, issuers, and states have clear Information on Coverage Benefits.
Best,
Algeria Wilson, MSW
Director of Public Policy
NASW Michigan Chapter
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