LAST UPDATED: 4/7/2020
We all are working to adapt to the volatile and fluid nature of the changes brought on by the COVID-19 pandemic. I hope this post finds you well, at your home and social distancing. Mountaineers are always free (montani semper liberi), but today and going forward please follow the "stay at home" order issued by the State of West Virginia. Let's bend and flatten this curve West Virginians along with the help of all humans around our globe.
It remains difficult to grasp and stay up to date on the fluid nature of the changing information relevant to our health care and business clients. The legal and regulatory landscape is in constant flux and a lot of questions are arising from our clients. As our health care law team works remotely to stay connected, share information, and attempts to analyze the most recent changes from the various state and federal agencies which regulate and oversee health care providers and the industry, we have pulled together this "resource" page post. We are regularly checking these various aggregation points for new or updated information that are specifically related to West Virginia. We thought it would be valuable to have an access point where not only we can go, but the general public can go, to access the latest information.
We will be adding and updating these resources as we go forward. If you know of any resource that we have not included, please leave a comment or send us an email. We will assess the information and consider adding it to the resource materials.
COVID-19 Data Resources and Real Time Tracking of the COVID-19 Crisis:
- Johns Hopkins University real time dashboard of global cases - Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU).
- Financial Times COVID-19 dashboard data - Coronavirus tracked: the latest figures as the pandemic spreads.
- Our World in Data resource page led by economist Max Roser - Coronavirus Disease (COVID-19) – Statistics and Research.
- Institute for Health Metrics and Evaluations (IHME) COVID-19 Projections, COVID-19 projections assuming full social distancing through May 2020. These projections allow you to see the United State and each state statistics and projections.
- The COVID Tracking Project - Most Recent Data (by state). The COVID Tracking Project collects information from 50 US states, the District of Columbia, and 5 other US territories to provide the most comprehensive testing data we can collect for the novel coronavirus, SARS-CoV-2. We attempt to report positive and negative results, pending tests, and total people tested for each state or district currently reporting that data.
- Information is Beautiful's COVID data in simple and easy to understand images - COVID 1-9 #Coronavirus Data Pack (updated every few days).
- DOMO Global Pandemic Coronavirus (COVID-19) Tracker. The latest statistics on the outbreak are gathered every 10 minutes from credible sources including WHO, CDC, Johns Hopkins University, Worldometer and data curated by Enigma.
- West Virginia Department of Health and Human Resources tracking of total positive cases in West Virginia - Coronavirus Disease 2019 (COVID-19) WV Cases.
- Aledade COVID-19 Postive Test Rate Map and Table (data sourced from https://covidtracking.com/).
- West Virginia University Online Map of COVID-19 testing sites in West Virginia.
- Appalachian Regional Commission (ARC) COVID Resources for Appalachia. Real time data maps and information.
- COVID-19 Cases in Appalachia Map (current number of confirmed cases of COIVD-19 in Appalachia.
- County-level Coronavirus Impact Planning.
- American Health Law Association - Coronavirus Pandemic Hub Resources (public info).
State of West Virginia Health Care Regulatory Agencies and Departments (including a short description of the scope of each agency/department along with a list of current COVID resources):
- Department of Health and Human Resources (DHHR): DHHR is comprised of the Bureau for Behavioral Health; Bureau for Child Support Enforcement; Bureau for Children and Families; Bureau for Medical Services; Bureau for Public Health; Office of Inspector General; and West Virginia Children’s Health Insurance Program.
- DHHR - Bureau for Medical Services (West Virginia Medicaid):
- Coronavirus Disease 2019 (COVID-19) Alerts and Updates. This is a list of updates from BMS/WV Medicaid.
- West Virginia Medicaid Max Script Days Limits Changed to 90 Days for Non-Controlled Maintenance Medications, 3/16/2020
- West Virginia Bureau of Medical Services, DHHR Memo to West Virginia Medicaid Providers regarding Non-emergent E&M visitis through Telehealth Modality, 3/13/2020. "Due to the World Health Organization declaring Coronavirus disease (COVID-19) a pandemic, the West Virginia Bureau for Medical Services (BMS) is allowing Nonemergent E&M visits to be rendered through the Telehealth Modality. The expansion of this service will include the use of live video conferencing in the appropriately equipped members home with a Medicaid enrolled provider in the originating site. All other telehealth regulations are expected to be followed as found in Chapter 519.17 of the WV Medicaid policy manual. The following codes 99211 and 99212, billed with place of service 02 will be allowed. BMS will continue to monitor the situation and work closely with our state and federal partners gathering further information and directives and will provide further notification if an extension is received."
- West Virginia Bureau of Medical Services, DHHR Memo to West Virginia Medicaid Providers regarding Psychological Testing and Evaluation Services through telehealth Modality, 3/12/2020. "Due to the World Health Organizations declaring Coronavirus disease (COVID-19) a pandemic, the West Virginia Bureau for Medical Services (BMS) is allowing Psychological Testing Services to be rendered through the Telehealth Modality through May 31, 2020. This effects the following service codes 96130, 96131, 96136, 96137, 96132, 96113, and 96146. BMS will continue to monitor the situation and work closely with our state and federal partners gathering further information and directives and will provide further notification if an extension of these suspended requirements is received."
- West Virginia Bureau of Medical Services, DHHR Memo to West Virginia Medicaid Providers regarding Medication Assisted Treatment Services Counseling/Therapy Requirements, 3/12/2020. "Due to the World Health Organizations declaring Coronavirus disease (COVID-19) a pandemic, the West Virginia Bureau for Medical Services (BMS) is suspending the counseling/therapy requirements regarding Medication Assisted Treatment Services until May 1, 2020. BMS will continue to monitor the situation and work closely with our state and federal partners gathering further information and directions and will provide further notification if an extension of these suspended requirements is received."
- West Virginia Public Employees Insurance Agency (PEIA): PEIA is West Virginia's public employee health insurance agency covering current and retired West Virginia state employees.
- PEIA Policy for COVID-19 - Updated 3/27/2020. This update covers diagnosis and testing, temporary expansion of telemedicine benefits, pre-certification/pre-authorization/prior approvals, increase in reimbursement, early refills for medications, and alternative care sites.
- Office of Health Facility Licensure and Certification (OHFLAC): OHFLAC’s primary functions are processing licensure application and investigating complaints filed against its regulated health care facilities. OHFLAC supervises eight programs: Administration; Behavioral Health Program; Chronic Pain Management Clinic Program; Life Safety Program; Medicare/Hospital Program; Nurse Aide Program; Nursing Home Program; and Assisted Living Program.
- 3/12/2020 announcement in response to COVID-19, including reporting requirements for all West Virginia providers to report "any postive COVID-19 illness in patients/residents/clients and employees to the local health department and OHFLAC". The notification requirements and information that must be reported are listed on this announcement.
- Office of the West Virginia Governor: Information about the Governor and his Administration are provided on the website.
- Current Coronavirus Disease (COVID-19) Alerts and Updates.
- State of West Virginia Office of the Governor Stay at Home Order, Executive Order 9-20 and FAQ Information issued 3/21/2020, including a copy of the complete order and FAQs.
- State of West Virginia Office of the Governor Executive Order, 14-20, issued 3/30/2020, and effective 3/31/2020. The order requires the closure of state park campgrounds, travel restrictions on individuals from Louisiana, New York, New Jersey, Connecticut, Italy, and China and requirement for 14 day isolation, authorizing West Virginia State Police to monitor travel from areas with substantial community spread, and misdemeanor penalties for violation by the public.
- State of West Virginia Executive Order 16-20 issued 3/31/2020, and effective 4/1/2020. The order states, “… all
elective medical procedures are prohibited, provided that patients will still
have access to urgent, medically necessary procedures like those needed to
preserve the patient’s life or long-term health; and provided that this
prohibition applies equally to all types of elective medical procedures
performed in hospitals, offices, and clinics throughout the state. The term
“elective” includes medical procedures that are not immediately medically
necessary to preserve the patient’s life or long-term health, except that
procedures that cannot be postponed without compromising the patient’s
long0term health, procedures that cannot be performed consistent with other law
at a later date, or procedures that are religiously mandated shall not be
considered “elective” under this Order.”
- Office of the West Virginia Attorney General: The Office of the Attorney General is responsible for prosecuting and defending legal actions on behalf of the State, and for ensuring that the rights of the State and its citizens are protected in matters before the circuit courts of this State, the West Virginia Supreme Court of Appeals, and all federal courts. The Attorney General is entrusted with enforcing the laws of the State as they relate to consumer protection, unfair trade practices, civil rights, and other important areas.
- No current information/updates.
- West Virginia Board of Medicine: The WVBOM is the state agency charged with protecting the health and safety of the public through licensure, regulation and oversight of medical doctors (MDs), podiatric physicians (DPMs), and collaborating physician assistants (PAs). The WVBOM is the sole authority for the issuance of licenses to practice medicine and surgery, to practice podiatry, and to practice as a physician assistant in collaboration with MDs and DPMs in West Virginia. The WVBOM is the regulatory and disciplinary body for medical doctors, podiatric physicians and their physician assistants.
- COVID-19 Information Updated 3/24/20
- Emergency Rule Regarding Chloroquine and Hydroxychloriquine 3/23/2020
- Federation of State Medical Boards - States Waiving Licensure Requirements/Renewals in Resposne to COVID-19, 4/2/2020. A collection and listing of all 50 states and actions taken by their respective State Medical Boards.
- West Virginia Board of Osteopathic Medicine: The West Virginia Board of Osteopathic Medicine handles the oversight of legal issuances of licenses to practice osteopathic medicine as physicians and physician's assistants in the state of West Virginia. The Board also investigates all complaints and acquires any disciplinary action necessary to protect the citizens of West Virginia.
- West Virginia Board of Dentistry: The West Virginia Board of Dentistry is an agency of the State mandated by legislature to protect the public health, safety, and welfare of its citizens. The Board regulates the profession of dentistry and licenses dentists and dental hygienists who have proven minimal competency standards by examination.
- NOVEL CORONAVIRUS (COVID-19) GUIDANCE & INFORMATION - UPDATED 3/24/2020*
- NOVEL CORONAVIRUS (COVID-19) GUIDANCE & INFORMATION - UPDATED 3/18/2020*
- NOVEL CORONAVIRUS (COVID-19) GUIDANCE & INFORMATION - UPDATED 3/16/2020*
- West Virginia Board of Pharmacy: The WVBOP regulates and oversees licensing for pharmacy practitioners including interns, pharmacy technician trainees, pharmacy technicians, nuclear pharmacy technician trainees/technicians, and pharmacists. Further, the WVBOP oversees the regulation and licensure of in state pharmacies, in state controlled substance permits/process, mail order pharmacies, manufacturers and while sale drug distributors.
- WVBOP Changes in business 3/18/2020 (WVBOP will not currently be accepting paper applications/notices. Please use online applications and emails as indicated)
- COVID 19 Memo 3/20/2020
- COVID-19 UPDATE 3/21/2020
- COVID-19 UPDATE 3/23/2020
- West Virginia Board of Optometry: The WVBO ensures that applicants for licensure practice in a manner that benefits and protects the public. The WVBO oversees annual license renewals, verification of license, complaint investigations, and other functions.
- West Virginia Board of Occupational Therapy: The West Virginia Board of Occupational Therapy regulates and licenses persons providing occupational therapy services to the general public in the State of West Virginia. The Board's purposes are to protect consumers and promote quality of occupational therapy services, and to assure the highest degree of professional care and conduct on the part of occupational therapist and occupational therapist assistants.
- West Virginia Board of Physical Therapy: The WVBOPT is a state regulatory board created by the WV Legislature to regulate the practice of physical therapy and athletic training in order to protect the public from the unauthorized, unqualified and unregulated practice of physical therapy. The WVBOPT is a part of the Executive Branch of the Government which enforces laws.
- Board Office Modified Work Conditions COVID-19)
- COVID-19 Update 3/24/2020 (telehealth, tehelsupervision, patient informed consent, documentation requirements, PER Homeland Security Guidance)
- West Virginia Registered Nursing Board: The WV RN Board promotes and protects public health, safety, and welfare through the regulation of registered professional nurses, advance practice registered nurses and dialysis technicians. The WV RN Board also oversees the prescriptive authority privileges through collaborative practice agreements.
- COVID-19 Information. Per this summary, the West Virginia RN Board by vote, has suspended some rules to expedite licensure. These rule suspensions are TEMPORARY in nature and all suspended requirements will have to be fulfilled after the emergency order is lifted.
- Bullet Points for Board Voted Suspended Rules On 3/20/2020:
- A Criminal Background Check (CBC) will still be required. However, if the facility where the applicant would go is closed and there isn’t one within a 50 mile radius then the applicant does NOT have to get the CBC. The applicant would have get the CBC as soon as other fingerprinting resources are available or within 30 days of the lifting of the State of Emergency, whichever comes first.
- The temporary permit (TP) is extended for more than 90 days. Therefore, the applicant would be able to have a temporary permit for more than 90 days. This applies to both exam applicants and endorsement applicants.
- Verifications do not have to be requested by applicants through NURSYS. The Board will utilize NURSYS and individual state websites.
- For limited prescriptive authority, the applicant does not have to provide documentation of pharmacotherapy in the clinical practice.
- Reinstatement applicants will not have to provide continuing education.
- Bullet Points from the Governor’s Signed Executive Order on 3/23/2020 (but see Executive Order 12-20 issued 3/26/2020, which rescinded the suspension of certain requirements):
- If a person is licensed in another state as a RN or APRN a WV license is NOT required to practice in WV as long as disciplinary action hasn’t been taken or there is none pending.
- There is no renewal of licenses.
- CRNAs can administer anesthesia without supervision. Suspension Rescinded by Governor 3/26/2020
- APRNs with prescriptive authority do not need a collaborative physician. Suspension Rescinded by Governor 3/26/2020
- No limitation on prescriptive writing privileges for APRNs with prescriptive authority as to prescriptive formulary limitations, prescriptive refill and supply limitations. Suspension Rescinded by Governor 3/26/2020
- Continuing education not required for APRNs. Suspension Rescinded by Governor 3/26/2020
- Disciplinary timelines for hearings are waived and may be conducted by telephone at the discretion of the agency.
- West Virginia State Board of Examiners for Licensed Practical Nurses: The WV LPN Board is a legally constituted agency of State government established by the West Virginia Legislature. The Board promotes and protects the public health, safety and welfare through licensure of practical nurses.
- Notice: The West Virginia LPN Board is instituting policies of social distancing to make our workplace as safe as possible. Staff who are able to perform their duties from home are working remotely. For a quicker response please use the message center in the nurse portal.
- West Virginia Board of Social Work: The purpose of the West Virginia Board of Social Work is to protect the public by setting standards of qualifications, education, training and experience for those seeking licensure in the profession of social work.
- West Virginia State Tax Department: The State Tax Department’s primary mission is to collect and accurately assess taxes due to the State of West Virginia in support of State services and programs.
- Coronavirus 2019 (COVID 19) Response
- 3/25/2020 letter by Senate President Carmichael and House Speaker Hanshaw among other West Virginia Legislators requesting Governor Justice to issue an Executive Order extending the deadline for filing state income tax returns in West Virginia from April 15 to July 15. (via @BradMcElhinny tweet).
- In his press conference held at 3:00 PM, March 25, Governor Jim Justice stated, “I have instructed State Tax Commissioner Dale Steager to extend the West Virginia state tax filing and payment deadline to July 15, 2020, to align with the Federal tax filing deadline.” The Administrative Order will be posted on the State Tax Department’s website at tax.wv.gov by end of day tomorrow, March 26.
West Virginia Hospitals and Health Care Systems Information:
- West Virginia Hospital Association:
- WVU Medicine: COVID-19:
- COVID -19: What you need to know.
- Strategies for Optimizing the Supply of PPE ased on CDC Guidance (version 1, 3/24/2020). This document is based on CDC guidelines on PPE optimization strategies to assist hospitals that need to make decisions about conserving PPE. The document is based on the CDC guidance, but provided in table format and is adapted from work by the New Jersey Hospital Association.
- Charleston Area Medical Center (CAMC):
- Covid resources and reported cases in West Virginia.
Federal Legislation and Information:
- CMS Current Emergencies - 2020 Coronavirus General Information and Guidance
- Families First Coronavirus Response Act (H.R. 6201, Public Law 116-127, March 18,2020).
- Coronavirus Aid, Relief and Economic Security (CARES) Act (H.R. 748, Public Law 116-136, effective March 27, 2020).
- CMS Press Release Trump Administration Providers Finaical Relief for Meciare Providers,3/28/2020. Information on expansion of accelerated and advanced Medicare payment.
- CMS Fact Sheet: Expansion of the Accelerated and Advanced Payments Program for Providers and Suppliers During COVID-19 Emergency
- Palmetto GBA Jurisdiction M Part A Mac Hub Information for Part A Providers in North and South Carolina, Virginia and West Virginia - COVID-19 Accelerated/Advance Payment Request (WV Providers - Part A and B)
- National Law Review article, CARES Act Healthcare Provisions: New and Expanded Tools for the Pandemic Crisis, 3/3/1/2020. Good summary by health care colleague and fellow AHLA member, Bill Horton.
- CMS Press Release 3/30/2020, Trump Administration Makes Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge. This is a summary of the most recent changes on CMS waivers and rule changes with additional links in the press release, including the Coronovirus Waivers & Flexibilties landing page with a lot of CMS information.
- CMS Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (Interim Final Rule with comment period), issued 3/26/2020 and applicable beginning on 3/1/2020. This interim final rule with comment period (IFC) gives individuals and entities that provide services to Medicare beneficiaries needed flexibilities to respond effectively to the serious public health threats posed by the spread of the 2019 Novel Coronavirus (COVID-19). Recognizing the urgency of this situation, and understanding that some pre-existing Medicare payment rules may inhibit innovative uses of technology and capacity that might otherwise be effective in the efforts to mitigate the impact of the pandemic on Medicare beneficiaries and the American public, we are changing Medicare payment rules during the Public Health Emergency (PHE) for the COVID-19 pandemic so that physicians and other practitioners, home health and hospice providers, inpatient rehabilitation facilities, rural health clinics (RHCs), and federally qualified health centers (FQHCs) are allowed broad flexibilities to furnish services using remote communications technology to avoid exposure risks to health care providers, patients, and the community. We are also altering the applicable payment policies to provide specimen collection fees for independent laboratories collecting specimens from beneficiaries who are homebound or inpatients (not in a hospital) for COVID-19 testing. We are also expanding, on an interim basis, the list of destinations for which Medicare covers ambulance transports under Medicare Part B. In addition, we are making programmatic changes to the Medicare Diabetes Prevention Program (MDPP) and the Comprehensive Care for Joint Replacement (CJR) Model in light of the PHE, and program-specific requirements for the Quality Payment Program to avoid inadvertently creating incentives to place cost considerations above patient safety. This IFC will modify the calculation of the 2021 and 2022 Part C and D Star Ratings to address the expected disruption to data collection and measure scores posed by the COVID-19 pandemic and also to avoid inadvertently creating incentives to place cost considerations above patient safety. This rule also amends the Medicaid home health regulations to allow other licensed practitioners to order home health services, for the period of this PHE for the COVID-19 pandemic in accordance with state scope of practice laws. We are also modifying our under arrangements policy during the PHE for the COVID-19 pandemic so that hospitals are allowed broader flexibilities to furnish inpatient services, including routine services outside the hospital.
- KFF Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19. This page aggregates tracking information on approved Medicaid emergency authorities to address the COVID-19 Coronavirus emergency. We currently include details on Section 1135 waivers and 1915 (c) Waiver Appendix K strategies, but will update soon to add additional emergency authorities.
Other Guidance, Resources and Information:
- American Medical Association
- COVID-19 (2019 novel coronavirus) resource center for physicians
- Special coding advice during COVID-19 public health emergency. Practical and simple outline of various COVID billing scenarios for physicians.
- Small Business Administration (SBA) - Disaster Loan Assistance (Federal Disaster Loans for Businesses, Private Non-profits, Homeowners and Renters)