Combating the Novel Coronavirus (COVID-19): Week of March 1

MHA Covid-19 update

MHA Coronavirus UpdateState data through March 4 indicated that Michigan has received more than 3 million doses of COVID-19 vaccine and administered more than 2.5 million vaccinations, marking a significant improvement in protection against the coronavirus in the state. However, nearly 1,300 new cases and 56 deaths were recorded March 6. The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Johnson & Johnson Vaccine Authorized for Emergency Use, Provider Materials Available

The Johnson & Johnson (Janssen) single-dose COVID-19 vaccine has received emergency use authorization from the U.S. Food & Drug Administration (FDA) and the Centers for Disease Control & Prevention (CDC) Advisory Committee on Immunization Practices for people aged 18 and older. The MHA issued a media statement on the official launch of a third safe and effective COVID-19 vaccine into circulation in the U.S. Johnson & Johnson (J&J) told the media it intends to deliver 20 million doses of the vaccine to Americans during March and 100 million doses by June.

Michigan received 82,700 doses of the single dose vaccine upon its approval. J&J immediately shipped all available doses and now needs to resume manufacturing; therefore, no new J&J vaccine will be available until the week of March 22. Updates on allocations will be available as that date approaches. A limited number of hospitals received J&J doses and have been advised to use them to pilot an effort to vaccinate patients being discharged from an inpatient or emergency department setting.

The Michigan Department of Health and Human Services (MDHHS) has posted new materials for providers that will be administering the J&J/Janssen vaccine on its Provider Education and Resources webpage, which includes important information on all three currently authorized vaccines. The MHA has also updated its vaccine toolkit, including communications tools, to reflect the addition of the J&J vaccine.

The MHA is aware of ongoing misinformation regarding both the effectiveness of this vaccine and how it was developed (as it relates to use of fetal tissue). Members are encouraged to join the MHA in countering misleading information on their communication channels whenever possible, using appropriate background information and talking points.

Members with vaccine questions may contact Ruthanne Sudderth at the MHA.

State Expands Eligibility for Vaccination to 50 and Older, Other Special Populations

The MDHHS announced March 3 that new groups would soon be eligible for the COVID-19 vaccine. Adults age 50 and older with underlying medical conditions or disabilities, as well as anyone 16 and older who cares for a child with special health needs, will be eligible starting March 8. Any adult age 50 and older will be eligible, regardless of health status, starting March 22. The MHA issued a media statement in support of the expanded eligibility.

Providers or regions that are not yet prepared to open eligibility to these groups are not required to do so, as many vaccination sites still have waiting lists of adults 65 and older. The expanded eligibility simply allows those who see declining numbers of previously eligible individuals to maintain their vaccination rates. The announcement follows the state’s long-held strategy to implement eligibility groups in overlapping waves to ensure vaccination rates remain as high as possible.

The state’s COVID-19 vaccine prioritization guidance has been updated to reflect the expansion. It outlines the eligible groups and timeframes, as well as the state’s goals in following this strategy.

Members with questions on vaccine eligibility should contact Ruthanne Sudderth at the MHA.

COVID-19 Relief Packages Pass U.S. House and Senate

The U.S. House of Representatives voted Feb. 27, largely along party lines, to approve a modified version of the American Rescue Plan Act of 2021, legislation to provide for a roughly $1.9 trillion COVID-19 relief package that includes a number of provisions that affect hospitals and health systems. The House bill included expanded subsidies for certain forms of healthcare coverage and provisions to bolster the nation’s COVID-19 healthcare response with additional resources for vaccines, treatment, personal protective equipment, testing, contact tracing and workforce development. Other healthcare-related provisions would provide funding to the Department of Labor for worker protection activities.

The Senate took up the legislation March 5 and passed, on a party-line vote, its own COVID-19 reconciliation bill the next day. The Senate retained the House’s provisions that affect healthcare, added $8.5 billion for rural health, and enhanced Medicaid funding and financial support for state and local government that will assist Michigan, including its efforts to protect against healthcare cuts. However, the Senate did not incorporate continued suspension of the sequester reduction to hospital Medicare payments or funding for loan forgiveness for Medicare accelerated payments to hospitals. Major changes in the Senate legislation affected an increase to the federal minimum wage, the income level cap for those receiving the $1,400 stimulus checks, and details surrounding expanded unemployment benefits.

The Senate version of the legislation will now return to the House for further deliberation and a vote. The House is expected to pass the bill and send it to President Joe Biden for signature before the expanded unemployment benefits that are currently in place expire March 14.

The MHA will soon contact members with more detail on this legislation and what it means for Michigan providers. Members with questions may contact Laura Appel at the MHA.

State Legislature Approves Federal COVID-19 Funds

The Michigan Legislature March 3 approved a supplemental spending bill that included $2.3 billion for COVID-19-related response activities. The bulk of healthcare-related funding reflects federal money that was sent to the state in December but had not yet been approved by the state Legislature.

The legislation includes $207 million for COVID-19 epidemiology and laboratories, $110 million for immunizations, and $150 million to increase direct care worker wages by $2.25 per hour through September 2021. It has been sent to Gov. Gretchen Whitmer for final approval.

An additional $347 million for COVID-19 epidemiology and laboratories was also included in the bill but is specifically tied to provisions that would eliminate the authority of the MDHHS director to issue pandemic-related orders and is expected to be vetoed. Members with questions may contact Adam Carlson at the MHA.

Remdesivir Add-on Payment to Hospitals Established

The MDHHS released a policy March 4 to establish an add-on payment to reimburse hospitals for remdesivir treatment costs for Medicaid COVID-19 patients discharged between Jan. 1 and Sept. 30, 2021. The MDHHS will reimburse hospitals up to $3,100 per five-day treatment.

The MDHHS will make these payments on a quarterly basis for both Medicaid fee-for-service and managed care patients. Implementation of this policy is pending approval by the Centers for Medicare & Medicaid Services. Members with questions may contact Vickie Kunz at the MHA.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).