Reps. Patrick Kennedy (D-Mass.), Fred Upton (R-Mich.) and Lisa Blunt Rochester (D-Al.) are sponsoring the Modernized Medicine Act of 2020 to temporarily increase rates for telemedicine for states that expand such services. The trio said in an April 17 statement that the legislation would boost the Federal Medicaid Assistance Percentage (FMAP) to the states, taking the financial pressure off state coffers and limit the exposure by patients and health care professionals to the COVID-19 pandemic. Kennedy said the increase in the FMAP borne by the federal government would “ensure providers can bring innovative care directly into their patients’ homes in times of crisis.”
The U.S. Centers for Medicare and Medicaid Services said in an April 19 bulletin that while it has recommended limited non-essential medical care, there are some areas in the U.S. that have experienced relatively low rates of exposure. Consequently, “it is important to be flexible and allow facilities to provide care for patients needing non-emergent, non-COVID-19 health care,” the agency said, citing the Trump administration’s phased plan for reopening the nation. The CMS said maximum use of “all telehealth modalities is strongly encouraged,” but that non-COVID care should be resumed with input from state and local authorities. Among the considerations involved are the adequate stocking of supplies and personal protective equipment.
The U.S. FDA said that health care professionals in the U.S. should continue to use serological tests to identify those who have been exposed to the SARS-CoV-2 virus and those who have recovered from COVID-19, but advised that such tests should not be the sole basis for diagnosing the disease. The agency said not all marketed serological tests have been evaluated by the agency – the FDA policy includes a period of 15 business days between test validation and notification of the FDA regarding distribution and usage – and referred to the April 14 announcement by the National Cancer Institute of a joint FDA/NIH/CDC effort to validate serological tests.
The FDA posted an update to its FAQs for swabs and viral transport media with the notice that non-nasopharyngeal specimens are acceptable substitutes when a nasopharyngeal specimen is unavailable. Among these are specimens collected from sites such as the oropharynx and the anterior nares, and the agency confirmed that it is acceptable to obtain samples from multiple sites from a given swab. A sample of sputum is deemed acceptable from patients with a productive cough. Sample self-collection is still not recommended, but the FDA said non-flocked swabs may be acceptable.