|Statewide Clinician Calls | ASAM Guidance | What to Tell Patients | Telehealth Resources | Resources for Employers
|Emergency Loans, Grants, & Tax Relief | Volunteer Opportunities | Resources for Addiction Specialists|
Last Updated December 23, 2020
The following guidance is drawn primarily from the Centers for Disease Control and Prevention’s (CDC), the American Society of Addiction Medicine (ASAM), the American Medical Association (AMA), the Maryland Department of Health (MDH), and MedChi, The Maryland State Medical Society. Every effort is being made by MDDCSAM staff to keep this guidance up to date, but we recommend always referring to MDH, CDC, and ASAM guidance for the most recent information. Please refer to the resource list at the bottom of this article for reference links.
COVID-19 Vaccine in DC & Maryland
The DC Health Department's vaccine prioritization matrix places health care persoonnel in group 1A. Details are developing rapidly, but there is still some uncertainty in how clinicians will access the vaccine in DC. Hospital-based clinicians began receiving vaccinations the week of December 14, and some independent physicians with privileges have been invited to be vaccinated in this Pfizer batch. In the larger Pfizer/Moderna batch coming prior to December 25, the vaccination list will expand to include healthcare workers in acute care and specialty hospital networks, front-line public health workers, and some FQHC workers. Other physician offices can expect to be in the next round of vaccinations in January when the next batch arrives. Specific details on the amount of vaccine and timing is TBD. For the latest updates on the roll-out, visit: https://www.msdc.org/home/covid-19/covid-vaccine.
The Maryland Health Department's vaccine prioritization pyramid places health care personnel in group 1A. Clinicians who are hospital based or have a relationship with a hospital can get it there. Vaccines at each hospital will be subject to the prioritization matrices developped by each individual hospital, which were created to comply with ACIP, CDC and Maryland Department of Health Guidance. If a clinician is nursing home related, they will be getting the vaccines thru Walgreens and CVS and can work with the nursing home to schedule.
If a clinician is community-based, vaccines will be administer through the county health department. Each county's health department is in a different stage of planning. A list of county health departments and their contact information is available online.
Learn more, and access resources to support future patient vaccine compliance at: www.medchi.org/Your-Resource/Public-Health/Vaccines.
Coordinated by MedChi, The Maryland State Medical Society, these statewide, all-physician calls are hosted by Howard Haft, MD, of the Maryland Department of Health. Join for critical updates on the spread, treatment of, and resources for combating COVID-19. The calls are held on Wednesdays at 5 pm, with interspersed flash briefings on Mondays. To register for upcoming calls or listen to recordings and view past slide decks from these calls, click here.
- Access to Buprenorphine in Office-Based Settings
- Ensuring Access to Care in Opioid Treatment Programs
- Infection Mitigation in Outpatient Settings
- Infection Control and Mitigation Strategies in Residential Treatment Facilities
- Adjusting Drug Testing Protocols
- Supporting Access to Telehealth for Addiction Services: Regulatory Overview and General Practice Considerations
- Promoting Support Group Attendance
- Adjusting Medication Dosage or Formulation
- Guidance for Hospitals
- Treating Pregnant People with OUD
- Criminal Justice System Guidance
- Treating People Who Are Homeless
- Supporting Access to Alcohol Use Disorder and Alcohol Withdrawal Treatment
- & More!
The Maryland Department of Health has created a resource page that is a helpful guide on what to say to patients, as does DC. The CDC has created a handout for medical practice to make available for concerned patients. Click here to download the pdf, or visit the CDC's web page of printable handouts and posters.
ASAM has released this guide to supporting access to telehealth for addiction services, including a regulatory overview and general practice considerations. Maryland Medicaid has expanded coverage of telemedicine services, as has Medicare. CPT has released new billing codes for COVID-19 related care.
From MedChi, The Maryland State Medical Society, and Its Component County Societies
- Medicare Telehealth Coding/Billing Guidelines - March 26, 2020
- Telemedicine FAQ's - Updated March 18, 2020
- On-Demand Webinar: Rapid Implementation of Telehealth
- On-Demand Webinar: Rapid Implementation of Remote Patient Monitoring
- Telemedicine Vendor Options
- Remote Patient Monitoring Vendor Options
- From Our RPM Speaker: Remote Patient Monitoring Implementation Guide
From the American Medical Association (AMA)
- AMA Quick Guide to Telehealth Implementation & COVID-19
- The AMA has created a Digital Health Implementation Playbook that is a thorough guide on the key steps, best practices and resources to help physicians and their practices integrate technology efficiently and effectively.
From the Centers for Medicare & Medicaid Services (CMS)
- General Provider Telehealth and Telemedicine Tool Kit
- FAQs on Telehealth and HIPAA during the COVID-19 nationwide public health emergency
- Medicaid Telehealth Guidance
- Medicaid State Plan Fee-for-Service Payments for Services Delivered Via Telehealth
- Clinician Letter - 4.8.2020
From Private Payors
- Backline Overview: Telehealth Care Coordination in Real-Time
From the Maryland Department of Health (MDH)
- March 26, 2020: Telehealth – Maryland State of Emergency – COVID-19 Frequently Asked Questions
- Notice: RE: COVID-19 #1: Temporary Expansion of Medicaid Regulations to Permit Delivery of Telehealth Services to the Home to Mitigate Possible Spread of Novel Coronavirus (“COVID-19”)
From the Maryland Healthcare Commission (MHCC): Broadening Access to Telehealth During a Public Health Emergency
From the U.S. Department of Health and Human Services (HHS): Notice from the HHS Office for Civil Rights (OCR) on Telehealth
The legal framework surrounding employment law as it relates to COVID-19 continues to evolve. One of MedChi's component county societies held a Q&A session with Paley Rothman, a local Maryland & DC law firm, recently. It is available to stream online: COVID-19 Employment Law Q&A. For frequently asked questions, please refer to the end of this slide deck.
- Template: MedChi Transportation and Child Care Essential Employee Letter (Fillable Document)
- Order of the Governor of the State Maryland - No. 20-03-25-01 Amending and Restating the Order of March 13, 2020, Controlling Child Care Access
- The Families First Coronavirus Response Act (FFCRA or Act) One pager from Department of Labor - The Families First Coronavirus Response Act (FFCRA or Act) requires certain employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to COVID-19. These provisions will apply from April 1, 2020 through December 31, 2020
HHS Medicaid/CHIP Provider Relief Fund: Payment Forms and Guidance
HHS expects to distribute $15 billion to eligible Medicaid/CHIP programs or Medicaid managed care plans. The payment to each provider will be at least 2 percent of reported gross revenue from patient care; the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve. The data submission period has been extended. Physicians must now submit their data by August 3, 2020. Before applying through the Enhanced Provider Relief Fund Payment Portal applicants should:
- Read the Medicaid Provider Distribution Instructions
- Download the Medicaid Provider Distribution Application Form
Telehealth Grant Funds
- The medical practice and medical license are in Maryland
- The medical practice is a private, independent group of five or fewer physicians
- The practice enrolls in Backline after March 1, 2020 as the result of the COVID-19 crisis
- MedChi has confirmed the practice’s enrollment with DrFirst
- Enrollment in Backline occurs before December 31, 2020
- Although some physicians will automatically be sent an advance payment based off the revenue data they submit in CMS cost reports, those physicians without adequate cost report data on file will need to submit their revenue information to the General Distribution Portal. (If you are unsure if you need to complete the portal, call the CARES Provider Relief line at 1-866-569-3522.)
- This portal should be accessed and completed by anyone who lost revenue in March and/or can estimate lost revenue for April. You will need you Tax Identification Number (TIN) to access the portal.
These resources can help you navigate the portal:
- The American Medical Association (AMA) has developed guidance on the fund portal.
- This fact sheet on the general distribution might be helpful as well.
- This slideshow can guide you through the process.
You should also be aware that a portion of the Provider Relief Fund will be used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured.
Each practice should consult their tax attorney and or accountant when deciding on an option.
Please note: The Paycheck Protection Program has hit its cap and no new loans will be issued until more money is appropriated for it by Congress.
Contact your lender to determine if they are an SBA-approved lender. Loans will not be issued by financial institutions that borrowers do not have an existing relationship with. The application is online however some large financial institutions have indicated that they are not ready to issue these loans yet. Lenders may also require additional information or a separate application. Please contact your lender ahead of time to determine if they are prepared to issue loans.
- Washington Post FAQ on Paycheck Protection Loan Program
- List of banks and lenders participating in the SBA's Paycheck Protection Program (PPP) small business loans
- PPP Loan Calculator
The SBA’s Economic Injury Disaster Loan Program provides loans to qualified entities that are impacted by the Coronavirus (COVID-19). The estimated time for completing this entire application is two hours and ten minutes, although you may not need to complete all parts.
This loan advance will provide up to $10,000 of economic relief to businesses that are currently experiencing temporary difficulties.
This loan enables small businesses who currently have a business relationship with an SBA Express Lender to access up to $25,000 quickly.
The SBA is also providing a financial reprieve to small businesses with existing loans during the COVID-19 pandemic.
Business Relief Frequently Asked Questions
What banks are issuing PPP loans? Fortune Magazine has a rolling list available on their website. You must register with their website, but access is free. List of banks and lenders participating in the SBA's Paycheck Protection Program (PPP) small business loans and PPP Loan Calculator.
Can I apply for a PPP loan if I have laid off or furloughed employees?
SBA will forgive loans if all employees are kept on the payroll for eight weeks and the money is used for payroll, rent, mortgage interest, or utilities. The eight-week period begins on the date the lender makes the first disbursement of the PPP loan to the borrower. The lender must make the first
disbursement of the loan no later than ten calendar days from the date of loan approval.
What about the additional unemployment compensation from the federal government? The Federal Pandemic Unemployment Compensation (FUPC) program which provides the additional money is being administered through the Maryland state unemployment program. If your employees qualify and begin receiving unemployment through the state, they will automatically see the increase from the Federal program once it is disbursed to the state. The best website for applying for unemployment is Maryland's Unemployment Insurance Bureau.
Can I apply for both state and county/federal loans or funding programs? If you have applied for state assistance, you will not be disqualified if you apply for other assistance through federal or local means. Though please be advised, if you have already applied for federal assistance, you should verify federal program eligibility terms through the U.S. Small Business Administration. (FAQ - COVID-19 LOAN & GRANT)
Maryland business and individual income taxpayers will be given a 90-day extension for tax payments. No interest or penalty for late payments will be imposed if 2019 tax payments are made by July 15, 2020. See 90-day extension for tax payments for more information. The federal tax filing deadline has been moved to July 15. Learn more
The Maryland Responds Medical Reserve Corps are seeking volunteers to staff clinics and field hospitals. To register for Maryland Responds, please visit the Medical Reserve Corps here. If you are a DC member, now is the time to join the DC Medical Reserve Corps if you have the time and ability - join today.
For the A-Z resource guide, and additional information on how to help - including Red Cross blood donations, Meals on Wheels, and other ways - visit Maryland Unites.
OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency. Learn more.
Information on Maryland's emergency COVID-19 regulations, including requirements to waive copayments and deductibles. Maryland Medicaid has expanded coverage of telemedicine services, as has Medicare. CPT has released new billing codes for COVID-19 related care.
From the Centers for Disease Control and Prevention
- Resource Center for Health Care Professionals
- Situation Summary
- Latest HAN Update Summary
- Factsheets, Handouts, and Posters
- MDH Coronavirus Clinician Letter -- 3.26.20
- COVID-19 - Surgical Procedures Guidelines
- MDH Directive Regarding Availability of Testing -- 3.20.20
- Maryland Emergency COVID-19 Regulations
- DC Health Notices
- DC COVID-19 Specimen Submission Guidelines
- DC Emergency Child Care Initiative for Health Care Professionals
- Maryland Department of Health's (MDH) web page for the latest updates on the virus
- DC Health's web page for health care professionals
- MedChi, The Maryland State Medical Society's resource page
- Medical Society of DC's resource page
- AMA's COVID-19 Resource Center
- For an up-to-date incidence map, see the Johns Hopkins School of Public Health GIS map.
No-Cost Continuing Medical Education
- Addiction Focused COVID-19 Education: ASAM has developed this on-demand webinar "Caring for Patients During the COVID-19 Pandemic." It is available at no-cost and is one hour in duration.
- General COVID-19 Education: MedChi developed a webcourse in partnership with Rockpointe and the Maryland Nurses Association to prepare healthcare providers who work in an ambulatory-care setting to properly manage patients who present to their outpatient facility with symptoms of COVID-19. This no-cost 1.5-hour webcourse will be available on-demand for the next 12 months.
Non-Office Based COVID-19 Testing Locations: The Maryland Department of Health is maintaining a list of non-office based testing locations updated on a rolling basis. View the list of locations. MSDC has a web page with rolling testing updates.