Paycheck Protection Program (PPP)

Paycheck Protection Program (PPP)

COVID-19 Week in Review

COVID-19 Week in Review

Week of May 22, 2020

Ototoxicity of FDA-Approved Drugs Being Re-Purposed for COVID-19 Treatment

According to the National Institutes of Health’s Center National Center for Advancing Translational Sciences, many drugs approved for other uses already have been tested in humans, so detailed information is available on their pharmacology, formulation, and potential toxicity. 

New Resources

CDC Releases Detailed Guidelines for Re-Opening Businesses

Vestibular Testing Safety: COVID-19 and Beyond

Surgical Monitoring Safety: COVID-19 and Beyond

Booth Safety: COVID-19 and Beyond

Our Essential Role in Communication: Resources That Can Help

Advocacy Updates

Senator Warren and Representative Rice Lead Bipartisan Letter to House and Senate Leadership Urging Inclusion of Medicare Audiologist Access and Services Act in Upcoming COVID-19 Packages

New Executive Order Directs Federal Agencies to Recommend COVID-19 Regulatory Waivers That Should Be Made Permanent


Previous Updates

Week of May 15, 2020

Our Essential Role in Communication: Resources That Can Help

With May as Better Hearing Month, this is an important time to continue to highlight our essential role in communication and hearing health care. With this in mind, we have developed informational pieces and resources you can use with your patients and/or share with your communities, colleagues, and other health-care providers as you see fit.

Best Practices Guidelines for Safely Conducting Hearing Testing During the COVID-19 Pandemic

This best practices document offers guidelines that are applicable to busy hearing conservation practices that use multiple test stations within an audiometric booth, as well as those using single-person booths. The document was prepared by NHCA, with participation of the Council for Accreditation in Occupational Hearing Conservation and several knowledgeable occupational medicine specialists, to minimize the risk of SARS CoV-2 infection through person-to-person spread within occupational health clinics, company in-house testing, and mobile test environments.

New Resources

New Resource Compiles Results of Recent Patient and Provider Telehealth Surveys 

The Alliance for Connected Care has created a resource that compiles the results of seven recent surveys of patients, providers, and consumers on their experiences with and perceptions of telehealth. 

Interactive Map Provides Information on COVID-19-Related State Legislation 

The National Conference of State Legislatures (NCSL) has created a resource that compiles all of the COVID-19-related legislation introduced to date. At least 38 states, the District of Columbia, Guam, and Puerto Rico have introduced legislation to support state action related to COVID-19. Several resolutions adjourn legislative sessions or adopt temporary rules to allow governing bodies to meet or vote electronically. 

CMS Provides Comprehensive COVID-19 Toolkit for Providers and Patients 

CMS has created a comprehensive COVID-19 toolkit for providers and patients. This online resource provides one-stop access to all of the materials that HHS/CMS has created on the topic to date.

Take Action

Encourage Your Elected Officials to Support Inclusion of Medicare Audiology Provisions in Future COVID-19 Legislation
On March 30, CMS announced that it would allow certain allied health-care care services to be paid for as Medicare telehealth services. However, audiologists and audiology services were not included in this list.

Email your representatives today on the Academy's Legislative Action Center.

Week of May 8, 2020

Re-Opening in a Post-COVID World

Re-opening your audiology practice after the COVID-19 pandemic can be both exciting and stressful for you and your patients. Being able to offer audiological services in a safe manner will be a step in the right direction to achieving our “new normal,” will reinstate some form of revenue for your practice, and most importantly, will bring much-needed service back to your patients who rely on their hearing to stay in touch with their family and friends, now more than ever.

Audiological Management of COVID-19 Survivors Treated with Hydroxychloroquine and Azithromycin

Audiologists have known about the ototoxicity of quinine (and its derivatives) and antibiotics (macrolide and aminoglycoside) for decades. But we have never seen the combined use of two drugs, each with known ototoxic potential, being used as an intervention strategy for the coronavirus pandemic (COVID-19).

Telehealth Information

National Governors Association Memo to Governors: “Strategies for Telehealth”

To date, all 50 states have taken action to increase access to services via telehealth. This memo to all state governors highlights some of the innovative approaches that have been employed including eliminating cost sharing requirements for telehealth services, waiving professional licensure requirements and mandating payment parity for services delivered via telehealth. 

Introduced Federal Legislation: COVID-19 Telehealth Bills

The Alliance for Connected Care has compiled a list of federal telehealth legislation that has been introduced to date in response to the COVID-19 crisis. 

Articles and Items of Interest

New Resources

FEMA Factsheet on PPE Preservation Best Practices

This guidance summarizes best practices for national implementation to sustain PPE while protecting workers during the pandemic response.  This fact sheet also amplifies CDC strategy on conventional, contingency and crisis capacity strategy for optimizing PPE. 

Obtaining PPE from Amazon: Latest News and Update

The Academy has heard from a number of members who have reported that Amazon Business does not recognize them as health-care providers for the purposes of purchasing supplies in bulk. The Academy spoke with an Amazon representative who indicated that the types of health-care providers recognized for the purposes of an Amazon business account in general varies from state to state and is based on state regulations. However, during the COVID-19 crisis, health-care practitioners in receipt of any valid state issued health-care license are eligible to purchase personal protective equipment (PPE). On the Amazon Business website, select the “COVID-19 Supplies on Amazon Business” tab. That will then take you through the process to set up a free Amazon business account and will request the individual’s NPI number.

MultiState COVID-19 State Reopening Guide

States have shifted the focus of their COVID-19 response from managing the public health crisis to the economic recovery phase. States have started allowing certain businesses to open, and most have announced plans for a phased reopening of the economy. Since each state’s degree of “openness” is determined by many factors, and because each state handled pandemic response differently, MultiState has developed a guide to condense these factors into one easy-to-understand “openness score” that allows you to compare states to one another. 

Week of May 1, 2020

President's Message: COVID-19—Planning for In-Person Care

Our goal is targeted, safe reintroduction of in-person care. None of us have any experience with this, none of us have had to shut down in a matter of days and then figure out how to re-open gradually. We have to stay in business, and we have to do it in a world that presents challenges that none of us have ever faced.

CMS Expands List of Medicare Eligible Telehealth Providers to Include Audiologists

On April 30, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an interim final regulation that states that, all professionals who are able to bill Medicare for their professional services will be considered eligible telehealth providers for the duration of the COVID-19 public health emergency. Though not named specifically in the CMS Fact Sheet or Press Release, it is our interpretation of the regulation that audiologists are considered eligible providers of telehealth services.


Telehealth Education and Information

Tele-audiology in a Pandemic and Beyond: Flexibility and Suitability in Audiology Practice ( Audiology Today, Jul/Aug 2020 Pre-Press)

Professional Liability and Tele-audiology Services ( Hearing Review, April 23, 2020)


New Resources

COVID-19: Moving Toward Full Audiology Services

Next COVID-19 Relief Package Likely to Provide Relief for States and Localities

Large Company CEOs Advocate for Consistent Guidelines for Returning to Work

Treasury Department Releases Updated FAQ (4-29) for Paycheck Protection Program 

COVID-19: Considerations for Treatment Using Quinine Derivatives and Other Ototoxic Compounds

Hydroxychloroquine was recently approved by the U.S. Food and Drug Administration (FDA) for emergency use to treat adults and adolescents with COVID-19.

Research supporting use of these agents for treatment of COVID-19 is currently limited to a few small samples with contradictory findings. In addition, optimal dosing strategies remain unknown. The FDA has released a fact sheet to help understand the findings. 

Chloroquine and hydroxychloroquine are synthetic derivatives of quinine. Quinine and its derivatives have a long history as anti-malarial and for treatment of autoimmune disorders such as lupus and rheumatoid arthritis. Review the historical commentary.

Read more…


New Resources

Administration Launches New Toolkit to Help States Navigate COVID-19 Health Workforce Challenges  

The Centers for Medicare and Medicaid Services (CMS) and the Assistant Secretary of Preparedness and Response (ASPR) released a new toolkit to help state and local healthcare decision makers maximize workforce flexibilities when confronting 2019 Novel Coronavirus (COVID-19) in their communities.  

Academy Requests Congress Suspend Expected Medicare Cuts Associated with Increase in E/M Code Reimbursement 

The Academy along with multiple physician and allied health groups signed on to a letter to congressional leaders requesting that they take action to suspend expected cuts to Medicare reimbursement in 2021. 

Paycheck Protection Program (PPP) To Receive An Additional Influx of Cash


Telehealth Education and Information

New HHS Website on Telehealth for Providers and Patients

Free Access
eAudiology Webinar: Supporting Patients at a Distance—Telehealth Now and in the Future (0.1 CEUs/Tier 1) 
May 1, 3:00 pm ET

Free Access
Seminars in Hearing Humanitarian Issue (May 2020)

Seminars in Hearing Article: eHealth Technologies Enable more Accessible Hearing Care (April 2020)

Week of April 17, 2020

eAudiology Telehealth Webinar—Register Today

Supporting Patients at a Distance: Telehealth Now and in the Future
May 1, 3:00 pm ET

The COVID-19 health-care crisis has intensified interest in the provision of audiology services via telehealth. State licensing boards, Medicaid programs, private payers, and Medicare have varying approaches to the telehealth and this webinar will provide an overview of these settings. Learn more about the Academy’s efforts to secure inclusion of audiologists in telehealth provisions under Medicare, an outline of the Academy Coding and Reimbursement Committee’s guidance on telehealth and reimbursement options, and member experiences in transitioning audiology practices to telehealth.  


COVID-19-Related State Executive Orders/Telehealth
The Council of State Governments has created a resource that provides access to all state executive orders issued to date on a wide range of topics. You can search this document by state to or by classification/subject area. Of particular note, under the classification tab, you may scroll down and access all of the state telehealth-related executive orders issued to date. 

Guidance for Businesses from Each State Chamber of Commerce
Many state chambers of commerce have created webpages dedicated to the COVID-19 impact and response and specific guidance for in-state businesses. The Council of State Chambers of Commerce has compiled links to all of the dedicated COVID-19 webpages from each of the individual state chambers of commerce. 


Take Action

Encourage Your Elected Officials to Support Inclusion of Medicare Audiology Provisions in Future COVID-19 Legislation
On March 30, CMS announced that it would allow certain allied health-care care services to be paid for as Medicare telehealth services. However, audiologists and audiology services were not included in this list.

Email your representatives today on the Academy's Legislative Action Center.

Week of April 10, 2020

Encourage Your Legislator to Support Inclusion of Medicare Audiology Provisions in Future COVID-19 Legislation

Congress is now working on crafting another COVID-19 relief package to follow up on the CARES Act passed last week. Congress and the Administration have taken many steps to expand the health-care workforce and remove barriers to providing services via telehealth.

However, to date, the current barriers in Medicare regarding access to audiologists and the provision of services via telehealth have not been addressed.

Please visit the Academy Legislative Action Center to access a template letter to contact your legislators about this critical issue.


The CARES Act Provider Relief Fund Begins Disbursements


Today, April 10, the Department of Health and Human Services (HHS) began distributing the initial $30 billion in COVID-19 relief funding to providers as part of the distribution of the $100 billion fund provided as part of the CARES Act.
 
This initial distribution of funds will go to hospitals and providers currently enrolled in Medicare and take effect immediately. Facilities and providers are allotted a portion of the $30 billion based on their share of 2019 Medicare fee-for-service (FFS) reimbursements. Therefore, those facilities and providers that billed significant amounts of Medicare FFS in 2019 are the priority in this first phase.
 
These are payments, not loans, and will not need to be repaid. Fund recipients will be prohibited from balancing billing COVID-19 patients for related services. Additional details from HHS can be found here.
 
A second phase of targeted distributions to providers is expected to follow soon and will focus on providers in areas particularly impacted by the COVID-19 outbreak, rural providers, and providers of services with lower shares of Medicare FFS reimbursement or who predominantly serve the Medicaid population.


Academy Speaks Directly with CMS Staff Regarding Medicare Audiology Services and Telehealth

On April 8, Academy staff participated in a CMS Special Open Door Forum to address CMS’ actions to increase access to telehealth in Medicare during the COVID-19 public health emergency. CMS gave an update on their actions to date and then took a limited amount of questions from the call participants. The Academy was able to pose the following question directly to CMS staff:

"To date, CMS has removed many existing barriers to the provision of services via telehealth to Medicare beneficiaries but not all. Specifically, the Agency has not yet removed the restriction on the provision of audiology services via telehealth. Given the fact that untreated hearing loss is an isolating factor in and of itself—which is compounded by the lockdowns in many senior living facilities,—will the Agency consider taking action to allow audiology services to be provided via telehealth?”

CMS staff responded that they are taking a broad look at using their waiver authority to further expand Medicare beneficiary access to needed services. CMS requested that the Academy provide follow-up information on the types of audiology services that could be provided via telehealth. Academy staff indicated that they would follow up via e-mail and also pointed out that the Veterans Administration has been providing tele-audiology services for quite some time.  


Academy and AAA Foundation Boards: We Are Here for You…We Hear You

The Boards of the American Academy of Audiology and the American Academy of Audiology Foundation recognize that our membership is dealing with myriad challenges as a result of the coronavirus.

We know that audiologists across the country are doing their best to serve their patients, support their families, and follow state and federal recommendations to “flatten the curve”…and they may be feeling worried, anxious, or uncertain. Watch the video message.


Resources

  • The Center for Connected Health Policy has created a resource that provides links to all state-related actions on telehealth that have been issued in response to the COVID-19 crisis. Information is provided on Executive Orders, changes to Medicaid/Medicaid managed care, specific legislation passed, and any guidance given by the state to private health plans.
  • The U.S. Senate Committee on Small Business and Entrepreneurship has created a helpful guide for small businesses outlining the various loan options available to them at this time, including associated tax consequences as well as contact information for small businesses to seek advice. 
  • States and localities continue to take additional measures to limit the spread of COVID-19, including requiring residents to  stay home and for non-essential businesses to close physical locations and require 100 percent of their workforce to telecommute. What businesses, then, are considered “essential”? This differs depending on state or locality. View the resource created by Multistate Associates.

COVID-19 Updates—Week of April 3, 2020

Academy Telehealth Update and Guide

Audiologists are beginning to employ creative solutions to assist their patients while mitigating the risk of further transmission of the virus.

Some former face-to-face visits are now being handled via telephone, video, and/or remote connection to hearing aid devices. Many audiologists are wondering if these remote services can be billed and reimbursed. This guide will help you understand options that are available to audiologists at the present time.

Treasury Department Releases Application Form and Fact Sheet for Forgivable Small Businesses Loans

Small businesses and sole proprietorships can apply starting on April, 3, 2020. The application form can be found here.  

For more details about the program, access the accompanying fact sheet from the Treasury Department.

 

Advocacy Updates

Statements from Academy Leadership

CEU-Eligible Online Education

The Academy is committed to ensuring audiologists have access to virtual CEU-eligible educational resources during this challenging time. 

On-demand seminars and live webinars are now available on eAudiology.org, and live webinars are scheduled throughout April. New webinars will be added each month. 

Brought to you by the AAA Foundation’s Educational Fund. Thank you to those who donated their AAA 2020 + HearTECH Expo Conference refunds toward this educational fund.

Treasury Department Releases Application Form and Fact Sheet for Forgivable Small Businesses Loans

The newly enacted Paycheck Protection Program included in the most recent COVID-19 relief package authorizes $349 billion in forgivable loans to small businesses to cover payroll, rent/mortgage and utilities.

President Signs “The Coronavirus Aid, Relief, and Economic Security Act” that Includes Small Business Assistance (CARES)

The recently enacted “CARES” Act includes the “Paycheck Protection Program” (PPP) for small businesses. The PPP is designed to provide short-term cash flow assistance to small businesses to help these businesses and their employees deal with the economic impact of the COVID-19 crisis. 

COVID-19 Resources

COVID-19 Resources

Ototoxicity of FDA-Approved Drugs Being Re-Purposed for COVID-19 Treatment

According to the National Institutes of Health’s Center National Center for Advancing Translational Sciences, many drugs approved for other uses already have been tested in humans, so detailed information is available on their pharmacology, formulation, and potential toxicity. 

Vestibular Testing Safety: COVID-19 and Beyond

Vestibular testing poses a unique set of safety challenges.

COVID-19 Return to Work Guidance and Recommendations for Vestibular Clinicians

As states begin issuing progressive deconfinement guidelines, hospitals and institutions are starting to reopen for elective procedures and consultations. Vestibular clinicians are opening their practices to evaluate, test or treat patients with dizziness and balance problems. 

Surgical Monitoring Safety: COVID-19 and Beyond

Specific to the neurotological surgical environment, the audiologist should consider a number of precautions.

Booth Safety: COVID-19 and Beyond

With these safety precautions in place, workplace surfaces need to be cleaned thoroughly between patient encounters. Specific to audiologists, we must consider safety related to the test booth environment.

Our Essential Role in Communication: Resources That Can Help

With May as Better Hearing Month, this is an important time to continue to highlight our essential role in communication and hearing health care. 

With this in mind, we have developed information pieces and resources you can use with your patients and/or share with your communities, colleagues, and other health-care providers as you see fit. 

 

COVID-19 Week in Review

See a recap of this week's news and resources. A new Academy update will be posted each Friday.


Practice Management Resources


Telehealth Resources

Telehealth and Medicare/Medicaid

Below is a resource list with information on the provision of telehealth services. The Academy will post additional information as it comes available.

Toolkits and Resource Centers


Treatment and Management Considerations


Government Resources


Public Awareness and Educational Resources


Communication Access Resources 


Free CEU-Eligible Online Education

The Academy is committed to ensuring audiologists have access to virtual educational resources during this challenging time. 

On-demand telehealth seminars are now available on eAudiology.org, and live webinars are scheduled throughout July. New webinars will be added each month. Please check the schedule of upcoming webinars to see the full list of offerings. Note: Content is free up to 30 days after live event and for live events only through July 31.

Brought to you by the AAA Foundation’s Educational Fund. Thank you to those who donated their AAA 2020 + HearTECH Expo Conference refunds toward this educational fund.


Mental Health


Resources for Students