In an effort to answer some of the most common questions coming in through Ask IDF, we thought that we would publically address some of the most common below.
I am on leave from my job due to the COVID-19 pandemic, and I am not sure if I will lose my job. Because of this, I am dealing with financial challenges as well as healthcare coverage. What assistance is available?
The Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act both provide relief to families and businesses impacted by the COVID-19. Every individual’s case is different but the FFCRA extends the Department of Labor’s employer requirements for paid sick leave and paid family medical leave. The Cares Act provides support to small businesses and to individuals. Support includes providing $1,200 to Americans making $75,000 or less ($150,000 in the case of joint returns and $112,500 for head of household) and $500 for each child, to be paid “as rapidly as possible.” It also expands eligibility for unemployment insurance including for self-employed, contractors, and furloughed workers and provides people with an additional $600 per week on top of the unemployment amount determined by each state. You must apply for unemployment insurance through your state agency.
I have been working remotely since mid-March. Everyone at the company is currently remote due to the pandemic. However, my supervisor/boss has given me a hard time and said that I need to send him weekly updated letters from my doctor to explain my disease and why I need to be working from home. He even called my doctor directly for information! Is this allowed? What are my rights?
First, you need to talk to your Human Resources (HR) Department. While they may be allowing everyone to work remotely now, there may be a need for you to have an extended period of time working remotely. You can request an accommodation under the ADA. Ask your HR department for the ADA packet so your doctor can fill out the paperwork and request the accommodation for you to work remotely until your physician releases you to return to the office. Under the ADA, your employer is required to make any reasonable accommodation for you as long as the accommodation request does not cause an undue hardship on the company.
Second, there is a section of the Health Information Portability and Accountability Act (HIPAA) known as the Privacy Rule that governs the type of information that an employee's doctors may provide to an employer. While the law does not restrict an employer from asking a healthcare provider for information, providers who release information without employee authorization will be in violation of HIPAA. Instead of asking for information from your doctor, it would have been best for your supervisor/boss to direct you to your HR department. If you file for accommodation through ADA, then you are disclosing your disability and allowing your doctor to release the information for your request.
I have CVID and I am a nurse who works in direct patient care. My doctor wants me to quarantine at home but my employer said I have to work or I will lose my job. What are my rights?
The Families First Coronavirus Response Act (FFCRA) provides relief and protections to many, but it does not cover everyone. If your employer has over 500 employees then the rules do not apply and employers of healthcare providers or emergency responders may elect to exclude these employees from eligibility for the leave provided under the Act.
It is up to you and your physician to determine what is needed for you at this time. If you must continue to work, there may be accommodations or requests for PPE that you can get through the American Disability Act (ADA).
I have been laid off and I am unable to afford the COBRA premiums. What can I do to make sure I can stay on my Ig replacement therapy?
If you are unable to stay on your current health plan through COBRA then you can shop for a health plan through your state’s marketplace. Losing your job and your insurance plan is a Qualifying Life Event (QLE) that makes you eligible for a Special Enrollment Period. This allows you to enroll in health insurance outside of the normal yearly Open Enrollment Period. You can go to Healthcare.gov to look at plans and enroll.
You should also reach out to the manufacturer of the Ig product you are using to see if they have any patient assistance programs that will help you to remain on your treatment. Visit IDF’s Patient Insurance Center for resources and contact information on Manufacturer’s Patient Assistance programs.
My hospital infusion center is closing and they are arranging to move me to IVIG treatments at home. I was concerned about going to the infusion center and being exposed to COVID-19 but having a nurse coming into my home doesn’t ease my worries either. Is this safe? How do I know the nurse they send to my home has not been exposed to the virus?
We understand your concerns, however, the home infusion providers are taking extra precautions to ensure that they follow strict screening and protocols to avoid spreading the virus. The National Home Infusion Association has issued and disseminated COVID-19 specific recommendations for providing home infusion services, sterile compounding guidance and a patient screening tool for the home and specialty infusion industry to provide safe services during this outbreak. If these protocols are followed, your risks of being exposed to the COVID-19 will be greatly reduced. When you schedule your appointment, make sure to ask your provider about the protocols that they follow.
I am on Medicare and receive IVIG infusions at a facility, what are my options to receive infusions at home?
Fortunately, most beneficiaries with PI who rely on IVIG have access to home infusions through enrollment in the Medicare IVIG Demonstration. This benefit is ending on December 31; IDF is strongly advocating to continue this beyond 2020. You may now also qualify to receive infusions through the home health services benefit for homebound individuals, which has been expanded during this public health emergency to include people who medically need to stay in their homes due to COVID-19 risk. These options will expand coverage to patients with PI diagnoses not listed as covered under Medicare for home infusions such as non-familial hypogammaglobulinemia (D80.1) who previously could only receive treatment at a hospital or infusion center. See IDF’s home infusion blog post for more details.
I am having some medical issues that I would generally make an appointment to have a consult with my physician, and I would like to be able to have a telehealth/virtual visit with my provider, will I be able to do this?
During this public health emergency, the Medicare reimbursement rules and the Health Insurance Portability and Accountability Act (HIPAA) requirements have been loosened to allow physicians and other healthcare providers to offer virtual consults, even on commonly used platforms such as FaceTime or Skype. For more details, see IDF’s blog on expanded telehealth services.
I have read that some hospitals may be withholding care and access to respirators to people with disabilities and/or compromised immune systems such as those with PI. Can they do that? Has anything been done to make sure this doesn’t happen?
There had been some concern raised that states and hospitals were preparing to implement discriminatory rationing practices against people with disabilities and certain preexisting conditions including those with impaired immune systems. In response to concerns raised by disability advocacy groups, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) issued a bulletin related to COVID-19 stating federal prohibitions on disability discrimination. In addition, IDF has joined an effort to make sure that states and hospitals are clear on their obligations not to discriminate when providing care.
Is there a website where I can access information regarding all the government resources available during the COVID-19 outbreak?
During this crisis, there is an innumerable number of resources online. There is a comprehensive U.S. government site that includes links to all the government-related programs and services currently available.