Pharmacy COVID-19 Testing

Helen Noonan-Harnsberger, PharmD, AVP Providence Health Plan

Riley Protz, PharmD, MBA, (Graduate, PSJH Administrative Pharmacy Resident on rotation at PHP, now at Salem Health)

Jessica Niculcea, PharmD, Clinical Pharmacist Specialist, PHP

August 6, 2020

Pharmacy COVID-19

Testing

A presentation for OHA & CCO Pharmacy Leaders

Disclaimer and Conflicts of Interest

+ As information regarding COVID-19 is being frequently updated, this

presentation utilizes the best available information and evidence

up to July 31, 2020.

+ Updates to this information may occur after presentation.

+ This presentation is educational in nature.

+ Potential conflicts of interest: None of the presenters have any

conflicts of interest to declare

+ Sponsorship: None

For additional questions please contact: Helen.Noonan-Harnsberger@providence.org

SARS-CoV-2 Infection

+ Following exposure to the virus,

symptoms develop within 2-14 days

+ Viral replication occurs

+ Viral antigen is detectable

+ Virus shedding occurs before symptoms

arise

+ Once immunity begins and antibodies

develop, virus counts and antigen

levels will fall

1. Testing for coronavirus. https://ncpa.org/covid-testing

Immunity to SARS-CoV-2

+ IgM antibodies develop first in an infection and

indicate presence of an acute infection

+ IgG antibodies develop later during an infection

and may circulate after the pathogen has been

eradicated from the body

+ Immunity response is not fully understood in response to

SARS-CoV-2

1. Testing for Coronavirus. https://ncpa.org/covid-testing

Laboratory Tests

+ Clinical Laboratory Improvement Amendments (CLIA) establishes

quality standards for all laboratory testing performed on specimens

derived from humans for diagnosis, prevention, and treatment of

disease

+ FDA approves the laboratory tests and determines complexity

+ Under CLIA, laboratory tests are classified regarding the technical

complexity and skill in three categories

+ Waived Complexity (W)

+ Moderate Complexity (M)

+ High Complexity (H)

Emergency Use Authorization to Test

+ The Department of Health and Human Services issues an Emergency Use

Authorization (EUA) under the Public Readiness and Emergency

Preparedness Act (PREP) on February 4th, 2020.

+ Allows for unapproved medical products or unapproved uses of approved medical products

to be used in an emergency to diagnose, treat, or prevent serious diseases

+ Technologies and therapies have not undergone full FDA scrutiny

+ Authorization for use does not mean FDA-approved

+ When the pandemic is declared over, the EUA will likely expire

+ Ex: Peramivir & H1N1

FDA Medical Device COVID-19 EUA Page

+ Provides information about all the medical devices, including laboratory

tests that have been authorized for use under the EUA

+ There are approximately 100 tests authorized for use under the EUA

2. In vitro diagnostics EUAs. https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#imft1

Navigating the COVID-19 EUA Page

+ W: CLIA-waived tests can be performed at a pharmacy

+ H: Pharmacies can collect the specimens and send the tests to a laboratory to be

run

2. In vitro diagnostics EUAs. https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#imft1

Navigating the COVID-19 EUA Page

+ HCP – Healthcare provider fact sheet

+ Patient – Patient fact sheet

+ IFU – Manufacture Instructions

2. In vitro diagnostics EUAs. https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#imft1

Oregon Health

Authority

(OHA)

Guidance

OHA Guidance for Clinicians

+ Oregon Health Authority (OHA) recommends COVID-19 viral testing

for people with new onset of a COVID-19-like illness

+ Fever or chills

+ Cough

+ Shortness of breath or difficulty breathing

+ Fatigue

+ Muscle or body aches

+ Diarrhea

3. https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le2267.pdf

+ Headache

+ New loss of taste or smell

+ Sore throat

+ Congestion or runny nose

+ Nausea or vomiting

OHA Guidance for Clinicians

+ OHA recommends that testing of people without symptoms of a

COVID-19-like illness be limited to the following groups:

+ Close contacts of confirmed or presumptive COVID-19 cases

+ Individuals exposed to COVID-19 in a congregate setting

+ Migrant/seasonal agricultural workers upon arrival in Oregon

+ People who identify as Black, African-American, Latino, Latina, Latinx, American

Indian/Alaska Native, Asian, Asian-American or Pacific Islander

+ People who identify as having a disability

+ People whose first language is not English

3. https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le2267.pdf

OHA Guidance for Clinicians

+ OHA recommends using only tests that have FDA approval or

Emergency Use Authorization (EUA)

+ Clinicians may order commercial tests based on their clinical

judgment; they do not need to contact Public Health.

3. https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le2267.pdf

OHA Guidance for Individuals

+ Oregon Health Authority (OHA) recommends individuals to contact

their primary healthcare provider or clinic if they believe they need

testing

+ OHA recommends individuals without a doctor to call 211 for a list

of clinics

3. https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le2267.pdf

OHA Guidance for Accuracy of Testing

3. https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le2267.pdf

OHA Testing Capacity

+ OHA estimates testing capacity at ~41,000 weekly tests

+ Dependent on the US Department of Health and Human Services (HHS) for

additional resources, supplies, and funding around testing

+ Oregon’s percentage positive rate has stayed low, until recently

4. Testing hub. https://coronavirus.jhu.edu/testing/testing-positivity

5. Willamette Week. https://www.wweek.com/news/2020/06/04/new-johns-hopkins-university-data-shows-oregons-covid-19-testing-lags-all-but-one-state/

6. COVID-19 weekly testing summary. https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Emerging%20Respitory%20Infections/Oregon-COVID-19-Testing-Summary-2020-07-27.pdf

National Testing Capacity*

+ Reported difficulty obtaining testing supplies for specimen

collection, transport, and testing

+ Backlog at laboratories that process tests

+ Increasing spread of COVID-19

7. Testing data in the U.S. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/testing-in-us.html

8. FAQs on testing for SARS-CoV-2. https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-testing-sars-cov-2#testingsupply

9. All state comparison of testing efforts. https://coronavirus.jhu.edu/testing/states-comparison

10. US lab giant warns of new Covid-19 testing crunch in autumn. https://www.ft.com/content/4c9b4ae0-0559-4fe2-8806-53c6a8e3ab3a

*Information last updated 7/23/2020

Oregon Testing Sites

OHA Resources

11. COVID-19 testing in Oregon. https://govstatus.egov.com/or-oha-covid-19-testing

Appointment Not Required

+ OHSU

+ First come, first serve

+ Both with and without symptoms

+ Hillsboro Stadium: 4450 NE Century

Blvd, Hillsboro, OR 97124

+ Portland Expo Center: 2060 N. Marine

Drive, Portland, OR 97217

+ Hours: Monday – Saturday, 9 a.m. – 4

p.m.

+ May close earlier to accommodate those

already in line

+ Columbia County Department Mobile

Testing Clinic

+ August 17

9-11am Walk-up Clinic

+ August 24

9-11 am Walk-up Clinic

+ August 31

9-11 am Walk-up Clinic

+ Capacity: 50 tests each day

12. COVID-19 resources for Oregon. https://www.ohsu.edu/health/coronavirus-resources#section-1117926

13. Testing sites. https://www.co.washington.or.us/HHS/CommunicableDiseases/COVID-19/testing-sites.cfm

Appointment Required –

Benton/Lincoln/Linn County

+Samaritan

+ Temporary testing centers

set up in Benton, Lincoln,

and Linn counties

+ Requires a clinician’s order

+ Patients instructed to

complete a MyChart E-Visit

or by calling provider

14. FAQs for Coronavirus & COVID-19. https://www.samhealth.org/health-services/coronavirus-information/coronavirus-symptoms-testing-questions-corvallis-albany-lebanon-newport

Appointment Required –

Clatsop/Columbia/Jackson County

+ Clatsop County Public Health

Department

+ Drive-through testing

+ Household Hazardous Waste disposal

facility: 1780 Williamsport Road

+ Mondays and Wednesdays

+ Call 503-325-8500 to make

appointment

+ Columbia County Department Mobile

Testing Clinic

+ August 9

9-12 pm Drive –through Clinic

+ Pre-register online

+ Capacity: 100 tests

+ Asante

+ Call Asante at 541-789-2813 to

schedule screening and appointment

+ La Clinica

+ Testing available for established

patients, uninsured, no other doctor, or

anyone who speaks Spanish only

+ Call 541-535-6239 to schedule

+ Valley Immediate Care

+ Open to everyone

+ House: Every day

+ Call 541-734-9030

15. Drive-through COVID-19 testing. https://www.co.clatsop.or.us/publichealth/page/drive-through-covid-19-testing

16. Community Resources. https://jacksoncountyor.org/hhs/COVID-19/Community-Resources/what-to-do-if-you-are-sick

Appointment Required –

Deschutes County

+ Deschutes County

+ Bend VA Clinic

+ Central Oregon Family Medicine

+ COPA

+ Family Care Center Redmond

+ High Lakes Health Care

+ La Pine Community Health Center

+ Mosaic

+ Mountain Medical

+ Summit Medical Group

+ Weeks Family Medicine

17. COVID-19 testing locations. https://www.deschutes.org/sites/default/files/fileattachments/health_services/page/12901/covid-19_test_locations_-_sarah_h._1.pdf

Appointment Required –

Crook/Jefferson/Klamath County

+ Crook County

+ Mosaic Medical Prineville

+ Prineville Family Care Clinic

+ St. Charles Health System

+ Jefferson County

+ Madras medial Group

+ Mosaic Medial

+ St. Charles Health System

+ Warm Springs Health & Wellness

+ Klamath County

+ Basin Immediate Care

+ Bonanza Clinic

+ Klamath County

+ Klamath Health Partnership

+ Merrill Clinic

+ Sky Lakes

+ Tribal Health

17. COVID-19 testing locations. https://www.deschutes.org/sites/default/files/fileattachments/health_services/page/12901/covid-19_test_locations_-_sarah_h._1.pdf

Appointment Required –

Gilliam/Sherman/Wasco County

+ Partnership with North

Central Public Health District

and the OHA

+ Call: 211

+ Call: 1-866-698-6155 or

medical provider

18. Wasco Gilliam Sherman Coronavirus & COVID-19 local updates. https://wascoshermangilliamcovid-19.com/

Appointment Required –

Tillamook County

+ Tillamook County Community

Health Centers

+ Call for appointment

+ Self-pay cost: $51.31

19. COVID-19 testing. https://tillamookchc.org/covid19-testing/

Appointment Required –

Multnomah County

+ Multnomah County Primary Care

Clinics

+ Established patients: call 503-988-

5558 for an appointment.

+ Can get tested at East, Northeast, or Mid County

Clinics

+ New patients: call 503-988-9093 for

an appointment.

+ Can get tested at East County Clinic

+ Central City Concern

+ Call 971-361-7888 to schedule

appointment.

+ In-person, phone, or video appointments

available.

+ One Medical

+ One Medical member: schedule

through One Medical app

+ New member: One Medical offering

30-day free trial membership

11. COVID-19 testing in Oregon. https://govstatus.egov.com/or-oha-covid-19-testing

20. COVID-19. https://www.centralcityconcern.org/Default.aspx?PageID=17221006&A=SearchResult&SearchID=32654638&ObjectID=17221006&ObjectType=1

Appointment Required –

Multnomah/Washington County

+ Kaiser Permanente

+ Testing at hospital and urgent care

locations

+ For Kaiser members only

+ Virginia Garcia Memorial Health

Centers

+ Screening available at their five primary

care clinics

+ Must meet with Virginia Garcia provider.

+ Call 503-359-5564, press 3

+ Accepting patients with no providers.

+ Call 503-214-1668 to establish with a

Virginia Garcia provider.

+ Neighborhood Health Center

+ Hillsboro clinic location

+ Existing NHC patients can call for

screening and those without a primary

care provider can call with phone or

video visit for screening

+ Call 503-941-3094

+ Legacy GoHealth

+ Cedar Hills Clinic: 2870 SW Cedar Hills

Blvd., Beaverton, OR 97005

+ Hours: Every day, 8 a.m. – 8 p.m.

+ Requires virtual visit

11. COVID-19 testing in Oregon. https://govstatus.egov.com/or-oha-covid-19-testing

Appointment Required –

Multnomah/Washington County

+ Providence

+ Tanasbourne: 10670 NE Cornell Rd, Hillsboro, OR 97214

+ Hours: M-F, 9 a.m. – 5:30 p.m.

+ Bridgeport: 18040 SW Lower Boones Ferry Rd, Tigard, OR

97224

+ Hours: Every day, 9 a.m. – 5:30 p.m.

+ American Family Care

+ 14278 SW Allen Blvd., Beaverton

+ Hours: M-F, 8 a.m. – 8 p.m.; Weekends, 9 a.m. –

6 p.m.

+ Telemedicine screening and directed to the

facility for drive-up testing or in-person visits with

collection onsite

+ Call 503-305-6262 or schedule visit online

+ Accepts uninsured: free office visit and COVID-

19 testing at all five facilities

+ ZoomCare

+ Must be screened by a provider through

video, in-person, or phone visit at a Zoom

clinic

+ Appointment will be scheduled for a drive-

through facility

+ Portland Urgent Care MobilMED for

Business (onsite)

+ Hours: M-F, 8 a.m. – 4 p.m.

+ Insurance accepted (exceptions: Kaiser and

Oregon Health Plan)

+ Self-pay: call for pricing

+ Call 503-249-9000 or schedule a TeleMED

appointment

11. COVID-19 testing in Oregon. https://govstatus.egov.com/or-oha-covid-19-testing

Pharmacy Testing Locations in Oregon

+ Rite Aid

+ 15 locations: Beaverton (1), Canby (1), Corvallis (1), Hermiston (1), Klamath Falls (1),

Lebanon (1), Milton Freewater (1), Ontario (1), Pendleton (1), Phoenix (1), Portland (2),

Roseburg (1), Salem (1), Silverton (1),

+ Walgreens

+ 1 location, mobile unit: 115 N 20

Ave, Cornelius OR 97113

22. No-Cost COVID-19 testing at Walgreens. https://www.walgreens.com/findcare/covid19/testing#!

21. Covid-19 testing. https://www.riteaid.com/pharmacy/services/covid-19-testing

Pharmacy Testing Locations Near Oregon - Washington

+ Rite Aid

+ 5 locations within 75 miles of Oregon

+ Union Gap: 2519 Main Street Union Gap, WA

+ Pasco: 215 North 4

Avenue Pasco, WA

+ Kennewick: 101 North Ely Street Kennewick, WA

+ Walla Walla: 2028 East Isaacs Avenue Walla Walla, WA

+ Vancouver: 2800 NE 162

Avenue Vancouver, WA

21. Covid-19 testing. https://www.riteaid.com/pharmacy/services/covid-19-testing

Pharmacy Testing Locations Near Oregon - Idaho

+ Rite Aid

+ 4 locations

+ 4 locations within 75 miles of Oregon

+ Boise: 5005 West Overland Road Boise, ID

+ Caldwell: 2107 Blaine Street Caldwell, ID

+ McCall: 451 Deinhard Lane McCall, ID

+ Meridian: 3250 S Eagle Road Meridian, ID

21. Covid-19 testing. https://www.riteaid.com/pharmacy/services/covid-19-testing

Pharmacy Testing

Options

Pharmacy Testing

Option 1: Send to a Lab

+ Gather specimen at the pharmacy and

send to laboratory

+ Does not require a CLIA waiver from CMS

Option 2: Analyze in Pharmacy

+Point-of-Care

+Perform and analyze the test at the

pharmacy

+Does require a CLIA waiver from CMS

Getting Set as a CLIA-waived “Laboratory”

+ Before testing, pharmacies must:

1. Provide training to all relevant staff members

2. Obtain a certificate of waiver from CMS

3. Comply with safety requirements

+ During the pandemic, every pharmacy is authorized

to perform a CLIA-waived test

Proper PPE for the Pharmacy

+ Face Masks

+ According to the CDC, face masks should be worn at all times in the pharmacy

+ N95 masks are recommended, then surgical masks, lastly cloth masks

+ Gloves

+ While no specific recommendations currently exist, utilization of gloves can help

to protect staff

+ Gowns

+ Gowns should be worn for collection of diagnostic respiratory specimens (I.e.

point-of-care testing required a nasal or nasopharyngeal swab)

23. NCPA. https://ncpa.org/sites/default/files/2020-04/PPE_Recommendations.pdf

Tests for SARS-CoV-2

1. Diagnostic of acute infection

• PCR and Antigen tests

• Nasopharangeal or Mid-turbine swab

2. Serological assessment of immune response (Antibody test)

• Immunoassays

• Blood specimens: finger stick or venous blood

Types of Diagnostic Test

Polymerase Chain Reaction Assay

+ Amplify pathogen-specific genetic targets

from a specimen

+Also known as molecular assay

+Can be point-of-care (POC) or lab processed

Antigen Test

+ Target molecules (antigens or antibodies)

are mobilized across a membrane and bind

to colormetric probes

+Quick turnaround time, but lower

sensitivity

There are two primary technologies that are used in infectious diseases tests that can be used in a

pharmacy

Specimen Collection

+ Originally most tests were nasopharyngeal, later on the FDA authorized tests to be mid-

turbinate (easier to self collect)

Antibody/Serology Testing

+ Detection of SARS-CoV-2 specific antibodies could help determine if

a patient has been infected with SARS-CoV-2 and gained immunity

+ Currently not recommended for widespread use

+ Tests results without scientific evidence could put people at risk of infection if they

believe they have immunity

+ Only highly and moderately complex tests are currently available

+ Cannot be performed in a pharmacy

2. In vitro diagnostics EUAs. https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#imft1

Pharmacy Billing

HHS Funding

24. Medicare administrative contractor. https://www.cms.gov/files/document/mac-covid-19-test-pricing.pdf

+ Coronavirus Aid, Relief, and Economic Security (CARES) Act provides $100

billion in relief funds, including to hospitals and other health care providers on

the front lines of the COVID-19 response. This includes funding for specimen

collection and diagnostic testing

+ Currently, the large pharmacy chains are relying on HHS funding to recoup the

cost of performing COVID-19 tests.

Medical Billing

+ Pharmacists and pharmacies are a valid provider type for both Current Procedural Terminology (CPT) and Health Care

Common Procedure Coding System (HCPCS) procedures codes for billing COVID-19 tests as a medical claim

Code

Description

Effective Date

Rate

87635

Diagnostic

COVID-19 testing

3/13/2020

$51.31

G2023

Homebound and non

-hospital inpatients; any specimen source

3/31/2020

$23.46

G2024

SNF or by a lab on behalf of an HHA; any specimen source

3/31/2020

$25.46

U0001

Testing

in a CDC laboratory

4/01/2020

$35.91

U0002

Testing

with a non-CDC kit

4/01/2020

$51.31

U0003

Should

identify tests that would otherwise be identified by CPT code 87635 but for being performed with these high throughput

technologies.

3/18/2020

$100.00

U0004

Should

identify tests that would otherwise be identified by U0002 but for being performed with these high throughput technologies

3/18/2020

$100.00

86769

Antibody; severe acute respiratory syndrome coronavirus 2 (SARS

-CoV-2) (Coronavirus disease [COVID-19])

NOTE: Multi

-step antibody testing

4/20/2020

$42.13

86328

Immunoassay for infectious agent antibody(

ies), qualitative or semiquantitative, single step method (eg, reagent strip); severe acute

respiratory syndrome coronavirus 2 (SARS

-CoV-2) [COVID-19])

NOTE

: Single-step antibody testing

4/20/2020

$45.23

24. Medicare administrative contractor. https://www.cms.gov/files/document/mac-covid-19-test-pricing.pdf

25. CMS rulings. https://www.cms.gov/files/document/cms-2020-01-r.pdf

Pharmacy Claim Billing

+ NCPDP has released a document with specific guidance on how to bill claims when test are covered under the pharmacy

benefit. The document details step-by-step how to fill out the claim.

+ When the pharmacist is administering the test (collecting the specimen) and/or interpreting and reporting the results,

the following codes should be submitted in the Professional Service Code Field

Medication

Administration: Indicates that the test has been administered. Submission of this

code assumes the kit has also been dispensed as

defined

Perform

Laboratory Test: Indicates that test analysis has been performed and results have

been interpreted. Submission of this code includes services as defined in MA above in addition

to informing the patient of test results and reporting the results to designated entities

26. NCPDP. https://www.ncpdp.org/NCPDP/media/pdf/NCPDPEmergencyPreparednessInformation.pdf

Pharmacy

Network

Testing

Pharmacy Network Testing Common Procedure

1. Patient will complete a screening survey online to determine if they are eligible

for a test.

2. Patient will drive to the drive-through testing location at a scheduled time.

3. Patient or pharmacist will perform the test using a nasal swab.

4. The specimen will either be sent to a laboratory partner for analysis or will be

analyzed on site by a pharmacist.

5. The patient will receive the test results through their online profile

How are pharmacies testing in Oregon?

+ Rite Aid

+ Process

+ Complete online screening survey

+ If qualified, provided with testing location

and time

+ Go to testing location and remain in

vehicle

+ Utilize a self-swabbing nasal kit for

testing under the instruction of a

pharmacist

+ Test results sent to Verily

+ Receive results via email and via phone if

positive in 2-7 days

+ Walgreens

+ Process

+ Complete online screening survey

+ If qualified, provided with testing location

and time

+ Go to testing location and remain in

vehicle

+ Utilize a self-swabbing nasal kit for

testing under the instruction of a

pharmacist

+ Test results sent to PWNHealth

+ Receive results via email or phone from

PWNHealth (time not stated)

21. Covid-19 testing. https://www.riteaid.com/pharmacy/services/covid-19-testing

22. No-Cost COVID-19 testing at Walgreens. https://www.walgreens.com/findcare/covid19/testing#!

What about in home testing by pharmacies?

+ Kroger Pharmacies (Includes Fred Meyer Pharmacies, QFC Pharmacies,

and all other Kroger affiliates)

+ Process

+ Complete online screening survey or assessment by a contact tracer

+ As of July 1, this EUA test NOT available in all states currently but authorization pending in

upcoming weeks. Testing location sent to patient’s home or other address

+ Patient utilizes a self-swabbing nasal kit following instructions provided, with 2-way video

visit between a licensed health care professional and the patient

+ Test sample sent to CLIA approved lab

+ Receive results via email and via phone if positive in 5-10 days

27. US Food & Drug Administration Letter Dated June 30, 2020 to Jim Kirby, Pharm.D., BCPS, CDE,, Senior Director, Kroger Company

Pharmacy Covid-19 Testing Survey

+ Providence Health Plan Pharmacy Division conducted a survey regarding COVID-19 testing for community

pharmacies within the Providence Health Plan Pharmacy Network (Survey conducted in June, 2020)

+ Received 17 responses – primarily from various large and moderate size pharmacy chains

+ Organizations conducting COVID testing: CVS, Fred Meyer, Rite Aid, Walgreens, Wal-Mart

+ Organizations planning to start testing: Bartells, Hi-School Pharmacy

+ Not all pharmacies are testing in Oregon or in the NW (An appendix is provided to inform

+ Testing utilized:

+ Nasopharyngeal swabs: CVS, Fred Meyer, Rite Aid, Walgreens, Wal-Mart

+ At-home testing kits: Fred Meyer

+ Anticipated testing in the future

+ Antibody/Serology test: Bartells, CVS, Fred Meyer, Rite Aid

+ Implications on FLU vaccine:

+ Majority (82%) expecting heavy demand and very active pharmacy based immunization during the fall and into 2021

+ Expect to participate in Covid-19 immunization once approved, available and the priority for vaccinating providers has been established

COVID-Ready

COVID-Ready Tool

+ End-to-end service for employers seeking to safely reengage staff returning

to the workplace

+ Integrates:

+ Health screening: online or mobile application

+ Symptom assessment

+ Testing services: employee self-register

+ Monitoring

+ Health care coordination: cloud-based data platform

+ Provides a comprehensive and recurring population health assessment

28. CovidReady. https://www.ayin.com/covidready

Summary

Conclusion: Key Takeaways

+ Under the PREP Act, pharmacists are authorized to order and administer COVID-19 tests

+ Current Oregon pharmacy practice act does not permit pharmacist to independently order and receive confirmatory findings for

delivery to patient

+ Current Oregon pharmacy practice act does permit pharmacists to collect Covid -19 test samples

+ OHA and respective counties provide resources to direct patients to COVID-19 testing locations

+ Education and communication by community pharmacies to their patients is essential during this pandemic

+ Assuring that citizens know about and utilize 211 to find a testing location near them is essential

+ Helping citizens also know that testing is available free of charge – even without insurance is also critical

+ At this time, diagnostic tests are available to be performed start-to-finish in the pharmacy, or

partnership for specimen analysis at a lab is possible

+ Medical Billing of CPT and HCPCS codes is the preferred form of billing, however pharmacy chains at

this time are still relying on HHS funding

+ Pharmacy chains are currently performing tests in select locations around the nation

+ It appears most pharmacy chains will continue with the process of drive-through testing and sending

specimens to labs for analysis

Thank You

References

+ 1. Testing for coronavirus. NCPA. Available from: https://ncpa.org/covid-testing.

+ 2. In vitro diagnostics EUAs. U.S. Food & Drug Administration. Available from: https://www.fda.gov/medical-

devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-

diagnostics-euas#imft1.

+ 3. COVID-19 testing guidance for health care providers. Oregon Health Authority. Available from:

https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le2267.pdf.

+ 4. Which U.S. states meet WHO recommended testing criteria? Johns Hopkins University & Medicine.

Available from: https://coronavirus.jhu.edu/testing/testing-positivity.

+ 5. New Johns Hopkins University data shows Oregon’s COVID-19 testing lags behind all but one state.

Willamette Week. Available from: https://www.wweek.com/news/2020/06/04/new-johns-hopkins-

university-data-shows-oregons-covid-19-testing-lags-all-but-one-state/.

+ 6. COVID-19 weekly testing summary. Oregon Health Authority. July 27, 2020. Available from:

https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Emerging%20Respitory%20Infectio

ns/Oregon-COVID-19-Testing-Summary-2020-07-27.pdf.

References

+ 7. Testing Data in the U.S. Centers for Disease Control and Prevention. July 23, 2020. Available from:

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/testing-in-us.html.

+ 8. FAQX on testing for SARS-CoV-2. U.S. Food & Drug Administration. Available from:

https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-testing-sars-cov-

2#testingsupply.

+ 9. All state comparison of testing efforts. Johns Hopkins University & Medicine. Available from:

https://coronavirus.jhu.edu/testing/states-comparison.

+ 10. US lab giant warns of new Covid-19 testing crunch in autumn. Financial Times. Available from:

https://www.ft.com/content/4c9b4ae0-0559-4fe2-8806-53c6a8e3ab3a.

+ 11. COVID-19 Testing in Oregon. Oregon Health Authority. Available from: https://govstatus.egov.com/or-

oha-covid-19-testing.

+ 12. COVID-19 Resources for Oregon. OHSU. Available from: https://www.ohsu.edu/health/coronavirus-

resources#section-1117926

References

+ 13. Testing sites. Washington County Oregon. Available from:

https://www.co.washington.or.us/HHS/CommunicableDiseases/COVID-19/testing-sites.cfm.

+ 14. FAQs for Coronavirus & COVID-19. Samaritan Health Services. Available from:

https://www.samhealth.org/health-services/coronavirus-information/coronavirus-symptoms-testing-

questions-corvallis-albany-lebanon-Newport.

+ 15. Drive-through COVID-19 testing. Clatsop County Oregon. Available from:

https://www.co.clatsop.or.us/publichealth/page/drive-through-covid-19-testing.

+ 16. Community resources. Jackson County Health & Human Services. Available from:

https://jacksoncountyor.org/hhs/COVID-19/Community-Resources/what-to-do-if-you-are-sick.

+ 17. COVID-19 Testing locations in Central Oregon, as of 7/6/2020. Available from:

https://www.deschutes.org/sites/default/files/fileattachments/health_services/page/12901/covid-

19_test_locations_-_sarah_h._1.pdf.

+ 18. Wasco Gilliam Sherman Coronavirus & COVID-19 local updates. Available from:

https://wascoshermangilliamcovid-19.com/.

References

+ 19. COVID-19 testing. Tillamook County Community Health Centers. Available from:

https://tillamookchc.org/covid19-testing/.

+ 20. COVID-19 (Coronavirus). Central City Concern. Available from:

https://www.centralcityconcern.org/Default.aspx?PageID=17221006&A=SearchResult&SearchID=32654638&Obje

ctID=17221006&ObjectType=1

+ 21. Covid-19 testing available. RiteAid. Available from: https://www.riteaid.com/pharmacy/services/covid-

19-testing.

+ 22. No-cost COVID-19 testing at Walgreens. Walgreens. Available from:

https://www.walgreens.com/findcare/covid19/testing#!.

+ 23. PPE use, re-use and sanitation recommendations for community pharmacies. National Community

Pharmacists Association. Available from: https://ncpa.org/sites/default/files/2020-

04/PPE_Recommendations.pdf.

+ 24. Medicare administrative contractor (MAC) COVID-19 Test Pricing. CMS. May 19, 2020. Available from:

https://www.cms.gov/files/document/mac-covid-19-test-pricing.pdf.

References

+ 25. CMS Rulings. Department of Health and Human Services. April 14, 2020. Available from:

https://www.cms.gov/files/document/cms-2020-01-r.pdf.

+ 26. NCPDP emergency preparedness information. NCPDP. Available from:

https://www.ncpdp.org/NCPDP/media/pdf/NCPDPEmergencyPreparednessInformation.pdf.

+ 27. US Food & Drug Administration Letter Dated June 30, 2020 to Jim Kirby, Pharm.D., BCPS, CDE., Senior

Director, Kroger Company

+ 28. CovidReady. Ayin Health Solutions. Available from: https://www.ayin.com/covidready .

+ 29. COVID-19 testing. CVS. Available from: https://www.cvs.com/minuteclinic/covid-19-testing.

+ 30. Kroger health COVID-19 testing locations. Kroger Health. Available from:

https://www.krogerhealth.com/covid-locations

+ 31. Supporting COVID-19 drive-thru testing. Walmart. Available from:

https://corporate.walmart.com/covid19testing.

Where are they testing?*

Pharmacy Chain

Testing States

CVS

Arizona, California, Connecticut, District Of Columbia, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Louisi

ana,

Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico,

New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Wisconsin

Kroger

Alaska, Alabama, Arizona, California, Colorado, Indiana, Illinois, Kentucky, Michigan

, Mississippi, North Carolina, Ohio, South

Carolina, Tennessee, Texas,

Virginia, Washington, Wisconsin

Rite Aid

California, Connecticut, Delaware, Idaho, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio,

Oregon

, Pennsylvania, Virginia, Washington

Walgreens

Alabama, Arizona

, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky,

Louisiana, Michigan, Missouri

, Nevada, New Jersey, New York, North Carolina, Ohio, Oregon, Rhode Island, South Carolina,

Tennessee, Texas

, Utah, Virginia, Washington, Wisconsin

Walmart

Alabama, Arkansas, Arizona, Colorado,

Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan,

Minnesota, Missouri,

Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Ohio, Pennsylvania, Texas, Virginia

29. COVID-19 testing. https://www.cvs.com/minuteclinic/covid-19-testing

30. Kroger health COVID-19 testing locations. https://www.krogerhealth.com/covid-locations

21. Covid-19 testing. https://www.riteaid.com/pharmacy/services/covid-19-testing

22. No-Cost COVID-19 testing at Walgreens. https://www.walgreens.com/findcare/covid19/testing#!

31. Supporting COVID-19 Drive-thru testing. https://corporate.walmart.com/covid19testing

*Information is current as of 7/23/2020 and likely to change

Appointment Required – Antibody Testing

+ Oregon Occupational Medicine (OOM)

+ Antibody testing only. No testing for active COVID-19

+ Email: info@oregonccmed.com

+ ZoomCare

+ Must be screened by provider through video, in-person, or phone visit at a Zoom clinic

+ Must be symptom-free for at least 10 days

+ Patient’s insurance will be billed directly. Cost for antibody panel is $150.

11. COVID-19 testing in Oregon. https://govstatus.egov.com/or-oha-covid-19-testing