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Coronavirus Disease (COVID-19) Update

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05/01/2020

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Key Updates:

  • The Centers for Medicare and Medicaid Services (CMS) announced a list of new regulatory flexibilities. These blanket waivers apply to all Medicare and Medicaid providers for the duration of the public health emergency. Providers do not need to apply for these waivers. Links to more information on the changes is available on this website including a link to the interim final rule (IFR) that makes the changes.
    • CMS is expanding the list of telehealth services that can be provided by audio connection only, without a real-time video connection. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.
    • CMS is expanding the list of distant site provider types who can furnish Medicare telehealth services to include any healthcare professional eligible to bill Medicare for their professional services.
    • Hospitals may bill as the originating site for telehealth services furnished by hospital-based practitioners to Medicare patients registered as hospital outpatients, including when the patient is located at home. 
    • Currently, hospitals that open new off-campus outpatient departments face reduced payment rates under the Medicare Hospital Outpatient Prospective Payment System (OPPS). CMS is now granting a temporary exemption from its site-neutral payment policy to hospitals that relocate or open new off-campus facilities.
    • Medicare will no longer require an order from the treating practitioner for beneficiaries to get COVID-19 tests and certain laboratory tests required as part of a COVID-19 diagnosis. During the Public Health Emergency, COVID-19 tests may be covered when ordered by any healthcare professional authorized to do so under state law. A written practitioner’s order is no longer required for the COVID-19 test for Medicare payment purposes.
    • CMS will pay hospitals and practitioners to assess beneficiaries and collect laboratory samples for COVID-19 testing. CMS will also make a separate payment when that is the only service the patient receives. Medicare and Medicaid will cover laboratory processing of certain FDA-authorized tests that beneficiaries self-collect at home.
    • CMS is giving providers flexibility to increase the number of beds for COVID-19 patients. Expand capacity can impact formulas used to calculate Medicare payments for certain types of facilities. Under the new waiver, teaching hospitals can increase the number of temporary beds without facing reduced payments for indirect medical education and hospital systems that include rural health clinics can increase their bed capacity without affecting the rural health clinic’s payments.
  • CMS also issued a new FAQ explaining new EMTALA flexibilities for remote (e.g. parking lot) testing sites.
  • Speaker of the House Nancy Pelosi said she wants $1 trillion in funding for states and municipalities in the next relief bill. Republicans are also open to funding for state and local governments. Both parties want the funding to be limited to helping states cover costs related to the coronavirus.
  • The Small Business Administration (SBA) issued a new regulation that limits Paycheck Protection Program (PPP) loans to $20 million per entity. This is intended to prevent large chains with independent locations from securing multiple PPP loans as a way around the $10 million cap on PPP loans. 
  • Gilead Sciences says it has 50,000 courses of Remdesivir ready to ship. Remdesivir promising results at increasing recovery time from COVID-19 patients. Gilead’s CEO published an open letter explaining the companies plans for expanding access to its promising drug.
  • CMS announced a new independent commission to provide recommendations on nursing home safety and quality. Nursing homes are among the hardest hit facilities by COVID-19.
  • The Department of Health and Human Services (HHS) awarded $20 million in grants to help expand telehealth services for vulnerable patients including pregnant women and children with special health care needs. The funding will also be used to streamline the process providers use to obtain multi-state licensure.
  • Many states are beginning to gradually re-open.