March 31, 2020
Area(s) of Interest: Payor Issues and Reimbursement Public Health
The Centers for Medicare and Medicaid Services (CMS) on Monday took a number of steps to equip the United States health care system with maximum flexibility to respond to the COVID-19 pandemic.
Key takeaways for Medicare physicians include:
- CMS has expanded telehealth coverage to include telephonic services, with in-person payment parity for 80 additional services including for NEW patients, patients in hospice, home health, at-home dialysis, rehabilitation and skilled nursing facilities, patients with acute and chronic conditions, and most notably emergency department visits to help screen and triage patients to the most appropriate setting. (For more information on telehealth flexibilities during this emergency, see CMA’s Telehealth Overview.)
- CMS is allowing health care systems and hospitals to provide services in locations beyond their existing walls to help address the urgent need to expand care capacity and to develop sites dedicated to COVID-19 treatment.
- Ambulatory surgery centers can contract with local health care systems to provide hospital services, or they can enroll and bill as hospitals during the emergency declaration as long as they are not inconsistent with their state’s emergency preparedness or pandemic plan.
- Hospital emergency departments can test and screen patients for COVID-19 at drive-through and off-campus test sites.
- Under certain circumstances, hospitals and other entities will also temporarily be able to perform tests for COVID-19 on people at home and in other community-based settings.
- Medicare will pay laboratory technicians to travel to a patient’s home to collect a specimen for COVID-19 testing, eliminating the need for the patient to travel to a health care facility for a test and risk exposure to themselves or others.
- CMS is suspending all verbal order requirements so physicians can focus more of their time on taking care of patients.
- CMS is eliminating audits and additional documentation and reporting requirements.
- CMS issued blanket waivers under the physician self-referral “STARK” law, EMTALA and Medicaid for COVID-19 purposes. These blanket waivers can be used by states without notifying or getting approval from CMS.
For more information, see: