The "No Surprises Act," which took effect on Jan. 1, 2022, creates federal protections intended…
The fight against the COVID-19 pandemic is unlike anything we’ve faced in our lives. We want to make sure the hospitals and healthcare workers on the front lines of this crisis have all the help they can get.
There’s been a rapid stream of information out there, including updates from the federal government on new and expanding resources available to healthcare providers. It’s easy to lose track of what news is most important amid the constant flurry of activity.
This roundup summarizes a few of the areas we’re following to keep informed, starting with recent news about the Coronavirus Aid, Relief and Economic Security Act (CARES).
The federal government has announced that emergency funding from the CARES Act would be used to reimburse hospitals for treating uninsured COVID-19 patients. The U.S. Department of Health & Human Services (HHS) has indicated that healthcare providers will be reimbursed at Medicare rates for testing uninsured patients for the virus and treating uninsured patients who have been diagnosed.
The program applies to testing and treatment on or after Feb. 4 and relates to a specific patient population. You must have:
- Checked for health care coverage eligibility and confirmed that the patient is uninsured.
- Verified that the patient does not have individual, employer-sponsored, Medicare, or Medicaid coverage.
- Verified no other payer will reimburse you for COVID-19 testing and/or care for that patient.
Steps will involve enrolling as a provider participant, checking patient eligibility, submitting patient information, submitting claims, and receiving payment via direct deposit. Claims can be submitted starting May 6. More details, including a portal for filing claims and a FAQ, are available at these links:
HRSA COVID-19 Claims Reimbursement Program Page
Claims Reimbursement Portal
FAQ for CARES Act Provider Relief Fund
The Centers for Medicare & Medicaid Service (CMS) was empowered to take proactive steps through 1135 waivers since a national emergency was declared March 13. Since that time, there’s been a rapid influx of 1135 waiver requests, and each one can vary greatly as states respond to the virus outbreak in different ways. CMS has been keeping track of each state’s waiver flexibilities on its Federal Disaster Resources page:
CMS State-by-state 1135 Waiver Updates
Approved State Actions to Address COVID – 19
The Kaiser Family Foundation has a Medicaid Emergency Authority Tracker that details on Medicaid Disaster Relief State Plan Amendments (SPAs), other Medicaid and CHIP SPAs, and other state-reported administrative actions; Section 1115 Waivers; Section 1135 Waivers; and 1915 (c) Waiver Appendix K strategies.
We will continue to monitor the situation and provide any updates that may be relevant to all the courageous healthcare professionals risking their lives for our country’s health. For now, here are some other resources you may want to consider following:
HFMA COVID-19 News
CDC COVID-19 Guide for Healthcare Professionals