As the U.S. scrambled to confront the COVID-19 pandemic, an unprecedented joint effort developed among federal and state governments, regulators, hospitals, suppliers and health-care providers. Out of necessity, institutions altered how they function—and how they cooperate—to save lives. Although the pandemic exposed flaws and weaknesses in the
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On May 22, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that implements a subset of the proposals from the February 18, 2020, proposed rule (85 FR 9002). This first final rule focuses on more immediate regulatory actions.
The Centers for Medicare & Medicaid Services today finalized requirements that will increase access to telehealth for seniors in Medicare Advantage (MA) plans, expand the types of supplemental benefits available for beneficiaries with an MA plan who have chronic diseases, provide support for more MA options for beneficiaries in rural communities, and expand access to MA for patients with End Stage Renal Disease (ESRD). Together, the changes advance President Trump’s Executive Orders on Protecting and Improving Medicare for Our Nation’s Seniors and Advancing American Kidney Health as well as several of the CMS strategic initiatives.
Due to the upcoming June 1, 2020, MA and Part D bid deadlines for the 2021 plan year, CMS is finalizing a subset of the proposed policies before the MA and Part D plans’ bids are due. CMS plans to address the remaining proposals for plans later in 2020 for the 2022 plan year. We understand that the entire healthcare sector is focused on caring for patients and providing coverage related to coronavirus disease 2019 (COVID-19), and we believe this approach provides plans with adequate time and information to design the best coverage for Medicare beneficiaries.
“CMS’s rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home,” said CMS Administrator Seema Verma. “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”
April 30, 2020 CMS made sweeping changes to expand Medicare telehealth coverage and services on 4/30/2020. This PDF contains the full lists of pre-COVID eligible services, as well as the newly added codes.
April 9, 2020 CMS: COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing
April 7, 2020 CMS: COVID-19: Telehealth Video, Coinsurance and Deductible Waived, ASC Attestations, Ambulance Modifiers, Lessons From Front Lines
April 3, 2020 (CMS) Medicare Coverage and Payment of Virtual Services -This video will provide you with answers to common questions about the Medicare telehealth services benefit.
For additional background information on the waivers and rule changes, go to: https://www.cms.gov/newsroom/fact-sheets/additional-backgroundsweeping-regulatory-changes-help-us-healthcare-system-address-covid-19-patient
For more information on the COVID-19 waivers and guidance, and the Interim Final Rule, please go to the CMS COVID-19 flexibilities webpage: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers
CMS COVID-19 Provider Enrollment Relief FAQs March 22, 2020
CMS End-Stage Renal Disease Providers Toolkit March 20, 2020
MEDICARE FEE FOR SERVICE TELEHEALTH COVERAGE March 19, 2020
COVID-19 Frequently Asked Questions (FAQs) for State Medicaid and Children’s Health Insurance Program (CHIP) Agencies. Last Updated March 18, 2020
CMS Medicare Telemedicine Health Care Provider Fact Sheet March 17, 2020
CMS Telehealth Toolkit for General Practitioners March 17, 2020
March 23, 2020 CMS Approves Medicaid Section 1135 Waivers for 11 Additional States in Response to COVID-19
Today, in keeping with its commitment to ensure states have the necessary tools to respond to the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) approved an additional 11 state Medicaid waiver requests under Section 1135 of the Social Security Act (Act), bringing the total number of approved Section 1135 waivers for states to 13. The waivers were approved within days of states’ submitting them, and offer states new flexibilities to focus their resources on combatting the outbreak and providing the best possible care to Medicaid beneficiaries in their states. These waivers support President Trump’s commitment to operating a COVID-19 response that is locally executed, state managed and federally supported. A copy of the press release can be found here: https://www.cms.gov/newsroom/press-releases/cms-approves-medicaid-section-1135-waivers-11-additional-states-response-covid-19.
For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.
Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19
On March 22, CMS announced it is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs with respect to upcoming measure reporting and data submission for those programs. The action comes as part of the Trump Administration’s response to 2019 Novel Coronavirus (COVID-19). CMS is implementing additional extreme and uncontrollable circumstances policy exceptions and extensions for upcoming measure reporting and data submission deadlines for several CMS programs. For those programs with data submission deadlines in April and May 2020, submission of those data will be optional, based on the facility’s choice to report. CMS recognizes that quality measure data collection and reporting for services furnished during this time period may not be reflective of their true level of performance on measures such as cost, readmissions, and patient experience during this time of emergency and seeks to hold organizations harmless for not submitting data during this period. You can find a copy of the press release here: https://www.cms.gov/newsroom/press-releases/cms-announces-relief-clinicians-providers-hospitals-and-facilities-participating-quality-reporting
CMS continues to monitor the developing COVID-19 situation and assess options to bring relief to clinicians: To keep up with the important work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov.
For complete and updated information specific to CMS, please visit the Current Emergencies Website.
To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.