The list below includes links to resources HFMA’s members will find useful as they help navigate their organizations through the COVID-19 emergency. These resources include information related to Medicare, state, and commercial health plans.
These resources include links to the best currently available information related to coding, billing, coverage of services, and disaster preparedness financing during the COVID-19 national emergency
Medicare – General:
- Expansion of The Accelerated and Advance Payments Program For Providers And Suppliers During Covid-19 Emergency: CMS issued guidance detailing how providers can access accelerated Medicare payments, as modified by the CARES Act to provide needed liquidity during the COVID-19 pandemic. This fact sheet provides details how hospitals and physicians can access these funds and how they will be repaid.
- Interim Final Rule in Response to COVID-19: On March 31st, CMS issued a rule that allows hospitals to increase capacity, increase the types of services that can be provided virtually, and reduce administrative burden.
- COVID-19 National Emergency Declaration Fact Sheet: Describes in general what Medicare regulations will be waived in response to the COVID-19 national emergency declaration.
- Provider Enrollment Simplification: Provides answers to frequently asked questions about CMS’s actions to reduce administrative barriers to enrolling additional providers in response to the COVID-19 national emergency.
- Relief for Hospitals and Providers Participating in Quality Reporting/Payment Programs: 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. See appendix I below for specific details for each program.
- COVID-19 Test Pricing: Provides payment amounts by MAC based on HCPCs code used.
Medicare – Telehealth Billing
- Telehealth Provider Fact Sheet: Provides an overview of Medicare’s expanded telehealth benefit during the national emergency.
- Telehealth Billing FAQs: Provides CMS’s answers to frequently asked questions related to billing Medicare for telehealth.
- Telehealth Toolkit: CMS has produced a “telemedicine toolkit” with links to internet resources. Many of these links will help providers learn about the general concept of telehealth, choose telemedicine vendors, initiate a telemedicine program, monitor patients remotely, and develop documentation tools. Additionally, the information contained within each toolkit will also outline temporary virtual services that could be used to treat patients during this specific period of time.
- Nursing Home Telehealth Toolkit: CMS has produced a “telemedicine toolkit” with links to internet resources. Many of these links will help nursing homes learn about the general concept of telehealth, choose telemedicine vendors, initiate a telemedicine program, monitor patients remotely, and develop documentation tools. Additionally, the information contained within each toolkit will also outline temporary virtual services that could be used to treat patients during this specific period of time.
- Medicaid FMAP Increase FAQs: CMS has released a FAQ related to the 6.2 percentage point increase in Federal Medicaid Assistance Percentage (FMAP) in the Families First Coronavirus Response Act.
- Approved State Medicaid Waivers Related to COVID-19: Despite the national emergency, states must apply for section 1135 waivers to relax certain federal requirements in response to COVID-19. This tool tracks which states have had waivers approved and what the waiver covers.
- State Policy Actions Related to COVID-19: The Kaiser Family Foundation has created a resource tracking which states have eliminated cost sharing for testing and treatment related to COVID-19 for the health plans they regulate.
- AAPC COVID-19 Coding Guidelines: AAPC has done a nice job of keeping this updated as new codes are released. The new CPT code for COVID testing is available here.
- Health Insurer COVID-19 Coverage: America’s Health Insurance Plans (AHIP) provides an up-to-date list of its members’ coverage policies for testing and services related to COVID-19 for fully insured products.
- FAQs on Essential Health Benefits Related to COVID-19: Provides HHS’s answers to frequently asked related to coverage for testing and treatment related to COVID-19.
Disaster Planning, Financing, and Reimbursement:
- HFMA Disaster Planning Checklist: Provides CFOs with a checklist to help their organizations prepare for events like the COVID-19 national emergency.
- CDC Disaster Planning Budget Tool: Currently, the industry doesn’t have clarity into how HHS will request documentation to support claims for reimbursement from the Public Health and Social Services Emergency Fund. However, it is anticipated that hospitals will be asked to accurately segregate the costs related to disaster response from normal operating costs. Keys to this will include accurate coding of pneumonia/COVID-19 cases, capture of direct costs in a discrete cost center, and documentation to support allocations of time from staff and resources that are split amongst activities. The CDC’s Disaster Budget Planning Tool is one example of a model providers could follow. While there’s no guarantee HHS will follow this model, it is a format one of their agencies has put forth as an approach.
- HFMA COVID-19 News Coverage: Stay up-to-date with the most current reporting on the crisis as it impacts health plans, hospitals, and physicians from DC and beyond.
- EMTALA Requirements Related to COVID-19: Provides an overview of acute care hospital requirements related to screening and treatment related to COVID-19.