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Updated COVID-19 Frequently Asked Questions Released by the CMS

On August 26, 2020, the Centers for Medicare and Medicaid (CMS) released an updated Frequently Asked Questions (FAQ) guide for questions related to COVID-19 and the public health emergency (PHE). The guide supplements the previously released FAQ guidance pertaining to 1135 Waivers under COVID-19.  The new guide includes additional details from COVID-19 legislation, emergency rules, and waivers.  The policies included in the FAQ are effective for the duration of the PHE unless superseded by future legislation. 

The FAQs address provisions from the Coronavirus Aid, Relief, and Economic Security (CARES) Act, as well as the two interim final rules: the Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COIVD-19 Public Health Emergency and Medicare and Medicaid Programs, Basic Health Program and Exchanges: Additional policy and Regulatory Revisions in Response to the COIVD-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program

The guidance covers a variety of topics related to COVID-19 testing including: 

  • payment for specimen collection for COVID-19 testing, and 

  • detailed coding information for COVID-19 laboratory testing, and diagnostic laboratory services.  

The guidance also includes FAQs on issues related to hospital services during the PHE, such as: 

  • temporary expansion sites, repurposing areas of hospitals, and Ambulatory Surgery Centers (ASCs) enrolling as hospitals.  

The FAQs also address key issues regarding Medicare Condition of Participation waivers, Medicare cost reports, how Medicare is reimbursing for beneficiaries that must be isolated due to COVID-19, and issues related to Medicare billing and claims processing for transfers during COVID-19. 

Changes made to the hospital inpatient prospective payment system (IPPS) under the CARES Act are also explained in the FAQs including increased payments, discharge of COVID-19 patients and claims processing updates. The guide contains FAQs regarding on-campus and excepted off-campus provider based departments (PBDs) under the COVID-19 PHE. 

Telehealth remains a key focus and the guidance addresses additional changes applicable to telehealth, such as:  

  • whether mental health visits can be furnished as a distant site telehealth service; 

  • whether a medical visit and a mental health visit can be reported on the same day when furnished as a distant site telehealth service; and 

  • how to report distant site telehealth services when a mental health visit is furnished on the same day as a medical visit; 

  • which services can be provided by telehealth during a waiver for the PHE; 

  • whether practitioners can provide Medicare telehealth services using video-enabled phones; and 

  • if the video connection is disconnected during an audio-video Medicare telehealth visit due to technological issues, whether the visit can still be billed as Medicare telehealth. 

The guidance also covers physician services and scope of practice issues that changed under the COVID-19 PHE. In addition, additional flexibilities provided under the teaching physician regulations during the COVID-19 PHE are addressed in the guidance. 

Other topics covered include: 

  • Hospital Outpatient Therapeutic Services Furnished in Temporary Expansion Locations

  • Partial Hospital Program (PHP) Services 

  • Ambulance Services 

  • Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), including expansion of virtual communication services for FQHCs and RHCs 

  • Durable Medical Equipment Interim Pricing in the CARES Act 

  • Home Infusion Services

  • Medicare Shared Savings Program Accountable Care Organizations (ACOs)

  • Cost Reporting/How to Report Relief Fund Payments on the Cost Report

  • Skilled Nursing Facility Services 

  • General Billing Requirements 

  • Home Health 

  • Part B Drugs and Vaccines 

  • National Coverage Determinations (NCDs)

  • Medicare Payment to Facilities Accepting Government Resources 

  • Oxygen

  • Temporary Department of Defense Sites

  • Hospice

  • Ambulatory Surgical Centers (ASCs)

  • Chronic Care Management Services

  • Hospital Billing for Remote Services

  • Diagnosis Coding under International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

  • Outpatient Therapy Services 

It is imperative that providers understand and remain abreast of updated guidance issued by CMS to ensure compliance with the COVID-19 legislation, emergency rules, and waivers. We are continuing to monitor Medicare changes during the COVID-19 PHE and will provide additional guidance as it becomes available. 

Copyright © 2020 Womble Bond Dickinson (US) LLP All Rights Reserved.National Law Review, Volume X, Number 259

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About this Author

Ashley McGlone healthcare Attorney Womble Bond Dickinson Law Firm Winston-Salem NC
Senior Counsel

Ashley is a seasoned healthcare attorney with nearly a decade of experience advocating on behalf of healthcare providers. She brings a wealth of industry knowledge and personal insight into the regulatory and operational challenges facing healthcare clients.

Ashley advises clients on issues related to government health payment programs under Medicare and Medicaid.  Her areas of substantive focus include physician reimbursement, quality and cost program reporting requirements, health information technology, and Alternative Payment Models.  Ashley...

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Alissa Fleming, Womble Dickinson Law Firm, Charleston, Health Care Law Attorney
Of Counsel

Alissa possesses first-hand knowledge of the healthcare industry as an attorney and registered nurse.  Her legal practice and medical background enable her to advise and represent national, regional and local healthcare providers on a broad and diverse spectrum of legal issues.

She has represented healthcare providers in health law and healthcare litigation throughout the duration of her career.  She regularly represents hospitals, long term care facilities, home health agencies, pharmacies, and professionals in healthcare litigation, regulatory and compliance issues, licensing, governance, business practice, operational and risk management, credentialing, medical staff and health information technology.  Alissa assists with facility and professional licensing, Certificate of Need, fraud and abuse, certification, reimbursement, scope of practice and patient privacy.  Her healthcare litigation experience includes the defense of hospitals, physicians, long term care facilities, and pharmacists against professional malpractice claims.  

In addition to Alissa’s healthcare practice, she regularly counsels and represents public and private employers and state higher education institutions on a variety of operational issues including employment contracts, policies, handbooks, terminations, discrimination, retaliation, harassment, employee discipline, retaliation, harassment, and work place investigations.  She represents employers in all aspects of litigation, including discrimination and retaliation in violation of Title VII, ADEA, FMLA, ADA and state employment laws.

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Sandra Louise Weikel Miller Womble Bond Dickinson Healthcare lawyer
Partner

Sandy has helped clients through the heavily regulated and often confusing health law and healthcare litigation landscape for 25 years, and, before practicing law, she worked for more than a decade as a registered nurse, including serving as a Director of Nursing. She represents hospitals, home health agencies, hospitals, long term care facilities and other related health care providers. Sandy’s experience stretches across healthcare spectrum and she represents health care providers in a variety of health law related issues, including federal and state fraud and abuse compliance,...

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Thomas Stukes, Womble Carlyle Law Firm, Greensboro, Healthcare Law Attorney
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Tom Stukes is a partner in Womble Carlyle’s Healthcare Industry Team and represents hospital systems, academic medical centers and other health care providers, and provider networks, throughout the country.

Tom has handled more than 40 hospital and medical center acquisitions, sales, mergers, consolidations, conversions and restructurings of public, nonprofit and for-profit clients and has been instrumental in the formation of a number of the largest hospital systems in North Carolina.

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