Important Rules, Laws and Updates

CMS Releases Guidance on Phasing in Elective and Other Non-Emergent Care

CMS – Re-Opening Essential & Non-Essential Services

“CMS recognizes that at this time many areas have a low, or relatively low and stable incidence of COVID-19, and that it is important to be flexible and allow facilities to provide care for patients needing non-emergent, non-COVID-19 healthcare. In addition, as states and localities begin to stabilize, it is important to restart care that is currently being postponed, such as certain procedural care (surgeries and procedures), chronic disease care, and, ultimately, preventive care.”

List of Telemedicine Billing Codes:

CMS has issued a list of reimbursable telemedicine services during the COVID-19 pandemic. To view the list, please see:

CMS – Telehealth Codes

New CMS “Flexibilities to Fight COVID-19” Expand Telehealth and RPM

CMS – Flexibilities to Fight COVID-19

In order to “equip the American healthcare system with maximum flexibility to respond to the 2019 Novel Coronavirus (COVID-19) pandemic,” CMS will now allow for more than 80 additional services to be provided via telehealth, which can be billed at the same rate as in-person visits.  Codes have also been updated for remote patient monitoring (RPM), including those related to ESRD.

Note additional guidance from Acadia on telemedicine and RPM on our COVID-19 alert page. For more information on implementing telehealth and RPM, please reach out to bkern@acadia.pro

CMS Expands the Accelerated and Advance Payments Program

CMS – Accelerated and Advanced Payments Fact Sheet

An accelerated/advance payment is a payment intended to provide necessary funds when there is a disruption in claims submission and/or claims processing.

Amount of Payment: Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period.

Processing Time: Each MAC will work to review and issue payments within seven (7) calendar days of receiving the request.

Repayment: CMS has extended the repayment of these accelerated/advance payments to begin 120 days after the date of issuance of the payment.

CMS Provides Telehealth Guidance

CMS – Medicare Telemedicine Provider Fact Sheet

CMS released a Fact Sheet related to telehealth, including the corresponding CPT codes. Also included are links to waivers and the details on lack of enforcement of certain HIPAA provisions by OCR.

Waivers:

CMS – Waivers

These waivers provide relief from certain requirements such as prior authorizations, enrollments, certain pre-admission reviews and reimbursement for care provided in alternative settings.

Federal Government Passes Coronavirus Aid Relief and Economic Security Act (“CARES”)

Senate Bill – 3548 Text

The $2 Trillion Relief measure includes the Paycheck Protection Program, which provides up to $349 billion in what can be forgivable loans to eligible entities. The loans are designed to help businesses cover payroll and rent, among other expenses. The CARES Act is a landmark piece of legislation with numerous provisions related to financial support for businesses as they navigate the disastrous implications of the COVID-19 pandemic.

HIPAA, Telehealth

HHS – Telehealth FAQs

OCR has stated that it will not pursue penalties for breaches that result from the good faith provision of telehealth services during the COVID-19 nationwide public health emergency.

Quality Reporting

CMS – Relief for Clinicians, Providers, Hospitals and Facilities Quality Report

CMS Announced relief for clinicians, providers, hospitals and facilities participating in quality reporting programs in response to COVID-19.

The Medical Professional Liability Market and the Impact of COVID-19