Below are the COVID-19 regulatory updates from CMS and HHS for this week:
Medicare to reprocess telehealth telephone E/M visits paid at lower rate
Medicare Administrative Contractors (MACs) will automatically reprocess claims for audio-only telephone Evaluation and Management visits (CPT codes 99441, 99442, and 99443) retroactive to March 1, 2020 that were previously denied or paid at the lower rate. Physicians and other qualified health care professionals are not required to do anything. On April 30, the Centers for Medicare & Medicaid Services (CMS) published an Interim Final Rule authorizing implementation of new payment rates for these services during the COVID-19 public health emergency (PHE). There are also a number of add on services (CPT codes 90785, 90833, 90836, 90838, 96160, 96161, 99354, 99355, and G0506) which Medicare may have denied during the PHE. MACs will also reprocess those claims for dates of service furnished on or after March 1.
OIG updates COVID-19 related frequently asked questions
The HHS Office of Inspector General (OIG) published answers to frequently asked questions (FAQs) about regulatory flexibility for health care providers during the COVID-19 PHE. The FAQs address the OIG’s administrative enforcement authorities under the federal Anti-Kickback Statute (AKS) and Civil Monetary Penalties Law (CMPL) prohibiting beneficiary inducement. If you have a question regarding how OIG would view an arrangement that is directly connected to the PHE and implicates the AKS or CMPL authorities, please submit your question to OIGComplianceSuggestions@oig.hhs.gov.
CMS waiver updates
CMS recently updated its suite of blanket waivers to ensure that healthcare providers and medical facilities have the flexibility they need to treat patients during the COVID-19 pandemic. The waivers are updated on an ongoing basis to align with evolving legislative and regulatory changes made during the PHE.
HHS awards $15 million to support telehealth providers during COVID-19 pandemic
The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA) awarded $15 million to 159 organizations across five health workforce programs to increase telehealth capabilities in response to the COVID-19 pandemic. HRSA made awards to organizations based on their capacity to implement COVID-19 telehealth activities that train high demand professions across the health care team. The investments will train students, physicians, nurses, physician assistants, allied health and other high-demand professionals in telehealth, and enable them to maximize telehealth for COVID-19 referrals for screening and testing, case management, outpatient care, and other essential care during the crisis. These funds are in addition to the nearly $583 million HRSA previously awarded to 1,385 health centers in all 50 states, the District of Columbia, and eight U.S. territories to expand COVID-19 testing.