Today [March 10, 2020],
the Centers for Medicare & Medicaid Services (CMS) is taking
further action to ensure patients have access to the critical healthcare
services they need in the wake of the 2019 Novel Coronavirus (COVID-19)
outbreak. Today, following a meeting with President Trump and Vice
President Pence, many leading insurance companies and their industry
associations announced they will be treating
COVID-19 diagnostic tests
as covered benefits and will be waiving cost sharing that would
otherwise apply to the test. The President also directed CMS to provide
more flexibility to Medicare Advantage and Part D plans to ensure they
have the tools they need to provide seniors with the best coverage. As a
result, CMS published a memorandum to Medicare Advantage (MA) and Part D
health and prescription drug plans informing them of the flexibilities
they have to provide healthcare coverage to Medicare beneficiaries for
COVID-19 testing, treatments, and prevention.
"The
President directed CMS to make sure Medicare Advantage beneficiaries
have access to the healthcare services they need during this time,” said
CMS Administrator Seema Verma. “Today we announced guidance to Medicare
Advantage and Part D plans to remove barriers that could prevent or
delay beneficiaries from receiving care. Medicare beneficiaries are at
the greatest risk of serious illness due to COVID-19 and CMS will
continue doing everything in our power to protect them."
In
the memorandum issued today, CMS outlines the flexibilities MA and Part
D plans have to waive certain requirements to help prevent the spread
of COVID-19. These flexibilities include:
- Waiving cost-sharing for COVID-19 tests
- Waiving cost-sharing for COVID-19 treatments in doctor’s offices or emergency rooms and services delivered via telehealth
- Removing prior authorizations requirements
- Waiving prescription refill limits
- Relaxing restrictions on home or mail delivery of prescription drugs
- Expanding access to certain telehealth services
These
waivers break down barriers to beneficiaries accessing care and allow
plans to work with pharmacies and providers to treat patients without
burdensome requirements limiting their options during this outbreak.
This
action is part of the broader effort by the White House Coronavirus
Task Force to ensure that all Americans – particularly those at
high-risk of complications from the COVID-19 virus – have access to the
benefits that can help keep them healthy while helping to contain the
spread of this disease. To keep up to date with the important work CMS
is doing in response to COVID-19, please visit the
Current Emergencies Website.
To view, CMS’s memorandum for MA and Part D plans, visit:
https://www.cms.gov/files/document/hpms-memo-covid-information-plans.pdf
Summary of CMS’s COVID-19 response actions to date:
On
March 9, 2020: CMS delivered guidance on the screening, treatment and
transfer procedures healthcare workers must follow when interacting with
patients to prevent the spread of COVID-19 in a hospice setting. CMS
also issued additional guidance specific to nursing homes to help
control and prevent the spread of the virus.
https://www.cms.gov/newsroom/press-releases/cms-issues-clear-actionable-guidance-providers-about-covid-19-virus
On
March 9, 2020: CMS issued a press release highlighting the telehealth
benefits in the agency’s Medicare program for use by patients and
providers. Expanded use of virtual care, such as virtual check-ins, are
important tools for keeping beneficiaries healthy, while helping to
contain the community spread of the COVID-19 virus.
https://www.cms.gov/newsroom/press-releases/telehealth-benefits-medicare-are-lifeline-patients-during-coronavirus-outbreak
CMS
published guidance to hospitals with emergency departments (EDs) on
patient screening, treatment and transfer requirements to prevent the
spread of infectious disease and illness, including
COVID-19. Medicare-participating hospitals are to follow both CDC
guidance for infection control and Emergency Medical Treatment and Labor
Act (EMTALA) requirements.
https://www.cms.gov/newsroom/press-releases/cms-issues-call-action-hospital-emergency-departments-screen-patients-coronavirus
March
6, 2020: CMS issued frequently asked questions and answers (FAQs) for
healthcare providers regarding Medicare payment for laboratory test and
other services related to the 2019-Novel Coronavirus (COVID-19).
https://www.cms.gov/newsroom/press-releases/covid-19-response-news-alert-cms-issues-frequently-asked-questions-assist-medicare-providers
March
5, 2020: CMS issued a second Healthcare Common Procedure Coding System
(HCPCS) code for certain COVID-19 laboratory tests, in addition to three
fact sheets about coverage and benefits for medical services related to
COVID-19 for CMS programs.
https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests
March
4, 2020: CMS issued a call to action to healthcare providers nationwide
and offered important guidance to help State Survey Agencies and
Accrediting Organizations prioritize their inspections of healthcare.
https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus
February 13, 2020: CMS issued a new HCPCS code for providers and laboratories to test patients
for COVID-19.
https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test
February 6, 2020: CMS gave CLIA-certified laboratories information about how they can test for SARS-CoV-2.
https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/notification-surveyors-authorization-emergency-use-cdc-2019-novel-coronavirus-2019-ncov-real-time-rt
February 6, 2020: CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19.
https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/information-healthcare-facilities-concerning-2019-novel-coronavirus-illness-2019-ncov
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