Louisiana State Medical Society
COVID-19 Bulletin #18 (5/1/2020)
May 1, 2020 by Chris LeBouef

HRSA COVID-19 Claims Reimbursement for Testing and Treatment of the Uninsured

As part of the FFCRA and CARES Act, the U.S. Department of Health and Human Services (HHS) will provide claims reimbursement to reimburse health care providers for testing uninsured individuals for COVID-19 and treating uninsured individuals with a COVID-19 diagnosis for dates of service or admittance on or after February 4, 2020.

HHS has contracted with UnitedHealth Group to administer the HRSA COVID-19 Uninsured Program on behalf of the Health Resources and Services Administration (HRSA), an agency of HHS. Providers can request claims reimbursement through the program electronically and will be reimbursed generally at Medicare rates, subject to available funding. To participate, providers must:
  • Verify and attest that the patient does not have individual, employer-sponsored, Medicare or Medicaid coverage, and no other payer will reimburse them for COVID-19 testing and/or treatment for that patient
  • Agree to not balance bill the patient
  • Agree to program terms and conditions
Reimbursement will be made for qualifying testing for COVID-19 and treatment services with a primary COVID-19 diagnosis (except for pregnancy, when the COVID-19 code may be listed as secondary), as determined by HRSA (subject to adjustment as may be necessary), including the following:
  • Specimen collection, diagnostic, and antibody testing.
  • Testing-related visits including in the following settings: office, urgent care, or emergency room or via telehealth.
  • Treatment, including office visit (including via telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), acute inpatient rehab, home health, DME (e.g., oxygen, ventilator), emergency ground ambulance transportation, non-emergent patient transfers via ground ambulance, and FDA-approved drugs as they become available for COVID-19 treatment and administered as part of an inpatient stay.
  • FDA-approved vaccine, when available.
  • For inpatient claims, the date of admittance must be on or after February 4, 2020.
Providers can begin signing up for the program on April 27, 2020. They can then begin submitting claims on May 6, 2020, and the earliest they will receive payment will be May 18. More information including how to participate and who is eligible can be found online here.

CMS Payments for Audio-Only Telephone Visits

In response to efforts by organized medicine, the Centers for Medicare & Medicaid Services (CMS) announced they will be increasing payments for audio-only telephone visits between Medicare beneficiaries and their physicians to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110, and the payments are retroactive to March 1, 2020.
 
This is a major victory for medicine that will enable physicians to care for their patients, especially their elderly patients with chronic conditions who may not have access to audio-visual technology or high-speed Internet.
 
The American Medical Association and the Federation also worked with Senator Hyde-Smith (R-MS), along with Senators Shaheen (D-NH), Manchin (D-WV), and Moran (R-KS), to spearhead the below letter to HHS Secretary Azar and CMS Administrator Verma on the same topic. The letter sent on April 29 had 37 signers and included the following requests:
  1. Increase Medicare payment rates for telephone-based evaluation and management (E/M) codes (99441-99443) to bring payments for these codes equal to Medicare’s established in-person visit codes (99212-99214) that will ensure that patients without advanced video-sharing capabilities are able to get care virtually while helping to sustain physician practices.
  2. Immediately provide guidance to Medicare Administrative Contractors (MACs) to ensure that recent CMS guidance and rules are followed appropriately to enable the payment of telephone E/M claims.
  3. Provide Members of Congress with a briefing on CMS efforts to address this issue by May 8, 2020.
Click here to read the letter.

Legislature Plans Monday Return

Louisiana’s legislative leaders have announced plans to reconvene the 2020 regular session on Monday, May 4. Details being released include safety measures to protect legislators, staff, and visitors. Measures include temperature checks, screenings, and wearing PPE. In the House, committees are planning to meet across two rooms and plexiglass dividers have been added between member desks on the floor. Access will be very limited and protocols will likely be adjusted fluidly to address “fixes” that may be needed to ease work.

Monday details include:

  • The House will convene at 9 a.m. They will have committee meetings following their floor session.
  • The Senate will convene at 2 p.m. They will not have committee meetings until Tuesday.

Rumors indicate legislators will be asked to identify priority legislation that needs to be passed now. The expectation in this is that a large percentage of legislation that has been filed will not be heard in this session. For now, the bodies must have a budget in place prior to June 30, recreate various state agencies, and fulfill requirements related to appointments and confirmations. Outside of these items, you will see bills that deal with this specific pandemic, procedures for emergency actions, and forward-looking legislation based on lessons learned over the last month.

Please continue to watch your emails for calls-to-action. We understand how busy and focused on current healthcare needs you are right now, so your support is even more appreciated than normal.


Gov. Edwards Formally Extends Louisiana's Stay at Home Order Until May 15

Gov. John Bel Edwards formally extended Louisiana’s Stay at Home order until May 15 as the state continues to slow the spread of COVID-19 to meet the White House threshold criteria for opening more of our economy. In recent days and weeks, Louisiana has seen a drop in new case counts and hospitalizations in some, but not all, regions of the state, though the death rate continues to be high.

More than 1,800 people in Louisiana have died from COVID-19. And while more than 17,000 people are estimated by the Louisiana Department of Health as being recovered,10,000 people in Louisiana are still sick, giving Louisiana a high disease burden. And this does not account for the thousands of asymptomatic and mildly symptomatic cases in our state among those not tested. As of Thursday morning, Louisiana was six per capita for cases in the United States.

  • Click here for a copy of the order.

LSMS T-Shirt Fundraiser

NEW DESIGN (below)- Sales start today and run through Friday, May 15, 2020! Click here to order now!

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