CMS Updates Related to Coronavirus (COVID-19) | Practicing DPMs | APMA
CMS Updates Related to Coronavirus (COVID-19)

Members can find all COVID-19 CMS-related news on this page. For relevant COVID-19 related APMA resources, including APMA recommendations and access to financial resources during this public health emergency, visit www.apma.org/COVID19

Medicare

  • General CMS COVID-19 Resource Page
  • Suspension of Medicare Sequester Through December 31, 2021
    Section 3709 of the CARES Act temporarily lifts the Medicare sequester, which reduces payments to providers by 2 percent, from May 1 through December 31, 2020, boosting payments for hospital, physician, nursing home, home health, and other care. The Medicare sequester would be extended by one year beyond current law to provide immediate relief without worsening Medicare’s long-term financial outlook. The US Congress voted in March to extend these cuts until December 31, 2021. Read APMA's full CARES Act summary.
  • CMS Advanced and Accelerated Payment Program (Suspended on April 26, 2020)
    CMS announced on April 26 its decision to reevaluate the amounts that will be paid under the Accelerated Payment Program and to suspend its Advance Payment Program to Part B suppliers. Find information about repayment and recoupment timelines and terms here.
  • Provider Relief Fund
    On April 10, 2020, the Department of Health and Human Services (HHS) began distributing the initial $30 billion in relief funding to Medicare fee-for-service (FFS) facilities and providers. These are grants, not loans, and do not have to be repaid. The funds you will receive from this fund will be in direct proportion to your practice’s share of Medicare fee-for-service spending. Hypothetically, if a Medicare provider with a Taxpayer ID Number (TIN) accounted for 1 percent of total Medicare FFS spending in 2019, the TIN would receive 1 percent of the $30 billion. All facilities and health professionals that billed Medicare FFS in 2019 are eligible for the funds. In September 2021, HHS announced the availability of $25.5 Billion in COVID-19 Provider Funding  for Phase 4 which opened on September 29.

    If you have not yet received the funds directly in your bank account, check with the bank account associated with your practice’s TIN. The automatic payments will come to the organizations via Optum Bank with "HHSPAYMENT" as the payment description. Within 30 days, you must sign and submit an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The portal for signing the attestation will be open the week of April 13 and will be linked from hhs.gov/providerrelief.

    APMA strongly encourages members to read the terms and conditions closely before attesting, and seek guidance from their legal counsel if necessary.
  • Expansion of Covered Telehealth Services in Response to COVID-19
    Please visit APMA’s full resource page on updates to providing non-face-to-face services.
    The OCR has also issued additional guidance on relaxed enforcement discretion for telehealth remote communications during the COVID-19 public health emergency:
      - OCR Bulletin: 2020 HIPAA and Novel Coronavirus (PDF, February 2020)
  • Provider Enrollment Relief Information
    The March 22 FAQ includes toll-free hotlines available to provide expedited enrollment and answer questions about COVID-19 enrollment requirements. As noted in the FAQs (updated August 2021), CMS is exercising its 1135 waiver authority in the following ways:
Physicians and Non-Physician Practitioners
  1. Establish toll-free hotlines to enroll and receive temporary Medicare billing privileges
  2. Waive the following screening requirements:
    1. Criminal background checks associated with fingerprint-based criminal background checks (FCBC)—42 C.F.R 424.518 (to the extent applicable)
    2. Site visits—42 C.F.R 424.517
    3. Postpone all revalidation actions
All Other Providers and Suppliers (including DMEPOS)
  1. Expedite any pending or new applications
  2. All clean web applications will be processed within seven business days and all clean paper applications in 14 business days
  3. Waive the following screening requirements for all enrollment applications received on or after March 1, 2020:
    1. Criminal background checks associated with the FCBC – 42 C.F.R. 424.518 (to the extent applicable)
    2. Site-visits – 42 C.F.R. 424.517
    3. Postpone all revalidation actions

Additionally, the FAQ addresses the process for physician and non-physician practitioners to initiate temporary Medicare billing privileges, including through an enrollment hotline, licensure, revalidation, and more.

  • Changes for 2021 MIPS PY Reporting
    CMS has made available again the COVID-19 Extreme & Uncontrollable Circumstances (EUC) Exception. Providers must proactively submit their application for this exception by December 31, 2021. Providers may apply to reweight one to all of the performance categories to zero, for a neutral payment adjustment to the 2023 payment year. Applications for this EUC will need to include a brief description of the data collection challenges you faced as a result of COVID-19 and how your 2021 performance will be impacted (although there is still no formal documentation requirement). Follow APMA's step-by-step instructions when applying for a 2021 MIPS PY COVID-19 EUC. Additional information can be found at www.apma.org/MIPS2021.

Medicaid

Alabama Illinois Montana Rhode Island
Alaska Indiana Nebraska South Carolina
Arizona Iowa  Nevada South Dakota 
Arkansas Kansas New Hampshire Tennessee
California Kentucky New Jersey Texas
Colorado Louisiana New Mexico Utah 
Connecticut Maine New York Virginia
Delaware Maryland North Carolina Vermont
District of Columbia Massachusetts North Dakota Washington
Florida Michigan Oklahoma West Virginia
Georgia Minnesota Ohio  Wisconsin
Hawaii Mississippi Oregon Wyoming
Idaho Missouri Pennsylvania


Leave Your Thoughts

Please sign in to leave a comment



Related Resources

Falls Prevention

Learn More

Coding

Learn More

APMA's "Back to Basics"

Learn More

ADVERTISEMENT
All your coding questions answered in one convenient, online resource. subscribe today!