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

Get MIPS 2020 PY COVID-19 Hardship Exception Information

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, 2020
    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. Read APMA's full CARES Act summary.
  • 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.
  • 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.

    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, 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 2019 MIPS PY Reporting
    For 2019 MIPS, CMS is extending the data submission deadline from March 31, 2020 to April 30, 2020 - Read APMA's response to this announcement here.

    After the initial announcement on March 22, CMS released additional guidance on March 27, 2020:
      - CMS MLN Memo Exceptions and Extensions for 2019 Quality Reporting Requirements (PDF)
      - Quality Payment Program – COVID-19 Response (PDF)

    2019 Performance Year: MIPS eligible clinicians reporting as individuals who have not submitted any MIPS data or submitted for only one performance category by April 30, 2020, will qualify for the automatic extreme and uncontrollable circumstances policy and will receive a neutral payment adjustment for the 2021 MIPS payment year. Clinicians reporting as individuals who have reported at least two performance categories or reporting as groups will need to proactively request the extreme and uncontrollable circumstances hardship, via the re-opened the 2019 extreme and uncontrollable circumstances application

    2020 Performance Year: For 2020 MIPS, CMS is evaluating options for providing relief around participation and data submission. 

  • CMS Adult Elective Surgery and Procedures Recommendations
    During the COVID-19 crisis, CMS provided guidance to limit non-essential adult elective surgery and medical and surgical procedures in order to better conserve critical resources such as ventilators and Personal Protective Equipment (PPE). This guidance also ensures limiting exposure of patients and staff to the SARS-CoV-2 virus.

Medicaid

  • General CMS Medicaid COVID-19 Resource Page
  • Medicaid Telehealth
  • States Currently Approved for 1135 Medicaid Waivers
    CMS has approved a number of 1135 Medicaid Waivers in recent days, offering states new flexibility to focus their resources on combating the outbreak and providing the best possible care to their Medicaid beneficiaries.
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 (no COVID-19 waiver to date)
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 (no COVID-19 waiver to date) Wisconsin (no COVID-19 waiver to date)
Hawaii Mississippi Oregon Wyoming
Idaho Missouri Pennsylvania

Some states have not yet applied for or received their 1135 Medicaid waivers. CMS has issued an FAQ to address this situation.


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