Centers for Medicare and Medicaid Services (CMS) Issues Second Round of Regulatory Waivers and Rule Changes, Including Additional Flexibilities for Telehealth
On April 30, CMS released the Interim Final Rule with Comment titled “Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program,” along with announcing additional flexibilities, including the continued expansion of telehealth coverage.
In response to efforts by ASCRS, the AMA, and the medical community, CMS will be increasing Medicare payments for audio-only telephone visits 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.
Specifically, this change will 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).
ASCRS ASOA will be developing an addendum to our Introduction to Tele-Ophthalmology Guide to reflect all the COVID-19 telemedicine changes.
Additional materials are available at these links:
ASCRS, AAO, and OOSS Release Ophthalmic ASC Reopening Check List
On April 29, ASCRS joined the AAO and OOSS in releasing guidance and an ophthalmic-specific checklist for reopening Ambulatory Surgery Centers (ASCs). The checklist provides details on how to approach and manage some of the key decisions involved.
ASCRS Joins the Surgical Coalition in a Letter to HHS, CMS, and ONC with Additional Requests to Ease Burdens on Physicians and their Practices.
ASCRS joined the Surgical Coalition in a letter to Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), and the Office of the National Coordinator for Health Information Technology (ONC) requesting additional regulatory help in easing the burdens on physicians and their practices including the Quality Payment Program (QPP), Advancing Interoperability and Patient Access to Data, and Information Blocking and the health IT Certification Program.
CMS Announces Suspension of the Advance Payment Program
On April 26, the Centers for Medicare & Medicaid Services (CMS) announced that it is reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending the program to Part B suppliers effective immediately. The agency paid over $100 billion to healthcare providers and suppliers through this program, which was expanded on March 28. CMS will not be accepting any new applications, and CMS will be reevaluating all pending and new applications considering the direct payments being made through the Provider Relief Fund.
For an updated fact sheet on the Accelerated and Advance Payment Programs, visit here.
For more information on the CARES Act Provider Relief Fund and how to apply, visit here.
CARES Provider Relief Fund Payment Portal is Now Open
Last week, the Department of Health and Human Services (HHS) announced additional plans for distributing funds from the CARES Act Provider Relief Fund and stated that $50 billion would be a “General Distribution” based proportionately on the provider’s 2018 net patient revenue. HHS intends the “General Distribution” to replace a percentage of a provider’s annual gross receipts, sales, or program service revenue.
Of that $50 billion, $30 billion has already been distributed to providers, and approximately $10 billion was released on April 24 to providers who have already shared cost data with HHS. For those that received funds from the initial $30 billion and would like to receive additional funds, you must sign into the General Distribution Portal to provide revenue data. Providers must attest to each payment associated with their billing Taxpayer Identification Number(s), if they have not already done so. Providers will also need to attest to the Terms and Conditions for the first $30 billion, if not done already. At this time, this portal is only for organizations which have already received payments through the CARES Act Provider Relief Fund. However, our understanding is that the majority of this second distribution will go to those providers, and specialties, who did not receive much money from the first distribution – as those payments were based on providers’ portion of Medicare fee-for-service revenue.
HHS has released a user guide to assist with this data submission process. One key element of the cost reporting is information from your tax returns. In addition, you will need your W-9 and Medicare or Medicaid ID number. The AMA has released guidance for using the HHS General Allocation Fund Portal.
HHS will use this data to calculate your proportional 2018 net revenue and provide such funds via electronic deposit, with the goal of such deposit within 10 business days of the submission. Payments will go out weekly, on a rolling basis, as information is validated. HHS has stated that they will be processing applications in batches every Wednesday at 12:00 noon EDT. Funds will NOT be disbursed on a first-come-first-served basis; therefore, an applicant will be given equal consideration regardless of when they apply.
The total funds being provided in this round will consider any funds the provider previously received as part of the $30 billion distribution. Subsequent to the funds being deposited, within 30 days of receipt of the funds, a provider is requested to log onto the CARES Act Provider Relief Fund attestation portal to confirm receipt and agree to the Terms and Conditions. (Note: These Terms and Conditions are NOT identical to those for the $30 billion distribution.)
If a provider meets certain Terms and Conditions, the payments received do not need to be repaid. These Terms and Conditions can be found here.
For more information, please visit here or call the CARES Provider Relief line at (866) 569-3522.
The Department of Health and Human Services (HHS) posted new Frequently Asked Questions and a fact sheet regarding this second round of disbursements