Medicare Telehealth Waivers

Updated March 1, 2022 Courtesy of MGMA

In 2020, the Department of Health & Human Services (HHS) instituted flexibilities that waived many of the generally applicable rules governing Medicare telehealth services in response to the COVID-19 pandemic. Many of these waivers are in effect through the duration of the COVID-19 public health emergency (PHE). Once the PHE concludes, many of these flexibilities will end without further congressional or regulatory action. The COVID-19 PHE is currently in effect through April 16, 2022. Please keep in mind that this resource addresses Medicare payment policy, and that Medicaid and commercial payers may institute their own payment rules.

View the complete waivers document

NCDHHS Deploys 300 Free Testing Sites in Underserved Communities

The NC Department of Health and Human Services announced a new effort to deploy up to 300 free testing sites in underserved communities. This targeted testing initiative seeks to confront historical health disparities by increasing access to no-cost COVID-19 testing for African American, Latinx/Hispanic and American Indian communities across the state.

A disproportionately high percentage of North Carolina’s confirmed cases of COVID-19 have occurred among historically marginalized populations. Mounting evidence shows the members of these populations experience higher rates of COVID-19 mortality and serious complications.

As many as 300 temporary testing sites will be deployed throughout the month of July, including drive-thru and walk-up sites. The initiative will increase testing capacity in more than 100 ZIP codes, providing testing access for 2.2 million African American, Latinx/Hispanic and American Indian individuals. Two vendors have been identified to begin this work, Vidant Health and Orig3n, Inc.

The initiative emphasizes a community testing approach. The awarded vendors are required to connect individuals with medical homes and provide services with culturally and linguistically appropriate standards, working within existing trusted community partnerships; additionally, no payment from the individual will be needed for the testing. Insurance, if available, will be billed but no co-pays or cost-sharing will be asked of anyone seeking testing. Those who are uninsured will have full access to free testing at these sites.

Communities were selected based on low testing capacity and high African American, Latinx/Hispanic and/or American Indian populations. Higher concentration of elderly populations with multiple chronic conditions and higher rates of construction and seasonal farm work were also factors.

For more information on testing, please see the Frequently Asked Questions about Testing. For more information about North Carolina’s response to COVID-19, visit nc.gov/covid19.

 

MGMA to HHS: Disburse remaining Provider Relief Funds

MGMA is urging the Department of Health & Human Services (HHS) to expeditiously provide financial relief to group practices by disbursing the remaining Provider Relief Funds. Congress appropriated $175 billion to HHS to deliver financial relief to healthcare providers in order to cover expenses and lost revenue attributable to COVID-19. HHS is making disbursements through a $50 billion General Distribution, however some providers that submitted applications for additional funding have yet to receive payments, despite applying over a month ago. MGMA is encouraging HHS to quickly deliver funds pursuant to those applications.

After accounting for disbursements to date, HHS still has approximately $95 billion in unallocated Provider Relief Funds. Since eligibility for payments under the $50 billion General Distribution was contingent upon Medicare enrollment, MGMA is urging HHS to support group practices underrepresented in this distribution, such as providers that do not accept Medicare.

Provider Relief Fund attestation deadline approaching

Group practices who received a payment from the Department of Health and Human Services (HHS) under the Provider Relief Fund must sign an attestation confirming receipt of funds and agreeing to conditions of payment within 45 days of payment. That means groups who received funding from the initial distribution on April 10 have until May 24 to attest. Notably, not returning the payment within 45 days of receipt will be viewed as acceptance of the funds and associated terms and conditions.

HHS also announced this week that providers have until June 3 to submit revenue information to be considered for an additional payment from the $50 billion general distribution. While HHS automatically disbursed payments from the first tranche ($30 billion) starting on April 10, most group practices must submit a request to receive additional funds from the second tranche ($20 billion).

Finally, HHS updated and clarified FAQs on the Provider Relief Fund general distribution. With the Department updating their FAQs and website periodically without any formal announcement or notification, MGMA recommends that group practices review this new guidance. See MGMA’s resource on financial relief programs for more information.

Join Us for Our April 21st Webinar on NC Medicaid’s Response to COVID-19

NC Medicaid Response to COVID-19:
The State of Things

April 21, 2020 | 12:00 PM – 1:00 PM EDT

Join us on April 21st from 12:00 PM to 1:00 PM as Dr. Shannon Dowler, FAAFP, CPE, of the Department of Health and Human Services (DHHS), presents “NC Medicaid Response to COVID-19: The State of Things.”

Our Speaker

Dr. Shannon Dowler, FAAFP, CPE
Chief Medical Officer, North Carolina Medicaid
Department of Health and Human Services
Dr. Shannon Dowler, FAAFP, CPE, is the Chief Medical Officer for North Carolina Medicaid in the Department of Health and Human Services. Her past experience with Medicaid includes chairing the Physician Advisory Group for Medicaid (an independent legislated non-profit whose sole purpose is advising Medicaid on clinical policy) for several years. She is a Past President of the NC Academy of Family Physicians and recently completed a four-year term on AAFP and ACOG commissions. In 2017 she received her Certified Physician Executive degree from the American Academy of Physician Leaders.

Dr. Dowler obtained her medical degree from East Carolina (Brody) School of Medicine and completed a Family Medicine Residency and Fellowship in Asheville at MAHEC. She has spent her career in the service of non-profits in public and community health including: the local health department, providing full spectrum care (OB without deliveries) as well as a long standing role in the STD clinic; as CMO for a large FQHC in WNC; and most recently as Associate Chief Quality Officer and Chief of Community Medicine and Population Health for Mission Health System, focusing on integration of healthcare and reducing unnecessary care variation across a health system.

Registration

This webinar is complimentary but you must be registered to attend. Space is limited so register early! After you register, you will receive an emailed confirmation with webinar and phone-in instructions.

• Click here to register

Continuing education credit may be granted through your professional organization (MGMA, PAHCOM, AHIMA, etc.). Please self-submit for these organizations.

Questions

For questions or more information please contact the NC Medical Society Foundation offices at ncmsfoundation@ncmedsoc.org; or by phone at 919-833-3836.

Regulatory Alert: HHS CARES Act Grant Funding Attestation Portal Now Open

Originally published by MGMA on April 16, 2020
Reprinted with permission from MGMA

The Attestation Portal for the initial $30 billion general distribution from the Department of Health & Human Services (HHS) is now open. Providers that received a payment from HHS as part of the Provider Relief Fund authorized under the CARES Act must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions within 30 days of receiving payment.

To complete the attestation, billing entities must provide their Taxpayer Identification Number. Should you choose to reject the funds, you must also complete the attestation to indicate this. The Portal will guide you through the attestation process to accept or reject the funds.

Group practices with questions about the grant funds can call the Provider Relief hotline at (866) 569-3522. Please note that the terms and conditions are subject to further clarification by HHS, and MGMA will pass along any additional guidance if it is made available.

COVID-19: What to Know as a Healthcare Provider

Originally published in the March 5, 2020 issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

As Coronavirus Disease 2019 (COVID-19) continues to spread, it is critical that the healthcare community remains informed on the latest guidance released by the Centers for Disease Control and Prevention (CDC), including CDC clinical criteria for “persons under investigation” and treatment guidelines for confirmed COVID-19 cases. As the Administration takes steps to mitigate growing concerns around the virus, Congress is working to pass supplemental funding to contain and treat its associated illness. The “Coronavirus Preparedness and Response Supplemental Appropriations Act” includes a provision to allow the Secretary of the Department of Health and Human Services to waive certain Medicare telehealth restrictions during the coronavirus public emergency. MGMA Government Affairs will continue to monitor and report on this issue as it develops.