A $2 trillion COVID-19 relief bill signed into law on Friday, March 27, 2020.
How does it provide economic support for HCPs?
The CARES Act offers economic support to HCPs in the following ways:
- Support through the Public Health and Social Services Emergency Fund (PHSSEF) not only for costs related to treating COVID-19 but also for lost revenue due to reductions in other services like elective procedures
- Support for entities with no more than 500 employees is available in the form of Payroll Protection Loans from the Small Business Association (SBA); portions of loans are eligible for deferral and/or forgiveness
- Economic Injury Disaster Loans are available to eligible entities with not more than 500 employees
- Suspends a planned 2% reduction in physician payments from May through December 2020
- Limits liability for volunteer HCPs during the COVID-19 emergency response
- Offers loan deferrals, loan flexibility and other provisions for medical students
The CARES Act also relaxes provisions governing telehealth coverage so that physicians can provide and bill for telehealth services.
- Boston Scientific will host a free webinar on April 9 and April 10 providing detailed information on what you need to know about telehealth changes during the COVID-19 emergency response. An e-mail invitation will be sent from Boston Scientific later this week
Where can I find more information?
Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (CMS-1744-IFC)
This Interim Final Rule issued by CMS outlines each of the changes and new policies the Agency has established to implement the Medicare- and Medicaid-related provisions of the CARES Act.
This Interim Final Rule issued by CMS outlines each of the changes and new policies the Agency has established to implement the Medicare- and Medicaid-related provisions of the CARES Act.
Medicare telehealth-related matters
- Greater flexibility of services that can be performed via telehealth
- Removal of frequency limitations
- Removal or relaxation of restrictions related to telehealth services for patients with ESRD, patients in nursing homes, face-to-face visit requirements
Flexibility for workforce-related matters
- Flexibility related to physician supervision requirements
- Relaxation of coverage-related requirements related to practitioner types or specialties allowed to provide covered services
- Temporary waiver of Medicare and Medicaid requirements that physicians and non-physician practitioners be licensed in the state where they are providing services (state requirements still apply)
Patients Over Paperwork
- Permission for certain referrals and the submission of related claims that would otherwise violate the Stark Law
- Waives coverage restrictions on respiratory-related devices, oxygen and oxygen equipment, home infusion pumps and home anticoagulation therapy during the public health emergency
- Updates to the Merit-based Incentive Payment System (MIPS) to:
- Allow clinicians impacted by the COVID-19 outbreak and unable to submit MIPS data to request reweighting and potentially receive a neutral MIPS adjustment for 2021
- Provide MIPS credit for participation in a clinical trial using a drug or biological to treat a patient with COVID-19
- Allows for expansion of accelerated and advance payment program for providers and suppliers during the public health emergency
Medicare Appeals
- Allows for flexibility in appeals process and extension of appeal filing deadlines and adjudication
Where can I find more information?
Hospitals Without Walls: Efforts to Expand Care Capacity
Hospitals without Walls is the name of a temporary program allowing hospitals to transfer patients to outside facilities while still receiving hospital payments under Medicare.
This program allows healthcare systems and hospitals to provide services in locations beyond their existing walls to address capacity needs related to COVID-19.
- Hospitals can transfer patients to outside facilities, including ambulatory surgery centers (ASCs) while still receiving hospital payments under Medicare
- ASCs can contract with local healthcare systems to provide hospital services or they can enroll and bill as hospitals during the emergency declaration as long as they are not in conflict with state-level Emergency Preparedness or Pandemic plans
- These sites may be used to provide services typically provided by hospitals, such as cancer procedures, trauma surgeries and other essential (non-elective) surgeries
- Physician-owned hospitals can increase their number of beds without sanctions
Where can I find more information?
Expansion of Accelerated and Advance Payment Program for Providers and Suppliers during the COVID-19 Emergency
This is an expansion of the program which allows CMS to make accelerated or advance payments to qualified providers and suppliers when there is a disruption in claims submission or claims processing or there is a national emergency or natural disaster.
Completed request form must be submitted to a provider’s Medicare Administrative Contractor (MAC); forms can be found on MAC websites
- Repayment of accelerated or advance payments extended to begin 120 days after the date of issuance of the payment
Where can I find more information?
1 This summary is based on publicly available information. Boston Scientific is not responsible for inaccuracies in underlying sources.
Disclaimer: This document is intended to be informational only. It is not intended as legal, regulatory or business advice and does not purport to be comprehensive.
