As the world continues to live with COVID-19, things are changing rapidly as society adjusts to our new “normal.” Congress continues to explore legislative solutions, including for affected workers. The Department of Health and Human Services (DHHS) and the Centers for Medicare & Medicaid Services (CMS), which administers the Medicare & Medicaid programs, continue to implement policy changes relating to Medicare and other health programs. As we all respond to these challenges, we continue to compile information on the virus as it relates to Medicare.
- Center for Medicare Advocacy Materials
- CMS (the Medicare agency) Materials
- Centers for Disease Control (CDC) Materials
- Medicaid Access Resources
- Materials From Other Sources
- Legislative Updates
Center for Medicare Advocacy Materials
- “COVID-19: AN ADVOCATES GUIDE TO MEDICARE CHANGES” (Updated December 1, 2020)
- HHS Office of Inspector General: Nursing Home COVID-19 Underscores Need for Better Staffing and Improved Surveys January 26, 2023
- Medicare Provisions in Year-End Spending Bill January 5, 2023
- Vaccinated Staff Equals Fewer Nursing Home Deaths – Require Boosters January 5, 2023
- Home for the Holidays | Leaving the Nursing Home During a Medicare-Covered Stay During the Coronavirus Pandemic November 17, 2022
- CMS Must Strengthen Oversight of Infection Prevention and Control in Nursing Home October 13, 2022
- CMS Encourages Health Care Providers to Prepare for the End of the COVID-19 Public Health Emergency August 25, 2022
- Nurse Staffing Study Confirms Nursing Home Resident Deaths Increased When Nurse Staffing Levels Declined During Pandemic July 28, 2022
- Report: CDC Attempts to Overcome Limited and Incomplete COVID-19 Data to Address Health Disparities July 21, 2022
- As Interstate Telehealth Emergency Licensure Waivers Expire, Study Examines Impact on Medicare Beneficiaries June 9, 2022
- An Exploration of the Pandemic’s Full Impact on Racial and Ethnic Minorities from March to December 2020 May 12, 2022
- Fewer Residents Died from COVID in Unionized Nursing Homes May 12, 2022
- Medicare Coverage of Over-the-Counter COVID Tests April 7, 2022
- Nearly Twice as Many Black COVID-19 Patients Categorized as Lowest Priority Group for Scarce Resources as Use of Crisis Standards of Care was Considered March 24, 2022
- Study: Medicare Beneficiaries with Dementia Died at Higher Rates During COVID-19 Pandemic March 17, 2022
- Case Against Nursing Facility Alleging Negligence and Wrongful Death From COVID-19 Affirmed to Belong in State Court March 3, 2022
- New Study: COVID-19-Related Discrimination Impacted All Racial/Ethnic Minorities March 3, 2022
- Hospitalized COVID-19 Patients with Disabilities Linked to Longer Stays & Greater Risk of Readmission February 3, 2022
- New York Nursing Homes Suing the State Received Federal Provider Relief Funds February 3, 2022
- Medicare Announces Coverage of Free Over-the-Counter COVID Tests February 3, 2022
- Pressure Grows for Medicare to Cover At-Home COVID Tests January 27, 2022
- Public Health Emergency Renewed January 20, 2022
- CT Governor Issues Executive Order Requiring Nursing Home Visitors Have Vaccine and Booster or Proof of Negative COVID Test – CT Long Term Care Ombudsman Expresses Support and Offers Assistance if Needed January 20, 2022
- Skyrocketing COVID-19 Cases Lead to Hospital Struggles Across the Nation January 13, 2022
- CMS Again Revises Visitation Guidance in Nursing Facilities January 13, 2022
- U.S. Supreme Court Will Hear Appeals of Vaccination Mandate for Health Care Providers on January 7; CMS Moves Ahead on Mandate in States Not Under Injunction December 30, 2021
- Vaccination of Nursing Home Staff Correlated with Fewer Cases and Deaths among Residents December 16, 2021
- Courts Order Preliminary Injunctions Against Vaccination Mandate for Medicare and Medicaid Providers and Suppliers December 9, 2021
- Report: Telehealth Use by Medicare Beneficiaries Increases Over 6,000% in 2020 December 9, 2021
- Updated Factsheet | CMS Nursing Home Visitation Guidance December 2, 2021
- Connecticut Begins Penalizing Long-Term Care Facilities Failing to Comply with Governor’s Vaccine Mandate November 4, 2021
- Affirmed: Negligence and Wrongful Death Cases Against Nursing Homes During COVID-19 Pandemic Belong in State Court November 4, 2021
- COVID Delays Cause Inequities in Cancer Outcomes October 21, 2021
- Report: COVID-related Death Rates in Nursing Homes Spike Due to Delta Surge October 7, 2021
- Government Releases $25.2 Billion in Provider Covid-19 Relief September 23, 2021
- CMS Now Reports Resident and Staff COVID-19 Vaccination Rates on Care Compare September 23, 2021
- New Survey | More Older Adults in the US, Especially People of Color, Suffered Economic Hardship Due to COVID-19 September 23, 2021
- Study Links Long-Term Care Staff Vaccination Rates with Disparities August 5, 2021
- With 44% of Nursing Home Staff Not Yet Fully Vaccinated, New Funding Initiatives to Study Vaccine Hesitancy Among LTC Workers Are Launched July 22, 2021
- Immunity for Long-Term Care Facilities During the Coronavirus Pandemic July 22, 2021
- Racial/Ethnic Minorities and Dually Eligible Beneficiaries More Likely to Get COVID-19 in Nursing Homes, According to Office of Inspector General June 24, 2021
- Nursing Home Health Equity: More Evidence Showing COVID-19’s Racial Disparities June 10, 2021
- At-Home COVID-19 Vaccinations Get a Medicare Payment Boost June 10, 2021
- Report: Nursing Homes Had Highest Death Rate of All Senior Housing From COVID – Although 39% Had None June 10, 2021
- Nursing Homes Fined for Infection Control Should Not Receive COVID-19 “Performance Based” Relief Funds May 27, 2021
- CMS Interim Final Rule Addresses Covid-19 Vaccinations for Nursing Home Residents and Staff May 20, 2021
- New COVID Vaccine Resources Available May 6, 2021
- Policies and “Regulatory Failure” Endangered Nursing Home Residents April 29, 2021
- Positive COVID News from Navajo Nation April 8, 2021
- Center Report: Billions of Dollars to Nursing Homes in Covid-19 Relief March 25, 2021
- Senate Finance Committee Hearing on Covid-19 and Nursing Homes March 18, 2021
- COVID Fact Sheets for Consumers March 18, 2021
- New CMS Guidance Allows Visitors in Nursing Homes March 11, 2021
- Historic COVID Relief Bill Passes March 11, 2021
- New Report Documents Causes and Cures for COVID-19 Crisis in Long-Term Care Facilities February 18, 2021
- Staffing is Key to Determining Whether Covid-19 Affects Nursing Home Residents February 4, 2021
- COVID-19 Vaccine Distribution and Health Equity February 4, 2021
- Speech Generating Devices: Beneficiary Voices Silenced Once Again by CMS January 28, 2021
- Expanded Medicare Skilled Nursing Facility Coverage During the Covid-19 Pandemic January 28, 2021
- RRF Foundation for Aging President Pens Article on COVID and Older Adults December 23, 2020
- Senators Casey and Wyden Release Third Report on Nursing Homes and COVID-19 December 17, 2020
- Toby S. Edelman on This is Getting Old: Moving Towards an Age-Friendly World December 15, 2020
- COVID-19 and Health Care Disparities December 10, 2020
- Utah Removes Age Discrimination from its “Crisis Standards of Care” December 3, 2020
- COVID-19 and Teeth December 3, 2020
- Nursing Home Residents and COVID-19: Staffing and Quality of Care Matter December 3, 2020
- Home for the Holidays | Leaving the Nursing Home During a Medicare-Covered Stay During the Coronavirus Pandemic November 19, 2020
- Center for Medicare Advocacy Senior Policy Attorney, Toby Edelman and Health and Aging Policy Fellow, Cinnamon St. John Featured On This Is Getting Old Podcast November 19, 2020
- Nursing Facilities and COVID: Staffing Matters November 5, 2020
- “Policy – Medicare’s Regulatory Response to the COVID-19 Crisis” November 5, 2020
- Utah’s Crisis Standards of Care: Discriminatory Medical Rationing October 29, 2020
- COVID-Only Nursing Facilities: What Happened To A Good Idea? October 15, 2020
- Special Report: CMS Releases Fifth Cumulative List of Focused Infection Control Surveys October 8, 2020
- AHRQ Launches National Nursing Home COVID Action Network Training Program October 8, 2020
- Nursing Facilities and Covid-19 – It’s not Inevitable October 8, 2020
- Study Finds Lower Mortality Rates in Unionized New York State Nursing Facilities September 17, 2020
- COVID 19 and Racial Disparities: Important New Analysis September 17, 2020
- CMS Long-Term Care Commission Issues Report September 17, 2020
- Kaiser Family Foundation Issues Report on Racial Disparities and COVID-19 September 10, 2020
- Senators Release Report Concerning Postal Service Problems and Delays in Receipt of Mail-Order Drugs September 10, 2020
- Testing Nursing Home Residents for COVID-19 September 10, 2020
- Congress Gives COVID Relief Money to Nursing Facilities, Regardless of Fraud Lawsuits, Poor Quality of Care August 27, 2020
- Responding to CMS Announcement on Nursing Home Enforcement – Infection Control Deficiencies in Nursing Facilities: QCOR Data August 20, 2020
- Nursing Facilities Owned By Private Equity Firms Have Higher Rates of Covid Infections than Other Facilities August 13, 2020
- Studies Find Higher Nurse Staffing Levels in Nursing Facilities Are Correlated With Better Containment Of Covid-19 August 13, 2020
- With Next COVID Relief Bill Stalled, President Trump Issues Directives of Questionable Authority and Threatens Social Security and Medicare August 13, 2020
- WHO Releases New Policy Brief: “Preventing and Managing COVID-19 Across Long-Term Care Services” July 29, 2020
- Research Underscores Disproportionate Impact of COVID-19 July 29, 2020
- Center for Medicare Advocacy Submits Recommendations to the Nursing Home Commission July 23, 2020
- COVID Does Not Have to Lead to Deaths in Nursing Homes July 23, 2020
- American Health Care Association’s CEO Issues Message to Members: “We Won’t Back Down” July 16, 2020
- Advocacy Update: Medical Rationing July 16, 2020
- Groups File Petition Demanding that HHS and its Agencies “Mitigate the COVID-19 Crisis in America’s Nursing Homes” July 16, 2020
- Medicare Expansion of Telehealth Helps Beneficiaries Access Care During the Pandemic – But Caution is Needed before Making These Changes Permanent July 16, 2020
- Recent COVID-19 Data Show Disparities in Rate of Infections July 9, 2020
- Center for Medicare Advocacy Comments on Coronavirus Reporting Requirements for Nursing Facilities July 9, 2020
- CMS Issues Clarifications on How to Obtain Additional Coverage during the Pandemic July 9, 2020
- Center Comments on Additional Policy and Regulatory Revisions in Response to COVID–19 July 9, 2020
- Special Report – Nursing Homes Cited With Immediate Jeopardy Deficiencies During Pandemic: Poor Health Inspection Results, Low Staffing Levels July 2, 2020
- CMS Liberalizes Visitation to Nursing Homes. . . A Little July 2, 2020
- Center for Medicare Advocacy Senior Policy Attorney Testifies Before Congressional Committee re: Nursing Facilities and the COVID-19 Crisis June 25, 2020
- Special Report – Nursing Homes Cited with Infection Control Deficiencies During the Pandemic: Poor Results In Health Inspections, Low Staffing Levels June 17, 2020
- House Briefing on Covid and Nursing Homes Highlights Longstanding Problems in Staffing and Infection Control; Committee Launches Investigation of CMS and Five Nursing Home Chains June 17, 2020
- COVID-19’s Impact on Beneficiary Rights – A Case Study Examining Medicare Coverage Exceeding 100 Days in a Skilled Nursing Facility June 11, 2020
- Infection Control Surveys at Nursing Facilities: CMS Data Not Plausible June 11, 2020
- CMS Nursing Home Infection Survey Results Simply Aren’t Plausible June 5, 2020
- How Many Nursing Home Residents Have Died of Covid-19? June 4, 2020
- Center for Medicare Advocacy Submits Comments on CMS COVID-19 Rule June 4, 2020
- COVID-19 and Medicare June 3, 2020
- Count On Us June 3, 2020
- Podcast with Judy Stein: Moving Forward with COVID-19 and Medicare May 28, 2020
- CMS Rule: Nursing Facilities Must Report Covid-19 Data to CDC, Residents, Families and Representatives May 28, 2020
- State Attorneys General Open Criminal Investigations of Nursing Facilities in Light of the Pandemic; For Regulatory Agencies, Business As Usual May 21, 2020
- Research: Low-Income and Communities of Color at Increased Risk From COVID-19 May 21, 2020
- Report: COVID-19 Disproportionately Affects Communities of Color May 14, 2020
- Case Study: Medicare Advantage and Repeated Coverage Denials Amid the COVID Crisis May 14, 2020
- COVID-19 Updates to Medicare Enrollment and Emerging Social Security Office Efficiencies to Process Changes for Beneficiaries May 7, 2020
- COVID Updates (April 23, 2020) April 23, 2020
- CMS to Require Transparency Regarding Coronavirus in Nursing Facilities April 23, 2020
Older CMA Materials
- Medicare Enrollment & COVID-19 (April 9, 2020)
- Medicare Skilled Nursing Facility Coverage, Discharges, and Transfers During the COVID Crisis (April 9, 2020)
- Medicare-Related COVID-19 Update – Legislative & Policy Changes (April 2, 2020)
- COVID-19 Update (with Details on Medicare Enrollment) (3/26/2020)
- Medicare Administrative Law Judge (ALJ) Hearings Continue as Scheduled. On 3/24/20, the Office of Medicare Hearings and Appeals, (OMHA) sent the following electronic message to stakeholders: Subject: OMHA OPERATIONS DURING THE COVID-19 PANDEMIC.
- Although Office of Medicare Hearings and Appeals (OMHA) office space is closed to the general public, OMHA remains open for business with employees working under maximum telework flexibilities per U.S. Office of Personnel Management guidance. OMHA hearings and appeals processing measures are proceeding as scheduled. Unless an appellant is notified directly that a hearing has been postponed or canceled, appellants should continue to appear for hearings by telephone as scheduled. The Chief Administrative Law Judge supports the Administrative Law Judges exercising flexibility with regard to reasonable requests to reschedule hearings. OMHA staff are responding to phone calls to adjudication team phones and toll-free lines. In an effort to continue operations as seamlessly as possible, minimal staff will be on-site in OMHA offices to receive and send mail and faxes. Additional information and updates will be provided as the situation evolves.
- COVID-19 and Medicare – Where We Stand Today (3/19/2020)
- The Coronavirus and Nursing Home Residents (3/19/2020)
- An Update from the Center for Medicare Advocacy (3/17/2020)
- CMS issues memo to State Survey Agency Directors titled “Upcoming Requirements for Notification of Confirmed COVID-19 (or COVID-19 Persons under Investigation) Among Residents and Staff in Nursing Homes” (April 19, 2020): https://www.cms.gov/files/document/qso-20-26-nh.pdf
In the memo, CMS reinforces “an existing requirement that nursing homes must report communicable diseases, healthcare-associated infections, and potential outbreaks to State and Local health departments. In rulemaking that will follow, CMS is requiring facilities to report this data to the Centers for Disease Control and Prevention (CDC) in a standardized format and frequency defined by CMS and CDC. Failure to report cases of residents or staff who have confirmed COVID -19 and Persons under Investigation (PUI) could result in an enforcement action.” CMS also announces that it will issue a “new requirement for facilities to notify residents’ and their representatives to keep them up to date on the conditions inside the facility, such as when new cases of COVID-19 occur.” - Be Aware – Requirements Waived for Providers through “end of the emergency declaration.” (4/9/2020, retroactive to 3/1/2020): https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf
- COVID Interim Final Rule Published in Federal Register 4/6/2020: https://www.govinfo.gov/content/pkg/FR-2020-04-06/pdf/2020-06990.pdf
- CMS Authorizes Pharmacists to issue emergency refills if prescribers are unavailable (4/3/2020)
- On 4/2/2020 CMS, in consultation with the Centers for Disease Control and Prevention (CDC), issued critical recommendations to state and local governments, as well as nursing homes, to help mitigate the spread of the Novel Coronavirus (COVID-19) in nursing homes. The recommendations build on and strengthen recent guidance from CMS and CDC related to effective implementation of longstanding infection control procedures.
- CMS Presentation: “CMS Waivers and COVID-19 Response” (April 2020): https://www.cms.gov/files/document/cms-waivers-and-covid-19-response.pdf
- Memo regarding flexibility in notices, including a new MOON. (3/30/2020)
- On 3/30/20, CMS issued a Press Release, Fact Sheet and Interim Final Rule (CMS-1744-IFC) announcing several provider waivers, including:
- Increasing hospital capacity: “Under CMS’s temporary new rules, hospitals will be able to transfer patients to outside facilities, such as ambulatory surgery centers, inpatient rehabilitation hospitals, hotels, and dormitories, while still receiving hospital payments under Medicare. For example, a healthcare system can use a hotel to take care of patients needing less intensive care while using its inpatient beds for COVID-19 patients.”
- “Ambulances can transport patients to a wider range of locations when other transportation is not medically appropriate. These destinations include community mental health centers, federally qualified health centers (FQHCs), physician’s offices, urgent care facilities, ambulatory surgery centers, and any locations furnishing dialysis services when an ESRD facility is not available.”
- “Medicare will pay laboratory technicians to travel to a beneficiary’s home to collect a specimen for COVID-19 testing, eliminating the need for the beneficiary to travel to a healthcare facility for a test and risk exposure to themselves or others. Under certain circumstances, hospitals and other entities will also temporarily be able to perform tests for COVID-19 on people at home and in other community-based settings.”
- Measures to rapidly expand the health care workforce
- “CMS is waiving the requirements for a nurse to conduct an onsite visit every two weeks for home health and hospice. This would include waiving the requirements for a nurse or other professional to conduct an onsite visit every two weeks to evaluate if aides are providing care consistent with the care plan, as this may not be physically possible for a period of time.”
- Expansion of “Patients Over Paperwork” initiative, including:
- “CMS is temporarily eliminating paperwork requirements and allowing clinicians to spend more time with patients. Hospitals will not be required to have written policies on processes and visitation of patients who are in COVID-19 isolation. Hospitals will also have more time to provide patients a copy of their medical record.”
- “People with Medicare now have broader access to respiratory devices and equipment such as non-invasive ventilators, multi-function ventilators, respiratory assist devices, and continuous positive airway pressure devices. Medicare will now cover respiratory-related devices and equipment for any medical reason determined by clinicians so that patients can get the care they need; previously, Medicare covered them under certain circumstances.”
- “The agency will continue to engage in oversight activities but will suspend requesting additional information from providers, healthcare facilities, Medicare Advantage and Part D prescription drug plans, and States. CMS is also reprioritizing scheduled program audits in Medicare Advantage, Part D plans, and Programs of All-Inclusive Care for the Elderly (PACE) organizations. Reprioritizing these audit activities will allow CMS and the organizations to focus on patient care. Additionally, CMS is modifying the calculation of the 2021 and 2022 Part C and D Star Ratings to address the expected disruption to data collection and measure scores posed by the COVID-19 pandemic.”
- Further promote Tele-health
- CMS will now pay for more than 80 additional services when furnished via telehealth. These include emergency department visits, initial nursing facility and discharge visits, and home visits, which must be provided by a clinician that is allowed to provide telehealth.
- Providers also can evaluate beneficiaries who have audio phones only.
- CMS is allowing telehealth to fulfill many face-to-face visit requirements for clinicians to see their patients in inpatient rehabilitation facilities, hospice and home health. During the pandemic, individuals can use commonly available interactive apps with audio and video capabilities to visit with their clinician.
- Home Health Agencies can provide more services to beneficiaries using telehealth, so long as it is part of the patient’s plan of care and does not replace needed in-person visits as ordered on the plan of care.
- Hospice providers can also provide services to a Medicare patient receiving routine home care through telehealth, if it is feasible and appropriate to do so.
- If a physician determines that a Medicare beneficiary should not leave home because of a medical contraindication or due to suspected or confirmed COVID-19, and the beneficiary needs skilled services, he or she will be considered homebound and qualify for the Medicare Home Health Benefit. As a result, the beneficiary can receive services at home.
- Virtual Check-In services, or brief check-ins between a patient and their doctor by audio or video device, could previously only be offered to patients that had an established relationship with their doctor. Now, doctors can provide these services to both new and established patients.
- Clinicians can provide remote patient monitoring services for patients, no matter if it is for the COVID-19 disease or a chronic condition. For example, remote patient monitoring can be used to monitor a patient’s oxygen saturation levels using pulse oximetry.
- MLN Connects Discussing Beneficiary Notice Requirements (3/26/2020)
- CMS News – More State Waivers, Provider Enrollment, Provider FAQs (3/26/2020)
- CMS issues memo Coverage and Payment Related to COVID-19 Medicare (issued 3/5/20, updated 3/23/20)
- Frequently Asked Questions on Medicare Provider Enrollment Relief (3/23/2020) related to COVID-19 including the toll-free hotlines available to provide expedited enrollment and answer questions related to COVID-19 enrollment requirements.
- New survey procedures for all providers (3/23/2020): https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and/prioritization-survey-activities
- Press Release (3/22/2020) in which CMS “announced it is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs with respect to upcoming measure reporting and data submission for those programs.”
- Telehealth Toolkit for General Practitioners: https://www.cms.gov/files/document/general-telemedicine-toolkit.pdf
- End-Stage Renal Disease Providers Toolkit: https://www.cms.gov/files/document/esrd-provider-telehealth-telemedicine-toolkit.pdf
Below are some new COVID19 materials from CDC related to people with disabilities and service providers:
- Guidance for Direct Service Providers
- Guidance for Group Homes for Individuals with Disabilities
- Guidance for Direct Service Providers, Caregivers, Parents, and People with Developmental and Behavioral Disorders
- People with Developmental and Behavioral Disorders
- Medicaid.gov: Inventory of Medicaid and CHIP Flexibilities and Authorities in the Event of a Disaster
- Medicaid.gov: State Resource Disaster Response Toolkit
- Kaiser Family Foundation tracker: Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19 and Kaiser Family Foundation issue brief: How Can Medicaid Enhance State Capacity to Respond to COVID-19?
- Center on Budget and Policy Priorities blog: Medicaid Agencies Should Prioritize New Applications, Continuity of Coverage During COVID-19 Emergency
- NHeLP issue brief: Overview on Using Medicaid to Respond to COVID-19
- Commonwealth Fund report: Using Medicaid Waivers to Help States Manage the COVID-19 Public Health Crisis
- Center for Public Representation site with COVID-19 resources
- The Arc’s COVID-19 response page
- Families USA report: State Health Coverage Strategies for COVID-19
- Social Security FAQ’s (updated regularly): https://www.ssa.gov/coronavirus/
- Center on Budget on Policy Priorities resource List (updated regularly): https://www.cbpp.org/covid-19-responding-to-the-health-and-economic-crisis
- New FAQ resource (4/28/2020) – The Protecting Immigrant Families Campaign has developed a new FAQ document which provides 1) answers to some frequently asked questions about public charge implications for families who are seeking public programs during the COVID-19 crisis and 2) answers to questions about immigrant eligibility for programs under new and existing policies.
- Will receiving Medicaid for COVID-19 testing and treatment be considered in a public charge determination? No. U.S. Citizenship and Immigration Services (USCIS) announced that it will not consider testing, treatment, or preventive care related to COVID-19 as part of a public charge determination, even if the services are provided or paid for by Medicaid or another program considered under the public charge regulations. The regulations also exempt emergency Medicaid from the benefits that can be considered in a public charge assessment.
- If an immigrant receives SNAP (Supplemental Nutrition Assistance Program, or food stamps) or cash assistance for reasons connected to COVID-19, such as a workplace closure, will those benefits be considered in a public charge determination? Maybe. USCIS has said that it will consider all “relevant and credible” evidence that a person’s need for benefits was related to the COVID-19 outbreak and recovery period as factors in the person’s public charge determination.4 However, it has not said that it would disregard the use of benefits specified in the regulations (other than for virus-related testing and treatment).
- Update re: SSI Recipients and Automatic Payments (4/15/20):
- Department of Treasury Press Release: https://home.treasury.gov/news/press-releases/sm979 states, in part:
“The Social Security Administration announced today that Supplemental Security Income (SSI) recipients will automatically receive their Economic Impact Payments directly to their bank accounts through direct deposit, Direct Express debit card, or by paper check, just as they would normally receive their SSI benefits. Treasury anticipates SSI recipients will receive these automatic payments no later than early May.”
- Department of Treasury Press Release: https://home.treasury.gov/news/press-releases/sm979 states, in part:
- Social Security – Enroll in Part B by fax: https://www.ssa.gov/thirdparty/whatsnew.html (April 15, 2020)
- From PsychHub – Videos to adress mental health needs during COVID-19:
- The Arc has released a Fact Sheet discussing stimulus payments, including individuals with SSI and VA beneficiaries (4/10/20)
- Benefits.gov – “Finding the Right Help during the COVID-19 (coronavirus) Outbreak” (Information on government benefits such as unemployment resources and healthcare coverage as well as resources for businesses and families) (3/24/2020).
- Office of Inspector General (OIG) Covid-19 Fraud Alert: (3/23/2020)
- Beware of At-Home Covid-19 Test Kits, FDA Warns Consumers (3/20/2020)
- SMP Consumer Fraud Alert: SMP Consumer Fraud Alert: COVID-19 page (3/20/2020)
- National Council for Behavioral Health: Training available for providers and others who are helping people with Coronavirus (3/20/2020)
- Immigrant Eligibility for Public Programs During COVID-19: https://protectingimmigrantfamilies.org/immigrant-eligibility-for-public-programs-during-covid-19/
Congress has recently passed three bills related to the COVID-19 crisis that range from providing additional funds for health care, propping up businesses, to assisting individuals. Some of the Medicare-related provisions of these bills are highlighted below. Congress is currently weighing a fourth bill that could, among other things, provide for additional support for Medicare beneficiaries.
- On 4/24/2020, the President signed into law the Paycheck Protection Program and Health Care Enhancement Act, H.R. 266 (referred to as an interim emergency funding package)
- On 3/27/20, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 748 (COVID Bill #3)
- For summaries of this wide-ranging bill, see, e.g., Manatt, Senate Finance Committee, NPR
- Provisions include:
- Several expansions of Telehealth Services, including:
- Sec. 3703. Expanding Medicare Telehealth Flexibilities – eliminates the requirement in COVID Bill #2 that limits the Medicare telehealth expansion authority during the COVID-19 emergency period to situations where the physician or other professional has treated the patient in the past three years. This would enable beneficiaries to access telehealth, including in their home, from a broader range of providers, reducing COVID-19 exposure.
- Sec. 3704. Allowing Federally Qualified Health Centers and Rural Health Clinics to Furnish Telehealth in Medicare This section would allow, during the COVID-19 emergency period, Federally Qualified Health Centers and Rural Health Clinics to serve as a distant site for telehealth consultations. A distant site is where the practitioner is located during the time of the telehealth service. This section would allow FQHCs and RHCs to furnish telehealth services to beneficiaries in their home. Medicare would reimburse for these telehealth services based on payment rates similar to the national average payment rates for comparable telehealth services under the Medicare Physician Fee Schedule. It would also exclude the costs associated with these services from both the FQHC prospective payment system and the RHC all-inclusive rate calculation.
- Sec. 3705. Expanding Medicare Telehealth for Home Dialysis Patients – This section would eliminate a requirement during the COVID-19 emergency period that a nephrologist conduct some of the required periodic evaluations of a patient on home dialysis face-to-face, allowing these vulnerable beneficiaries to get more care in the safety of their home.
- Sec. 3706. Allowing for the Use of Telehealth during the Hospice Care Recertification Process in Medicare – Under current law, hospice physicians and nurse practitioners cannot conduct recertification encounters using telehealth. This section would allow, during the COVID-19 emergency period, qualified providers to use telehealth technologies in order to fulfill the hospice face-to-face recertification requirement.
- Sec. 3707. Encouraging the Use of Telecommunications Systems for Home Health Services in Medicare – This section would require the Health and Human Services (HHS) to issue clarifying guidance encouraging the use of telecommunications systems, including remote patient monitoring, to furnish home health services consistent with the beneficiary care plan during the COVID-19 emergency period
- Sec. 3708. Enabling Physician Assistants and Nurse Practitioners to Order Medicare Home Health Services – This section would allow physician assistants, nurse practitioners, and other professionals to order home health services for beneficiaries, reducing delays and increasing beneficiary access to care in the safety of their home
- Sec. 3711. Increasing Medicare Access to Post-Acute Care – This section would provide acute care hospitals flexibility, during the COVID-19 emergency period, to transfer patients out of their facilities and into alternative care settings in order to prioritize resources needed to treat COVID-19 cases. Specifically, this section would waive the Inpatient Rehabilitation Facility (IRF) 3-hour rule, which requires that a beneficiary be expected to participate in at least 3 hours of intensive rehabilitation at least 5 days per week to be admitted to an IRF. It would allow a Long Term Care Hospital (LTCH) to maintain its designation even if more than 50 percent of its cases are less intensive. It would also temporarily pause the current LTCH site-neutral payment methodology.
- Sec. 3712. Preventing Medicare Durable Medical Equipment Payment Reduction – This section would prevent scheduled reductions in Medicare payments for durable medical equipment, which helps patients transition from hospital to home and remain in their home, through the length of COVID-19 emergency period.
- Sec. 3713. Eliminating Medicare Part B Cost-Sharing for the COVID-19 Vaccine – This section would enable beneficiaries to receive a COVID-19 vaccine in Medicare Part B with no cost-sharing [once a vaccine is developed]
- Sec. 3714. Allowing Up to 3-Month Fills and Refills of Covered Medicare Part D Drugs – This section would require that Medicare Part D plans provide up to a 90-day supply of a prescription medication if requested by a beneficiary during the COVID-19 emergency period.
- Note that the bill also provides $200 million for CMS to assist nursing homes with infection control and support states’ efforts to prevent the spread of coronavirus in nursing homes. (Title VIII)
- Several expansions of Telehealth Services, including:
- On 3/18/20, President Trump signed into law H.R. 6201, Families First Coronavirus Response Act, H.R. 6201 (COVID Bill #2) (here is a summary) which contains several Medicare-related provisions, including:
- Section 6002. Waiving Cost Sharing Under the Medicare Program For Certain Visits Relating To Testing For COVID-19. This section requires Medicare Part B to cover beneficiary cost-sharing for provider visits during which a COVID-19 diagnostic test is administered or ordered. Medicare Part B currently covers the COVID-19 diagnostic test with no beneficiary cost-sharing.
- Section 6003. Waiving Cost Sharing Under the Medicare Advantage Program for Certain Visits Relating to Testing for COVID-19. This section requires Medicare Advantage to provide coverage for COVID-19 diagnostic testing, including the associated cost of the visit in order to receive testing. Coverage must be provided at no cost to the beneficiary.
- Section 6010 – Clarification Relating to Secretarial Authority Regarding Medicare Tele-Health Services Furnished During COVID-19 Emergency Period – made a technical correction to the first COVID bill for new Medicare beneficiaries by permitting coverage of telehealth services for a beneficiary who had been seen by a provider (or a member of the provider’s practice) within the past three years and had received a service that could have been paid for by Medicare if the person had been enrolled in Medicare [note this provision was further revised in COVID Bill #3]
- On 3/6/20, President Trump signed into law the Coronavirus Preparedness and Response Supplemental Appropriations Act, H.R. 6074 (COVID Bill #1)
-
- This bill includes the ‘‘Telehealth Services During Certain Emergency Periods Act of 2020” which allows the Secretary of HHS to waive or modify certain Medicare requirements with respect to telehealth services furnished during certain emergency periods – including allowing Medicare beneficiaries to access telemedicine services from any geographic area and from their homes using technology like a smart phone
-