CMS Offers More Flexibility, Financial Stability for COVID-19 Care
By Andis Robeznieks

1.26 interstate billing

This story was originally published by the American Medical Association.

The Centers for Medicare & Medicaid Services (CMS) has taken several actions that will give physicians, hospitals and other providers greater flexibility and the financial stability they need to combat the COVID-19 global pandemic.

“With physicians stretched thin in the fight against the COVID-19 pandemic, our health care workforce needs flexibility, reduced red tape and immediate solutions to increase capacity and ensure access to care in every patient setting, including from home,” said AMA President Patrice A. Harris, MD, MA.

Measures include Medicare coverage for telephone visits, many new services added to Medicare’s telehealth list, and remote monitoring for all patients—not just those in rural areas and not just those with COVID-19.

Additionally, CMS has expanded eligibility of its Accelerated and Advance Payment Program, which provides an emergency cash advance based on historical payments and is intended to provide necessary funds when there is a disruption in claim submission or processing, such as the COVID-19 pandemic.

Payments can be requested by hospitals, doctors, durable equipment suppliers and other Medicare Part A and Part B providers, CMS announced.

CMS had also previously extended the March 31 deadline to submit 2019 performance data for the Medicare Quality Payment Program’s Merit-based Incentive Payment System (MIPS) to April 30. MIPS-eligible physicians and other clinicians who do not submit data by April 30 will qualify for the “automatic extreme and uncontrollable circumstances” policy and will automatically avoid a MIPS-related penalty and, instead, receive a neutral payment adjustment for the 2021 MIPS payment year.

“Major disruptions to the health care system caused by COVID-19 are a significant financial burden on providers,” said CMS Administrator Seema Verma. These actions “will ensure that they have the resources they need to maintain their all-important focus on patient care during the pandemic.”

Along with expanded telehealth coverage, other flexibilities (PDF) Medicare has instituted include:

  • Allowing physicians licensed in one state to provide care across state lines.
  • Testing patients where they are. This includes drive-up testing and sending technicians to patients’ homes.
  • Allowing hospital care in alternative settings such as ambulatory surgery centers and in community resources such as hotels and convention centers.
  • Allowing hospitals to support physician practices by transferring equipment and providing meals, laundry service and childcare for staff.
  • Allowing physician-owned hospitals to temporarily expand their number of licensed beds, operating rooms and procedure rooms. Additionally, physician-owned hospitals can temporarily convert observation beds to inpatient beds to accommodate the surge in patients.

Why it’s important: The AMA applauded the moves as “timely recognition that flexibility is needed at all levels to respond nimbly and effectively to COVID-19.”

“Practicing medicine is harrowing and dangerous in the face of the pandemic, but less noticed is the fiscal peril that many practices face,” Dr. Harris said. “CMS has recognized this, and its recent action to immediately send accelerated payments to physicians will help keep practices open to Medicare patients.”

In addition to providing care, physician practices are small businesses whose financial viability has been disrupted by the postponement of visits and elective procedures, and to support the physical distancing that is necessary to curb community spread of COVID-19. Additionally, staffing shortages have been exacerbated by school closures that cause childcare issues for doctors, nurses and support staff.

What’s next: Medicare will start processing the accelerated and advance payment requests immediately and CMS said it anticipates that payments will be issued within seven days of a physician’s request.

CMS has also posted a step-by-step guide (PDF) on how to submit a request for an accelerated or advance Medicare payment.

Physicians can learn more about the AMA’s COVID-19 advocacy efforts and track the fast-moving pandemic with the AMA's COVID-19 resource center, which offers a library of the most up-to-date resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.  

Last Updated On

April 02, 2020

Related Content

Coronavirus