Health Care

HHS Expands Phase 3 Provider Relief Fund Eligibility

On October 22, 2020, the Department of Health and Human Services (HHS) announced that the Phase 3 Provider Relief Fund (PRF) application period has been expanded to include additional provider applicants, including residential treatment facilities, chiropractors, and eye and vision providers who have not yet received PRF distributions. Regardless of whether or not they accept … Read more HHS Expands Phase 3 Provider Relief Fund Eligibility

HHS Updates Provider Relief Fund Distribution Reporting Requirements

On October 22, 2020, the Department of Health and Human Services (HHS) announced that it had updated its final reporting guidance originally published in September. The update includes clarification that, for purposes of relief payment for lost revenues attributable to COVID-19, recipients must submit information showing a negative change in year-over-year net patient care operating … Read more HHS Updates Provider Relief Fund Distribution Reporting Requirements

Hospitals Must Ensure that Patients Can Exercise Religious Rights

On October 20, 2020, the Office for Civil Rights (OCR) at the Department of Health and Human Services announced that it had resolved two religious discrimination complaints concerning clergy access to patients during the COVID-19 pandemic. More specifically, complainants alleged that hospitals had denied requests for clergy to have access to hospital patients to administer … Read more Hospitals Must Ensure that Patients Can Exercise Religious Rights

person holding injection

Kentucky Publishes Draft COVID-19 Vaccination Plan

On October 16, 2020, the Kentucky Department of Public Health published a first draft vaccination plan for distribution of the COVID-19 vaccine to Kentucky’s local health departments and provider organizations as it becomes available in late 2020 or in 2021. The draft vaccination plan considers the phases of vaccination set out by the Centers for … Read more Kentucky Publishes Draft COVID-19 Vaccination Plan

CMS to Allow Pharmacies to Direct Bill for SNF COVID-19 Vaccinations

On October 16, 2020, CMS announced that it will allow Medicare-enrolled immunizers, including, but not limited to, U.S. pharmacies, to bill and receive direct reimbursement from the Medicare program for vaccinating Medicare beneficiaries residing in skilled nursing facilities (SNFs).  In absence of the exercise of such discretion, the Social Security Act’s Consolidated Billing Provisions would … Read more CMS to Allow Pharmacies to Direct Bill for SNF COVID-19 Vaccinations

CMS Releases Supplement to State Medicaid & CHIP Telehealth Toolkit

On October 14, 2020, the Centers for Medicare and Medicaid Services (CMS) announced  the release of a new supplement to its State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version.  This toolkit contains helpful examples and insights into lessons learned from various states that have implemented telehealth changes.  … Read more CMS Releases Supplement to State Medicaid & CHIP Telehealth Toolkit

CMS Expands Services Covered Under Telehealth

On October 14, 2020, the Centers for Medicare and Medicaid Services (CMS) announced  the addition of 11 new telehealth services that Medicare Fee-For-Service will pay for during the COVID-19 public health emergency, including cardiac and pulmonary rehabilitation services.  Medicare will begin immediately paying practitioners who furnish these newly added telehealth services and will continue during … Read more CMS Expands Services Covered Under Telehealth

Growing Concerns About Changes to COVID-19 Provider Relief Fund

In our September 25 post titled “HHS Publishes Reporting Requirements for Provider Relief Fund Recipients and Changes Lost Revenue Calculation,” we reported on the Department of Health and Human Services (HHS) new Post-Payment Reporting Requirements applicable to providers who received payments of more than $10,000 from the Provider Relief Fund and changes to the lost … Read more Growing Concerns About Changes to COVID-19 Provider Relief Fund

Restrictions on Use of Provider Relief Fund Distributions

On October 9, 2020, the Department of Health and Human Services (HHS) published CARES Act Provider Relief Fund Frequently Asked Questions.  Among these FAQs, HHS stated that it was not permissible to use Provider Relief Fund distributions to repay payments made under the CMS Accelerated and Advance Payment (AAP) Program.

CMS Incentives for Faster COVID-19 Tests

On October 15, 2020, the Centers for Medicare and Medicaid Services (CMS) announced  incentives to encourage faster high throughput COVID-19 diagnostic tests.  Effective January 1, 2021, Medicare will pay $100 to laboratories that complete COVID-19 diagnostic tests within two days of the specimen being collected while laboratories that take longer than two days to complete … Read more CMS Incentives for Faster COVID-19 Tests

CMS Releases New Repayment Terms for COVID-Related Medicare Loans

On October 8, 2020, the Centers for Medicare & Medicaid Services (CMS) announced amended terms for repayments of loans issued under the Accelerated and Advance Payment Programs during the COVID-19 pandemic.  As reported last week, a new short-term spending bill, the Continuing Appropriations Act, 2021 and Other Extensions Act  extended the beginning of the repayment … Read more CMS Releases New Repayment Terms for COVID-Related Medicare Loans

Hospitals Must Report Daily Flu, COVID-19 Data to HHS

On October 6, 2020, the Department of Health and Human Services (HHS) announced that starting October 7, hospitals will have 14 weeks to comply with federal COVID-19 data-reporting requirements.  This timeline follows the interim final rule published on September 2 that requires all Medicare and Medicaid-certified hospitals to provide daily data updates to HHS on … Read more Hospitals Must Report Daily Flu, COVID-19 Data to HHS

Antigen Testing

On September 28, 2020, the Kentucky Department of Public Health released guidance to providers regarding interpretation of results from point-of-care antigen tests: A positive result in an individual with symptoms consistent with COVID-19 or with history of specific exposure to COVID-19 provides presumptive laboratory evidence and the individual would be classified as a probable COVID-19 … Read more Antigen Testing

Aerosol Exposure Consensus Statement

On September 29, 2020, the Kentucky Department of Public Health released a COVID-19 Aerosol Exposure Consensus Statement:  “Until scientific understanding recommends otherwise, it is the consensus opinion and statewide guidance agreed upon by the Kentucky Commissioner for Public Health and the state’s 61 local health department directors that, outside of environments meeting separate high-risk criteria: … Read more Aerosol Exposure Consensus Statement

Congress Delays CMS Recoupment of Accelerated and Advanced Payment Program Loans

As we reported last week, the Centers for Medicare & Medicaid Services (CMS) confirmed that it had delayed recouping Medicare Accelerated and Advance Payment Program loans made to providers under the CARES Act to allow more time for Congress to negotiate the repayment terms of those loans.  On September 30, a short-term spending bill was … Read more Congress Delays CMS Recoupment of Accelerated and Advanced Payment Program Loans

HHS Announces Additional $20 Billion in New Phase 3 Provider Relief Funding

On October 1, 2020, the Department of Health and Human Services (HHS) announced that an additional $20 billion in funding will be available for providers fighting the COVID-19 pandemic.  Providers who have already received Provider Relief Funds may apply, as well as newly-practicing providers and an expanded group of behavioral health providers treating the effects … Read more HHS Announces Additional $20 Billion in New Phase 3 Provider Relief Funding

HHS Publishes Reporting Requirements for Provider Relief Fund Recipients and Changes Lost Revenue Calculation

On September 19, 2020, the Department of Health and Human Services (HHS) published new Post-Payment Reporting Requirements applicable to providers who received payments of more than $10,000 from the Provider Relief Fund*.  Qualifying recipients will be required to report: (1) healthcare expenses attributable to the coronavirus not reimbursed by other sources; (2) general and administrative … Read more HHS Publishes Reporting Requirements for Provider Relief Fund Recipients and Changes Lost Revenue Calculation

CMS Confirms Medicare Loan Recoupment Delay

As we previously reported, providers who received loans this spring through the Medicare Accelerated and Advance Payment Programs were due to have Medicare claim reimbursements withheld by the Centers for Medicare & Medicaid Services (CMS) beginning in August to recoup those loans.  Providers have reported that CMS had not yet taken action to recoup the … Read more CMS Confirms Medicare Loan Recoupment Delay

HHS to Allow Pharmacists to Order and Administer COVID Vaccines

On September 9, 2020, the Department of Health and Human Services (HHS) announced that it had published guidance authorizing state-licensed pharmacists to order and administer COVID-19 vaccinations to persons age 3 and up, subject to certain requirements.  The authorization preempts any state and local laws that prohibit those who satisfy the HHS requirements from ordering … Read more HHS to Allow Pharmacists to Order and Administer COVID Vaccines

HHS OIG Will Audit Medicare Payments for COVID-19 Patient Discharges

As we previously reported, the Centers for Medicare & Medicaid Services (CMS) recently published new guidance requiring hospitals to document a positive COVID-19 laboratory test to receive a 20% increase in the Medicare Severity-Diagnosis Related Group (MS-DRG) weighting factor for their inpatients being treated for COVID-19. The Department of Health and Human Services Office of … Read more HHS OIG Will Audit Medicare Payments for COVID-19 Patient Discharges

Kentucky Renews State of Emergency for Pharmaceutical Dispensing

On September 4, 2020, Governor Andy Beshear signed Executive Order 2020-749 renewing pharmacists’ authority to dispense emergency refills of up to a 30 day supply of any non-scheduled medication for Kentucky residents. This Order became effective on September 6 and will remain in effect for 30 days, subject to renewal.   

CHFS Clarifies State Guidance on Essential Workers

On September 10, 2020, the Cabinet for Health and Family Service’s Department for Public Health issued guidance clarifying that in the face of the ongoing COVID-19 pandemic and the reopening of all industries in the state, only healthcare workers and first responders fall into the category of “critical” workers who may be exempt from specific … Read more CHFS Clarifies State Guidance on Essential Workers

Kentucky Cabinet for Health and Family Services Updates Guidance on Long-Term Care Facility Admissions, Discharges, and Transfers

On August 28, 2020, the Kentucky Cabinet for Health and Family Services (CHFS) issued updated guidance in a Provider Guidance Memo concerning the determination of the most appropriate setting for care of a resident of a long-term care facility (LTCF) who exhibits symptoms of, or tests positive for, COVID-19.  The updated guidance instructs providers and … Read more Kentucky Cabinet for Health and Family Services Updates Guidance on Long-Term Care Facility Admissions, Discharges, and Transfers

Government May Publish Names of Hospitals with Missing Data Reporting

On September 2, 2020, the Wall Street Journal reported that the federal government is planning to publicize the names of hospitals that have not met COVID-19 data reporting requirements as early as next week.  Hospitals are required to submit data daily to the Department of Health and Human Services (HHS) Protect reporting system on testing, … Read more Government May Publish Names of Hospitals with Missing Data Reporting

CMS Hasn’t Started Recouping Loans by Garnishing Medicare Pay to Hospitals and Providers

As we reported on August 7, 2020, hospitals and providers are facing repayments of loans received this spring through the Medicare Accelerated and Advance Payment Programs. The first of these repayments became due in mid-August, 120 days after the first loans were issued.  These loans were set to be recouped through Medicare claim reimbursement withholding … Read more CMS Hasn’t Started Recouping Loans by Garnishing Medicare Pay to Hospitals and Providers


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