Medicare updates for Providers for COVID-19

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Medicare Updates

Guidance for Processing Attestation Statements from Ambulatory Surgical Centers (ASC) Temporarily Enrolling as Hospitals for the duration of the COVID-19 Public Health Emergency

On April 3, CMS published a Memorandum to state survey business enterprise directors concerning how ASCs can briefly join as a sanatorium for the duration of the COVID-19 public health emergency (PHE). The memo discusses the authority created through the 1135 emergency waiver to allow for these flexibilities as well as the process for operating with the MAC to enroll as a sanatorium during the PHE.

Effective date: Immediately. This policy should be communicated with all survey and certification groups of workers, their managers, and the nation/local workplace education coordinators straight away. This steerage will cease to be in effect while the Secretary determines there may be no longer a public health emergency because of COVID-19. At that time, CMS will send a public note that this steering has ceased to be powerful through its website.

Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

On April 3, CMS posted Medicare Claims Processing Transmittal 10033, which rescinds and replaces Transmittal 10026, dated April 1, to revise the coverage phase eliminating the CLFS reporting length is not on time verbiage. This transmittal is no longer sensitive and can now be published on the internet.

Effective date: April 1, 2020
Implementation date: April 6, 2020

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update

On April 6, CMS posted Medicare Claims Processing Transmittal 10039, which rescinds and replaces Transmittal 4540, dated February 27, to make MPFSDB record revisions for COVID-19. Updates for codes G2023, G2024, 87635, 98966, 98967, 98968, 99441, 99442, and 99443 have been added to the April 2020 MPFSDB replace file and are listed in the CR attachment. The original transmittal was issued regarding an update to charge files for the Medicare Physician Fee Schedule.

On February 27, CMS posted a revised MLN Matters 11661 to accompany the transmittal.

Effective date: January 1, 2020
Implementation date: April 6, 2020

2021 Medicare Advantage and Part D Rate Announcement

On April 6, CMS published the 2021 Medicare Advantage and Part D Rate Announcement. CMS finalized modifications to the methodologies used to pay MA agencies, PACE corporations, and Part D sponsors. This consists of the continuing phase-in of the 2020 CMS-Hierarchical Condition Categories (HCC) model, underneath which CMS will calculate risk ratings for 2021 bills based totally on 75% of the hazard rating calculated with the 2020 CMS-HCC version and 25% of the hazard rating calculated with the 2017 CMS-HCC version. The charge statement also consists of information on adjustments to big name rankings, stumble upon records/RAPS facts hazard scores, and extra.
CMS posted a Fact Sheet at the equal date to accompany the rate announcement.

Non-Emergent, Elective Medical Services, and Treatment Recommendations

On April 7, up to date its Recommendations on suspending non-crucial surgeries and strategies for the duration of the general public fitness emergency. These suggestions have a tiered framework to prioritize offerings and take care of those who need it maximum, and it consists of a listing of key issues for providers while making those choices.

Claim Status Category and Claim Status Codes Update

On April 10, CMS published Medicare Claims Processing Transmittal 10045, which rescinds and replaces Transmittal 4460, dated November 15, 2019, to replace the WPC website records in the historical past section. The authentic transmittal turned into issued regarding updates to claim reputation class and declare popularity codes.

On April 10, CMS revised MLN Matters 11467 to accompany the transmittal.

Effective date: April 1, 2020
Implementation date: April 6, 2020

Source: Medicare Insider | April 15, 2020

 

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