CMS is providing supplemental information for transferring or discharging residents between skilled nursing facilities (SNFs) and/or nursing facilities based on COVID-19 status (i.e., positive, negative, unknown/under observation). In general, if two or more certified LTC facilities want to transfer or discharge residents between themselves for the purposes of cohorting, they do not need any additional approval to do so. However, if a certified LTC facility would like to transfer or discharge residents to a non-certified location for the purposes of cohorting, they need approval from the State Survey Agency.

A copy of the guidance and a graphic explaining the various scenarios can be found here:  https://www.cms.gov/files/document/qso-20-25-nh.pdf

CMS is removing the non-invasive ventilator (NIV) product category from Round 2021 of the DMEPOS Competitive Bidding Program due to the novel COVID-19 pandemic, the President’s exercise of the Defense Production Act, public concern regarding access to ventilators, and the NIV product category being new to the DMEPOS Competitive Bidding Program.

DME Competitive Bidding Program

CMS, together with the Departments of Labor and the Treasury, issued guidance to ensure Americans with private health insurance have coverage of COVID-19 diagnostic testing and certain other related services, including antibody testing, at no cost. This includes urgent care visits, emergency room visits, and in-person or telehealth visits to the doctor’s office that result in an order for or administration of a COVID-19 test. As part of the effort to slow the spread of the virus, this guidance is another action the Trump Administration is taking to remove financial barriers for Americans to receive necessary COVID-19 tests and health services, as well as encourage the use of antibody testing that may help to enable health care workers and other Americans to get back to work more quickly.

Press Release
Guidance

CMS is implementing changes to increase payments to Inpatient Prospective Payment System (IPPS) hospitals and Long-Term Care Hospitals (LTCHs) under Sections 3710 and 3711 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act. When you submit an IPPS claim for discharges on or after January 27, 2020, or an LTCH claim for admissions on or after January 27, 2020, and we receive it:

• April 20, 2020, and earlier, Medicare will reprocess. You do not need to take any action.
• On or after April 21, 2020, Medicare will process in accordance with the CARES Act.

For more information, see MLN Matters Special Edition Article SE20015.

CMS helps expand testing capacity and monitoring for COVID-19 in nursing homes and other settings with high volume testing needs

Under President Trump’s leadership, the Centers for Medicare & Medicaid Services (CMS) today announced Medicare will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of 2019 Novel Coronavirus (COVID-19) cases. This is another action the Trump Administration is taking to rapidly expand COVID-19 testing, particularly for those with Medicare, including nursing home residents who are among the most vulnerable to COVID-19 and most affected by COVID-19 outbreaks across the country.

“CMS has made a critical move to ensure adequate reimbursement for advanced technology that can process a large volume of COVID-19 tests rapidly and accurately,” said CMS Administrator Seema Verma. “This is an absolute game-changer for nursing homes, where risk of Coronavirus infection is high among our most vulnerable.”

Medicare will pay the higher payment of $100 for COVID-19 clinical diagnostic lab tests making use of high-throughput technologies developed by the private sector that allow for increased testing capacity, faster results, and more effective means of combating the spread of the virus. High-throughput lab tests can process more than two hundred specimens a day using highly sophisticated equipment that requires specially trained technicians and more time-intensive processes to assure quality. Medicare will pay laboratories for the tests at $100 effective April 14, 2020, through the duration of the COVID-19 national emergency.

Increasing Medicare payment for these tests will help laboratories test in nursing home communities that are vulnerable to the spread of COVID-19. On March 30, 2020, CMS announced that Medicare will pay new specimen collection fees for COVID-19 testing for homebound and non-hospital inpatients, to help facilitate the testing of homebound individuals and those unable to travel. As a result of these actions, laboratories will have expanded capability to test more vulnerable populations, like nursing home patients, quickly and provide results faster.

For other COVID-19 laboratory tests, local Medicare Administrative Contractors (MACs) remain responsible for developing the payment amount in their respective jurisdictions. MACs are currently paying approximately $51 for those tests. As with other laboratory tests, there is generally no beneficiary cost-sharing under Original Medicare.

This announcement builds upon recent CMS actions to expand testing for COVID-19. On March 30, 2020, CMS announced that hospitals, laboratories, and other entities can perform tests for COVID-19 on people at home and in other community-based settings outside of the hospital. This will both increase access to testing and reduce risks of exposure. Additionally, CMS took action to allow healthcare systems, hospitals, and communities to set up testing sites to identify COVID-19-positive patients in a safe environment.

Increasing Medicare payment for tests that use high-throughput technologies, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.

For more information on this payment announcement, please visit: https://www.cms.gov/files/document/cms-2020-01-r.pdf

There are more than 19,000 COVID-19 cases in the state as of midnight today with numbers expected to continue increasing, highlighting an even greater need to ensure that Pennsylvania’s hospitals are equipped to care for patients and workers. To assist, Governor Tom Wolf today announced a new loan program – the Hospital Emergency Loan Program, or HELP – that will provide short-term financial relief to Pennsylvania’s hospitals as they prepare for the growing surge of individuals infected with COVID-19 and the economic fallout of the nationwide pandemic.

“The combination of increased costs and reduced revenue has hurt many hospitals financially,” Gov. Wolf said. “We must support our hospitals through this unprecedented time. When this pandemic finally ends, we’re going to need hospitals to care for our regular medical needs, like heart attacks and broken bones. This new loan program will provide immediate relief to our hospitals, which are on the frontlines of this pandemic.”

The $450 million loan package will be available to the commonwealth’s hospitals to provide immediate financial support for working capital to ensure that these facilities have sufficient personnel, equipment, and personal protective equipment.

The funding was dispersed by the Pennsylvania Infrastructure Investment Authority (PENNVEST) and will be administered by the Pennsylvania Department of Community and Economic Development through the Pennsylvania First Program (PA First). It was approved by Treasurer Joe Torsella, who played a crucial role in the expedited release of this emergency funding.

“Hospitals across Pennsylvania should be focused on saving lives, not worrying about how to make ends meet until federal relief funds arrive months from now,” said Pennsylvania State Treasurer Joe Torsella, whose office must approve any investments made by the PENNVEST board. “I am proud to approve this prudent investment that will provide immediate, low-cost, and direct financing to enable hospitals to sufficiently staff their floors, purchase treatment supplies and protective equipment, and successfully prepare for the surge of COVID-19 patients in the coming weeks. I commend the PENNVEST board for taking this step, and Governor Wolf for his leadership and continued commitment to protecting Pennsylvanians throughout this crisis.”

Pennsylvania health care facilities licensed as hospitals by the Pennsylvania Department of Health under the Health Care Facilities Act of 1979 that are eligible to receive federal grant funding through the CARES Act are eligible for HELP. The maximum loan size is $10 million per hospital at an interest rate of 0.5 percent.

Applications will be available on DCED’s website starting at 10:00 AM April 13 through April 20. The costs must be incurred between March 1 and Sept. 1.

HELP will allow hospitals to take responsive action now until funding through the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act, which was signed into law on March 27, 2020, is dispersed completely, with the goal of easing the financial strain of the pandemic and smoothing the transition back into regular health care operation.

Permitted expenses under HELP will mirror those under the CARES Act, allowing hospitals to close out their loan with CARES funding once it is received.