Here is a summary of recent Centers for Medicare & Medicaid Services (CMS) actions taken in response to the 2019 Novel Coronavirus (COVID-19), as part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, click here www.coronavirus.gov. For information specific to CMS, please visit the CMS News Room and Current Emergencies Website. CMS updates these resources on an ongoing basis throughout the day; the information below is current as of April 16, 2020 at 10:15 a.m. ET.

 CMS Increases Medicare Payment for High-Production Coronavirus Lab Tests

CMS announced that Medicare will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases. This is another action the Trump Administration is taking to rapidly expand COVID-19 testing. Along with the March 30 announcement that Medicare will pay new specimen collection fees for COVID-19 testing, CMS’s actions will expand capability to test more vulnerable populations, like nursing home patients, quickly and provide results faster. Medicare will pay laboratories for the tests at $100 effective April 14, 2020, through the duration of the COVID-19 national emergency.

Press Release

 CMS Implements CARES Act Hospital Payment and Inpatient Rehabilitation Facility Waivers

The Coronavirus Aid, Relief, and Economic Security (CARES) Act increases payment for Inpatient Prospective Payment System (IPPS) and long-term care hospital (LTCH) inpatient hospital care attributable to COVID-19. CMS provided guidance for IPPS hospitals and LTCHs on how to code claims to receive the higher payment.

The CARES Act also waives the requirement that Medicare Part A fee-for-service patients treated in inpatient rehabilitation facilities receive at least 15 hours of therapy per week.

 MLN Connects Article

Emergency Declaration Waivers Summary

 CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic

CMS has approved 52 COVID- related emergency waivers, 31 state amendments, 11 COVID-related Medicaid Disaster Amendments and one CHIP COVID-related Disaster Amendment in record time. States are using a toolkit CMS developed to expedite the application and approval of Medicaid state waivers and State Plan Amendments.

CMS recently approved two additional COVID-related emergency Medicaid waivers, delivering urgent regulatory relief to ensure the Commonwealth of Puerto Rico and the Commonwealth of the Northern Mariana Islands can quickly and effectively care for their most vulnerable citizens. CMS also approved COVID-related Medicaid Disaster Amendments that bring relief to Arkansas and Rhode Island. These approvals help to ensure that states have the tools they need to combat COVID-19 through a wide variety of state plan flexibilities.  CMS continues to authorize amendments to ensure emergency flexibilities in programs that care for the elderly and people with disabilities, including most recently for Colorado, Louisiana and Nevada. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

Section 1135 Waivers

1915(c) Waiver Appendix K Amendments

Medicaid State Plan Amendments

CHIP State Plan Amendments

CMS has temporarily waived several Medicare regulations to support hospitals, clinics, and other healthcare facilities during the 2019 Novel Coronavirus (COVID-19) pandemic.  The new waivers focus on reducing supervision and certification requirements so that practitioners can be hired quickly and perform work to the fullest extent of their licenses.  This Fact Sheet summarizes the new changes in addition to previous waivers that impact all types of providers, including Critical Access Hospitals, Rural Health Clinics, physicians, skilled nursing facilities, and others.

With the U.S. losing over 22 million jobs since the start of the COVID-19 pandemic, WalletHub today released updated rankings for the States with the Biggest Increases in Unemployment Due to Coronavirus, along with accompanying videos.

To identify which states’ workforces have been hurt most by COVID-19, WalletHub compared the 50 states and the District of Columbia based on increases in unemployment claims. We used this data to rank the most impacted states in both the latest week for which we have data (April 6) and overall since the beginning of the coronavirus crisis (March 16). Below, you can see highlights from the report, along with a WalletHub Q&A.

Increase in Pennsylvania Unemployment Due to Coronavirus (1=Worst, 25=Avg.):

• 1,973.57% Increase in Unemployment Claims (April 2020 vs April 2019)
  • 238,357 the week of April 6, 2020 vs 11,495 the week of April 8, 2019
  • 17th lowest increase in the U.S.
•  773.17% Increase in the Number of Unemployment Claims (April 2020 vs January 2020)
  • 238,357 the week of April 6, 2020 vs 27,298 the week of January 1, 2020
  • 8th lowest increase in the U.S.
• 2,882.22% Increase in Unemployment Claims Since Pandemic Started
  • 1,298,125 between March 16, 2020 and April 6, 2020 vs 45,039 between March 18, 2019 and April 8, 2019
  • 26th highest increase in the U.S.

WalletHub Q&A

How do the job losses from coronavirus compare to those caused by the Great Recession?

“During the Great Recession, a grand total of 8.8 million Americans lost their jobs. The coronavirus pandemic has already claimed 22 million jobs,” said Jill Gonzalez, WalletHub analyst. “While there have been 22.7 million jobs created since the Great Recession, COVID-19 is unfortunately on track to wipe out all of the job gains by the end of this week, according to WalletHub projections.”

How do red states and blue states compare when it comes to increases in unemployment?

“With an average unemployment rank of 24, Red States suffered a higher increase of their unemployment during the coronavirus outbreak than Blue States, which rank 29 on average,” said Jill Gonzalez, WalletHub analyst. “The lower the rank, the higher the increase in initial unemployment claims that state received during the coronavirus pandemic.”

The state with the current largest number of COVID-19 cases in the U.S. is New York. How has New York’s unemployment rate been affected?

“New York has seen a 783% increase in initial unemployment claims from the beginning of 2020 to the 15^th week,” said Jill Gonzalez, WalletHub analyst. “This is better than the average increase of 1,709%.”

What can states do in order to minimize the rise in their unemployment rates?

“States should aggressively focus on helping the companies in the most need. The federal response will include sending checks to most citizens, even those whose income has not been affected by the coronavirus. States can use a more targeted approach to divert resources to the companies affected the most, thus having maximum impact for the money spent,” said Jill Gonzalez, WalletHub analyst.

To view the full report and your state’s rank, please visit:
https://wallethub.com/edu/states-with-the-biggest-increase-in-unemployment-due-to-coronavirus/72730/

WASHINGTON, April 15, 2020 – USDA Rural Development has taken a number of immediate actions to help rural residents, businesses and communities affected by the COVID-19 outbreak. Rural Development will keep our customers, partners, and stakeholders continuously updated as more actions are taken to better serve rural America.

Read the full announcement to learn more about the opportunities USDA Rural Development is implementing to provide immediate relief to our customers, partners, and stakeholders.

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