Today, the Centers for Medicare & Medicaid Services (CMS) is posting an update to its Frequently Asked Questions (FAQs) on the Medicaid.gov website to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the 2019 Novel Coronavirus (COVID-19) outbreak. CMS is taking this action to continue its efforts to protect the health and safety of providers and patients, including those who are covered by Medicaid and CHIP.
These FAQs cover a range of topics and issues that reflect questions and concerns raised by state Medicaid and CHIP agencies. The document includes answers to questions related to the flexibilities CMS is affording to states in managed care, benefits, financing, 1115 demonstrations, and leveraging “1135” waivers offered as part of the President’s declaration of a national emergency. As questions and issues continue to come into CMS, FAQs will continue to be issued to provide clear communication with states. States may submit questions to CMS through their state leads.
The COVID-19 FAQs for State Medicaid and CHIP agencies can be found here: https://www.medicaid.gov/state-resource-center/downloads/covid-19-faqs.pdf
These FAQs, and earlier CMS actions in response to the COVID-19 virus, are 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 Current Emergencies Website.
Summary of CMS Public Health Action on COVID-19 to date:
March 17, 2020: CMS waived certain requirements in Medicare, Medicaid, and CHIP under Section 1135 authority for the state of Florida in response to the COVID-19 national emergency. This action enables the state to waive prior authorization requirements, streamline provider enrollment processes, allow care to be provided in alternative settings in the event a facility is evacuated to an unlicensed facility, and more.
March 13, 2020: CMS following President Trump’s declaration of a national emergency announced aggressive actions and regulatory flexibilities to help healthcare providers and states contain the spread of COVID-19.
March 13, 2020: CMS issued frequently asked Questions (FAQs) on Essential Health Benefits (EHB) Coverage in response to the 2019 Novel Coronavirus (COVID-19) outbreak. The FAQ detail existing federal rules governing health coverage provided through the individual and small group insurance markets that apply to the diagnosis and treatment of COVID-19.
March 12, 2020: CMS issued frequently asked questions (FAQs) to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the 2019 Novel Coronavirus (COVID-19) outbreak. CMS is taking this action in its continuing efforts to protect the health and safety of providers and patients, including those who are covered by Medicaid and CHIP.
March 10, 2020: CMS issued guidance to home health agencies and dialysis facilities with actionable information for healthcare workers on screening, treatment and transfer procedures to follow when interacting with patients in response to the 2019 Novel Coronavirus Disease (COVID-19).
March 10, 2020: CMS issued a frequently asked questions to ensure State Survey Agencies and accrediting organizations charged with inspecting nursing homes and other health care facilities, understand that non-emergency survey inspections are suspended. This shift in survey prioritization enables State Inspectors to address the spread of the 2019 Novel Coronavirus Disease (COVID-19).
March 10, 2020: CMS issued guidance on Medicare Advantage (MA) and Part D health and prescription drug plans informing them of the flexibilities they have to provide healthcare coverage for testing, treatments, and prevention of 2019 Novel Coronavirus Disease (COVID-19). Leading insurance companies and their industry associations announced they will be treating COVID-19 diagnostic tests as covered benefits and will be waiving cost sharing that would otherwise apply to the test.
March 10, 2020: CMS issued guidance on the range of facemasks that can be temporarily used based on recent changes to CDC and FDA facemask and respirator guidance in light of COVID-19 and supply demands. These are steps the White House Task Force is taking to ensure a maximum supply of facemasks and respirators are available that allow healthcare providers to safely treat patients without exposing themselves or others to COVID-19.
On March 9, 2020: CMS delivered guidance on the screening, treatment and transfer procedures healthcare workers must follow when interacting with patients to prevent the spread of COVID-19 in a hospice setting. CMS also issued additional guidance specific to nursing homes to help control and prevent the spread of the virus.
On March 9, 2020: CMS issued a press release highlighting the telehealth benefits in the agency’s Medicare program for use by patients and providers. Expanded use of virtual care, such as virtual check-ins, are important tools for keeping beneficiaries healthy, while helping to contain the community spread of the COVID-19 virus.
On March 9, 2020: CMS published guidance to hospitals with emergency departments (EDs) on patient screening, treatment and transfer requirements to prevent the spread of infectious disease and illness, including COVID-19. Medicare-participating hospitals are to follow both CDC guidance for infection control and Emergency Medical Treatment and Labor Act (EMTALA) requirements.
March 6, 2020: CMS issued frequently asked questions and answers (FAQs) for healthcare providers regarding Medicare payment for laboratory test and other services related to the 2019-Novel Coronavirus (COVID-19). https://www.cms.gov/newsroom/press-releases/covid-19-response-news-alert-cms-issues-frequently-asked-questions-assist-medicare-providers
March 5, 2020: CMS issued a second Healthcare Common Procedure Coding System (HCPCS) code for certain COVID-19 laboratory tests, in addition to three fact sheets about coverage and benefits for medical services related to COVID-19 for CMS programs. https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests
March 4, 2020: CMS issued a call to action to healthcare providers nationwide and offered important guidance to help State Survey Agencies and Accrediting Organizations prioritize their inspections of healthcare. https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus
February 13, 2020: CMS issued a new HCPCS code for providers and laboratories to test patients for COVID-19. https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test
February 6, 2020: CMS gave CLIA-certified laboratories information about how they can test for SARS-CoV-2. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/notification-surveyors-authorization-emergency-use-cdc-2019-novel-coronavirus-2019-ncov-real-time-rt
February 6, 2020: CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/information-healthcare-facilities-concerning-2019-novel-coronavirus-illness-2019-ncov