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 Senate Stimulus Package Targets Providers Impacted by COVID-19

A more than $2 trillion COVID-19 stimulus bill approved by unanimous vote by the Senate on March 25 includes a number of measures affecting the long term and post-acute care (LT/PAC) profession, such as a temporary suspension of the Medicare sequestration cut and a $100 billion fund for eligible health care providers.

The Senate-passed Coronavirus Aid, Relief, and Economic Security Act (HR 748), which now goes to the House of Representatives for consideration, also includes the deferral of the 6.2 percent payroll tax; $200 million in funding to prevent, prepare for, and respond to COVID-19; childcare support for health care sector employees; a new loan program for certain employers; and funding for housing for the elderly and those with disabilities.

House Speaker Nancy Pelosi (D-Calif.) on Thursday said the House would approve the Senate stimulus package on Friday. President Trump said he will sign the Senate-approved legislation into law once the House sends it to him.
Unrelated to the congressional developments, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) listed a number of issues pertinent to LT/PAC providers tied to the COVID-19 crisis.
--AHCA/NCAL said although the Office of Medicare Hearings and Appeals (OMHA) office space is closed to the general public, OMHA hearings and appeals processing measures are proceeding as scheduled. Unless an appellant is notified directly that a hearing has been postponed or canceled, appellants should continue to appear for hearings by telephone as scheduled. The office will demonstrate flexibility with regard to reasonable requests to reschedule hearings. Additional information and updates will be provided as the situation evolves.
--UnitedHealthcare (UHC) issued a press release stating a suspension of the requirement for Prior Authorizations (PAs) for all SNF admissions through May 31, 2020. According to UHC, the admitting provider must notify the within 48 hours of transfer, and penalties still apply. Further, length of stay reviews still apply, including denials for days that exceed approved length.
This is a national release and appears to cover all UHC plans, AHCA/NCAL said. Providers that are in network with UHC should check their provider manual or with their local UHC representative to confirm this policy change applies, and any other specific requirements related to PAs. If a provider is not in network with UHC, providers should continue to get and document PAs to protect their ability to bill claims.
Cigna has also announced it is waiving PAs for the transfer of its patients to in-network subacute facilities, including SNFs. Providers that are in network with Cigna should check their provider manual or with their local Cigna representative to confirm this policy applies, and any other specific requirements related to PAs.
AHCA/NCAL has a template letter requesting similar administrative relief from other Managed Care Organizations.
--The Centers for Medicare & Medicaid Services (CMS) has announced another measure to free up the attention of providers as they respond to the COVID-19 pandemic. To this end, the release of the fourth quarter fiscal year 2019 (Q4FY19) Programs for Evaluating Payment Patterns Electronic Report (PEPPER) scheduled for an April release has been delayed for SNFs and other providers. Providers will be notified about the rescheduled release date for the Q4FY19 PEPPERs when determined.
--The Drug Enforcement Administration (DEA) has granted an exception to allow practitioners in states that have granted reciprocity with other states for medical licensing to prescribe controlled substances in another state.
Under the exception, DEA-registered practitioners are not required to obtain additional registration(s) with DEA in the additional state(s) where the dispensing (including prescribing and administering) occurs, if authorized to dispense controlled substances by both the state in which a practitioner is registered with DEA and the state in which the dispensing occurs.
Practitioners, in other words, must be registered with DEA in at least one state and have permission under state law to practice using controlled substances in the state where the dispensing occurs, AHCA/NCAL said. This applies to prescription of controlled substances via telemedicine in states where they are not registered with DEA. This is effective March 23, 2020, through and during of the public health emergency. 
AHCA/NCAL said to note that some states may also require state-specific registration for narcotic prescribing. Practitioners should be certain to comply with any additional steps required for state compliance.
Additional COVID-19 related information from the DEA is available here.
For additional questions, please email COVID19@ahca.org and visit www.ahcancal.org/coronavirus for more information and resources.
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