Here to partner with you in the fight against the spread of COVID-19. We’re all in this together! 

Helping you Manage Your Hospitals During COVID-19

We hope each of our clients is safe and know you’re busy on the front lines doing your part to remediate and treat the patients suffering from the COVID-19 Virus.  We are grateful for your role in helping America combat what we hope is a once in a lifetime crisis.VersaSuite is practicing “shelter in place” guidelines established by Governor Gregg Abbott regarding business operations for the State of Texas.  As a result, We are equipped to support you with a fully staffed support team working remotely.

 

If you need to reach any individual, you may contact them by calling our main number 1-800-903-8774 and using the dial by name function to reach each person.  All calls and voice mails are forwarded directly to each individual at their home office.  Our VPN networks allow us to function much like we would if we were in office.

 

We are prayerful that this “new normal” ends for all of us soon and will continue to support your EHR and Patient needs during this crisis. 

CARES Act: Provisions to Help Rural Hospitals

Help for Rural Hospitals

The Coronavirus Aid, Relief, and Economic Security (CARES) Act, signed into law on March 27, provides resources and flexibility for rural hospitals.

American Hospital Association Take: The legislation will help rural hospitals that are in dire financial need due to this devastating pandemic. While this is an important first step forward, more will need to be done for rural providers to deal with the unprecedented challenge of this virus. We will continue to work with Congress to make sure providers on the front lines – hospitals, physicians and nurses – remain prioritized for future federal assistance as the COVID-19 pandemic spreads. The following describes some key provisions of the law that will have important impact for rural providers.

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US Federal Government Action for COVID-19

CARES Act FAQ

Attached is a set of FAQs from the CARES Act, the $2+ trillion law recently passed.  Pages 1-6 are immediately applicable to healthcare organizations seeking information about accelerated payments and relaxation of laws and regulations that could hamper care in the current environment, but we are attaching the entirety of the document, knowing that some of the other content could be of interest to our clients.

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Accelerated and Advanced Payments

Accelerated and advance Medicare payments provide emergency funding and addresses cash flow issues based on historical payments when there is disruption in claims submission and/or claims processing. These expedited payments are typically offered in natural disasters to accelerate cash flow to the impacted health care providers and suppliers. In this situation, CMS is expanding the program for all Medicare providers throughout the country during the public health emergency related to COVID-19.  The payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers.

To qualify for accelerated or advance payments, the provider or supplier must:

  • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/ supplier’s request form
  • Not be in bankruptcy
  • Not be under active medical review or program integrity investigation
  • Not have any outstanding delinquent Medicare overpayments

Medicare will start accepting and processing the Accelerated/Advance Payment Requests immediately. CMS anticipates that the payments will be issued within seven days of the provider’s request.

An informational fact sheet on the accelerated/advance payment process and how to submit a request can be found here.

General Waivers

1135 Waivers :  Secretary Azar announced March 13 that states could apply for an 1135 waiver (under Medicaid).  Examples of waivers available to states under section 1135 of the Act include:

  • Temporarily suspend prior authorization requirements;
  • Extend existing authorizations for services through the end of the public health emergency;
  • Modify certain timeline requirements for state fair hearings and appeals;
  • Relax provider enrollment requirements to allow states to more quickly enroll out-of-state or other new providers to expand access to care, and
  • Relax public notice and submission deadlines for certain COVID-19 focused Medicaid state plan amendments, enabling states to make changes faster and ensure they can be retroactive to the beginning of the emergency.

CMS FAQs Page

Describes provider-specific fact sheets on new CMS waivers and flexibilities: CMS Coronavirus Waivers & Flexibilities

Telehealth

CMS Telehealth/Digital Health Actions: CMS has announced a series of waivers and policy changes. Under the new rules, providers may bill for telehealth visits at the same rate as in-person visits, including emergency department visits, initial nursing facility and discharge visits, home visits, and therapy services with new as well as established patients. Virtually all of these changes are temporary for the duration of the Public Health Emergency. Of note, CMS Administrator Seema Verma was notified by America’s Health Insurance Plans (AHIP) that private plans will match CMS’s waivers for Medicare beneficiaries in areas where in-patient capacity is under strain. See CMS frequently asked questions document about the changes included in its announcement. These were both in compliance with H.R. 6704 and by existing authority They include:

  • Waivers of originating and geographic site restrictions on Medicare telehealth services, permitting the delivery of these services in all areas of the country and all locations, including patients’ homes.
  • The ability of providers to use expanded telehealth authority for new and established patients for diagnosis and treatment of COVID-19, as well as for conditions unrelated to the pandemic.
  • Permission for providers to use everyday communications technologies, such as FaceTime or Skype, during the COVID-19 public health emergency, without running afoul of HIPAA penalties.

Please note that the list of payment codes applicable to televisits is changing rapidly. We recommend visiting the American Telemedicine Association’s web site for the latest information. 

CMS Coding Guidance on E-VISITS:  In all types of locations including the patient’s home, and in all areas (not just rural), established Medicare patients may have non-face-to-face patient-initiated communications with their doctors without going to the doctor’s office by using online patient portals. These services can only be reported when the billing practice has an established relationship with the patient. For these E-Visits, the patient must generate the initial inquiry and communications can occur over a 7-day period. The services may be billed using CPT codes 99421-99423 and HCPCS codes G2061-G2063, as applicable. The patient must verbally consent to receive virtual check-in services. The Medicare coinsurance and deductible would apply to these services.

Medicare Part B also pays for E-visits or patient-initiated online evaluation and management conducted via a patient portal. Practitioners who may independently bill Medicare for evaluation and management visits (for instance, physicians and nurse practitioners) can bill the following codes:

  • 99421: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5–10 minutes
  • 99422: Online digital evaluation and management service, for an established patient, for up to 7 days cumulative time during the 7 days; 11– 20 minutes
  • 99423: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes.

Clinicians who may not independently bill for evaluation and management visits (for example – physical therapists, occupational therapists, speech language pathologists, clinical psychologists) can also provide these e-visits and bill the following codes:

  • G2061: Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
  •  G2062: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes
  • G2063: Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes.

HIPAA Telehealth Waiver: HHS Office for Civil Rights (OCR) will exercise enforcement discretion and waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency. Learn more here. 

IRS Changes for Telehealth in HDHP plans: CARES Act Sec. 3701 allows an employer offering a high-deductible health plan (HDHP) to cover telehealth services prior to a patient reaching the deductible and without making the individual ineligible to fund a health savings account (HSA) in plan years beginning on or before December 31, 2021.

IRS High Deductible Waiver: IRS issued guidance 2020-15 allows for testing and treatment of COVID-19 to be covered by high deductible health plans (HDHPs) prior to satisfaction of the plan’s minimum deductible without making an induvial ineligible for an HSA/HDHP plan (current law).

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