COVID-19 Legislative Update - 3/16/2020 March 17, 2020 Coronavirus, Federal Legislation, Legislation, Public Health Alert, Resources Coronavirus, Coronavirus Testing, COVID-19, COVID-19 Testing, Legislation 0 RCMA COVID-19 Resources RUHS Public Health Resources CMA Resource Center U.S. House Speaker Nancy Pelosi and U.S. Treasury Secretary Steven Mnuchin reached an agreement on Friday on a new far-reaching coronavirus response package. The U.S. House of Representatives passed the legislative package early Saturday morning with a bipartisan vote of 363-40. It is expected to be voted on in the U.S. Senate as early as Monday. The legislative package will ensure free coronavirus testing and expand the safety net to cope with the potentially catastrophic economic impact of the coronavirus outbreak. Specifically, the bill includes the following: Mandates coverage and waives all patient cost-sharing for COVID-19 tests, and associated physician visits for evaluating the need for testing. This mandate applies for patients who are privately insured, uninsured or enrolled in Medicare, Medicaid, SCHIP, TriCare, the Veterans Administration, the Indian Health Services or contract/referral services for Indians. Medicare will cover 100% of the payment amount for COVID-19 tests and associated physician visits. The bill also specifies that Medicare COVID-19 testing-related services is a medical visit in any of the following categories of HCPCS evaluation and management (E&M) service codes: office and other outpatient services, and services provided in hospital observation, emergency departments, nursing facilities, rest homes or custodial care, and home health. Outpatient payment includes hospital outpatient, the Medicare physician fee schedule, the prospective payment system and rural health clinic payments. CMS is also mandated to provide a modifier for physicians to include on claims to identify COVID-19 testing-related services. Prohibits prior authorization or utilization management requirements for COVID-19 testing and associated physician visits for all patients. Provides Medicaid eligibility to the uninsured for purposes of COVID-19 testing. The federal government will pay for 100% of the cost of COVID-19 testing and associated physician visits for these uninsured patients and will not require a state match. Increases federal matching funds for the Medicaid program overall by 6.2% Increases OSHA protections for health care workers. Provides $1 billion in funding for food assistance programs (school lunch, emergency food assistance, aging and disability programs, and the women, infants and children nutrition program) Provides up to two weeks of paid sick leave for workers who work for the government or employers with 500 employees or less. Provides up to 3 months of paid family and medical leave for government employees and employees who work for employers with less than 500 employees. The paid family and medical leave begins after the first 14 days of sick leave and is not less than two-thirds of the employee's regular payment rate. Increases funding for state unemployment funds by $1 billion. Provides tax credits to employers to offset the costs of emergency sick leave. The California Medical Association (CMA) is checking with the American Medical Association CPT and Centers for Medicare and Medicaid Services (CMS) to get clarification on a physician’s ability to bill for telephone codes for new patients and whether patient copays will be waived for telephonic visits. This package comes on the heels of legislation that Congress enacted last week to provide $8.3 billion in funding to assist with COVID-19 vaccine development and treatment, public health preparedness, low-interest small business loans and financial assistance to help Americans afford the vaccine. Last week’s legislation also gave broad authority for HHS Secretary Azar to waive Medicare telehealth requirements so that physicians can provide services related to screening, testing and treatment of coronovirus in all settings and geographic regions. Azar is expected to release the details of the telehealth waiver soon. We will provide an update when details are available. ------------------------------------------------------------------------------------------------ The California Medical Association (CMA) has been working closely with Governor Gavin Newsom and public health officials as they respond to the COVID-19 outbreak. Today, CMA delivered a letter to Gov. Newsom with CMA’s recommendations for addressing the barriers that physicians are encountering during this public health emergency. Telehealth The letter calls for the Governor to issue an executive order to expedite and expand access to telehealth services, which can help physician practices manage screening and care while reducing potential exposure and continued spread of COVID-19. Physicians want to implement telehealth but face ongoing barriers to implementation, including uncertainty as to whether public and private health plans will pay for these services. Consistent Messaging and Guidance CMA told Gov. Newsom that physicians and their patients need coordinated and consistent messaging and guidance on the changing situation and how health care workers should respond. CMA further recommended a statewide, sustained public education campaign to help counter misinformation that contributes to panic. Use of Droplet Precautions Lack of consistent guidance regarding how COVID-19 is transmitted is generating uncertainty and concern from health care workers regarding whether their facility’s personal protective equipment (PPE) protocols are appropriate and strains the limited supply of protective equipment and spaces in health care facilities. CalOSHA’s determination that COVID-19 is an airborne infectious disease conflicts with guidance from the CDC that COVID-19 spreads via droplet transmission. CMA is continuing to encourage the application of droplet precautions in health care settings and request that the state work with the CDC to clarify guidance that PPE protections for droplet transmission is the appropriate standard for protecting health care workers. Community Testing CMA supports efforts to quickly expand community testing to efficiently identify individuals who do and do not have COVID-19. However, until sufficient testing supplies are available, physicians need clear guidance on how limited testing supplies should be directed and which patients should be prioritized for testing. CMA is also urging the state to direct public and private health plans to collaborate to facilitate standardization on payment and coding procedures for COVID-19 testing and to provide clear guidance to physicians on payment and coding related to testing. Health Care Workers CMA told Gov. Newsom that it is critical that the state provide clear guidance regarding how decisions about the quarantine and furlough of health care workers should be made. CMA believes that health care workers exposed to COVID-19 patients should self-monitor for symptoms and may continue to work if they are asymptomatic. This will help to ensure that the state health care workforce is not unnecessarily reduced during this epidemic and patients continue to have access to care. CMA will continue to work with Gov. Newsom and public health officials as California navigates the COVID-19 pandemic. View CMA’s letter here. ________________________________________ The California Medical Association (CMA) has set up a COVID-19 resource page, where you will find links to the latest news, research and developments on the COVID-19 outbreak for physicians and other health care providers. Comments are closed.
