Federal Government Takes Steps to Protect People with Medicare and Limit the Spread of Coronavirus

This week, as the number of COVID-19 (also called coronavirus) cases continues to grow across the U.S., policymakers in Washington D.C. took steps to ensure people with Medicare can safely access needed care.

In a blog post on March 3, the Centers for Medicare & Medicaid Services (CMS) clarified that coronavirus testing will be covered under Medicare Part B as a clinical diagnostic laboratory test, for which beneficiaries usually pay nothing. The coverage is retroactive to February 4, 2020, but providers will have to wait until April 1 to submit claims to Medicare.

On March 4, the agency also announced several actions aimed at limiting the spread of coronavirus:

• First, CMS suspended all non-emergency nursing facility inspections across the country, ordering its 8,200 inspectors to temporarily focus only on infection control and other serious health threats. As a result, surveyors will be working to ensure the effective implementation of infection control procedures at nursing homes and hospitals, prioritizing those in locations where coronavirus has been identified among patients or in the community. In addition to these emergent issues, state agency surveyors will continue to conduct statutorily-required inspections nationwide, including responding to all immediate jeopardy complaints as well as allegations of abuse and neglect.
• The agency also issued guidance to help nursing homes and hospitalsaddress the coronavirus outbreak. Geared toward answering frequently asked questions from facilities and providers, the memos outline how to screen patients, staff, and visitors for infection and when hospitalization is needed over self-isolation. They also cover how to transfer patients between nursing homes and hospitals and when providers should take precautionary measures.
• Finally, CMS announced that it has deployed an infection prevention specialist to the Centers for Disease Control and Prevention’s (CDC) Atlanta headquarters to assist with the development of future rapid-response guidance.

Congress also took action this week, passing an $8.3 billion emergency funding bill aimed at improving preparedness and response.

The bill supports an array of activities, including vaccine research and development; federal, state, and local public health agencies; and loans for small businesses affected by the outbreak. Notably, it also gives the HHS Secretary the authority to temporarily waive Medicare’s geographic and originating site telehealth restrictions for people in areas where certain emergency declarations have been issued—including nationwide pursuant to a national public health emergency due to the coronavirus. Lifting these restrictions would allow qualifying beneficiaries in urban and rural areas to access the benefit from their own homes.

This provision could improve access to Medicare’s telehealth benefit during the current outbreak and in the future. Medicare Rights welcomes its inclusion in the supplemental spending bill.

More detailed federal guidance on using telehealth during the coronavirus is expected, as are additional federal agency materials. Stakeholders have already requested information from CMS on the challenges facing health care workers in home-based settings, as well as on the problems facilities anticipate if the coronavirus continues to spread—such as potential shortages of medical and other supplies.

Medicare Rights will continue to monitor this evolving situation and we will provide updates and information as available. If you have questions about your Medicare coverage and the outbreak, please call our National Helpline at 800-333-4114.

Read the CMS blog post, Medicare now covers coronavirus testing.

Read the CMS press release, CMS announces actions to address spread of coronavirus.

For more information on the coronavirus, please visit the Centers for Disease Control website.