###Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov, [1] https://www.hrsa.gov/coviduninsuredclaim, CMS News and Media Group We estimated the likelihood of new-onset, self-reported Long Covid after a second SARS-CoV-2 infection, and compared to a first infection. Section 4113(d) of the 2023 Consolidated Appropriations Act, continue to provide Medicaid and CHIP coverage, CMS waived the federal Medicare requirement. An official website of the United States government Heres how you know. These guidelines are a set of rules that have been developed to accompany and complement the Residents who refuse testing may require transmission-based precautions based on symptoms or vaccination status. USTR Releases 2023 Special 301 Report on Intellectual Property Washington Signs Into Law an Act for Consumer Health Data Privacy: Dont Look Twice, Its Alright The FCC Pulls Back the Curtain on Trending in Telehealth: April 18 24, 2023. Adults who work full-time may still be eligible for Medicaid in expansion states because they work low-wage jobs and still meet income eligibility criteria (Figure 4).An individual working full . Nurse aides hired after the end of the PHE will have four months from their hiring date to complete the mandatory trainings. HIPAA Enforcement Discretion The Office for Civil Rights (OCR) has been exercisingenforcement discretionthroughout the COVID-19 pandemic regarding telehealth and remote communications. The guidance issued today can be viewed here:https://www.cms.gov/files/document/faqs-part-44.pdf. How do eligible providers submit claims? Secure .gov websites use HTTPSA Territories Can Adopt to Maintain Coverage of Eligible Individuals as they Return to Normal Operations, Connecting Kids to Coverage: State Outreach, Enrollment and Retention Strategies issue brief, Promoting Continuity of Coverage and Distributing Eligibility and Enrollment Workload in Medicaid, the Childrens Health Insurance Program (CHIP), and Basic Health Program (BHP) Upon Conclusion of the COVID-19 Public Health Emergency, Mandatory Medicaid and CHIP Coverage of COVID-19-Related Treatment under the American Rescue Plan Act of 2021, Available Flexibilities and Funding Opportunities to Address COVID-19 Vaccine Hesitancy, Temporary increases to FMAP undersections 9811, 9814, 9815, and 9821 of the ARP, Medicaidand CHIPCoverage and Reimbursement of COVID-19TestingActivities, Updated Guidance Related to Planning for the Resumption of Normal State Medicaid, Childrens Health Insurance Program (CHIP), and Basic Health Program (BHP) Operations Upon Conclusion of the COVID-19 Public Health Emergency, COVID-19 FAQs for State Medicaid and CHIP Agencies, New COVID-19 FAQs for State Medicaid and CHIP Agencies, COVID-19 FAQs on implementation of Section 6008 of the Families First Coronavirus Response Actand Coronavirus Aid, Relief, and Economic Security (CARES) Act, COVID-19 FAQs on implementation of Section 6008 of the Families First Coronavirus Response Act, Medicaid, Childrens Health Insurance Program (CHIP), and Basic Health Program (BHP) Related Provisions in the American Rescue Plan Act of 2021, State Health Office Letter:Planning for the Resumption of Normal State Medicaid, Childrens Health Insurance Program (CHIP), and Basic Health Program (BHP) Operations Upon Conclusion of the COVID-19 Public Health Emergency, Medicaid and Childrens Health Insurance Program COVID-19 Health Emergency Eligibility and Enrollment Pending Actions Resolution Planning Tool, General Transition Planning Tool for Restoring Regular Medicaid and Childrens Health Insurance Program Operations after Conclusion of the Coronavirus Disease 2019 Public Health Emergency, SMDL: COVID-19 Public Health Emergency Section 1115(a) Opportunity for States, CIB: Medicaid Substance Use Disorder Treatment via Telehealth, and Rural Health Care and Medicaid Telehealth Flexibilities Guidance, CIB: Nursing Home Strategies for COVID-19 Only Isolation of COVID-19 Residents, CIB: Medicaid Managed Care Options in Responding to COVID-19, COVID-19 Managed Care Delivery System and Provider Payment Initiatives, Operationalizing Implementation of the Optional COVID-19 Testing (XXIII) Group Potential State Flexibilities guidance, Coverage of Monoclonal Antibody Products to Treat COVID-19. The EUA requires Quidel to develop a mobile phone application or website to facilitate results reporting by the user and health care provider. 197 0 obj <>/Filter/FlateDecode/ID[<8113D489A4B65846B687C57AD4A46217>]/Index[174 38]/Info 173 0 R/Length 109/Prev 232650/Root 175 0 R/Size 212/Type/XRef/W[1 3 1]>>stream The following guidance shall continue toremain in effectin accordance with the . CMS refers to CDC guidance, Reports of COVID-19 level of community transmission area available on the, CMS Releases Major Medicaid Access and Managed Care Rules, HHS BinaxNOW Program to Continue After PHE Ends, Requirements of Participation eCompetencies, Payroll Based Journal (PBJ) Mandatory Reporting, Quality Assurance/Performance Improvement (QAPI), Occupational Safety and Health Administration (OSHA), CMS Extends Date To Submit Updated ABN Form for Medicare Services, MACs Resume Medical Review on a Post-Payment Basis, AHCA/NCALs Infection Preventionist Training is Ideal for Assisted Living Nurses, NHSN Updates Instructions and Adds Testing to Resident Impact and Facility Capacity Pathway, Available Now! Mask requirements in certain locations. ) The guidance also includes information on federal reimbursement for COVID-19-related services provided to the uninsured. The Centers for Medicare & Medicaid Services Friday released guidance clarifying federal requirements for health plans to cover certain items and services related to diagnostic testing for COVID-19 without cost-sharing, prior authorization or other medical management requirements.. Medicare beneficiaries will continue to have access to COVID-19 vaccines without cost sharing when the PHE expires. (Medicare wont cover over-the-counter COVID-19 tests if you only have Medicare Part A (Hospital Insurance) coverage, but you might be able to get free tests through other programs or insurance coverage you may have.). The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. A federal government managed website by theCenters for Medicare & Medicaid Services.7500 Security Boulevard Baltimore, MD 21244, An official website of the United States government, Improving Care for Medicaid Beneficiaries with Complex Care Needs and High Costs, Promoting Community Integration Through Long-Term Services and Supports, Eligibility & Administration SPA Implementation Guides, Medicaid Data Collection Tool (MDCT) Portal, Using Section 1115 Demonstrations for Disaster Response, Home & Community-Based Services in Public Health Emergencies, Unwinding and Returning to Regular Operations after COVID-19, Medicaid and CHIP Eligibility & Enrollment Webinars, Affordable Care Act Program Integrity Provisions, Medicaid and CHIP Quality Resource Library, Lawfully Residing Immigrant Children & Pregnant Women, Home & Community Based Services Authorities, January 2023 Medicaid & CHIP Enrollment Data Highlights, Medicaid Enrollment Data Collected Through MBES, Performance Indicator Technical Assistance, 1115 Demonstration Monitoring & Evaluation, 1115 Substance Use Disorder Demonstrations, Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations, Seniors & Medicare and Medicaid Enrollees, Medicaid Third Party Liability & Coordination of Benefits, Medicaid Eligibility Quality Control Program, State Budget & Expenditure Reporting for Medicaid and CHIP, CMS-64 FFCRA Increased FMAP Expenditure Data, Actuarial Report on the Financial Outlook for Medicaid, Section 223 Demonstration Program to Improve Community Mental Health Services, Medicaid Information Technology Architecture, Medicaid Enterprise Certification Toolkit, Medicaid Eligibility & Enrollment Toolkit, SUPPORT Act Innovative State Initiatives and Strategies, SUPPORT Act Provider Capacity Demonstration, State Planning Grants for Qualifying Community-Based Mobile Crisis Intervention Services, Early and Periodic Screening, Diagnostic, and Treatment, Vision and Hearing Screening Services for Children and Adolescents, Alternatives to Psychiatric Residential Treatment Facilities Demonstration, Testing Experience & Functional Tools demonstration, Medicaid MAGI & CHIP Application Processing Time, Stand-alone Vaccine Counseling-specific HCPCS codes, SHO: Medicaid and CHIPCoverage of Stand-aloneVaccine Counseling, Vaccine Counseling for Medicaid and CHIP Beneficiaries, Overview of Strategic Approach to Engaging Managed Care Plans to Maximize Continuity of Coverage as States Resume Normal Eligibility and Enrollment Operations, Strategies States and U.S. Revised COVID-19 staff testing is based on the facilitys county level of community transmission instead of county test positivity rate. Pennsylvania Medical Supply Company Agrees to $5 Million Settlement. The Food and Drug Administration today released final guidancefor transitioning medical device enforcement policies and emergency use authorizations established during the COVID-19 public health emergency to normal operations. or This guidance makes clear that private group health plans and issuers generally cannot use medical screening criteria to deny coverage for COVID-19 diagnostic tests for individuals with health coverage who are asymptomatic, and who have no known or suspected exposure to COVID-19. Beginning January 1, 2021, what is the HRSA COVID-19 Uninsured Program reimbursement rate for high-throughput COVID-19 polymerase chain reaction (PCR) testing claims with HCPCS codes U0003 and U0004? This waiver will end with the expiration of the PHE, but states may apply for an exemption to this requirement from CMS. French Insider Episode 21: Between Warring Giants: How European What Appellate Courts Are Missing About PAGA Standing After Viking New Antidumping and Countervailing Duty Petition on Non-Refillable After May 15, 2023, PERMs Must Be Filed Via DOLs FLAG System, Applying for an Emergency or Urgent Expedited U.S. Passport, UFLPA Enforcement Remains Work in Progress. After this, CMS will reimburse for monoclonal antibodies as it does for other biological products. Medicare covers up to 8 over-the-counter COVID-19 tests each calendar month, at no cost to you, until the Public Health Emergency ends on May 11, 2023. Section 4113(d) of the 2023 Consolidated Appropriations Actdelays the in-person visit requirements for Medicare patients receiving mental health treatment via telehealth until at least 2025. Cookies used to make website functionality more relevant to you. lock Medicare Part B (Medical Insurance) will cover these tests if you have Part B. In other news, the Food and Drug Administration today issued an emergency use authorization for the Quidel QuickVue At-Home COVID-19 Test, a prescription antigen test that allows individuals to collect and test a sample at home when their health care provider suspects they have COVID-19 within six days of symptom onset. The guidance also includes information for providers on how to get reimbursed for COVID-19 diagnostic testing or for administering the COVID-19 vaccine to those who are uninsured. A research team funded by the National Institutes of Health has launched a. to assess the apps performance and usability. QNS 24x7 on Instagram: "<<<{((QNS))}>>> >> MHA issues order with . The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Jason A. Levine, Gillian H. Clow, Ryan Martin-Patterson, Giles Judd, and Stephen Tagert, ALSTON & BIRD LLPBefore delving into recent developments in COVID-19 litigation, we have an announcement. In addition, the guidance confirms that plans and issuers must cover point-of-care COVID-19 diagnostic tests, and COVID-19 diagnostic tests administered at state or locally administered testing sites. Copyright 2023 Robinson & Cole LLP. The Centers for Medicare & Medicaid Services (CMS) today issued an interim final rule requiring COVID-19 vaccinations for workers in most health care settings, including hospitals and health systems, that participate in the Medicare and Medicaid programs. Medicaid Supplemental Payment & Directed Payment Programs, CMS Revises NF COVID-19 Testing Requirements for Staff and Residents. Slowing the Spread of Litigation: An Update on First Circuit COVID-19 Has Your Business Attorney Met Your Estate Planning Attorney? In 2014, Tennessee's legislature passed a "Fetal Assault Law," which made it possible to prosecute pregnant women for drug use during pregnancy. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. This memorandum provides guidance for facilities to meet the new requirements. You can decide how often to receive updates. The Centers for Disease Control and Prevention April 19 recommended a second Moderna or Pfizer COVID-19 bivalent vaccine dosefor adults aged 65 and older at least four months after their initial bivalent dose, and for immunocompromised individuals at least two months after their initial bivalent. One such existing program is through the Provider Relief Fund program, which has a separate effort for providers to submit claims and seek reimbursement on a rolling basis for COVID-19 testing, COVID-19 treatment, and administering COVID-19 vaccines to uninsured individuals (the HRSA COVID-19 Uninsured Program), Through previous guidance and rulemaking, the Departments addressed coverage requirements for COVID-19 vaccines and diagnostic testing in an. In a studyof adults hospitalized between February 2022 and February 2023, when the omicron variant predominated, monovalent mRNA vaccination was 76%, More than 1,000 executive leaders from the nations top hospitals and health systems convened at the 2023 AHA Annual Membership Meeting, April 23-25 in, In response to questions from AHA and others and informed by testing results, the Food and Drug Administration April 21announced that health care, The Centers for Disease Control and Prevention April 19 recommended a second Moderna or Pfizer COVID-19 bivalent vaccine dosefor adults aged 65 and older, CMS clarifies when health plans must cover COVID-19 tests; FDA authorizes new at-home test, The Centers for Medicare & Medicaid Services.