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How the COVID-19 State of Emergency is Impacting Hospital Reimbursement

A new CMS waiver will allow facilities to treat patients they normally wouldn't be able to see and still be reimbursed for the care.
By |
Parkland Hospital

Because of President Trump’s declaration of emergency last week due to COVID-19, CMS issued several waiver that will impact hospitals and how they are reimbursed. The waives targeted acute care hospitals as well as long term acute care hospitals and inpatient rehabilitation facilities.

The waivers allow acute care hospitals more flexibility to relocate patients within its facility in order to better serve potential COVID-19 patients. This may entail moving acute care inpatients to a psychiatric unit and vice-versa as necessary, as long as the facilities are appropriate to treat the patient. No matter where they end up, CMS said patients should continue to be billed for the reason they came to the hospital, rather than the unit where they are being treated. The same process can be used for rehabilitation units in acute care hospitals.

Another waiver is allowing long term acute care hospitals and inpatient rehabilitation facilities to admit and be paid for patients who normally wouldn’t qualify for them while excusing the facilities from their patient ratio regulations.

Usually, these sorts of waivers require a state or provider request, but because this is a blanket waiver, permission isn’t needed. Instead, the provider informs the CMS regional office of its plans to use the waiver to ensure payment, which Texas did on March 14.

Hospitals will be using specific codes to notify payers that patients are disaster or catastrophic related, though the details on exactly how CMS will be reimbursing the hospitals is still unclear. In the past, CMS has paid the normal rate.

The waiver is set to last for the duration of the declared emergency unless CMS says otherwise. There are weekly calls for hospitals each Monday for hospitals to learn more about these waivers from 11 a.m. to 12 p.m. . The call-in information is 1-888-455-1397 / Passcode 5854574.

Find more information about CMS’ response to Coronavirus and the waivers here.

Research for this piece was done by attorneys from Dallas firm Husch Blackwell LLP, including partners Eric Weatherford and Joseph (Joe) V. Geraci, who co-lead the firm’s Healthcare Regulatory & Compliance Counseling group, and Alison Hollender and Mackenzie Wortley, attorneys who assists clients on healthcare law issues

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