The President announced during his press conference declaring a national emergency, that he was suspending the Medicare three-day stay requirement before a SNF admission. We have not yet seen anything in writing about this from CMS and will forward to you when we receive any more information.
Following a declaration of a State of Emergency by the President yesterday, the Centers for Medicare and Medicaid Services (CMS) issued new guidance via a memorandum that is based on the newest recommendations from the Centers for Disease Control and Prevention (CDC). It directs nursing homes to significantly restrict visitors and nonessential personnel, as well as restrict communal activities inside nursing homes. All individuals other than essential health care staff and visits for end-of-life situations, should no longer enter skilled nursing facilities (SNFs) until further notice. Here's a quick summary:
- Document absence of symptom
- Those with symptoms of a respiratory infection (fever, cough, shortness of breath, or sore throat) should not be permitted to enter the facility at any timeeven in end-of-life situations).
This new guidance means facilities need to explore mechanisms to allow family members, ombudsman, resident representatives, and others to communicate with the residents.
This new guidance should be used in place of AHCA's visitor guidance released on March 9 (which has now been removed from the website).
AHCA/NCAL is now in the process of updating existing documents and tools on the website to ensure they match the newest guidance. So, please keep checking AHCA/NCAL's COVID-19 website.
Because assisted living communities are regulated at the state level, this CMS guidance does not impact ALs; however, the risk to the elderly in ALs is just as serious. Unless there is guidance put forth for ALs by their state governors and state agencies, ALs should consult AHCA/NCAL's guidance and this email emphasizing the goal to try and reduce the number of people entering the facility.
CDC guidance does state much of this information could also be applied in assisted living.
The Medicare claims processing systems will be able to accept HCPCS codes (U0001, U0002) starting on April 1, 2020, for dates of service on or after February 4, 2020. It is important to note that Local Medicare Administrative Contractors (MACs) are responsible for developing the payment amount for claims they receive for these newly created HCPCS codes in their respective jurisdictions until Medicare establishes national payment rates. View a map of CMS MAC coverage and the MAC by MAC rates. For details on how to submit billing, please check your MAC websites and/or call their provider support number. The relevant CMS guidance is Medicare Coverage and Payment Related to COVID-19 and is located here.
CMS is waiving 42 CFR 483.20 to provide relief to SNFs on the timeframe requirements for Minimum Data Set (MDS) assessments and transmissions. CMS has not yet issued technical guidance on how to implement.
For "certain beneficiaries who recently exhausted their SNF benefits, the waiver authorizes renewed SNF coverage without first having to start a new benefit period". CMS has not yet issued technical guidance on how to implement.
"Temporarily waive requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state." Note: this is for billing purposes and State licensing still needs to be followed. CMS has not yet issued technical guidance on how to implement.
Separately, the House of Representatives passed a relief package late yesterday. It still must be passed in the Senate, but it includes a temporary 6.2% FMAP increase to state Medicaid programs, paid sick leave for employers with 500 employees or less, tax credits, and funding for certain tests. We will continue to monitor this legislation and keep you posted about possible implementation.
Please email COVID19@ahca.org for additional questions, and visit
www.ahcancal.org/coronavirus for additional information and resources.
As a reminder, we continue to advise: