Medicare Compliance & Reimbursement

Plus: Medicaid providers finally receive CARES Act assistance.

If you’re getting ready to lay down some COVID-19 testing protocols, the Centers for Disease Control and Prevention (CDC) has some new recommendations.

On June 13, the CDC revised its COVID-19 testing advice for the sixth time. The new guidance “consolidates recommendations for COVID-19 testing, including interim testing guidelines for nursing home residents and healthcare personnel, as well as testing strategy options for high-density critical infrastructure workplaces after a COVID-19 case is identified. These recommendations compile and update previous testing guidance,” CDC says.

See the changes at www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html.

In other news…

Medicaid providers haven’t been included in the plethora of Provider Relief Fund dispersals so far, but now they can apply for their piece of $15 billion in additional funding.

Now: The Department of Health and Human Services (HHS) announced on June 9 “additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs.”

However, to get the funding, Medicaid and CHIP providers must meet certain conditions.

Condition No. 1: “HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Allocation,” HHS explains in the release. That refers to either of the two rounds of CARES Act PRF funding in April and May that totaled $50 billion.

Condition No. 2: Providers must “have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020,” HHS stipulates in the release.

HHS estimates that “the initial General Distribution provided payments to approximately 62 percent of all providers participating in state Medicaid and CHIP programs,” the release says. “The Medicaid and CHIP Targeted distribution will make the Provider Relief Fund available to the remaining 38 percent.”

Find the HHS Provider Relief Fund information on the Medicaid and CHIP dispersals as well as links to terms and conditions and past funding disbursements at www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html.