CMS eases requirements for COVID-19 tests, boosts payments for telephonic visits 

coronavirus nih
The Centers for Medicare & Medicaid Services issued a slew of new COVID-19 regulatory changes Thursday. (NIH)

The Trump administration is easing requirements on testing for COVID-19 to make it easier to administer drive-thru and “parking lot” testing facilities. 

Ordinarily, a patient requires an order from a physician or other practitioner who is overseeing his or her care. The Centers for Medicare & Medicaid Services (CMS) will no longer require that written order to allow Medicare beneficiaries to get tested, the agency said Thursday. 

The testing updates were included in a flurry of regulatory changes issued by CMS—the changes are a mix of CARES Act mandates and requests from providers. For instance, CMS also said Thursday it will grow the number of services it will cover as audio-only telephone visits to include behavioral health and patient education services. 

Product Spotlight

Top-Rated Mobile App for Health Insurance Members

Zipari’s Mobile App is the smarter, easier, and better way for payers to engage members on the go and directly in the palm of their hands. Members can find the right doctors, receive notifications, send messages, view claims, track spending, talk to a nurse, download ID card, and more. It’s ready to install and launch in a few months.

CMS will also boost the payment rate for telephone visits to match those for similar office and outpatient care, an increase that is retroactive to March 1. 

RELATED: Half of physicians now using telehealth as COVID-19 changes practice operations 

An increase in payments for telephonic visits has been hotly requested by physicians. 

Under the new testing protocols, pharmacists can now team up with doctors and other medical practitioners to assess patients and collect specimens for testing, and the physicians can then bill Medicare for that service. Pharmacists can also administer the tests themselves if they’re enrolled in Medicare as a laboratory, CMS said. 

CMS also said it will now cover certain antibody, or serology, tests and processing for home tests that have been approved by the Food and Drug Administration. 

“Testing is vital, and CMS’ changes will make getting tested easier and more accessible for Medicare and Medicaid beneficiaries,” CMS Administrator Seema Verma said. 

RELATED: CMS boosts Medicare payments for high throughput COVID-19 diagnostic tests 

The regulatory rollback comes as the country’s largest pharmacy chains have pledged to significantly ramp up their testing capabilities. The White House has its eyes on reopening the economy, and widespread access to rapid testing is a critical step toward reaching that goal. 

In addition to heeding calls from docs to boost payments for telephonic visits, CMS also announced several steps to help accountable care organizations (ACOs) navigate the pandemic.  

CMS will adjust financial methodology for ACOs to exclude COVID-19 costs and will skip its annual application process, allowing current ACOs the option to extend through 2021. ACOs will also have the option to maintain their current level of risk for next year instead of having their risk level automatically increase. 

Providers have also requested such changes as the pandemic puts significant pressure on value-based care programs.

Other regulatory changes issued Thursday include: 

  • Due to the pandemic, CMS will consider coverage for new telehealth services on a sub-regulatory basis, skirting the rule-making process and allowing the agency to consider new services more quickly. 

  • CMS will not cut Medicare payments to teaching hospitals that reassign residents to other facilities, nor will it penalize the hospitals that bring in those residents. 

  • Hospitals will be afforded greater flexibility to grow bed capacity during a surge. For example, a teaching hospital can create more temporary beds without being penalized by Medicare for indirect medical education. 

  • Long-term acute care facilities can accept acute care hospital patients and will be paid at a higher Medicare rate, as required in the CARES Act. 

Suggested Articles

President Donald Trump issued an executive order Monday to support healthcare in rural areas by permanently expanding telehealth services.

Tenet generated $88 million in profits in the second quarter thanks in part to more than $850 million in aid from a federal provider relief fund.

Ancestry gots its start in geneology. Now the company is expanding into more advanced genetic health screening.