Tag: public health emergency

Medical reviews begin for pandemic claims

Medicare Administrative Contractors (MACs) have resumed post-payment medical reviews on claims during the public health emergency, according to Palmetto GBA and the latest MLN Connects newsletter. Since August, MACs have limited medical reviews to claims with dates of service before March 2020. “MACs may now begin conducting post-payment medical reviews for later dates of service,” […]

OIG releases message on telehealth reviews

The U.S. Department of Health and Human Services Principal Deputy Inspector General Christi A. Grimm recently released a message regarding telehealth. “Where telehealth and other remote access technologies were once a matter of convenience, the public health emergency made them a matter of safety for many beneficiaries,” says Grimm. A year later, there is strong […]

Federal Rules Impose Strict Deadlines for Health Plans to Cover COVID-19 Vaccines

Health plans will have to start covering COVID-19 vaccines shortly after their approval, regardless of whether they are delivered by an in-network provider, under regulations finalized by three federal agencies. The interim final rule published on November 6 (85 Fed. Reg. 71142) is designed to implement various health care and coverage provisions of the Coronavirus […]

CMS expands access to COVID-19 antibody treatments for Medicare beneficiaries

The Food and Drug Administration issued an emergency use authorization (EUA) for the monoclonal antibody therapy bamlanivimab on November 9. As a result, Medicare beneficiaries will receive coverage of monoclonal antibodies to treat COVID-19 during the public health emergency, announced CMS administrator Seema Verma. CMS anticipates that healthcare providers will initially receive the monoclonal antibody […]

Breaking: CMS delays OASIS-E due to COVID-19

CMS delayed the implementation of OASIS-E, originally schedule to take effect Jan. 1, 2021, to provide flexibilities for agencies to respond to the public health threats stemming from COVID-19 public health emergency (PHE), according to an interim final rule dated April 28. Agencies will be required to use OASIS-E beginning with discharges and transfers on […]