Uninsured Coverage COVID-19:
As the coronavirus and resulting disease of COVID-19 continues to plague Americans, more and more citizens are concerned about testing positive. While many chose to skip testing for COVID-19 in the earlier days of the pandemic for fear of unintentional exposure, now people are heading to test sites in large numbers, eager to catch and treat the disease early if they have contracted it. Thankfully, H.R. 6201, the Families First Coronavirus Response Act was signed by President Trump on March 18, 2020, making testing for COVID-19 universally free for most Americans, including the uninsured.
Though COVID-19 testing is free, not all insurers will waive cost-sharing requirements for the treatment of the disease, including things like emergency room visits and hospital admissions. COVID-19 insurance policy changes continue to evolve as the disease and possible treatments evolve. The Centers for Medicare & Medicaid Services (CMS), the federal agency within the US Department of Health and Human Services (HHS) that administers the Medicare program and works with state governments to administer Medicaid and other programs, directed Medicare Advantage Organizations to uniformly waive or reduce cost-sharing amounts for laboratory tests, telehealth options, and other services to address the COVID-19 pandemic for all enrollees as needed. And regarding traditional Medicare, the CMS has called for the agency to waive cost-sharing of Medicare beneficiaries for services that result in a requirement of any COVID-19 tests, services that are related to administering a COVID-19 test, or services that are related in any way to the medical evaluation of beneficiaries to determine a need for a COVID-19 test. (Such services include emergency room evaluations, hospital admissions for observation, healthcare provider office visits, and any other related outpatient services. (Note: because a vaccine for COVID-19 has not been made available to all Americans yet, plans may voluntarily cover any vaccination used for the disease, with or without cost-sharing, but is not required to do so.)
The American College of Emergency Physicians (ACEP) provides information regarding COVID-19 management as the disease evolves on their web site. Their COVID-19 pages provide some current guidance with links to clinical resources, federal guidance, and more. ACEP states that medical coding and billing professionals should use designated codes developed for COVID-19 related claims and should not charge Medicare patients any coinsurance and/or deductible amounts for the specifically outlined services related to the disease. ACEP states that the policy, retroactive to March 18, 2020, and lasting through the end of the COVID-19 national emergency, allows for requests for resubmission of any claims sent before the codes were available to receive full payment.
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