Costs for testing are being waived as diagnostic tests proceed.
EDITOR’S NOTE: The World Health Organization (WHO) has declared that the coronavirus is now a pandemic.
With the novel coronavirus (COVID-19) outbreak intensifying across the country and large-scale public gatherings of all types being postponed or canceled en masse, federal officials and insurers are scrambling to eliminate financial barriers to testing and care, marking part of a broader effort to ensure that the nation’s healthcare infrastructure does not become overwhelmed.
The Centers for Medicare & Medicaid Services (CMS) announced Tuesday that many leading insurance companies and their industry associations are now indicating that they will be treating COVID-19 diagnostic tests as covered benefits, and will be waiving cost-sharing that would otherwise. The agency also pledged to provide more flexibility to Medicare Advantage and Part D plans, “to ensure they have the tools they need to provide seniors with the best coverage.”
As part of a flurry of related activity, CMS published a memorandum to Medicare Advantage (MA) and Part D health and prescription drug plans, informing them of the flexibilities they have to provide healthcare coverage to Medicare beneficiaries for COVID-19 testing, treatments, and prevention.
More than 1,000 people have now tested positive for the virus in more than 30 states, with pockets of infection reflecting substantial ease of spread.
“The President directed CMS to make sure Medicare Advantage beneficiaries have access to the healthcare services they need during this time,” CMS Administrator Seema Verma said in a statement. “Today we announced guidance to Medicare Advantage and Part D plans to remove barriers that could prevent or delay beneficiaries from receiving care. Medicare beneficiaries are at the greatest risk of serious illness due to COVID-19, and CMS will continue doing everything in our power to protect them.”
In the aforementioned memorandum, CMS outlined the flexibilities MA and Part D plans have to waive certain requirements to help prevent the spread of the virus; specifically, the relief involves:
The changes mark part of a broader effort on the part of the newly created White House Coronavirus Task Force, which has publicly announced an intention to ensure that all Americans – particularly those at high risk of complications from the COVID-19 virus – have access to benefits while helping to contain the spread of disease.
To view CMS’s memorandum for MA and Part D plans, go online to https://www.cms.gov/files/document/hpms-memo-covid-information-plans.pdf.
CMS has announced changes in policy to address the coronavirus outbreak several times per week recently, including half a dozen times since the start of the month alone:
On March 9, CMS delivered guidance on the screening, treatment, and transfer procedures healthcare workers must follow when interacting with patients to prevent the spread of COVID-19 in a hospice setting. CMS also issued additional guidance specific to nursing homes to help control and prevent the spread of the virus: https://www.cms.gov/newsroom/press-releases/cms-issues-clear-actionable-guidance-providers-about-covid-19-virus
Also on March 9, CMS issued a press release highlighting the telehealth benefits in the agency’s Medicare program for use by patients and providers: https://www.cms.gov/newsroom/press-releases/telehealth-benefits-medicare-are-lifeline-patients-during-coronavirus-outbreak
Additionally, on March 9, CMS published guidance to hospitals with emergency departments (EDs) on patient screening, treatment, and transfer requirements to prevent the spread of infectious disease and illness, including COVID-19, ordering that Medicare-participating hospitals follow both Centers for Disease Control and Prevention (CDC) guidance for infection control and Emergency Medical Treatment and Labor Act (EMTALA) requirements: https://www.cms.gov/newsroom/press-releases/cms-issues-call-action-hospital-emergency-departments-screen-patients-coronavirus
On March 6, CMS issued frequently asked questions and answers (FAQs) for healthcare providers regarding Medicare payment for laboratory test and other services related to the outbreak: https://www.cms.gov/newsroom/press-releases/covid-19-response-news-alert-cms-issues-frequently-asked-questions-assist-medicare-providers
On March 5, CMS issued a second Healthcare Common Procedure Coding System (HCPCS) code for certain COVID-19 laboratory tests, in addition to three fact sheets about coverage and benefits for medical services related to COVID-19 for CMS programs: https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests
On March 4, CMS issued a call to action to healthcare providers nationwide and offered important guidance to help State Survey Agencies and Accrediting Organizations prioritize their inspections of healthcare: https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus
That’s how Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz announced the publication of the CMS Final Rule on the Adoption of Standards
It just seems that a week does not go by when an insurance company doesn’t develop a new policy that leads to confusion in the
Please log in to your account to comment on this article.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Stacey Shillito, CDIP, CPMA, CCS, CCS‑P, CPEDC, COPC. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
BLOOM INTO SAVINGS! Get 25% OFF during our spring sale through March 27. Use code SPRING26 at checkout to claim this offer.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
