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Official Publication of The Denver Medical Society April 2020

COVID-19 updates and resources

Denver  Medical Society has joined with Colorado Medical Society and other medical communities across the state to coordinate efforts to bring you critical up to date information on the COVID-19 pandemic and its impact on Colorado. Join weekly virtual physician town hall meetings on Wednesday evenings from 6 PM-7:30 PM. Each town hall will cover new information and engage directly with key stakeholders to get support and answers on the COVID-19 pandemic.  Register for the April 1st Town Hall at 6:00 pm, featuring Senators Michael Bennet and Cory Gardner.

Join the Physician COVID-19 Discussion Board to stay in touch with your colleagues and share information. Visit the same page for resources and FAQs.

AMA releases special coding advice related to COVID-19

New guidance from the AMA provides special coding advice during the COVID-19 public health emergency. One resource outlines coding scenarios designed to help health care professionals apply best coding practices. The scenarios include telehealth services for all patients. Examples specifically related to COVID-19 testing include coding for when a patient: comes to the office for E/M visit, and is tested for COVID-19 during the visit; receives a telehealth visit re: COVID-19 and is directed to come to physician office or physician’s group practice site for testing; receives a virtual check-in/online visit re: COVID-19 (not related to E/M visit), and is directed to come to physician office for testing; and more. There is also a quick-reference flowchart that outlines CPT reporting for COVID-19 testing. A new web page on the AMA site also outlines CMS payment policies and regulatory flexibilities related to COVID-19. 

Infection-control FACE MASK
Port Plastics is a local plastics distributor in Denver Colorado. As a company we are producing 1,000,000 face shields a week at our Mid-West location. We will have 40,000+ shields on our floor next week. Locally we carry a large variety of materials that may be beneficial for your locations at this time. We carry acrylic, polycarbonate, PETG, and mylar of various thickness and sheet sizes that may be used as temporary quarantine barriers. Please contact our team at (303) 371-5000 for orders and any other questions you may have about our products and current inventory.
CMS Offers Accelerated Payments for Healthcare Providers 

CMS announced on March 28 that it will accelerate advanced Medicare payments available to physicians and other healthcare providers due to the effects of the COVID-19 pandemic. 

The move means that practices can apply now to their Medicare Administrative Contractors to receive 100 percent of their Medicare payment amount for a three-month period based on historical payments. MACs will issue the payments within seven days, the Centers for Medicare & Medicaid Services said in a fact sheet accompanying its announcement (PDF). 

Recoupment of advance payments will begin 120 days after the accelerated payment is made. Practices will then have another 90 days to repay the balance. The balance would be the amount of the payment less anything that would be credited to the practice based on new claims submitted after that time. 

To apply, practices must obtain an accelerated advance payment request form from their MAC's website. CMS has COVID-19 hotlines at each MAC to help with the requests. To contact your MAC, review CMS' MAC list (PDF). 

Typically, practices receive Medicare payments after delivering services to patients. However, CMS offers advance payments in emergencies, such as natural disasters, to address cash flow issues. 

"With our nation's health care providers on the front lines in the fight against COVID-19, dollars and cents shouldn't be adding to their worries," CMS Administrator Seema Verma said in the agency's release announcing the move. "Unfortunately, the major disruptions to the healthcare system caused by COVID-19 are a significant financial burden on providers. Today's action will ensure that they have the resources they need to maintain their all-important focus on patient care during the pandemic." 

Hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers are eligible. 

According to CMS, to qualify for the payments, the provider or supplier must:

  • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider's/ supplier's request form,
  • Not be in bankruptcy,
  • Not be under active medical review or program integrity investigation, and
  • Not have any outstanding delinquent Medicare overpayments.
AMA COVID-19 Resource Center

Visit the AMA Resource Center and sign-up for breaking updates. Share your ideas with JAMA for conserving PPE and find CDC tracking data.

FAQs About Med Mal Coverage from The Doctors Company

Suspending or reducing your practice? Volunteering from retirement? Am I covered for telemedicine? Find continually updated answers and resources here.

Request  for Plans Violating Telehealth Guidelines
Based on reports of ERISA plans either not covering certain telehealth codes or simply not following Medicare’s telehealth coverage guidance during the COVID-19 pandemic, the AMA is seeking examples of this behavior. If this is something that you are seeing in your practice please share your experience by emailing so that they can establish the scope of the problem. 
CARE Act Signed into Law

Provisions of particular interest to physicians and their practices include the following:

  • Creates a new loan product within the Small Business Administration for loans of up to $10 million to help cover payroll and overhead costs, with expanded loan forgiveness criteria. Physician practices with not more than 500 employees may qualify.
  • $100 billion in direct financial support to hospitals, physician practices, and other health care providers under the Public Health and Social Services Emergency Fund. This support is for costs of treating COVID-19 patients as well as to ease the financial impact on those who lose revenue due to reductions in other services as a result of the pandemic. Exact eligibility criteria and application process is not yet defined pending implementation.
  • Suspension of the 2% Medicare sequester in May through December 2020.
  • Limitations on liability for volunteer health care professionals during COVID-19 emergency response.
  • A temporary waiver of the face-to-face visit requirement with home dialysis patients.
  • Authority for the Secretary of HHS to waive telehealth coverage requirements for new patients during a national emergency. Previous legislation provided flexibility only for established patients seen within the past three years.
  • Secretary will also allow for enhanced use of telehealth under Medicare for federally qualified health centers.

Also of interest, the "health extenders" package that was set to expire on May 22 has now been extended to Nov. 30. For a complete summary, visit the AMA COVID-19 website.

Telemedicine Online Discussion
This discussion, sponsored by AMA's Physician Innovation Network (PIN), is designed to share best practices and the latest policy and payment updates to support physicians and practices in expediting the implementation of telemedicine, so care can continue to be provided to those who need it most. Join the conversation here.

You can also listen to last week's webinar on Telehealth and Virtual Private Practice Strategies presented by CMS.
Denver Medical Bulletin: Alan E. Kimura, MD-President/Publisher / Elizabeth L. Lowdermilk, MD-Chair of the Board / Michael L. Moore, MD, President Elect / Jeremy L. Weiss, DO, Treasurer / Kathy Lindquist-Kleissler, Executive Director. The Bulletin is the official publication of the Denver Medical Society, established April 11, 1871, as the first medical society in the Rocky Mountain West. Published articles represent the opinions of the authors and do not necessarily represent the official policy of the Denver Medical Society. All correspondence concerning editorial content, news items, advertising and subscriptions should be sent to: The Editor, Denver Medical Bulletin, 1850 Williams Street, Denver, CO 80218.
Phone (303) 377-1850.
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