October 8, 2020 COVID-19 Updates - Rate updates for A4930 and A4927
Maine Department of Health & Human Services sent this bulletin at 10/08/2020 06:14 PM EDT
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October 8, 2020 COVID-19 Updates
Federal Public Health Emergency (PHE) is Extended
As previously communicated, MaineCare’s temporary policy changes and guidance related to our COVID-19 response are approved for the duration of the federal Public Health Emergency (PHE), which is declared by U.S. Health and Human Services Secretary Azar.
The federal PHE that was set to expire on October 22, 2020 has been renewed for an additional 90 days through January 20, 2021.
As a reminder, a PHE declaration lasts until the Secretary declares that the PHE no longer exists or upon the expiration of the 90-day period beginning on the date the Secretary declared a PHE exists, whichever occurs first. The Secretary may extend the PHE declaration for subsequent 90-day periods for as long as the PHE continues to exist, and may terminate the declaration whenever he determines that the PHE has ceased to exist.
In regard to our temporary policy changes and guidance related to the COVID-19 pandemic, we are working on guidance to help prepare providers for the end of PHE, whenever that may occur, and will keep providers updated on the status of the declaration.
For more information on MaineCare’s COVID-19 policy changes and guidance, please visit our COVID-19 webpage. For more information about the federal PHE, please visit the HHS website.
Provider Relief Fund Updates
Third General Distribution of Provider Relief Fund: The federal Department of Health and Human Services has announced a third phase of general distribution funding from the Provider Relief Fund (PRF). HHS is allocating $20 billion for this funding round, with details on eligibility and payment methodology available here. The application period for this third round opens on Monday, October 5 and closes on November 6. Highlights on eligibility and payment elements are below.
- Eligibility: Any provider that has previously received, accepted, or rejected a general distribution award; behavioral health providers; and health care providers that began practicing between January 1, 2020 and March 31, 2020.
- Payment Methodology: Initial payments will be made to any provider that has not yet received a total of two percent of net patient revenue from the PRF, including providers who have received no PRF payment to date or providers who have received some payment below two percent of net patient revenue. With the remaining $20 billion after these payments, add-on payments will be made based on changes in a provider’s net patient revenue and operating expenses, with consideration for any previous PRF funding awards made to that provider.
- Reporting Requirements: The federal Health and Human Services has released guidance on the reporting requirements for providers who received one or more payments through general or targeted distribution exceeding $10,000 in the aggregate regarding the data elements that they will be required to report as part of the post-payment reporting process. You can also review this summary of reporting requirements that includes key dates and action items, guidelines for use of PRF funds, and required reporting data elements.
Rate updates for A4930 and A4927, CR 97661
Effective October 1, 2020, the rate for A4927 - Gloves, non-sterile, per 100 was increased to $7.87 and the rate for A4930 - Gloves, sterile, per pair was increased to $0.70. The rates were updated in MIHMS on October 7, 2020, and claims submitted prior to that date will be adjusted. No provider action is needed.