Reimbursement options for COVID-19 related care in uninsured individuals

Washington State Health Care Authority sent this bulletin at 06/25/2021 03:00 PM PDT

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Reimbursement options for COVID-19 related care in uninsured individuals

The Health Care Authority (HCA) sends you this notification to clarify reimbursement options when testing for and treating COVID-19 in uninsured patients. Specifically, we aim to answer frequently asked questions around the Health Resources & Services Administration (HRSA) portal, and Alien Emergency Medical (AEM).

We are also including some helpful resources for discussing the COVID-19 vaccine with clients / patients.

What is the HRSA COVID-19 Uninsured Program?

The HRSA COVID-19 Uninsured Program was established in February 2020 as a reimbursement program for providers that have performed tests and provided treatment, including vaccines to uninsured individuals on or after February 4, 2020.

Why would a provider choose reimbursement through the HRSA COVID-19 Uninsured Program instead of AEM?

The HRSA COVID-19 Uninsured Program reimburses providers at Medicare rates and covers additional services including but not limited to, skilled nursing facilities, long-term acute care, durable medical equipment and home health. While AEM may cover COVID-19 testing and treatment, it is limited to medically necessary emergencies, such as acute hospitalizations.

HRSA portal is not administered by HCA, and eligible reimbursements are made directly between HRSA and providers.

Additional information

Other provider/patient vaccine conversation resources

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.