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Medicare Regulatory Changes Due to Covid-19

Medicare Diagram

Covid-19 has altered many facets of our lives, from wearing masks in public to being mindful of things like social-distancing. The pandemic has changed things we don’t usually think about, as well. Some of the changes made at the federal level were to Medicare regulations, to provide health care providers, Medicare Advantage plans, and Part D plans more resources to respond to the crisis created by the pandemic. The changes gave flexibility to providers and patients alike. It is important to be aware of the changes and how they might impact you. 

In total, Congress and the Trump administration have relaxed 212 Medicare regulations since the pandemic began earlier in the year. The changes offered relief from certain regulations, giving healthcare providers more leeway in how they administer care. Changes have also waived certain rules around Medicare participation, allowing patients to seek alternative care. The changes also provide reimbursement for telehealth sessions for physicians. 

Under rules governing national health emergencies, the president and the secretary of the Department of Health and Human Services can invoke 1,135 waivers, which allow them to make Medicare regulatory changes. Most of the regulatory changes were made through 1,135 waivers, and most are temporary. According to the rule, changes can be made to the following: “Conditions of participation or other certification requirements; program participation and similar requirements; pre-approval requirements; requirements that physicians and other healthcare professionals be licensed in the state in which they are providing services, so long as they have equivalent licensing in another state; emergency Medical Treatment and Labor Act (EMTALA); stark self-referral sanctions; performance deadlines and timetables may be adjusted (but not waived), and limitations on payment for health care items and services furnished to Medicare Advantage enrollees by non-network providers.”

For patients, changes include paying for Covid-19 related tests, antibody tests, and Covid-related hospital stays. While there isn’t a Covid-19 vaccination just yet, Medicare will cover the cost of administering it for Medicare participants when it becomes available. 

Additionally, Medicare has expanded its access to telehealth appointments under regulatory changes, allowing participants to access more services in various ways. As mentioned, Medicare is reimbursing these costs for doctors, as well. Through this change, a variety of services can be covered, including physicians, clinical psychologists, licensed social workers, physical and occupational therapists, and speech-language pathologists. Virtual check-ins and the use of portals to communicate with healthcare providers are also covered. 

Because of the strain put on hospitals during the crisis, Medicare has also relaxed how it covers hospital spaces. Medicare now covers healthcare in facilities that are not designated as healthcare facilities but are providing services during the crisis. Certain requirements for skilled-nursing facilities have also been waived in some instances. 

Regulatory changes also created new codes in order for healthcare providers to bill Medicare properly for the diagnosis and treatment of Covid-19 and Covid-related illnesses. 

While most of the Medicare regulatory changes seem positive in light of the pandemic, there are some things both healthcare providers and patients may want to consider. For instance, patients may receive a lower level of care, as providers are seeing more patients. This is a risk in a number of the regulatory changes, as providers, while being given the green light to see more patients, may also face the brunt of dealing with the pandemic in greater numbers. 

As the pandemic grips the nation, seeking a proficient estate planning attorney can help you navigate all of the changes and ensure you’re making decisions with the best information possible. Contact The Mattar Firm today to schedule a consultation. 844-444-4444.


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