This page is intended to connect Iowa physicians and clinic administrators to the most up-to-date resources as our state responds to the rapidly evolving COVID-19 pandemic. If you are unable to locate necessary information or have information or have further questions, please contact Kady Reese or Dennis Tibben with IMS.
CMS Expands Telehealth Adoption Across Country - 10/14/2020
The Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth. The actions reinforce President Trump’s Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans by increasing access to better care.
CMS Announces New Repayment Terms for Medicare Loans Made to Providers During COVID-19
The Centers for Medicare & Medicaid Services (CMS) announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program as required by recent action by President Trump and Congress. This Medicare loan program allows CMS to make advance payments to providers and are typically used in emergency situations. Under the Continuing Appropriations Act, 2021 and Other Extensions Act repayment will now begin one year from the issuance date of each provider or supplier’s accelerated or advance payment.
HHS to Open New Round of Provider Relief Funding - 10/1/2020
HHS has announced an additional $20 billion in provider relief funding available to the following groups:
· Providers who previously received, rejected, or accepted a General Distribution Provider Relief Fund payment. Providers that have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible for an additional payment.
· Behavioral Health providers, including those that previously received funding and new providers.
· Healthcare providers that began practicing January 1, 2020 through March 31, 2020. This includes Medicare, Medicaid, CHIP, and behavioral health providers.
Applications for this latest round of funding opens on Monday, October 5.
IDPH Quarantine Recommendation Changes - 9/30/2020
Yesterday the Iowa Department of Public Health released revised quarantine recommendations for people who have been exposed to a positive case of COVID-19 in community-based settings. These changes are based upon the use of masks or face coverings by both the person testing positive for COVID-19 and their close contacts (fewer than six feet apart for 15 minutes). The guidance places emphasis on correct and consistent wearing of face coverings in applying these recommendations.
As this guidance differs from the current quarantining guidance from the CDC and national expertise, IMS continues to encourage physicians to engage with their local public health partners and school districts as schools, businesses, and communities work to navigate and make decisions.
One thing is consistent across all guidances – the importance of wearing face coverings and following public health precautions to protect yourself and others from COVID-19:
Preparing for a COVID-19 Vaccine: IDPH Planning & Distribution Workgroup - 9/24/2020
The Iowa Department of Public Health has convened a stakeholder workgroup, comprised of IMS and other leaders within the provider and public health community, to assist with planning and distribution of an anticipated COVID-19 vaccine. IMS has prepared this meeting summary to quickly convey the latest updates and will continue to provide these regular updates as they become available. Please note, this information is rapidly evolving and may change. Practices are encouraged to contact IMS with any questions about this information.
CDC COVID-19 Vaccination Program Interim Playbook Released - 9/16/20
CDC has released the interim playbook outlining planning and operations guidance for state and local public health jurisdictions, including the Iowa Department of Public Health (IDPH), in preparation for the approval and allocation of COVID-19 vaccines. The playbook includes guidance related to the phased approach for vaccine distribution, determination of critical populations, and provider recruitment and engagement in vaccine administration.
AMA Announces New CPT Codes as COVID-19 Advancements Expand - 9/8/2020
The American Medical Association (AMA) published an update to the Current Procedural Terminology (CPT®) code set that includes the following two code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic:
Learn More about CPT codes 99072 & 86413 here
Deadline Extended for Providers to Apply for Medicaid CARES Act Provider Relief Fund Distribution
Who is eligible to apply? - Providers who bill Medicare, Medicaid, Medicaid managed care, or CHIP, Dental providers who accept insurance, as well as bill patients directly, and First-time or previous applicants may apply as long as they haven’t already received 2% of their patient revenue. Follow this 6-step application process to apply:
State Extends Public Health Emergency Declaration - 8/24/2020
The governor has issued another 30-day extension to the Public Health Disaster Emergency Declaration. This updated declaration runs through midnight on September 20 and extends, in the same form as the previous declaration, all of the areas of interest to medicine.
IDPH Releases Initial COVID-19 Vaccine Plan - 8/18/2020
IDPH has released the initial plan for administration of an anticipated COVID-19 vaccine, along with steps providers can take to prepare, starting with registration for the IRIS system.
New SARS-CoV-2 PCR Diagnostic Testing Considerations - 8/18/2020
The American Medical Association staff has generated the below document for physicians concerning diagnostic testing for SARS-CoV-2. The document provides considerations for responsible use of limited testing resources that physicians should consider when seeking polymerase chain reaction (PCR) diagnostic testing. For example, physicians should be good stewards of limited resources by prioritizing PCR diagnostic testing services for those with a medical need, such as those with COVID-19 symptoms, those with a known exposure to someone with COVID-19, those in need of pre-procedure testing, and health care workers.
HHS Provider Relief Fund Accepting Additional Applicants - 8/11/2020
On July 31, 2020, HHS announced that certain Medicare providers would be given another opportunity to receive additional Provider Relief Fund payments. Starting August 10th, these eligible providers may now submit their application for possible funds by August 28, 2020. This deadline aligns with the extended deadline for other eligible Phase 2 providers, such as Medicaid, Medicaid managed care, CHIP, and dental providers. For more information, please visit the HHS website.
Proposed CY 21 Physician Fee Schedule Extends COVID-19 Telehealth Policies
CMS has published the proposed Calendar Year 2021 Physician Fee Schedule, which includes both permanent and temporary extensions of many telehealth coverage expansions and policy flexibilities that were initially implemented in response to COVID-19.
Confirmation of CMS Coverage for COVID Counseling
CMS has confirmed provider reimbursement coverage for patient counseling around the importance of self-isolation for patients who are being tested for COVID-19, regardless of where the test is administered. CMS will use existing evaluation and management (E/M) payment codes to reimburse providers who are eligible to bill CMS for counseling services. CMS has also created a Counseling Check List to assist providers in counseling and providing resources to patients.
UnitedHealthcare Extends COVID-19 Flexibilities Through October 22 - 7/29/2020
UnitedHealthcare recognizes that the persistence of COVID-19 cases across the country continues to have an impact on the healthcare system – both for COVID-19-related care as well as for regular preventive visits. To provide ongoing support to members and providers, UnitedHealthcare is extending many of the COVID-19 temporary program, process and coverage changes through Oct. 22, 2020. Full details, including applicable benefit plans and service information, can be found online.
IMS: Iowa's State of Public Health Disaster Emergency Declaration UPDATE - 7/24/2020
Renewal of a Public Health Emergency
USA Health and Human Services Secretary Alex Azar extended the current COVID-19 public health emergency, for an additional 90 days. This was originally set to expire on July 25.
AMA Releases New Physician Wellness Resources - 7/8/2020
7/7/2020 - Health Resources & Services Administration (HRSA) released a new Fact Sheet for Medicaid and CHIP Providers that is now available on the Provider Relief Fund website. Applications are due July 20, 2020
Gov. Reynolds signs new proclamation continuing the State Public Health Emergency Declaration - 6/25/2020
HHS Provider Relief Fund Update - 6/19/2020
Last week, HHS launched an application portal to distribute $15 billion in CARES Act Provider Relief Fund payments to eligible Medicaid and CHIP physicians and organizations. The payment will be at least 2 percent of reported gross revenue from patient care, and the final amount will be determined based on submitted data, including the number of Medicaid patients served. Eligible physicians and organizations have until July 20, 2020, to submit their application and report other necessary information, such as annual patient revenue data.
Wellmark to Continue Paying Health Care Providers the Same for Virtual Visits Until Feb. 1 2021 - 6/17/2020
Wellmark Blue Cross and Blue Shield announced it has agreed to extend the same reimbursement fee to Iowa providers for virtual visits as is paid for in-person visits until Feb.1, 2021. This applies to all appropriate medical and behavioral health virtual visits with any Wellmark in-network provider in Iowa.
UnitedHealthcare Extends COVID-19 Temporary Telehealth Expansion and Cost Share Waivers - 6/17/2020
UnitedHealthcare is temporarily expanding the dates through which they are waiving the Centers for Medicare & Medicaid Services (CMS) originating site requirements for Medicare Advantage, Medicaid and Individual and fully insured Group Market health plan members.
COVID-19 Liability Protections - 6/12/2020
The following COVID-19 Liability Protections have passed the legislature and currently await the governor’s signature:
IMS Elective Procedures & Public Health Declaration Updates - 6/10/2020
HHS Announces Enhanced Provider Portal, Relief Fund Payments for Safety Net Hospitals, Medicaid & CHIP Providers - 6/9/2020
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs. HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution. HHS is also announcing the distribution of $10 billion in Provider Relief Funds to safety net hospitals that serve our most vulnerable citizens. The safety net distribution will occur this week.
HHS Announces New Laboratory Data Reporting Guidance for COVID-19 Testing - 6/8/2020
Yesterday, the U.S. Department of Health and Human Services (HHS) announced new Guidance that specifies what additional data must be reported to HHS by laboratories along with Coronavirus Disease 2019 (COVID-19) test results. The Guidance standardizes reporting to ensure that public health officials have access to comprehensive and nearly real-time data to inform decision making in their response to COVID-19. As the country begins to reopen, access to clear and accurate data is essential to communities and leadership for making decisions critical to a phased reopening.
UnitedHealthcare Continues Phasing Out COVID-19 Flexibilities – 6/1/2020
UHC has published a schedule of when COVID-19 policy flexibilities will phase out, starting today.
June 1 – All prior authorization requirements and site of service reviews resume.
June 24 – Telehealth flexibilities extended through this date for Individual and fully-insured Group Market plans.
June 30 – Claims with a date of service on or after Jan. 1, 2020 will not be denied for timely filing if submitted by
AMA Publishes Updated Clinic Reopening Guide – 5/28/2020
The AMA has published updated clinic reopening guide, which includes a reopening checklist, a template pre-appointment patient screening script and information for practices considering implementing a tele-triage program.
CDC Issues COVID-19 Serology Testing Guidelines – 5/27/2020
The CDC has issued interim guidelines on the use of serological testing to determine proactive immunity and infectiousness among COVID-19 patients.
State Extends Emergency Declaration – 5/26/2020
Governor Reynolds has issued a new Public Health Disaster emergency Declaration, extending many of the provisions of interest to the medical community until June 25. In doing so, she modified slightly the partial ban on elective procedures, lowering the threshold for ICU beds hospitals must reserve for potential COVID-19 patients from 30% to 20% of ICU bed capacity.
CDC Releases Detailed Reopening Guidance – 5/21/2020
The CDC has released its long-form state reopening guidance, which includes recommendations on disease surveillance, healthcare system capacity, infection control and contact tracing, testing usage, surveillance assessment and hospital gating, and setting-specific guidance.
Medicaid Issues Updated COVID-19 Testing & Lab Coding Guidance – 5/20/2020
IME has published a new Informational Letter to update coding guidance for COVID-19 testing and lab services.
Medicare Updates COVID-19 Testing Payment Guidance – 5/19/2020
CMS has issued updated guidance to Medicare Administrative Contractors for the payment rates to assign to new COVID-19 testing codes.
AHRQ COVID-19 Telehealth White Paper
New IMS Patient & Family COVID-19 Communication Resource
Medicare Telehealth Coverage & Payment FAQ Video
UHC Ending Most Medicare Advantage Coverage for Audio-Only Telehealth
CMS Announces Additional Practice Flexibilities
CMS has announced an additional round of COVID-19 blanket waivers, including payment parity for audio-only telehealth visits and additional flexibility for telehealth services under the Medicare program, as well as flexibility for medical staff privileging and the scope of services that may be provided at ambulatory surgical centers.
HHS partnered with UnitedHealth Group (UHG) to deliver the CARES Act Provider Relief Fund payments. Physicians with inquiries about the status of their payments should contact UHG Provider Relations. Upon receiving funds, providers have 30 days from the date of payment to complete the payment attestation and agree to the terms and conditions. Practices that do not already have direct deposit through CMS or UHG’s Optum Pay, will receive a paper check unless they call UHG to set up direct deposit.
LifeServe is looking to collect COVID-19 Convalescent Plasma (CCP) from patients who have had a confirmed SARS-CoV-19 diagnosis and subsequent resolution of symptoms. They have issued CCP donor guidance.
· CDC Guidance: Elective Surgeries & Nonemergent Medical Services
· IMS Letter: Protecting Yourself and Loved Ones from COVID-19
IDPH Issues Guidance for Reporting COVID-19 Deaths & Poison Alert
Medicare Releases FAQ Video on Telehealth Flexibility
State and federal officials, as well as commercial payers, have implemented numerous policy and regulatory changes in recent weeks to help practices implement more wide-spread telehealth services. To help practices make sense of it all, IMS has arranged for Katie Fergus, President of Des Moines-based PractiSynergy, provide an overview of both the national and state-specific billing and coding changes that have been implemented. This webinar will be held on Wednesday, April 8 from 12:00-1:00 pm.
IME Issues COVID-19 Updates: Waivers, FAQs, Telehealth Billing Guidance
· IME Informational Letter No. 2125 – Medicaid Waivers & FAQ Documents
· IME Informational Letter No. 2126 – Telehealth Billing Guidance
The Board of Medicine has issued updated guidance on liability protections afforded to individuals volunteering during the COVID-19 pandemic, as well as information for recent medical graduates to obtain expedited emergency licensure.
· IMS Summary of Key Healthcare Provisions (Updated 3/27/2020)
· UnitedHealthcare Releases Billing & Coding Updates
· Paramount Health Options Assembles Commercial Carriers Telehealth Billing & Coding Quick Reference Guide
o PHO Telehealth Billing & Coding QuickReference Guide
· Updated PPE Shortage Reporting and StockpileRequest Guidance
· IMS Resource Page: Business Resources for Impacted Practices
Governor Signs New State Public Health Emergency Declaration
· CMS Relaxes MIPS & ACO Reporting Requirements
Wellmark Announces Telehealth Coverage Updates, Including Payment Parity
Medicaid Issues Updated COVID-19 Billing Guidance
· CMS Procedural Recommendations
· CMS Announces Expanded Telehealth Benefits for Medicare Beneficiaries
· HHS Office of Civil Rights Easing Enforcement of HIPAA Standards for Telehealth Services
· Wellmark Waives Credentialing Standards, Allows Telephonic Visits, & Ensures Partial Reimbursement for Services
· UnitedHealthcare Waives Originating Site Restrictions, Allows Telephonic Visits, & Ensures Partial Reimbursement for Services
IMS Staff Working Remotely; All April IMS In-Person Meetings Cancelled
COVID-19 Vaccination Resources
PPE Manufacturers and Distributors
Provider Personal Protection
Personal Protective Equipment & Medical Supplies
Volunteer to Help with Disaster Response
COVID-19 Practice Guidelines & Resources
Billing & Coding
External Resource Pages
Public Health Disaster Emergency Declarations
LifeServe Blood Center
LifeServe Blood Center is looking to collect COVID-19 Convalescent Plasma (CCP) from patients who have had a confirmed SARS-CoV-19 diagnosis and subsequent resolution of symptoms. They have issued CCP donor guidance.
Business Resources for COVID-19 Impacted Practices