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Reimbursement Relief for Healthcare Providers Treating the Uninsured

Reimbursement relief is on the way for healthcare providers who have conducted COVID-19 testing or provided treatment for COVID-19 individuals who are uninsured. The COVID-19 Uninsured Program Portal allows for providers to submit claims for reimbursement beginning May 6, 2020 for COVID -19 services on or after February 4, 2020. These reimbursements will be made at Medicare rates.

stethoscope

Funds for testing the uninsured were made available through the Families First Coronavirus Response Act and funds for treating the uninsured were a result of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.  

There are five steps to being reimbursed:

1. Enrolling as a provider participant
2. Checking patient eligibility
3. Submitting patient information
4. Submitting claims electronically
5. Receiving payment via direct deposit

The Health Resources & Services Administration (HRSA) has determined that the following services are eligible for reimbursement:
  • Specimen collection, diagnostic, and antibody testing
  • Testing related visits including office, urgent care, emergency room, and telehealth settings
  • Treatment including office visits, telehealth, emergency rooms, inpatient, outpatient, skilled nursing facilities, acute   inpatient rehab, home health, emergency ambulance transportation, non-emergent patient transfers via ambulance, and FDA approved drugs as they become available for COVID-19 as part of an inpatient stay
  • FDA-approved vaccine when it becomes available
Services not covered by traditional Medicare will not be covered along with these services:
  • Treatments without a COVID-19 primary diagnosis, except for pregnancy when the COVID-19 code may be listed as secondary.
  • Hospice services
  • Outpatient prescription drugs
The HRSA has provided a very informative FAQ document that goes into detail regarding patient eligibility, claims and coding, and program administration. You can find that document here.

This is great news for providers, and if your healthcare practice needs assistance in applying for these funds, please contact your McBrayer healthcare attorney today.


Lisa English Hinkle is a Member of McBrayer law. Ms. Hinkle chairs the healthcare law practice and is located in the firm’s Lexington office. Contact Ms. Hinkle at lhinkle@mcbrayerfirm.com or (859) 231-8780, ext. 1256.

Services may be performed by others.

This article does not constitute legal advice.

Lexington, KYLouisville, KYFrankfort, KY: MML&K Government SolutionsWashington, D.C.