Avoid Post-COVID-19 Trouble: Comply with CMS Copay Waivers

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Recently, Medicare and a variety of private payers have implemented copay and cost sharing waivers related to COVID-19 that you must comply with.

You can rest assured that when the coronavirus outbreak has subsided, auditors will be looking for practices that didn’t adhere to these new rules, and you DON’T want to be one of them.

The changes encompass more than whether you should collect a copay or not. These new rules have modified documentation requirements, changed when you can and can’t write-off amounts due, waive copays for a variety of virtual care services, and altered your out-of-network obligations. The good news is that you don’t have to face these rule modifications alone.

Healthcare attorney and practice expert, Heidi Kocher, B.S., M.B.A, J.D., CHC, will walk you through each of the recently implement COVID-19-related waivers during an upcoming online training session.

During this training, Heidi will provide you with a step-by-step guidance related to exactly how you can comply with these new rules.

Here are just a few of the front-line coronavirus waiver questions you’ll receive answers to during this 60-minute online training session:

  • Are co-pays for commercial insurance companies waived for all telehealth visits?
  • What telehealth waivers are available to help care for individuals who are quarantined/self-isolated?
  • Will CMS issue guidance on loosening prior authorization requirements for populations who may be quarantined?
  • Is the test for the detection of COVID-19 coverable?
  • What will payers consider medically necessary to qualify for a copay waiver?
  • Have telehealth requirements changed to receive reimbursement for non-face-to-face home health care?
  • Are copays only waived for telehealth visits regarding COVID-19 exposure or all visits?
  • Has cost sharing been waived for COVID-19 tests and treatment?
  • If providing drive up testing services, are they billable, and have copays been waived?
  • And so many more…

Don’t risk the consequences of noncompliance with recent Medicare and private payer waiver rule changes. Medicare and private payer auditors are ready to go when this pandemic ends – and it will end. They have made it clear that they are counting on the additional revenue based on findings of fraud.

You can protect your practice and yourself from having to fight back against allegations of fraud and be authorized to get paid for more of the claims that you file by attending this upcoming expert-led training and implementing what you learn. It really is that easy.

Don’t wait, register for this online training today.

Meet Your Expert

Heidi Kocher
B.S., M.B.A, J.D., CHCHealthcare Attorney, Liles Parker PLLC

Heidi has 20 years of experience in health care legal and compliance related issues. Her experience includes positions at a large hospital corporation, serving as a compliance officer for a sleep lab/DME company and a compliance director, chief privacy officer and interim chief compliance officer at a medical device manufacturer.

In addition, she has represented and advised critical access and long-term care hospitals, physician groups, home health agencies, DME companies, pharmacies (including compounding pharmacies), non-profit organizations, and licensed individuals. As a result, she understands the complexities and challenges that providers large and small face in complying with increasingly varied and complex laws.

She is an expert in all aspects of compliance and privacy programs, including developing and deploying policies, procedures and training. Her experience includes implementing the various requirements and aspects of a Corporate Integrity Agreement, responding to and defending audits from Medicare, Medicaid and private insurers up through the ALJ level, guiding clients through voluntary self-disclosures, seeking advisory opinions from the OIG, and defending FDA audits.

Heidi developed criteria for and implemented an aggregate spend system, permitting a medical device manufacturer to timely report correct information under the Physician Open Payments Acts (also known as the Physician Payments Sunshine Act).

In addition, she is experienced in developing and implementing a compliance program to address Foreign Corrupt Practices Act requirements, including Eucomed guidelines. She also has significant reimbursement experience, addressing coverage policy issues, challenging denials, recoupments, and loss of billing privileges, obtaining HCPCS codes, and other reimbursement related issues.

Reviews

Great on new changes, dates and explanations.
Florine Johnson
CFO, Tessie Cleveland Community Services Corp
Very good presentation of materials and answering of questions related to current situations.
Angela Oswald
Revenue Cycle Manager, Primary Health Solutions
Great speaker!
Cathy Wells
Profee coder, Resolution
The speaker was very versed on the subject and presented the material well. Thank you for the links, that is very helpful.
trisha adams
Manager, Physicians Health Plan