Portal to Access Reimbursement for Testing and Treatment of Uninsured COVID-19 Patients is Now Open

Health care providers who have conducted COVID-19 testing or treatment of uninsured patients with COVID-19 on or after February 4, 2020 can now file claims for reimbursement for treating and testing these patients.  The earliest providers will start to receive payment is May 18, 2020.  Generally, providers will be reimbursed at Medicare rates for these services.  Program guidance sets forth a separate fee schedule for ambulance providers and home health services.

As part of the federal response to the coronavirus pandemic, approximately $2 billion is available to reimburse providers for COVID-19 testing for uninsured individuals and treating uninsured individuals with COVID-19.  The Health Resources & Services Administration (HRSA) has contracted with UnitedHealth Group to administer the program and providers must enroll as a provider participant via the portal here in order to receive reimbursement.  Once enrolled as a provider participant, additional steps to receive reimbursement include checking patient eligibility, submitting patient information, and submitting claims and receiving payments electronically.  No paper claims will be accepted.

According to HRSA, reimbursement will be made for qualifying testing for COVID-19 and treatment services with a primary COVID-19 diagnosis as determined by HRSA (subject to adjustment as may be necessary), including the following:

• Specimen collection, diagnostic and antibody testing.
• Testing-related visits including in the following settings: office, urgent care or emergency room or telehealth.
• Treatment, including office visit (including telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care, acute inpatient rehab, home health, DME (e.g., oxygen, ventilator), emergency ambulance transportation, non-emergent patient transfers via ambulance, and FDA-approved drugs as they become available for COVID-19 treatment and administered as part of an inpatient stay.
• FDA-approved vaccine, when available.

As we have seen with other COVID-19 relief funding, providers must read the fine print.  Providers should carefully review all attestations required to participate in the program and should be familiar with the extensive list of terms and conditions for both testing and treatment.  Importantly, providers should maintain all documentation demonstrating compliance with the program requirements in the event of any post-payment audit review.