Updated-What to expect when the COVID-19 public health emergency ends

Updated July 2, 2020

The public health emergency (PHE) began on January 31^st, 2020.  While it is currently set to expire on July 25^th, there are recent indications that the PHE will be extended for an additional 90 days.  While not an official statement, the spokesperson for HHS tweeted that the department “expects to renew” the current PHE for COVID-19.  An extension would be good news for healthcare providers.

Click here to see a report on the unofficial statement from HHS.

Many of the waivers and flexibilities currently available for COVID-related services base their start and end dates on two declarations—the public health emergency mentioned above and the President’s emergency declaration on March 13, 2020 under the National Emergencies Act (NEA).   The NEA declaration can be terminated at any time by presidential proclamation or by a Congressional joint resolution.

Both declarations, PHE and NEA, need to be active for the following waivers and flexibilities: 

1. Waiver that allows licensed practitioners in one state to practice in other states without fully licensing in that state
   
2. Waiver that allows payment of transports to alternative destinations, such as urgent care, physician offices and COVID facilities
   
3. Waiver that allows verbal consent by the patient to replace a patient signature on the billing authorization

The following programs are dependent on the Public Health Emergency declaration only, which is slated to end July 25^th, but could be extended an additional 90 days:

1. CARES Act General Allocation Relief Funds, Round 1 and Round 2:  Providers who accepted funds from Round 1 or Round 2 are required to waive patient out-of-network costs, starting with dates of service March 18, 2020.  After the PHE ends, patients can be billed for out-of-network fees.
   
2. Uninsured COVID-19 Patient program:  this program is currently scheduled to continue until the funds are exhausted.
   
3. Most commercial insurance plans are waiving patient copays, coinsurance & deductibles for COVID-19 patients through the end of the PHE, unless the payer opts for a later date of service.  For instance, United HealthCare is waiving copays and deductibles through September 30th.

Click here for more details on health insurance plan actions.

Washington State Programs:

1. WA Medicaid temporarily increased payment for Medicaid patients with suspected or confirmed COVID beginning with dates of service 2/29/2020.  All payments will return to the current fee schedule when Washington State terminates the state of emergency.
   
2. WA GEMT temporarily increased the cost-per-transport for claims with an FMAP of 50% or 65%.  This applies to dates of service January 1^st through June 30^th, 2020.

Miscellaneous Changes:

1. Medicare sequestration of 2% is waived from May 1st through December 31st.  It will resume on claims with dates of service beginning January 1, 2021.
   
2. Ambulance providers scheduled to submit cost data reporting in 2020 have the option to delay until 2021.