AMA’s guidance on antibody testing
The American Medical Association (AMA) issued guidance to help physicians and the public understand potential uses and limitations of antibody testing. The AMA warns against determining immunity or discontinuing physical distancing based on antibody testing.
MACs are expected to automatically adjust retroactive changes to audio-only claims payment
Since the Centers for Medicare and Medicaid Services (CMS) announced it would pay for the audio-only telephone visit codes at rates equivalent to E&M office visit codes, questions have been raised. The questions focus on whether the Medicare Administrative Contractors (MACs) would automatically reprocess these claims at the new rates or if physicians will need to resubmit them.
CMS informed the AMA that the MACs will be expected to automatically adjust retroactive changes to claims payment. CMS also noted that it takes time to implement changes. During COVID-19, the agency did not follow its usual process between publishing a new (interim) final rule, pushing it out and implementing the typical change requests that happen in the normal course of events. CMS recommends physicians give the MACs some time to catch up and then check with the MACs if they have questions.
CMS makes policy change to accept data gathered through audio-video telehealth visits
CMS recently made a policy change to accept data gathered through audio-video telehealth visits in Medicare Advantage plan risk scores.
Rules regarding emergency waivers and regulatory changes
CMS’ Federal rules regarding emergency waivers and regulatory changes only applies to Federal requirements and the waivers do not apply to state statutory or regulatory requirements for licensure or scope of practice. Waivers include:
- Medicare will no longer require an order from the treating physician or other practitioner for beneficiaries to receive a COVID-19 test and certain laboratory tests that are required as part of a COVID-19 diagnosis.
- Pharmacists are now allowed to work with a physician or other practitioner to provide assessment and specimen collection services, and the physician or other practitioner can bill Medicare for the services. Pharmacists will also be able to perform certain COVID-19 tests if they are enrolled in Medicare as a laboratory, in accordance with a pharmacist’s scope of practice and state law.