- Coronavirus tests will be available for Medicare beneficiaries who cannot leave their homes, and testing will be ramped up in nursing homes, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma said Monday. CMS is making a number of moves to relax regulations on the health care system so, for example, hospitals can treat patients in alternative sites and increase staffing.
- Medicare officials have issued an alert to all beneficiaries that scammers may try to use the coronavirus as an opportunity to steal their identities and commit Medicare fraud. Centers for Medicare and Medicaid officials reminded enrollees that Medicare will never call them to ask for their Medicare number.
- The Centers for Medicare and Medicaid Services recommends that nonessential, elective surgeries and other medical procedures be postponed during the coronavirus outbreak. CMS also asks that nonessential dental exams and procedures be postponed.
- Medicare expands telehealth options so more patients — especially older adults — can get medical advice and care while remaining in their homes and stemming the spread of the coronavirus.
- CMS tells Medicare Advantage and Part D prescription drug plans they can relax copays and other cost sharing when it comes to testing for the coronavirus.
Testing expanded for shut-ins, nursing homes
Medicare beneficiaries whose doctors think they should be tested for COVID-19 but who are not able to leave their homes will be able to get test kits brought to them, thanks to the relaxation of federal health system restrictions during the pandemic.
In addition, Medicare will pay for lab companies to collect samples in nursing homes, which house many older Americans.
"We hope that this will encourage more testing of our nursing home residents, who are among the most vulnerable,” Verma said on a call with reporters Monday night. “We know that over 150 nursing homes have been affected. By increasing testing, we can isolate those patients that have been impacted and keep other residents healthy."
CMS had earlier announced an expansion of telehealth services, but Verma said those rules are being relaxed even more. Virtual emergency room visits will now be allowed and doctors will be paid for clinical phone calls with their patients, something designed to eliminate any issues Medicare enrollees might have accessing the technology used in more traditional telehealth services. CMS is also expanding the use of telehealth for inpatient rehabilitation, hospice care and home health, Verma said.
Under the relaxed regulations, hospitals will, for example, be able to move patients to alternative sites — such as tented operations, dormitories and outpatient centers — to make room in main hospitals for COVID-19 patients. Rules regarding the ability of hospitals to hire local physicians and other health professionals to meet the surging demand are also being temporarily suspended.
Protect yourself against Medicare fraud
Medicare officials are warning beneficiaries that fraudsters may try to use the coronavirus crisis as an opportunity to try and steal their identity and commit Medicare fraud.
“In some cases they might tell you they'll send you a Coronavirus test, masks, or other items in exchange for your Medicare number or personal information,” the alert from the Centers for Medicare and Medicaid Services says. “Be wary of unsolicited requests for your Medicare number or other personal information. Only give your Medicare number to participating Medicare pharmacists, primary and specialty care doctors or people you trust to work with Medicare on your behalf. Remember, Medicare will never call you to ask for or check your Medicare number.”
CMS urges enrollees to treat their Medicare guard like it’s a credit card. Here are some tips the agency has for how to protect against being the victim of Medicare fraud.
- Medicare will never contact you for your Medicare Number or other personal information unless you’ve given them permission in advance.
- Medicare will never call you to sell you anything.
- You may get calls from people promising you things if you give them a Medicare Number. Don’t do it.
- Medicare will never visit you at your home.
- Medicare can’t enroll you over the phone unless you called first.
Postpone unnecessary care
As hospitals are increasingly facing shortages in everything from protective gear to respirators to personnel, the Centers for Medicare and Medicaid Services is recommending that surgeries and other medical procedures that are not absolutely necessary be postponed.
“The reality is clear and the stakes are high: We need to preserve personal protective equipment for those on the front lines of this fight,” CMS Administrator Seema Verma said in a statement announcing the recommendations. CMS officials say postponing elective procedures will free up personal protective equipment (PPE), hospital beds and ventilators.
Dental procedures use a lot of the PPE that is increasingly in short supply and “have one of the highest risks of transmission” of coronavirus because of how close the dentist or his assistants have to get to their patients. “To reduce the risk of spread and to preserve PPE, we are recommending that all nonessential dental exams and procedures be postponed until further notice,” the CMS news release says.
CMS officials also made it clear that the guidance they are issuing is based on recommendations — not requirements. “The decision about proceedings with nonessential surgeries and procedures will be made at the local level by the clinician, patient, hospital, and state and local health departments,” the CMS statement says.
Beyond the urgency of a procedure and the availability of beds, PPE and staff, federal officials suggest that doctors and patients consider the health and age of patients, “especially given the risks of concurrent COVID-19 infection during recovery.”
Here are some examples of procedures CMS officials recommend be postponed and those that could proceed:
- Postpone: Outpatient surgery and procedures for illnesses that are not life-threatening. Procedures include: colonoscopy, endoscopies, cataract surgery, carpal tunnel release surgery
- Consider postponing: Conditions that are not life-threatening but could be life-threatening in the future. These procedures require a hospital stay. Procedures include: knee replacement and elective spine surgery; elective angioplasty; low risk cancer procedures.
- Do not postpone: Most cancer procedures; transplants, cardiac procedures for patients with symptoms, limb-threatening vascular surgery, neurosurgery.
Telehealth options expanded
As federal officials continue to urge Americans — particularly older adults — to stay in their homes to stem the spread of the coronavirus, President Donald Trump on Tuesday said telehealth options for Medicare recipients are being expanded and made easier to take advantage of.
“Medicare patients can now visit any doctor by phone or video conference at no additional cost, including with commonly used services like FaceTime and Skype,” Trump said at a White House briefing. The administration is also relaxing federal health privacy laws so providers can use a wider variety of technologies to treat their patients remotely.
“These changes allow seniors to communicate with their doctors without having to travel to a health care facility so that they can limit risk of exposure and spread of this virus,” Seema Verma said at Tuesday’s briefing. “Clinicians on the front lines will now have greater flexibility to safely treat our beneficiaries,” she added.
Medicare has been gradually ramping up the use of telehealth in recent years. But while Medicare Advantage plans have been allowed to offer liberal telehealth benefits for several years, beneficiaries of original Medicare have had more limited telehealth benefits, amounting to brief virtual check-ins. And beneficiaries would not generally be able to get telehealth services in their own homes. About 40 million Americans are enrolled in original Medicare.
Tuesday’s announcement will allow all Medicare beneficiaries to “see” their doctors remotely for the kind of routine checkups and monitoring of chronic conditions that would normally be done in a provider’s office. A Medicare enrollee, for example, who has diabetes, can now confer with his or her doctor without leaving the house, and a medical professional can order a new medicine or refill a prescription without needing to see the patient in person. Nursing home residents will also be able to have telehealth consultations with their doctors.
And, while regular Medicare copays will apply to telemedicine visits, CMS officials say that during the coronavirus emergency, providers can waive or reduce cost sharing for telehealth visits.
“Clinicians on the front lines will now have greater flexibility to safely treat our beneficiaries.” Verma said in a statement announcing the telehealth expansion.
Medicare benefits during the outbreak
Government leaders have already outlined a number of ways Medicare Advantage and Medicare Part D plans can be more flexible when it comes to certain costs related to COVID-19. Here are some ways CMS says Medicare Advantage and Medicare Part D can potentially “mitigate the impact on the health care system” and help speed up access to care, especially for high-risk populations:
- Waive cost sharing for COVID-19 tests.
- Waive cost sharing for COVID-19 treatments in doctor’s offices or emergency rooms and services delivered via telehealth.
- Remove prior-authorizations requirements — this is when approval from Medicare is required before a certain service is provided.
- Waive prescription refill limits.
- Relax restrictions on home or mail delivery of prescriptions.
Editor's note: This story, originally published March 11, has been updated to reflect new information.