The Health Resources and Services Administration (HRSA), through funding from the Family First Cononavirus Relief Act and CARES Act, will provide claims reimbursement to healthcare providers generally at Medicare rates for testing uninsured individuals for COVID-19 and treating uninsured individuals with a COVID-19 diagnosis. Acceptance of claims began May 6 for dates of service retroactive to Feb. 4, 2020 for this population. CMS has not issued a federal Marketplace special enrollment period (SEP) for those who are uninsured, however, special enrollment periods are still available for those who lost coverage or experienced a life event such as divorce or moving. Here’s the timeline:
- February 4 – Retroactive date to request claims reimbursement
- April 27 – Sign up period begins for the program
- April 29 – On-demand training starts
- May 6 – Begin submitting claims electronically
- Mid-May – Begin receiving reimbursement
When submitting claims you must attest that: you have checked for healthcare coverage eligibility and confirmed that the patient is uninsured; you have verified that the patient does not have individual, employer-sponsored, Medicare or Medicaid coverage, and no other payer will reimburse you for COVID-19 testing and/or care for that patient; you will accept defined program reimbursement as payment in full; and you agree not to balance bill the patient. For more, visit the COVID-19 Testing & Treatment Claims for the Uninsured website.