CMS Loosens Rules for Coronavirus Testing

CMS Loosens Rules for Coronavirus Testing

Medicare and Medicaid will no longer require a doctor’s prescription for COVID-19 screening

Medicare and Medicaid beneficiaries can now get tested for COVID-19 without a written order from a physician, which will make it easier for individuals to get screenings in drive-up sites and pharmacies.

“Testing is vital, and CMS’s changes will make getting tested easier and more accessible for Medicare and Medicaid beneficiaries,” CMS Administrator Seema Verma said in announcing the change that will be in effect throughout the public health emergency.

The announcement means that any health care professional, including pharmacists who are enrolled in Medicare as a covered laboratory, will be able to order the coronavirus test and CMS will pay for it. CMS will also cover tests individuals take at home and some antibody testing to help determine whether someone may have developed an immune response to the virus and therefore might not be at immediate risk for COVID-19 reinfection.

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.

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References:

Bunis, Dena, AARP 2020, accessed 5 January 2021, < https://www.aarp.org/health/medicare-insurance/info-2020/coronavirus-medicare-costs.html >