Reimbursement Strategies and COVID-19: Getting Paid by Commercial Payers

This CLE course will provide guidance to healthcare counsel on revenue cycle issues caused by COVID-19, including issues arising from the passage and implementation of the CARES Act, changes to payment and other policies by commercial payers (including Medicare Advantage and Medicaid managed care payers), and the rapid expansion of telehealth. The panel will discuss strategies for improving payment from commercial payers in light of these issues.

With many changes put in place to improve access to testing and treatment for COVID-19, healthcare providers are facing new reimbursement challenges:

• All payers must cover COVID-19 testing without cost-sharing, but providers must understand what testing includes, what the payers are obligated to pay, and when cost-sharing applies;
• Providers must navigate myriad changes to commercial payer policies, as well as changes to procedures made necessary by CMS and state and local law;
• Providers that received payments under the Provider Relief Fund created by the CARES Act must adhere to a strict set of terms and conditions, including a prohibition on balance billing of COVID-19 patients;
• Providers need to adopt innovative strategies to ensure payment for telehealth services, while at the same time navigate payer policies on telehealth and applicable law.

Listen as our authoritative panel of healthcare attorneys examines these and other reimbursement issues arising in the wake of the COVID-19 epidemic.