The Centers for Medicare and Medicaid Products and services these days released a Medicaid Informational Bulletin that identifies versatility that can improve reimbursement for nursing homes through the COVID-19 community wellbeing crisis.

The flexibilities have been produced out there to “enhance payment” for nursing homes that have applied an infection handle practices, this sort of as the generation of an isolation wing for COVID-19 people.

What’s THE Effect: FOR STATES

For point out nursing homes, flexibilities include things like:

  • For each diem greenback or share boosts to current base fees
  • Developing new payment methodologies for amenities performing as isolation centers
  • Modifying fee-location tactics
  • Taking away some payment penalties
  • Enabling for specialized payment adjustments
  • Developing new or modifying current supplemental payments
  • Growing payment fees for mattress keep days

“States can improve payments to acknowledge extra costs incurred in providing Medicaid services, such as extra labor costs and offer costs this sort of as costs for personal protecting devices,” the steerage mentioned.. “States can further target payment boosts to nursing amenities that are dealing with residents diagnosed with COVID-19, or to nursing amenities in geographic regions that are dealing with an outbreak.”

What’s THE Effect: FOR MANAGED Care

In states that use a managed treatment supply process, immediate particular payments produced by managed treatment ideas can be sent to companies via a point out-directed payment, according to CMS.

The company has established up an “expedited overview and approval system” for the states that wish to apply immediate payments.

THE Larger Development

CMS has documented far more than 188,000 COVID-19 situations and far more than 48,000 COVID-19 deaths in nursing homes to date.

This reimbursement steerage follows the announcement that nursing homes throughout the state confront far more than $15 million in fines from CMS for noncompliance with an infection-handle needs and failure to report an infection data through the pandemic.

In the CIB released these days, CMS also integrated illustrations of states that have already employed the versatility.

In Iowa, the point out created COVID-19 Reduction Fee (CRR) payments of $300 for each day to eligible nursing amenities for just about every resident. Ohio created a tiered payment process primarily based on a resident’s amount of COVID-19 isolation. In it, amenities get $250 for each quarantined affected individual day and up to $984 for each affected individual day if mechanical air flow is wanted.

And in Michigan, amenities in “COVID-19 Regional Hubs” get an increased payment fee of  $five,000 for each mattress payment in the 1st month and a supplemental payment of $200 for each resident for each day subsequent the 1st month.

ON THE Report

“CMS encourages states to make use of the flexibilities out there to aid the nursing facilities’ capacity to properly treatment for all residents, such as COVID-19 positive residents, through this community wellbeing crisis,” the company mentioned. “CMS encourages states to do so via near alignment with applicable CDC steerage and in near coordination with the point out company liable for survey and certification of nursing amenities.”

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