Questions remain on HRSA’s FAQs on billing uninsured COVID-19 claims

• Claims submissions for payment from the CARES Act Provider Relief Fund began last week.
• HRSA updated its FAQs to address questions about determining who is covered by the fund and what services are eligible based on diagnosis coding.
• What’s not clear is whether “Medicare rates” are provider specific rates that include Indirect Medical Education and Disproportionate Share Hospital payments.

The Health Resources and Services Administration (HRSA) updated its FAQs to address questions about determining who is covered by the fund and what services are eligible based on diagnosis coding. Payments are based on “current year Medicare fee schedule rates.”

The FAQ is clear that while payments are wage adjusted, basing payments on “Medicare rates” doesn’t include the Medicare 20% increase in payments for inpatient discharges. What’s not clear (and HRSA has yet to answer a question from HFMA as of May 8) is whether “Medicare rates” are provider specific rates that include Indirect Medical Education and Disproportionate Share Hospital payments.

Takeaway

While some dollars for providing care to uninsured COVID-19 patients is better than no dollars, if HRSA excludes the add-on payments, it will be a significant loss for teaching and safety net providers.