Q&A: Case managers and COVID-19

Q: There have been frequent waivers and regulatory changes throughout the COVID-19 public health emergency. What are the most important changes that case managers need to be aware of?

A: As the challenges of COVID-19 continue, it is clear that case management will remain at the forefront. In the coming weeks and months, many lessons will be learned about how to address the needs of our patients and communities. It is vital for case managers to stay informed.

Some of the top areas of interest are as follows:

• Coding. CMS has created a healthcare procedure coding system for providers and labs testing patients with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). For more information, check out this guidance document.
• Waiver of three-day stay requirement for skilled nursing facilities (SNF). As part of the emergency declaration, CMS waived the requirement of a three-day inpatient hospital stay for SNF admission. Case managers should familiarize themselves with the waiver. Additional information is available on the recently released CMS fact sheet.
• Medicare changes in coverage during this public health emergency ensure that lab tests for COVID-19 are entirely covered, with no cost to the patient. All medically necessary hospitalizations with the diagnosis of COVID-19 are also covered, including a delay in discharge due to the need for hospital quarantine. Case managers and/or patients can advocate to receive these benefits. CMS also made provisions to increase Medicaid services, such as no charges for COVID-19 testing.
• Loss of employment. Upon discharging a patient who has been determined to be jobless due to an event connected with COVID-19, social workers or case managers can direct the patient to file for unemployment, as accommodations have been made by the federal government. 
• Increased production of healthcare equipment. The Defense Production Act, which was invoked on March 19 and can be utilized at any time by the government, is a wartime measure to direct manufacturers to produce healthcare equipment such as the N95 mask that will protect case management and all healthcare staff.

Editor’s Note: The answer to this question was provided by June Stark, RN, BSN, MEd in the May issue of Case Management Monthly. Stark is an adjunct instructor at HCPro and an adjunct professor at Regis College in Weston, Massachusetts.