Organizations can file claims for treating uninsured COVID-19 patients via HHS portal

HHS’ Health Resources & Services Administration (HRSA) launched a portal that allows organizations to submit claims for treating uninsured novel coronavirus (COVID-19) patients. Under the COVID-19 Uninsured Program, reimbursement is available for claims for testing, treatment, and inpatient admissions billed on or after February 4. However, organizations will not be allowed to balance bill patients.

The program covers the following for uninsured patients with a primary COVID-19 diagnosis:

• Specimen collection, diagnostic, and antibody testing
• Testing-related visits (office, urgent care, emergency room, or telehealth)
• Treatment, including:
  • Office visit/telehealth visit
  • Emergency room
  • Outpatient/observation
  • Skilled nursing facility
  • Long-term acute care
  • Acute inpatient rehab
  • Home health
  • Durable medical equipment
  • Emergency ground ambulance transportation
  • Non-emergent patient transfers via ground ambulance
  • FDA-approved drugs as they become available and are administered as part of an inpatient stay
• FDA-approved vaccine, when available

Claims must be submitted in accordance with Medicare’s timely filing requirements and must be completed and final.

Organizations must enroll in the program as provider participants and are expected to check patients’ eligibility to be covered by the program. The following must be attested to at patient registration:

• Verification that the patient is not insured and that no other payer will cover the patient’s COVID-19 testing or care
• The organization will accept program reimbursement as payment in full
• The organization will not balance bill the patient
• The organization agrees to the program’s terms and conditions and acknowledges that it may be subject to post-payment audit and review

Payment is based on Medicare rates, subject to availability of resources in the Provider Relief Fund. The Provider Relief Fund is a $100 billion relief fund for hospitals and other providers established by the CARES Act.

An FAQ addresses questions including accounting for funds for purposes of cost reports and similar reports, determining eligibility, and more.