Attention All Members: Summary for HRSA COVID-19 Claims Reimbursement for Testing & Treatment of the Uninsured

As part of the FFCRA and CARES Act, the U.S. Department of Health and Human Services (HHS) will provide claims reimbursement to reimburse health care providers for testing uninsured individuals for COVID-19 and treating uninsured individuals with a COVID-19 diagnosis for dates of service or admittance on or after February 4, 2020.

HHS has contracted with UnitedHealth Group to administer the HRSA COVID-19 Uninsured Program on behalf of the Health Resources and Services Administration (HRSA), an agency of HHS. Providers can request claims reimbursement through the program electronically and will be reimbursed generally at Medicare rates, subject to available funding. To participate, providers must:

·    Verify and attest that the patient does not have individual, employer-sponsored, Medicare or Medicaid coverage, and no other payer will reimburse them for COVID-19 testing and/or treatment for that patient

·    Agree to not balance bill the patient

·    Agree to program terms and conditions

Reimbursement will be made for qualifying testing for COVID-19 and treatment services with a primary COVID-19 diagnosis (except for pregnancy, when the COVID-19 code may be listed as secondary), as determined by HRSA (subject to adjustment as may be necessary), including the following:

·    Specimen collection, diagnostic and antibody testing.

·    Testing-related visits including in the following settings: office, urgent care or emergency room or via telehealth.

·    Treatment, including office visit (including via telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), acute inpatient rehab, home health, DME (e.g., oxygen, ventilator), emergency ground ambulance transportation, non-emergent patient transfers via ground ambulance, and FDA-approved drugs as they become available for COVID-19 treatment and administered as part of an inpatient stay.

·    FDA-approved vaccine, when available.

·    For inpatient claims, date of admittance must be on or after February 4, 2020.

Providers can begin signing up for the program on April 27, 2020. They can then begin submitting claims on May 6, 2020, and the earliest they will receive payment will be May 18. More information including how to participate and who is eligible can be found online at http://coviduninsuredclaim.linkhealth.com/.

Please pass on to providers in your communities that are testing and treating uninsured patients. We are holding a webinar with HRSA on the program tomorrow to learn more!

© 2020 United HealthCare Services, Inc.