PDF Version
TO: Hospital Providers
RE: COVID-19 Unwinding – Changes to Hospital Allowances
Per federal guidance, the COVID-19 public health emergency (PHE) will
end on May 11, 2023. Therefore, some flexibilities the Alabama Medicaid Agency
(Medicaid) implemented due to the COVID-19 PHE will end at this time. Medicaid
intends to keep providers updated on changes that will be forthcoming during
the return to normal operations. Medicaid is working with the Centers for
Medicare and Medicaid Services (CMS) to prepare to end some flexibilities
implemented during the COVID-19 PHE. Notice of changes will be provided through
additional notices via State Plan notice, Administrative Code notice, waiver
notice, or provider ALERTs.
Below are some changes that are forthcoming:
Medicaid will:
·
Discontinue allowance of extending inpatient stays
for recipients in response to the COVID-19 pandemic ready for discharge and
awaiting placement in a LTC setting.
·
Discontinue 20% increase in per diem rates for
COVID-19 for patients with a COVID-19 diagnosis for inpatients stays.
·
Discontinue hospital billing of Q3014 (telemedicine
origination site facility fee) on a UB-04 claim type for outpatient clinic
services provided via telemedicine to a Medicaid recipient in their home.
As noted in previous ALERTs:
- Effective
May 12, 2023, recipient signatures are required to be kept on file as
verification that the recipient was present on the date of service for
which the provider seeks payment. More information can be found in the
Alabama Administrative Code, Chapter 1, Rule No. 560-X-1-.18 Provider and
Recipient Signature Requirements.
- Effective
June 1, 2023, providers should no longer bill the CR modifier for COVID-19
related services or equipment.
- Effective
October 1, 2024, copayments will be reinstated for applicable services and
recipients.
Medicaid is working with the CMS to prepare to end other flexibilities
implemented during the COVID-19 PHE. Please continue to visit the Alabama Medicaid
website for up-to-date information related to the “unwinding” process.
If you have questions, please contact the Provider Assistance Line at
(800) 688-7989.
The Current Procedural Terminology (CPT) and Current
Dental Terminology (CDT) codes descriptors, and other data are copyright © 2023 American Medical Association
and © 2023 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.