This page was last updated on 5/11/2022. Please check back frequently for updates.

ASCO has compiled resources from federal agencies and state health departments for oncology professionals to access rapidly changing information on the COVID-19 pandemic. These links capture updates from government authorities and payers and will be updated on a regular basis as new resources become available. Additionally, ASCO has developed resources to address existing information gaps.

ASCO Resources

National and Public Health Emergencies

On January 31, 2020, Health and Human Services (HHS) Secretary Azar declared a public health emergency (PHE) effective January 27, 2020, affording the Centers for Medicare & Medicaid Services (CMS) the flexibility to quickly support Medicare beneficiaries. On March 13, 2020, the President declared a national emergency effective March 1, 2020, affording additional flexibilities such as Section 1135 waivers. The most recent renewal of the PHE occurred on April 12, 2022, with an effective date of April 16, 2022. This renewal expires after 90 days unless renewed again by the Secretary. However, in an earlier letter to Governors, the Acting Secretary of HHS indicated that states will be provided with 60 days' notice prior to PHE termination or expiration.

During the Public Health Emergency, enrollment in Medicaid and CHIP has grown by over 14 million and now covers nearly 85 million people (as of September 2021). As a condition of receiving enhanced federal funding, states agreed not to terminate enrollment for most individuals enrolled in Medicaid from March 2020 through the end of the month in which the PHE concludes. Given these flexibilities and the process of returning to normal operations at the end of the PHE, most individuals will have to go through the Medicaid/CHIP eligibility renewal process for the first time in months or years when the PHE eventually ends. When the continuous coverage requirement expires, states will have up to 12 months to return to normal eligibility and enrollment operations.

On March 3, 2022, CMS issued additional guidance to states on initiating eligibility renewals for all individuals enrolled in Medicaid and CHIP within 12 months of the eventual end of the PHE, and on completing renewals within 14 months. CMS also released a PHE Unwinding toolkit for states and groups that assist people with Medicaid coverage to help beneficiaries through the eligibility renewal process.

For access to additional resources, including the guidance issued in March, please see CMS’ Medicaid Unwinding webpage.

 

*May 11, 2022* Provider Relief Fund: May 18 Deadline to Request Late Reporting for Period 2

Providers who experienced one or more extenuating circumstances that prevented them from submitting a completed PRF Report in Reporting Periods 2 by the deadline may submit a request to report late via the Request to Report Late Due to Extenuating Circumstances Form. These requests are due by May 18, 2022.

HRSA will not require non-compliant providers to return funds until after the Request to Report Late Due to Extenuating Circumstances process for a Reporting Period has closed. Providers who submit a request will be notified by HRSA if their request is approved or denied. Providers whose request is approved will receive a notification to proceed with completing the report. Providers whose request is denied will need to return their funds to become compliant with their PRF reporting requirement. Non-compliant providers will be excluded from receiving and/or retaining future PRF payments, including any applicable Phase 4 payments. For more details on non-compliance, review the Reporting Non-Compliance Fact Sheet.

Reporting Period 1. The deadline for providers to submit a Request to Report Late Due to Extenuating Circumstances for Reporting Period 1 has now passed. Starting the week of May 9, 2022, providers who submitted a request will receive an email from UHG_HRSA@ProviderEmail.uhc.com if their request is approved and must submit their completed report within 10 days of receiving the approval notice.

Review the Request to Report Late Due to Extenuating Circumstances webpage for more details.

Other Provider Relief Fund (PRF) Updates

On April 13, 2022, HHS/HRSA announced the distribution of more than $1.75 billion in PRF payments. With the release of these payments, HRSA has distributed approximately $13.5 billion from the Provider Relief Fund to nearly 86,000 and nearly $7.5 billion in American Rescue Plan (ARP) Rural payments to more than 44,000 providers since November 2021.

In September of 2021, HHS opened applications for $25.5 billion in COVID-19 provider funding. With this latest installment, nearly $21 billion of this funding has been awarded.

Phase 4 payments reimburse smaller providers for a higher percentage of losses during the pandemic and include bonus payments for providers who serve Medicaid, Children's Health Insurance Program (CHIP), and Medicare beneficiaries.

PRF payments received in the first half of 2022 can be used until June 30, 2023. With these latest payments, approximately 92 percent of all Phase 4 applications have been processed. The remaining applications require additional manual review.

On January 25, 2022, HHS announced that it was making more than $2 billion in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 7,600 providers across the country. Similar to payments allocated in December 2021, these payments are based on lost revenues and increased expenses due to COVID-19 and will be made to physicians who previously applied for relief funds. HHS will reimburse a larger share of losses and increased expenses for smaller providers. See here for additional information on current and previous disbursements, reporting requirements, and auditing.

HRSA COVID-19 Uninsured Program Stops Accepting Claims

The HRSA COVID-19 Uninsured Program (UIP) has stopped accepting claims for vaccine administration due to a lack of sufficient funds. The program accepted claims for vaccine administration until 11:59 PM on April 5, 2022; the program stopped accepting claims for testing and treatment on March 22, 2022. Any vaccine administration claims submitted in the Portal after April 5, 2022, will not be adjudicated for payment. For additional information, see these HRSA COVID-19 Uninsured Program claims submission deadline FAQs.

Telehealth and Medicare

Effective for services starting March 1, 2020, and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for telehealth services for all Medicare beneficiaries. ASCO has developed a reference guide for telehealth services and other communication-based technology services including e-visits, virtual visits, and telephone evaluation and management services in Medicare.

In the 2021 Physician Fee Schedule (PFS) Final Rule, released December 2, 2020, CMS permanently added approximately 10 services to the telehealth list beginning in 2021 and temporarily added an additional set of services through December 31, 2021, or the year in which the PHE ends, whichever is later. In the 2022 PFS proposed rule, CMS proposes temporarily extending certain telehealth services beyond the end of the pandemic and finalizing code G2252 for 11-20 minutes of audio-only assessment.

See COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing (last updated February 16, 2022) for additional details on billing during the public health emergency.

See ASCO in Action for more information on the 2022 PFS changes and refer to this earlier ASCO in Action for additional details on previous changes.

Private Payers and Telehealth

Private insurers and other payers have been changing and expanding their coverage policies for telehealth in response to COVID-19. ASCO has developed a resource guide to help cancer care providers and patients follow this change. This chart will be regularly updated, but we also encourage individuals to independently confirm the coverage details for their respective plans.

CMS and OSHA Vaccine Requirements

On November 4, 2021, CMS and OSHA released interim final rules outlining requirements for vaccination, testing, and exemptions for workers at Medicare- and Medicaid-regulated facilities and for workers at companies or organizations with 100 or more employees, respectively.

Both rules became the subjects of lawsuits and eventually, this litigation made its way to the U.S. Supreme Court. On January 13, 2022, the Court ruled that the CMS rule could go forward and allowed CMS to enforce its vaccine mandate nationwide; however, the Court blocked OSHA from enforcing its large employer vaccinate-or-test Emergency Temporary Standard (ETS). OSHA withdrew the ETS effective January 26, 2022; although OSHA is withdrawing the Vaccination and Testing ETS as an enforceable emergency temporary standard, OSHA is not withdrawing the ETS to the extent that it serves as a proposed rule. The action does not affect the ETS's status as a proposal or otherwise affect the status of the notice-and-comment rulemaking commenced by the Vaccination and Testing ETS.

CMS has since issued a variety of materials designed to assist facilities and providers with the implementation of the Medicare- and Medicaid-regulated facilities mandate, including a guidance memo, vaccination requirements FAQs, an infographic, an implementation timeline, and a vaccine requirement decision tree. On February 1, 2022, CMS issued a letter to health care facility administrators reminding them that the mandate is now in effect in all 50 states and encouraging them to move quickly on their vaccination programs.

View the CMS rule and the OSHA rule.

Please see ASCO in Action for additional details.

Prior updates for historical reference purposes are available in the Prior COVID-19 Government, Reimbursement & Regulatory Updates.