New Requirements for Hospital, Laboratory COVID-19 Reporting, and Medicare Beneficiary Testing

August 26, 2020

On August 25, 2020, the Centers for Medicare & Medicaid Services (CMS) released its third COVID-19-related interim final rule with comment period (IFC). Summarized below are select provisions from the rule. Comments are due 60 days after publication in the Federal Register.

Hospital Reporting

The rule will require hospitals and critical access hospitals to report data daily, including, but not limited to, elements such as the number of confirmed or suspected COVID-19 positive patients, ICU beds occupied, and availability of essential supplies and equipment such as ventilators and personal protective equipment. The new rules make reporting a requirement of participation in the Medicare and Medicaid programs.

The rule also requires that hospitals provide the results of COVID-19 tests performed in their in-house laboratories. Hospitals will face possible termination of Medicare and Medicaid payment if unable to correct reporting deficiencies.

Laboratory Reporting

The new rule implements a CARES Act requirement that laboratories report COVID-19 test results daily to the Secretary of the Department of Health and Human Services. All laboratories conducting COVID-19 testing and reporting patient-specific results—including hospital labs, nursing homes, and other facilities conducting testing for COVID-19—will be required to comply. If a laboratory does not report the required information, CMS will impose a civil monetary penalty in the amount of $1,000 a day for the first day, and $500 for each subsequent day. Labs will have a one-time, three-week grace period to begin reporting required test data.

Repeat Testing for Medicare Beneficiaries

CMS is also revising its previous policy that covered repeated COVID-19 testing for Medicare beneficiaries without practitioner orders during the public health emergency. The revised policy specifies that each beneficiary may receive one COVID-19 test without the order of a physician or other health practitioner, but Medicare will require such an order for all further COVID-19 tests.

Online COVID-19 resources as well as news, advocacy, and analysis on cancer policy are available on the American Society of Clinical Oncology’s (ASCO) website and ASCO in Action.