Medicare Rule Changes Due to Covid

The Centers for Medicare and Medicaid Services has issued an emergency declaration to healthcare providers to be able to handle more patients. Part of it relates to nursing homes and part relates to homecare.

Those seniors receiving in home services do not have to see their doctor to get their home health orders renewed as was previously required. It also allows out of state health care companies to give care as long as they hold a care license in their home state. So Connecticut families near Rhode Island, Massachusetts and New York may have more options for home care services. Medicare recipients who need durable medical equipment such as wheelchairs, walkers, braces or hospital beds have had the rules relaxed on how often the equipment can be received, how many items can be received, how they are paid for and how the equipment is returned. A visit to the doctor is no longer absolutely required. And if the equipment breaks, is lost or wears out a new doctor’s order is not required because it assumes doctors may be flat out taking care of
COVID patients.

For many nursing facilities, the new rules allow placement of Medicare patients into different parts of the facility, so that COVID patients can be separated. In addition, the three- night stay in a hospital rule does not apply if the patient needs to be moved out earlier to make room for COVID patients. This three-day rule has trapped many families into paying privately for nursing home care if they did not have a three day stay before hospital discharge. A typical example is a Medicare patient needing nursing home care after a hip replacement. It even allows for rehabilitation services exceeding 100 days. Extra days are not automatic, but the family and facility can request more time if skilled medical care is still needed. We have seen clients approved for extra days of care they would not have gotten in the past, so there is no harm in signing the appeal form. It costs nothing and Medicare may pay for more days. This can happen even if the patient must be moved to another area of the facility to free up beds for COVID patients. It can even happen if the appeal period has expired.

For patients with COVID, the normal 25-day rule for Medicare coverage in a hospital is not applied, and coverage will continue. In addition, the Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) can be modified to free up money and resources due to the emergency.

All of the above is helpful, but there is one negative aspect, and that is scammers finding another way to trick seniors. The scammers will call and in an official sounding voice say “You can get free COVID supplies for Medicare. All I need is your Medicare card number.” You know where that leads. But overall, the rules changes are helping Medicare patients get or continue their care covered by Medicare during this difficult time.