SPS Check-in: COVID-19 Update and CMS Changes

Posted by SPS on Apr 9, 2020 1:42:00 PM

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Introducing the SPS Check-in! This series of short videos will help you stay informed on our business, the industry, and the regulatory environment. Watch our inaugural video, hosted by SPS President Regina Weger, to learn about the current state of SPS and the CMS regulatory changes impacting our industry. 

This is the first in a series of short videos where we intend to share information and news about SPS, the industry, business trends and changes to the regulatory environment

As we are all learning amidst the isolation required during the Coronavirus Pandemic, it can be a distressing experience.  We’re no longer in the presence of our extended family, friends, and coworkers. While some of us are working from home, we are also homeschooling our children, and caring for or worrying about our aging family members--all while doing our best to ensure everyone stays healthy.  And let’s not forget running from store to store in a desperate search for toilet paper. 

Much like you, we are prioritizing safety at SPS. We are adapting to new business norms that just 1 month ago would have been inconceivable.  We are exercising social distancing by enabling many employees to work from home, providing personal protective equipment for those in our distribution centers, implementing additional cleaning standards, and putting other mitigation plans in place so we can continue the service you’ve come to rely on. 

We recognize the tremendous impact COVID-19 is already having, and will continue to have on our nation’s economy, on our industry, and on our customer partners. At present we are seeing regional impacts as O&P practices are available for patients on an “as needed” basis while practices located in the hot spots of COVID-19 have skeleton crews, or have closed. We are also keeping in close contact with our suppliers to ensure we have adequate inventory and are prepared to make adjustments should there be any disruption to our supply chain.

Last week, the federal government passed legislation in the form of a 2.2 Trillion dollar stimulus package known as the CARES ACT. In our next video, I’ll highlight areas of interest within the Cares Act, for business owners as well as employees, intended to bring financial relief during this unprecedented time. 

For now, I’ll share the latest regulatory and reimbursement changes announced by CMS. These changes are intended to equip our healthcare system with maximum flexibility and we understand will apply for the duration of the COVID-19 emergency declaration.

  1. It was announced last week that prior authorization for six lower limb prosthetic codes initially planned to commence in four states (PA, MI, TX, and CA) on May 11, 2020 and nationwide on October 8, 2020 has been paused.
  2. CMS has also announced that it would suspend most Medicare Fee-For-Service (FFS) medical reviews during the emergency period due to the COVID-19 pandemic. This includes pre-payment medical reviews conducted by (MACs) under the Targeted Probe and Educate program, and post-payment reviews conducted by the MACs, Supplemental Medical Review Contractors (SMRC) and Recovery Audit Contractor (RAC). No additional documentation requests will be issued for the duration of the COVID-19 pandemic. In addition, Targeted Probe reviews that are in process will be suspended and claims will be released and paid.
  3. Lastly, CMS announced last Saturday an expansion of its advanced payment program for Medicare to ensure participating health care providers and suppliers have the resources needed during the COVID-19 crisis. This funding addresses cash flow issues during this period of economic disruption. These payments are based on a 3 month period of Medicare receipts, and if approved, will pay out in 7 days. This is essentially a 0% interest loan that companies do not need to start paying back for 120 days, but must be repaid within 210 days.

We all know the normal patterns of our lives have suddenly been disrupted, and none of us can say when this will end. The important thing to remember is that this is temporary.  And if you’re still in desperate search of toilet paper, fear no more.  SPS just received a new shipment this week. 

To learn more about COVID-19's impact on the industry and resources you can leverage to support your business through this unprecedented time, visit the SPS COVID-19 Resource Center.


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Topics: O&P Industry, News, SPS Check-in

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