[May 15, 2020] New Temporary Rate Increases for COVID-19 Ready Units and COVID-19 Positive Residents in Nursing Facilities - IHCA
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[May 15, 2020] New Temporary Rate Increases for COVID-19 Ready Units and COVID-19 Positive Residents in Nursing Facilities

Posted May 15, 20202 min Read

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The Office of Medicaid Policy and Planning (OMPP) recently announced two new temporary rate adjustments related to COVID-19:

  • A temporary 2% enhanced reimbursement rate for nursing facilities (NFs) that attest they are “COVID-19 Ready” and comply with a list of requirements established by the Indiana State Department of Health (ISDH).
    • Click here for the attestation statement and list of requirements to qualify as COVID-19 Ready
  • COVID-19 Ready facilities will receive a rate add-on of $115 for treatment of COVID-19 positive residents in a COVID-19 Unit (aka a Red unit) for up to a 21-day period. To receive the $115 day rate add-on, facilities must comply with the Guidelines for Nursing Facility COVID-19 Units.
    • Click here for the Guidelines for Nursing Facility COVID-19 Units.

These enhanced rates are in addition to the 4.2% increase for all NFs that became effective March 1, 2020.

How do facilities attest to being COVID-19 Ready?

To receive these enhanced rates, NFs can either:

  • Check a box located in the EMResources portal indicating they are COVID-19Ready and comply with the ISDH requirements. This functionality is currently live.
  • Complete the attestation statement and email it to Derris Harrison at OMPP at Derris.Harrison@fssa.in.gov.  Only one attestation form is required.

What is the effective date of enhanced rates?

COVID-19 Ready Enhanced Rate

If a NF attests to the COVID-19 readiness of their facility in May, the effective date of the enhanced rates will be applied retroactively to May 1, 2020.  NFs that submit their attestation in June or later will receive the 2% higher rate beginning with the date of attestation.

COVID-19 Resident Add-on

The facility must bill claims for COVID-19 positive residents with the primary diagnosis code of U07.1.  The $115 per resident day add-on is limited to 21 days per resident.

The temporary 2% rate increase and the temporary $115 per patient per day add-on will remain available until the earlier of (1) the end of the National Public Emergency or (2) August 31, 2020.

If you have questions about the new COVID-ready enhanced rates, please do not hesitate to contact Elizabeth Eichhorn at eeichhorn@ihca.org.

About the Author

Elizabeth Eichhorn, Director of Reimbursement Policy and Payor Affairs