Reimbursement Strategies and COVID-19: Getting Paid by Commercial Payers

A live 90-minute CLE webinar with interactive Q&A


Tuesday, July 28, 2020 (in 13 days)

1:00pm-2:30pm EDT, 10:00am-11:30am PDT

or call 1-800-926-7926

This CLE webinar will provide guidance to healthcare counsel on revenue cycle issues caused by COVID-19, including issues arising from the passage and implementation of the CARES Act, changes to payment and other policies by commercial payers (including Medicare Advantage and Medicaid managed care payers), and the rapid expansion of telehealth. The panel will discuss strategies for improving payment from commercial payers in light of these issues.

Description

With many changes put in place to improve access to testing and treatment for COVID-19, healthcare providers are facing new reimbursement challenges:

  • All payers must cover COVID-19 testing without cost-sharing, but providers must understand what testing includes, what the payers are obligated to pay, and when cost-sharing applies;
  • Providers must navigate myriad changes to commercial payer policies, as well as changes to procedures made necessary by CMS and state and local law;
  • Providers that received payments under the Provider Relief Fund created by the CARES Act must adhere to a strict set of terms and conditions, including a prohibition on balance billing of COVID-19 patients;
  • Providers need to adopt innovative strategies to ensure payment for telehealth services, while at the same time navigate payer policies on telehealth and applicable law.

Listen as our authoritative panel of healthcare attorneys examines these and other reimbursement issues arising in the wake of the COVID-19 epidemic.

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Outline

  1. Pursuing payment for COVID-19 testing and treatment
  2. Prohibitions on balance billing
  3. CARES Act-initiated changes to payments for COVID-19 patients and application to commercial payers (including ERISA payers)
  4. Payer policies related to COVID-19
  5. Telehealth issues and strategies
  6. COVID-19 issues under Medicare Advantage and Medicaid managed care payers
  7. Patient mix challenges arising from patients losing employer-based coverage

Benefits

The panel will review these and other key issues:

  • How will reimbursement from commercial payers change because of COVID-19?
  • When can cost-sharing be implemented?
  • What are best practices to ensure appropriate payment?

Faculty

Augsburger, Marcia
Marcia L. Augsburger

Partner
King & Spalding

Ms. Augsburger has more than 24 years of experience advising clients on a broad range of healthcare industry and...  |  Read More

Barnes, John
John C.J. Barnes

Partner
King & Spalding

Mr. Barnes specializes in managed healthcare arrangements. He advises clients on the structuring of risk-based managed...  |  Read More

Boswell, James
James W. Boswell, III

Partner
King & Spalding

He has extensive experience in handling a full range of commercial litigation matters. He has handled jury trials,...  |  Read More

Goff, Stephen
Stephen L. Goff

Partner
King & Spalding

Mr. Goff focuses on healthcare litigation and managed care contracting. He represents healthcare providers in a variety...  |  Read More

Hayes-Kibreab, Amanda
Amanda L. Hayes-Kibreab

Partner
King & Spalding

Ms. Hayes-Kibreab specializes in complex business litigation, arbitration and dispute resolution on behalf of...  |  Read More

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