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Results: 1 - 20 of 48
| Q | Will Medicare pay for seasonal flu vaccinations even if the vaccinations are rendered earlier in the year than normal? |
|---|---|
| A | Medicare will pay for seasonal flu vaccinations even if the vaccinations are rendered earlier in the year than normal. More >> |
| Q | Will Medicare fee-for-service pay for the administration of the H1N1 vaccine furnished during a hospital inpatient stay? |
| A | Generally, Medicare fee-for-service payment rules provide that services furnished during a Medicare-covered inpatient stay must be included within a single, bundled Part A payment. More >> |
| Q | How will Medicare billing systems account for the possibility of multiple claims for influenza vaccination in the same season (e.g., 1 seasonal + 1-2 H1N1 doses)? |
| A | Medicare systems will be programmed to pay for both a single dose of the seasonal flu vaccine and its administration and for one or more administrations of the H1N1 vaccine (but, again, not the H1N1 vaccine itself if it is supplied to providers free of charge), and payment will be subject to normal billing and payment rules that apply to influenza vaccine. |
| Q | Will it be possible for providers enrolled as mass immunizers to roster bill Medicare for H1N1 administration as they do for seasonal flu? |
| A | Yes. |
| Q | How should hospitals handle Medicare billing for services that involve the use of the Strategic National Stockpile (SNS) provided drugs? |
| A | For services rendered to Medicare fee-for-service (FFS) beneficiaries, standard Medicare FFS billing rules apply. More >> |
| Q | Will Medicare payment policy change if the H1N1 vaccine is released under an emergency utilization authorization (EUA) under section 564 of the Food, Drug and Cosmetic Act? |
| A | No. |
| Q | Will Medicare pay for diagnostic tests for H1N1 flu (e.g., nasal swabs) for beneficiaries? |
| A | Under Part B, Medicare will cover diagnostic tests as set forth in 42 CFR 410.32 and other existing policies. More >> |
| Q | Will Medicare cover and pay for a surgical mask to prevent the spread of/infection from H1N1 flu, if prescribed by a physician? |
| A | No. More >> |
| Q | Will Medicare pay for physician services and vaccine administration provided outside the normal setting (e.g., shelters)? |
| A | Yes. More >> |
| Q | Will Medicare reimbursement for H1N1 vaccine administration be the same as for seasonal influenza? |
| A | Yes, the Medicare payment amount for the H1N1 vaccine’s administration will be the same as the payment for administration of seasonal flu vaccine. More >> |
| Q | Is there a mechanism for submitting 1135 waiver questions that have not been addressed on the CMS WebSite? |
| A | Additional Questions regarding 1135 that are not addressed at the http://www.cms.hhs.gov/H1N1/ Web site can be sent to the following mailbox:
Pandemic@cms.hhs.gov. More >> |
| Q | May a hospital permit a physician, who does not have privileges to practice at the hospital, to assist in the emergency room and may the physician bill Medicare for the services rendered? |
| A | No, the Medicare hospital Conditions of Participation (CoPs) require that the hospital's governing body must grant privileges to each physician before he/she may practice in the hospital. More >> |
| Q | How does the President’s National Emergency declaration under the National Emergencies Act differ from a Stafford Act declaration? How does the request process for assistance under the Stafford Act differ from the request process for 1135 waivers? |
| A | Presidential proclamation of a national emergency under the National Emergencies Act and a Presidential declaration of an emergency or major disaster under the Stafford Act are distinct and separate declarations. More >> |
| Q | Specifically, what does this National Emergency Act (NEA) Declaration enable? What do 1135 waivers allow hospitals to do if a waiver is requested and granted? |
| A | An NEA Declaration fulfills the second of the two conditions required for the Secretary of HHS to be able to grant 1135 waivers. More >> |
| Q | Why declare a National Emergency for the 2009 H1N1 pandemic now; why can’t we wait until a hospital or region needs these 1135 Waivers? |
| A | The H1N1 epidemic is challenging. More >> |
| Q | Do Medicare 1135 waivers affect State laws or regulations? |
| A | Under section 1135, only certain Federal requirements relating to Medicare, Medicaid, CHIP, and HIPAA may be waived or modified as listed in section 1135. More >> |
| Q | Has the authority to grant 1135 waivers been granted before? |
| A | Yes, there are several instances where 1135 Waiver authority has been granted under the Stafford Disaster Relief and Emergency Assistance Act (as opposed to the National Emergencies Act) to help healthcare facilities cope with large patient burdens. More >> |
| Q | Is the HIPAA Privacy Rule suspended during a national or public health emergency? |
| A | No. The HIPAA Privacy Rule is not suspended during a national or public health emergency. More >> |
| Q | When and to what entities does the HIPAA 1135 waiver granted in response to the 2009 H1N1 influenza pandemic apply? |
| A | The HIPAA waiver only applies to hospitals nationwide that have instituted a disaster response plan and for up to 72 hours from the time the hospital implements its disaster response plan. More >> |
| Q | When and where are 1135 waivers (not related to HIPAA) in effect? |
| A | The Secretary may issue specific waivers or modifications under section 1135 only to the extent they ensure that sufficient health care items and services are available to meet the needs of Medicare, Medicaid, and CHIP beneficiaries in the emergency area during the emergency period. More >> |
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Results: 1 - 20 of 48
