Your State Level Resources

Third-Party Payer Updates

Much like CMS did, many payers made changes as a result of and during the COVID-19 public health emergency (PHE). There was not a mandate requiring them to make any specific changes, so not every payer made changes. Many payers did, however, but they didn’t all make the same changes, nor did they make the changes effective at the exact same time. Keeping up with and tracking those changes may seem like a daunting task—but it is certainly a critical one.

Some of the most common changes we saw made by third-party payers fell into one of the following categories:

1. Prior authorization requirements

2. Signature requirements (proof of delivery)

3. Face-to-face requirements

4. Allowing telehealth for certain services or to meet certain requirements

5. Allowing different levels of clinicians to write orders

6. Covering equipment under different circumstances than was previously allowed

7. Reimbursement changes (especially for those payers that follow the Medicare fee schedule)

[ Each payer could in fact decide on their own when to go “back to normal.” ]

Regardless of the type of change, and whether the policy was slightly relaxed/modified or waived entirely, the vast majority of these changes are temporary and will only last through the end of the PHE. Each payer could in fact decide on their own when to go “back to normal” in terms of these policies. It is imperative that you stay in touch with these changes and watch for notices from the payers that you work with.

VGM has also created a tool that houses links to hundreds of payers. Right now, the links contained within the tool outline the changes that have been made by these various payers. Once they start returning to their standard policies, coverage criteria, etc., they will likely house information regarding that return on some of these same webpages. A link to VGM’s resource tool for third-party payer changes can be found at www.vgm.com/coronavirus under the heading of “Health Plan Policy Changes.”

Checklist for Third Party Payer Changes

Third Party Payer Changes Tracking

Identify all payers to which my company submits claims

Identify what COVID-19 related changes the payer has made

Determined whether changes are temporary or permanent

For temporary changes, identify a start and end date for the policy changes

Identify what the payer is responsible for to ensure proper claims processing and payment

Identify what my company is responsible for doing to ensure proper claims processing and payment

State by State Business Reopening Guidance

To help track the differences across each state and provide the latest guidance and information to America’s employers, the U.S. Chamber has launched the following interactive state map and state guides. Below, you will find the latest guidelines, timelines, and other critical information for businesses aiming to restart safely and sustainably amid the pandemic, as well as (at the bottom of each state profile) a link to the latest information for employers in that state.

Click the link below and select any state to find guidelines and timelines for employers (updated daily):

www.uschamber.com/article/state-by-state-businessreopening-guidance

Additional State Resources to Check

Official Government Websites

Click on your state’s official government website. State governments have been working hard to keep their websites up to date with the latest coronavirus-related guidance and regulations.

Visit the state websites below and find information on COVID-19 updates and more.

Your State or Governor’s Official Social Media Accounts

Most states and their governors operate official accounts on Facebook, Twitter, and other social media platforms. In recent months, these accounts have been largely dedicated to real-time updates on coronavirus statistics and executive orders. Be sure to look for the blue “Verified” checkmark next to the account name to ensure it’s a legitimate page.