AHA urges flexible approach to new CMS documentation requirement

AHA today urged the Centers for Medicare & Medicaid Services to provide flexibility regarding the agency鈥檚 new COVID-19 test documentation requirement for the diagnostic-related group add-on payment.
鈥淭his new requirement will put substantial administrative burden on hospitals at a time when they are focusing their efforts and resources on critical patient care,鈥 the association wrote. 鈥淭hus, we urge CMS to allow provider documentation to suffice if the test result is unavailable.鈥
The Coronavirus Aid, Relief, and Economic Security Act provided a 20% add-on to the inpatient prospective payment system DRG rate for patients diagnosed with COVID-19 during the public health emergency. CMS recently added a requirement to have a positive COVID-19 laboratory test documented in the patient鈥檚 medical record in order for the claim to be eligible. The new requirement would be applied to admissions on or after Sept. 1, 2020.
鈥淲e have heard from our hospital members that acquiring test results from other health care providers, local testing centers and other third party entities can be a burdensome process, sometimes resulting in long delays or unobtainable results,鈥 the letter notes. 鈥淚n order to receive the add-on payment, hospitals would have to dedicate considerable time and effort to obtain a patient鈥檚 third party result to manually add into the medical record, and in some cases would ultimately have to re-test the patient.鈥