WMS COVID-19 Updates

WBC Endurance Fund in High Demand

Wyoming Business Council's Endurance Fund requests total over $100 million more than available for distribution - brings changes to application process.

In order to equitably handle the recent high demand for COVID-19 Business Relief Program dollars, the Wyoming Business Council will prioritize the review and approval of Endurance Fund applications.

The Endurance Fund opened on Nov. 2 with at least $24 million for businesses and select nonprofits to cover COVID-19 related losses and expenses. The new fund amount consists of unspent dollars from the Wyoming Legislature's COVID-19 Business Relief Program. To date, more than 1,600 entities have submitted applications, totaling more than $161 million.

To ensure financial help reaches entities with the fewest resources and the greatest need, the Business Council has prioritized Endurance Fund applicants who have not received previous COVID-19 Business Relief Program funding.

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Medicare Coverage and Payment Updates

On Oct. 28, CMS issued a fourth COVID-19 Interim Final Rule with Comment, which provides coverage and payment details for COVID-19 vaccines and therapeutics.

Medicare will cover the cost of COVID-19 vaccines and their administration and will waive out-of-pocket costs for both traditional fee-for-service beneficiaries and beneficiaries enrolled in Medicare Advantage plans. Medicare will pay physicians $28.39 to administer coronavirus vaccines. For vaccines that require two doses, Medicare will pay $16.95 for the first dose and $28.39 for the second dose.

The AMA is carefully analyzing these payment rules and has early concerns about a lower payment rate for initial vaccine doses. The rule also requires Medicaid, Children's Health Insurance Program agencies and most private health plans to administer the vaccine at no cost to patients during the public health emergency. The Department of Health and Human Services will cover the vaccine and its administration for any uninsured individuals through the CARES Act Provider Relief Fund.

Additional notable provisions in the interim final rule include:

Physicians and other health care professionals who perform COVID-19 diagnostic tests must post their cash prices online via their website.
CMS will pay hospitals add-on payments in the inpatient and outpatient settings for COVID-19 therapeutics.
CMS also extends for six months the Comprehensive Care for Joint Replacement (CJR) model, which will now end on Sept. 30, 2021.

The rules are effective immediately and comments are due on Jan. 4, 2021. CMS released additional information including a fact sheet, COVID-19 vaccine resources and FAQs on billing for therapeutics.