The federal government has created options for providers to receive reimbursement for COVID-19 health care services provided for the uninsured. The first option is the COVID-19 Uninsured Program through the Health Resources and Services Administration (HRSA). Beginning May 6, 2020, providers may submit claims to receive reimbursement for COVID-19 testing and treatment services provided for the uninsured through this Program for dates of services on/after February 4, 2020. For more information on the COVID-19 Uninsured Program, please visit: https://www.hrsa.gov/CovidUninsuredClaim
The federal government has also created an option for Vermont Medicaid to pay providers for COVID-19 testing and testing-related services for certain uninsured individuals. DVHA intends to implement this option when the HRSA Program is no longer available. DVHA is developing a process for enrolled Vermont Medicaid-participating providers to be reimbursed for COVID-19 testing and testing-related services of individuals who are uninsured. This process is subject to federal requirements and is currently limited to FDA-approved testing needed to detect or diagnose COVID-19, the administration of that testing, and associated medical visit. DVHA will provide more information about the process, including the client application and instructions for providers, as soon as it is available.
If a provider is not able to access reimbursement through the HRSA COVID-19 Uninsured Program, Vermont Medicaid reimbursement may be available if the person who received treatment applies for Medicaid and is denied solely due to immigration status. For Vermonters ineligible for Medicaid solely due to immigration status, treatment for COVID-19 has been appropriately deemed an emergency medical condition when the treatment is delivered in an emergency department or hospital setting. As a result, Vermont Medicaid is able to provide coverage for the treatment of COVID-19 when provided in an emergency department or hospital for Vermonters ineligible for Medicaid due solely to immigration status. (Treatment for COVID-19 delivered on an outpatient basis will be evaluated on a case by case basis to determine if the treatment meets the emergency services standard for Medicaid coverage.)
Department of Vermont Health Access
280 State Drive
Waterbury, Vermont 05671-1010