The federally declared public health emergency (PHE), set to expire on October 23, was renewed and will remain due to the continued impact of the COVID-19 pandemic. The more relaxed regulatory rules regarding Medicare and Medicaid compliance associated with the PHE is no more, as healthcare provider’s ramp up preparedness with focus on internal processes. 

​In the early stages of the pandemic, CMS guidance indicated that a provider's documentation was sufficient to receive reimbursement from payers. The 20‐percent higher Medicare reimbursement for inpatient COVID treatment and a positive test result was not necessary. However, effective September 1, 2020, CMS has enlisted a mandate requiring hospitals to have positive COVID‐19 laboratory tests in patients' records to qualify for Medicare's 20‐percent add‐on payment. Suffice it to say, ensuring appropriate reimbursement for COVID-19 claims require careful management and attention to detail.