Credentialing Standards   /   April 2020

Medicare Advantage Plans & COVID-19: What You Need to Know

Medicare Advantage Plans & COVID-19: What You Need to Know

COVID-19 is putting tremendous stress on the healthcare system – especially on front-line facilities, providers, and your coworkers. CredSimple and our subsidiary Glenridge Health are working to provide our clients with current industry and government regulatory and compliance changes.

Medicare Advantage Program

As of today, COVID-19 has not impacted the pending deadlines for Medicare Advantage expansion applications (due mid-April), expansion network reviews and triennial network reviews (due June).  With mid-April just around the corner, it is unlikely that the expansion applications will be delayed, but the June submissions may be impacted.

The front lines of the COVID-19 pandemic have providers of all specialties and all areas of the country experiencing significant change to their business.  Primary care, ED/ER, ICU, cardiology, radiology amongst others have shifted their priorities to not only delivering care to a much higher than normal number of patients, but they may be doing so with a severely limited staff.  Other specialties have cut back available hours and are seeing far fewer patients as patients delay all but critical care.

Our professional recruiters and contracting teams are experiencing intermittent and delayed responses to health plan contracting requests. Given the breadth of work our teams are performing across the country, we have unique insight and have been proactively communicating this information to the CMS. So far, the feedback we have received from the CMS is that modifications to the Medicare Advantage provider network submission deadline is not currently being considered

As we continue to support our payer/health plan clients by pursuing signed provider contracts, while being mindful of the burden now carried by so many providers, we will also continue to stay in close communication with the CMS. We will make our findings and recommendations available to the CMS and publish the latest guidance.

If you have any questions or need additional support, please contact us at info@credsimple.com.

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