From the President of Fortress Insurance Company - Novel Coronavirus (COVID-19) Update (3/27/2020)
Fortress has updated its FAQs on our website regarding the COVID-19 matter to clarify that:
• Yes, a policyhoder has coverage should a patient make an allegation that they contracted the COVID-19 virus from the practice, and
• Yes, a policyholder has coverage for teledentistry done for patients located in a state where the dentist is licensed to practice.
We have also developed a set of two new forms regarding the COVID-19 pandemic based on policyholders' questions:
• Emergency Dental Treatment Notice and Acknowledgment of Risk - an informational form on the risk of COVID-19 during emergency dental treatment.
• Patient Disclosures - form for patient to disclose if they have any risk attributes for the COVID-19 virus which may impact treatment decisions. The dentist should follow up on any affirmative answers to the questions posed on this form with the patient prior to treatment and document the discussion.
Fortress recommends, but does not mandate, these forms be used as additional tools during the pandemic if desired based on the clinical judgment of the practitioner.
We continue to receive a number of questions from policyholders and will continue to make additional information available as it is developed. If the information provided raises additional questions, please call Fortress at 800-522-6675 or email email@example.com to get an accurate answer. We are here to support you.
Coronavirus and Business Income Losses (Submitted by Endorsed Partner Brown and Brown)
COVID-19, better known as the Coronavirus, originated in Wuhan, China. According to the Centers for Disease Control (CDC), the Coronavirus is thought to be transmitted person-to-person through “respiratory droplets produced when an infected person coughs or sneezes … these droplets can land in the mouths or noses of people … or possibly be inhaled into the lungs."
The ultimate global economic impact of this virus will remain unknown for many months after the danger and fear have passed. Everyone is understandably concerned about the potential economic and physical risks.
Our agency is getting many inquiries regarding the insurance implications of this virus, and the most common question relates to business income, specifically: “Is there business income coverage if a governmental authority (civil authority) requires businesses to close?"
The short answer is no, there is no business income coverage. Before business income responds there must be damage to property leading to the cessation of a business. This requirement applies to business income dependent property losses and civil authority losses covered by business income policies. Additionally, there is a specific property exclusion applicable to viruses that may (generally will) apply.
The above is true of “standard" business income forms; there may be some proprietary forms that respond, but these are rare and not likely found in policies for small businesses.
Our goal is to provide information on insurance coverages for this type of loss in general. One should reach out to their insurance agent/carrier for a definitive determination of coverage.
Reeves Administration announces temporary Medicaid changes in response to coronavirus outbreak
In response to the coronavirus outbreak, the Mississippi Division of Medicaid (DOM) will expand its coverage of telehealth services throughout the state in alignment with Governor Tate Reeves’ recommendations on leveraging telemedicine to care for patients while limiting unnecessary travel, clinic visits and possible exposure.
Effective immediately through April 30, 2020, DOM’s Emergency Telehealth Policy will allow additional use of telehealth services to combat the spread of Coronavirus Disease 2019 (COVID-19). Details of enhanced services include the following:
- A beneficiary may access telehealth services from his or her home.
- A beneficiary may use his or her personal cellular device, computer, tablet, or other web camera-enabled device to seek and receive medical care with a qualified distant-site provider.
- The requirement for a telepresenter to be present with the beneficiary is waived when the beneficiary receives telehealth services in the home.
- Any provider that is eligible to bill DOM for services is now allowed to serve as a distant site provider, including Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
- Any limitation on the use of audio-only telephonic consultations is waived.
These enhanced telehealth options will be available in fee-for-service Medicaid, Medicaid managed care, and the Children’s Health Insurance Program.
“We’re not taking any chances. We are taking every step necessary to slow the spread of COVID-19 and ensure public health throughout Mississippi. This is about protecting our doctors, our nurses, our healthcare workers, and all Mississippians. Increasing telehealth services across Mississippi limits the potential for exposure and helps combat the spread throughout our communities,” said Governor Tate Reeves.
The agency also is seeking federal approval for an 1135 Medicaid waiver to give the program a wider range of flexibilities during the emergency. If approved, the 1135 waiver would give DOM the discretion, when necessary and proper, to relax prior authorization requirements, eliminate Preadmission Screening and Annual Resident Review (PASRR) reviews at nursing homes, suspend revalidations for current providers, and expedite new provider enrollment.
“An unprecedented virus requires unprecedented response,” said Medicaid Director Drew Snyder. “The aggressive steps announced today will help ensure Medicaid beneficiaries continue to have critical access to the care they need while supporting the broader effort to combat COVID-19.”
Other requested Section 1135 flexibilities include allowing care to be provided in alternative settings, revising rules for critical access hospitals, and relaxing telehealth security requirements so that providers can use readily available platforms like Facetime and Skype to facilitate telehealth visits with patients.
Additional information on policies, coding, and reimbursement related to the COVID-19 outbreak will continue to be added to a resource page on the agency’s website at https://medicaid.ms.gov/coronavirus-updates/.
Providers are asked to direct their questions to 800-884-3222.
DOM remains committed to ensuring that Medicaid beneficiaries receive access to care, that Medicaid providers are reimbursed for necessary services, and that taxpayer dollars continue to be spent responsibly.