CMS ISSUES BLANKET EMERGENCY COVID-19 WAIVERS FOR HEALTHCARE PROVIDERS

The Centers for Medicare & Medicaid Services has issued blanket emergency COVID-19 waivers designed to expand Medicare beneficiaries’ access to telehealth services, to make it easier for Medicare and Medicaid beneficiaries to get tested for COVID-19, to ensure that hospitals have the capacity to handle COVID-19 patients through temporary expansion sites, and to expand the health care workforce. The waivers are automatic, meaning that health care providers need not apply to receive the waivers, and they are effective retrospectively from March 1, 2020 through the end of the emergency declaration. 

In a press release announcing the waivers, CMS stated that it was “taking action to ensure states and localities have the flexibilities they need to ramp up diagnostic testing and access to medical care, key precursors to ensuring a phased, save and gradual reopening of America.” Some of the key actions are highlighted below. 

Telehealth:

 

  • CMS has allowed the use of audio-only telehealth services for certain services including telephone evaluation and management services as well as behavioral health counseling and educational services.

 

  • CMS has increased payments for telephone visits to match payments for similar office and outpatient visits.
  •   CMS has authorized hospitals to bill Medicare for services furnished remotely by hospital-based practitioners to Medicare patients registered as hospital outpatient, even when the patient is at home, specifically including counseling and education services as well as therapy services.

 

  •  CMS has waived the its previous prohibition against paying rural health clinics and federally qualified health clinics when offering telehealth services at distant sites, allowing Medicare beneficiaries in rural and medically underserved areas to be treated using telehealth services from their homes.

 

  • CMS expanded the types of health care professionals that can furnish and receive Medicare payment for distant site telehealth services to include all professionals who are eligible to bill professional services, specifically including physical therapists, occupational therapists, and speech language pathologists.

 

  • CMS has allowed physicians and other practitioners to render telehealth services from their homes without reporting their home address on their Medicare enrollments.

Increased Hospital Capacity: 

  • CMS has provided flexibility for hospitals to increase the number of beds for COVID-19 patients without impacting their Medicare payments, for example by allowing teaching hospitals to increase their number of temporary beds without reduced payments for indirect medical education and allowing inpatient psychiatric and inpatient rehabilitation facilities to increase their beds without facing reduced teaching status payments.
  •    CMS has waived certain requirements on freestanding inpatient rehabilitation facilities to allow them to accept patients from acute care hospitals experiencing a surge even if patients do not require rehabilitation care.
  • CMS will allow certain provider-based hospital outpatient departments that relocate off-campus to be paid at the higher Outpatient Prospective Payment System rates rather than at the lower Physician Fee Schedule rates.

Expanded Testing for COVID-19: 

  • CMS will pay for COVID-19 tests for Medicare beneficiaries when ordered by any authorized health care professional, not just the beneficiary’s treating physician.
  •    Medicare and Medicare will cover certain antibody tests that may aid in determining wither a person has developed immunity to COVID-19 and will pay for laboratory processing of certain FDA-authorized tests that beneficiaries self-collect at home.

Expanded Provider Enrollment: 

  • CMS has established a toll-free hot-line allowing physicians and other practitioners to receive temporary Medicare billing privileges.
  • CMS has allowed opted-out physicians and other practitioners to terminate their opt-out status early and enroll in Medicare.
  • CMS has allowed licensed providers to render services outside of their state of enrollment.

CMS’s press release is linked here and the full list of COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers is linked here. Whatley Kallas, LLP’s earlier article on CMS’s previously issued COVID-19 waivers is linked here.