COVID-19: In Sweeping Set of Changes, Agency Opens Up New Flexibilities to Providers for COVID-19 Response; Additional Details Included for Plans and State Surveyors

By: | March 31, 2020

Access our complete summary of these developments here.

 

On March 30, the Centers for Medicare & Medicaid Services (CMS) instituted a sweeping array of new provider flexibilities for supporting the health care system’s response to the COVID-19 pandemic (press release). The changes leverage many of the avenues available to the agency in affecting policy, importantly including blanket 1135 waiver authority and the agency’s interim final rulemaking ability.

First, CMS outlines its emergency declaration blanket waivers, invoking section 1135 waiver authority, in an expansive fact sheet here (additional detail with illustrative examples on application of the blanket waivers here). In summary, the fact sheet outlines several key new flexibilities, organized primarily by provider type. These new waiver flexibilities are effective as of March 1, 2020 and may be used without notifying CMS. They will remain in place through the end of the emergency declaration.

In addition to these blanket waivers, CMS also issued an interim final rule with comment period (IFC) that includes additional temporary flexibilities for providers not covered in the blanket waiver. These changes are intended to remain in effect for the duration of the public health emergency and are also applicable as of March 1, 2020. Comments on any of the provisions in the IFC are due 60 days following its publication in the Federal Register, or approximately by May 31, 2020.

Together, these sets of changes are intended to allow providers the ability to more swiftly respond to the growing needs of the COVID-19 pandemic, including important supports for infection control and prevention. Providers will be able to offer services via telehealth more broadly, and in some cases by audio-communication only. The changes also expand the available health care workforce by allowing more practitioners to deliver services, and will also enhance the capacity for providers to treat the growing number of patients by permitting them to deliver off-campus care in new facility types (e.g., hotels and convention centers). Hospitals and dialysis centers may also establish COVID-only centers to help reduce transmission to other patients and health care workers. Last, the administration is attempting to alleviate burden on providers by rolling back certain regulatory requirements on reporting deadlines and other documentation requirements. A high-level infographic on these changes is provided here. As mentioned above, a list of illustrative examples for how providers can apply these new flexibilities begins on p. 6 here.

Last, CMS provided additional information to State Surveyors and Accrediting Organizations, and Medicare Advantage (MA) and Part D plan sponsors. The information covers reprioritization changes to non-emergency survey inspects, as well as its reprioritization of risk adjustment data validation (RADV) audit activities.

To access our full summary of these developments, click here.

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Josh LaRosa