COVID-19: CMS Makes Regulatory Changes
CMS has made regulatory changes, effective immediately, to relieve hospitals of barriers during the COVID-19 pandemic. We have provided a brief summary that highlights the details of these temporary CMS changes.
Increase Hospital Capacity
CMS “Hospitals Without Walls” is an approach to temporary expansion sites that will allow hospitals to prevent the spread of COVID-19 and prevent a delay in care for patients requiring treatment.
- Ambulatory Surgery Centers can be used to provide hospital services.
- Leverage these sites to decant services such as cancer procedures, trauma surgeries, and other essential surgeries.
- CMS will temporarily permit non-hospital buildings and spaces to be used for patient care and quarantine sites, if allowed by state law.
- CMS will allow hospitals, laboratories, and other entities to perform tests for COVID-19 at home and in other community-based settings outside of the hospital.
- CMS will allow hospital emergency departments to test and screen patients for COVID-19 at drive-through and off campus test sites.
- During this public health emergency, ambulances can transport patients to a wider range of locations when other transportation is not medically appropriate.
- Physician owned hospitals can temporarily increase the number of their licensed beds, operating rooms, and procedure rooms.
- Hospitals can bill for services provided outside their four walls.
- Hospitals can use telehealth to assess patients to determine the most appropriate site of care, freeing emergency space for those that need it most.
- New rules ensure that patients can be screened at alternate treatment and testing sites which are not subject to EMTALA as long as the national emergency remains in effect.
Rapidly Expand the Health Care Workforce
CMS’ temporary requirements allow hospitals and healthcare systems to increase their workforce capacity by removing barriers for physicians, nurses, and other clinicians to be readily hired from the local community as well as those licensed from other states without violating Medicare rules.
- Local private practice clinicians and their trained staff may be available for temporary employment.
- CMS is issuing waivers so that hospitals can use other practitioners, such as physician assistants and nurse practitioners to the fullest extent possible.
- CMS is waiving the requirements that a certified Registered Nurse Anesthetist (CRNA) is under the supervision of a physician.
- CMS has issued a blanket waiver to allow hospitals to provide benefits and support to their medical providers and suppliers to temporarily enroll in Medicare.
Put Patients Over Paperwork
By extending reporting deadlines and suspending documentation requests that would take time away from patient care, CMS is emphasizing prioritizing patients over paperwork.
- CMS is temporarily eliminating paperwork requirements and allowing clinicians to spend more time with patients.
- During the public health emergency, hospitals will not be required to have written policies on processes and visitation of patients who are in isolation due to COVID-19.
- CMS is providing temporary relief from many audit and reporting requirements so that providers, healthcare facilities, Medicare Advantage health plans, Medicare Part D prescription drug plans, and states can focus on providing care to Medicare and Medicaid beneficiaries affected by COVID-19.
Further Promote Telehealth in Medicare
These temporary changes will ensure patients have access to physicians and other providers while remaining safely at home.
- CMS will now allow for more than 80 additional services to be furnished via telehealth. During the public health emergencies, individuals can use interactive apps with audio and video capabilities to visit with their clinician for an even broader range of services. Providers also can evaluate beneficiaries who have audio phones only.
- Providers can bill for telehealth visits at the same rate as in-person visits.
- CMS is allowing telehealth to fulfill many face-to-face visit requirements for clinicians to see their patients in inpatient rehabilitation facilities, hospice and home health.
- CMS is making it clear that clinicians can provide remote patient monitoring services to patients with acute and chronic conditions and can be provided for patients with only one disease. For example, remote patient monitoring can be used to monitor a patient’s oxygen saturation levels using pulse oximetry.
- In addition, CMS is allowing physicians to supervise their clinical staff using virtual technologies when appropriate, instead of requiring in-person presence.
After reading the brief summary of the most recent regulatory changes from CMS, please review the full details and how these changes apply to your organization according to your state laws. Here, you can read the full, official letter from CMS and the FAQ with more detail. It is also wise to follow CMS.gov/newsroom for updates.
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