President Trump Declares National Emergency - CMS Announces Waivers

March 14, 2020
 

On Friday, March 13, 2020 the White House declared a national emergency in response to the COVID-19 pandemic. This has allowed the Centers for Medicare & Medicaid Services (CMS) to issue an 1135 to relax certain rules and conditions of participation (CoPs) for many healthcare providers.  Listed below are a few of those which may impact NARA members:
 

• Eliminating the 3-day hospital stay rule for admission to skilled nursing facilities and also providing relief to SNFs on the timeframe requirements for Minimum Data Set assessments and transmission;
• Waiving requirements that critical access hospitals limit the number of beds to 25 and length of stay to 96 hours;
• Enabling acute care hospitals to house acute care patients in a separate unit;
• Waiving replacement requirements when durable medical equipment gets damaged or unusable. A contractor can waive requirements such as a new physician’s order, face-to-face requirement and other documentation;
• Allowing long-term care hospitals to exclude patients stays from the 25-day average length requirement if treatment is required in conjunction with the emergency;
• Suspending certain Medicare screening requirements including site visits and fingerprinting for non-certified Part B suppliers and create a toll-free hotline for providers to enroll and get temporary Medicare billing privileges;
• Waiving requirements to allow IRFs to exclude patients from the hospital’s or unit’s inpatient population for purposes of calculating the 60 percent rule, if an IRF admits a patient solely to respond to the emergency and the patient’s medical record properly identifies the patient as such. In addition, during the applicable waiver time period, CMS will also apply the exception to facilities not yet classified as IRFs, but that are attempting to obtain classification as an IRF;
• Relief to Home Health Agencies on the timeframes related to OASIS Transmission. CMS is also allowing Medicare Administrative Contractors (MACs) to extend the auto-cancellation date of Requests for Anticipated Payment (RAPs) during emergencies;
• Expanded use of telemedicine to help limit close contact between providers and patients that could potentially spread the virus. Further provision to expand telehealth will be forthcoming from CMS in the near future.

Providers must document in the medical record these special circumstances are related to capacity or other crucial circumstances due to the disaster or emergency.
 
For the press release outlining CMS announcement click here.
 
For the fact sheet outlining these actions click here.
 
CMS Announces New Measures to Protect Nursing Home Residents – click here for the news release.
Actions include:

• Restricting all visitors, effective immediately, with exceptions for compassionate care, such as end-of-life situations;
• Restricting all volunteers and nonessential health care personnel and other personnel (i.e. barbers);
• Canceling all group activities and communal dining; and
• Implementing active screening of residents and health care personnel for fever and respiratory symptoms.

The CPT Editorial Panel has created a new CPT code for COVID-19 diagnostic testing. The code is effective today, March 13 and further information click here.
 

NARA continues to update the Coronavirus outbreak webpage to provide a central location for links and resources.  We will continue to add updates and new links as resources become available.