CMS Announces Further Round of Regulatory Waivers and Flexibilities to Address the COVID-19 Pandemic
On Thursday, April 30, 2020, CMS announced a second round of regulatory waivers and flexibilities to address the COVID-19 pandemic. Information on the new waivers and flexibilities, as well as provider-specific fact sheets, are now available on the CMS website. These changes are numerous, and we strongly recommend that our clients review the changes most pertinent to their businesses. Some highlights include the following:
- Medicare will no longer require an order from the treating physician or other practitioner for beneficiaries to obtain COVID-19 tests and certain laboratory tests required in connection with COVID-19 diagnosis. During the public health emergency, COVID-19 tests may be covered when ordered by any health care professional authorized to do so under state law.
- Due to announced changes, Medicare beneficiaries may be tested at “parking lot” test sites operated by pharmacies and other entities consistent with state requirements.
- CMS will pay hospitals and practitioners to assess beneficiaries and collect samples for COVID-19 testing, making separate payment when that is the only service the patient receives.
- Medicare and Medicaid will cover certain serology (antibody) tests.
- CMS is taking a number of further steps to allow hospitals to provide services at other sites (including patient homes) that are not part of the existing hospitals and to set up temporary expansion sites to better serve patients.
- For purposes of both Medicare and Medicaid, nurse practitioners, clinical nurse specialists, and physician assistants can now (i) order home health services; (ii) establish and periodically review plans of care for home health patients; and (iii) certify and re-certify patient eligibility for home health services.
- CMS is waiving limitations on the types of practitioners that can provide Medicare telehealth services, allowing other practitioners such as physical therapists, occupational therapists, and speech language pathologists to provide such services.
- Hospitals may bill for Medicare telehealth services furnished remotely by hospital-based practitioners to Medicare patients registered as hospital outpatients, including when the patient is at home when the home is serving as a temporary provider-based department of the hospital.
- CMS is adding to the list of Medicare covered services that may be conducted by audio-telephone, including adding many behavioral health and patient education services. CMS is also increasing payment for these telephone visits to match the applicable payments for similar office and outpatient visits.
- CMS continues to add to the list of services that may be furnished as Medicare telehealth services and will continue to add services on a sub-regulatory basis based on input from health care practitioners.
- CMS is waiving the interactive audio-video requirement for certain evaluation and management services, allowing these services to be conducted via audio-only telephone as Medicare telehealth services.
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The material in this publication was created as of the date set forth above and is based on laws, court decisions, administrative rulings, and congressional materials that existed at that time, and should not be construed as legal advice or legal opinions on specific facts. In some cases, the underlying legal information is changing quickly in light of the COVID-19 pandemic. The information in this publication is not intended to create, and the transmission and receipt of it does not constitute, a lawyer-client relationship. Please contact your legal counsel for advice regarding specific situations.