Health Reform WK-EDGE CMS removes barriers, increases flexibility for providers during coronavirus pandemic
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Friday, April 10, 2020

CMS removes barriers, increases flexibility for providers during coronavirus pandemic

By Rebecca Mayo, J.D.

An interim final rule issued by CMS aims to ensure that local hospitals and health systems have the capacity to absorb and effectively manage potential surges of COVID-19 patients.

To ensure pre-existing Medicare payment rules do not inhibit innovative uses of technology and capacity in the efforts to mitigate the impact of the 2019 Novel Coronavirus (COVID-19), CMS is changing payment rules to offer more flexibility. The new flexibilities expand telehealth services even further than recent telehealth expansions and expanding the ability to treat outside of hospitals, making it easier for providers to enroll in Medicare so they can temporarily assist in COVID-19 efforts, and allowing hospitals to provide benefits and support to staff. A number of paperwork requirements are also being temporarily eliminated to hospitals and staff can focus efforts on caring for patients (Notice, 85 FR 19230, April 6, 2020).

Location of care. To allow facilities to increase the capacity for treating COVID-19 patients, the new rules allow hospitals to transfer patients to outside facilities, such as ambulatory surgery centers, inpatients rehabilitation hospitals, hotels, and dormitories. Ambulatory surgery centers can contract with local health care systems to provide hospital services, or they can enroll and bill as hospitals during the public health emergency. Additionally, doctor-owned hospitals may increase their number of beds without incurring sanctions. Ambulances can transport patients to a wider range of locations when other transportation is not medically appropriate and laboratory technicians may travel to a beneficiary’s home to collect a specimen for COVID-19 testing. A Medicare beneficiary will be considered homebound and qualify for the home health benefit if a physician determines that they should not leave home because of a medical contraindication or due to suspected or confirmed COVID-19.

Telehealth. Telehealth services will now be covered for more than 80 additional services, including emergency department visits, initial nursing facility and discharge visits, and home visits. Virtual check-in services that previously required a previously established doctor-patient relationship may now be provided to both new and established patients. Home health agencies and hospice providers can also provide more services to beneficiaries using telehealth where feasible and appropriate. Telehealth may also fulfill many face-to-face visit requirements for clinicians to see their patients in inpatient rehabilitation facilities, hospice and home health.

Workforce. A blanket waiver allows hospitals to provide benefits and support to their medical staffs, such as multiple daily meals, laundry services for personal clothing, or child care services while physicians and other staff are at the hospital providing patient care. Local private practice clinicians and their trained staff who may now be available for temporary employment since nonessential medical and surgical services are postponed, may more easily enroll in Medicare to assist in COVID-19 efforts. Medical residents have more flexibility to provide services under the direction of the teaching physician and teaching physician may provide supervision virtually using audio/video communication technology. Verbal orders are also permitted rather than written orders by hospital doctors so they can focus on taking care of patients.

Paperwork reduction. Hospitals will not be required to have written policies on processes and visitation of patients who are in COVID-19 isolation and will have more time to provide patients a copy of their medical record. Respiratory-related devices and equipment will now be covered for any medical reason determined by clinicians rather than only under certain circumstances. Audit activities will be suspended to allow CMS and organizations to focus on patient care.

MainStory: TopStory AccessNews AgencyNews Covid19 NewsFeed

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