Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
Late in the day on Monday, March 30, 2020, CMS posted Medicare & Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency Interim Final Rule with Comment Period. As per their usual policy/mandate, there is a 60-day comment period. The Interim Rule provides that these regulations are effective March 1, 2020.
The contents of the Interim Final Rule are:
- Background
- Provisions of the Interim Final Rule
- Payment for Medicare Telehealth Services Under Section 1834(m) of the Act
- Frequency Limitations on Subsequent Care Services in Inpatient and Nursing Facility Settings, and Critical Care Consultations and Required “Hands-on” Visits for ESRD Monthly Capitation Payments
- Telehealth Modalities and Cost-sharing
- Communication Technology-Based Services (CTBS)
- Direct Supervision by Interactive Telecommunications Technology
- Clarification of Homebound Status under the Medicare Home Health Benefit
- The Use of Telecommunications Technology Under the Medicare Home Health Benefit During the PHE for the COVID-19 Pandemic
- The Use of Technology Under the Medicare Hospice Benefit
- Telehealth and the Medicare Hospice Face-to-Face Encounter Requirement
- Modification of the Inpatient Rehabilitation Facility (IRF) Face-to-Face Requirement for the PHE During the COVID-19 Pandemic
- Removal of the IRF Post-Admission Physician Evaluation Requirement for the PHE for the COVID-19 Pandemic and Clarification Regarding the “3-Hour” Rule
- Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
- Medicare Clinical Laboratory Fee Schedule: Payment for Specimen Collection for Purposes of COVID-19 Testing
- Requirements for Opioid Treatment Programs (OTP)
- Application of Teaching Physician and Moonlighting Regulations during the PHE for the COVID-19 pandemic During the PHE for COVID-19
- Special Requirements for Psychiatric Hospitals (§ 482.61(d))
- Innovation Center Models
- Remote Physiologic Monitoring
- Telephone Evaluation and Management (E/M) Services
- Physician Supervision Flexibility for Outpatient Hospitals – Outpatient Hospital Therapeutic Services Assigned to the Non-Surgical Extended Duration Therapeutic Services (NSEDTS) Level of Supervision
- Application of Certain National Coverage Determination and Local Coverage Determination Requirements During the PHE for the COVID-19 Pandemic
- Change to Medicare Shared Savings Program Extreme and Uncontrollable Circumstances Policy
- Level Selection for Office/Outpatient E/M Visits When Furnished Via Medicare Telehealth
- Counting of Resident Time During the PHE for the COVID-19 Pandemic
- Addressing the Impact of COVID-19 on Part C and Part D Quality Rating Systems
- Changes to Expand Workforce Capacity for Ordering Medicaid Home Health Services, Medical Equipment, Supplies and Appliances and Physical Therapy, Occupational Therapy or Speech Pathology and Audiology Services
- Origin and Destination Requirements Under the Ambulance Fee Schedule
- Merit-based Incentive Payment System Updates
- Inpatient Hospital Services Furnished Under Arrangements Outside the Hospital During the Public Health Emergency (PHE) for the COVID-19 Pandemic
- Advance Payments to Suppliers Furnishing Items and Services under Part B
- Waiver of Proposed Rulemaking
- Collection of Information Requirements
- Response to Comments
- Regulatory Impact Analysis
- Regulations Text
Today (March 31, 2020) CMS provided additional waivers as noted in this Press Release. The states that were approved today are:
- Montana
- Texas
- Vermont
- West Virginia
If you missed it, I provided the waiver website earlier today.