CMS Posts COVID-19 Public Health Emergency Interim Final Rule & Additional Waivers

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.