Skilled Nursing Facilities and/or Nursing Facilities: CMS Flexibilities to Fight COVID-19

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

On November 4, 2020, CMS issued a 13-page document with this title and opening paragraph:

“Since the beginning of the COVID-19 Public Health Emergency, the Trump Administration has issued an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility to respond to the 2019 Novel Coronavirus (COVID-19) pandemic. These temporary changes will apply immediately across the entire U.S. healthcare system for the duration of the emergency declaration. The goals of these actions are to 1) expand the healthcare system workforce by removing barriers for physicians, nurses, and other clinicians to be readily hired from the community or from other states; 2) ensure that local hospitals and health systems have the capacity to handle a potential surge of COVID-19 patients through temporary expansion sites (also known as CMS Hospital Without Walls); 3) increase access to telehealth in Medicare to ensure patients have access to physicians and other clinicians while keeping patients safe at home; 4) expand in-place testing to allow for more testing at home or in community based settings; and 5) put Patients Over Paperwork to give temporary relief from many paperwork, reporting and audit requirements so providers, health care facilities, Medicare Advantage and Part D plans, and States can focus on providing needed care to Medicare and Medicaid beneficiaries affected by COVID-19.”

The document addresses:

  • Ensuring all Americans Have Access to a COVID-19 Vaccine When One Becomes Available **
  • Patients Over Paperwork
  • Establish data reporting vehicle critical to addressing the pandemic
  • Payment
  • Medicare appeals in Fee for Service, Medicare Advantage (MA) and Part D
  • Cost Reporting
  • CMS Facility without Walls (Temporary Expansion Sites)
  • Specific Physical Environment Waiver Information
  • Workforce
  • Medicare Telehealth
  • Additional Guidance

** Indicates items added or revised in the most recent update