04.03.20

CMS Makes Sweeping Regulatory Changes Aimed at Helping U.S. Health Care System Address COVID-19 Patient Surge

Source: Eyewire News

The recent $2 trillion stimulus package passed by congress and signed by the President will have a direct impact on Medicare providers. The Centers for Medicare & Medicaid Services (CMS) said that as part of the CARES Act legislation, it will provide emergency funding to Medicare providers by dramatically expanding its accelerated and advance-payment program during the COVID-19 emergency.

“Special funding will be provided, due to the significant disruption to the healthcare industry, with providers being asked to delay non-essential surgeries and procedures, other healthcare staff unable to work due to childcare demands, and disruption to billing, among the challenges related to the pandemic … The payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers,” according to CMS.

To qualify for accelerated or advance payments, the provider or supplier must:

  • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s or supplier’s request form,
  • Not be in bankruptcy,
  • Not be under active medical review or program integrity investigation, and
  • Not have any outstanding delinquent Medicare overpayments.

CMS stated that Medicare will start accepting and processing the accelerated/advance payment Requests immediately. CMS anticipates that the payments will be issued within 7 days of the provider’s request. An informational fact sheet on the accelerated/advance payment process and how to submit a request can be found here.

In addition, the Trump Administration has issued temporary regulatory waivers and new rules aimed at equipping the American health care system with flexibility to respond to the COVID-19 pandemic. The goals of these actions are to ensure that local hospitals and health systems have the capacity to handle a potential surge of COVID-19 patients through temporary expansion sites. The new CMS rules also aim to remove barriers for health care professionals to be readily hired from the community or from other states; and to increase access to telehealth.

The regulatory changes include:

Increase Hospital Capacity: CMS will allow communities to take advantage of local ambulatory surgery centers that have canceled elective surgeries, per federal recommendations. CMS will now temporarily permit non-hospital buildings and spaces to be used for patient care and quarantine sites, provided that the location is approved by the State and ensures the safety and comfort of patients and staff.

Rapidly Expand the Healthcare Workforce: Local private practice clinicians and their trained staff may be available for temporary employment since nonessential medical and surgical services are postponed during the public health emergency.

Put Patients over Paperwork: CMS is temporarily eliminating paperwork requirements and allowing clinicians to spend more time with patients. Medicare will now cover respiratory-related devices and equipment for any medical reason determined by clinicians so that patients can get the care they need.

Further Promote Telehealth in Medicare: CMS will now allow for more than 80 additional services to be furnished via telehealth. During the public health emergencies, individuals can use interactive apps with audio and video capabilities to visit with their clinician for an even broader range of services. 

These temporary changes will apply immediately across the entire U.S. healthcare system for the duration of the emergency declaration. For additional background information on the waivers and rule changes, visit CMS.gov.

 

Related Content