CMS Approves Sweeping Changes to Expand Care During the National Emergency

April 01, 2020


On March 30, the Centers for Medicare and Medicaid Services (CMS) announced several new temporary waivers and an interim final rule to expand beneficiary access to services during the coronavirus disease 2019 (COVID-19) outbreak. Section 1135 of the Social Security Act grants CMS the authority to temporarily waive requirements related to Medicare, Medicaid, CHIP and HIPAA during a national emergency.

The agency released several waivers and additional flexibilities for healthcare providers, facilities and laboratories. CMS is allowing hospitals to partner with local ambulatory surgical centers in the area to provide care in areas impacted by COVID-19; non-hospital buildings can temporarily be used to treat patients. Additionally, CMS is waiving provider enrollment requirements to expand the workforce and is eliminating paperwork requirements.

The agency is also expanding the list of services that can be offered via telehealth. While CMS did not waive the video requirement for telehealth services as many stakeholders had hoped, they did waive the requirement of universally paying the facility rate for telehealth services. During the emergency period, practitioners are being instructed to bill for the service as if the service was being performed in-person. In other words, office-based practitioners will be paid at the non-facility rate (higher rate for office visits) and facility-based practitioners will be paid at the facility rate (lower rate for office visits).

CMS indicates these new regulations will drastically improve and expand the care provided to beneficiaries during the COVID-19 outbreak. CMS has posted additional background information related to the regulatory changes and a list of the new waivers and interim final rule.

Check back to the McDermottPlus website for additional in-depth summaries for the new CMS waivers and flexibilities.



For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459/ or Mara McDermott at 202-204-1462/

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