COVID-19 RURAL DIGEST

MAY 13, 2020

CMS announces major changes in healthcare delivery

• Flexibility for Medicare Telehealth Services
  • CMS is waiving the requirements of section 1834(m)(4)(E) of the Act and 42 CFR § 410.78 (b)(2) which specify the types of practitioners that may bill for their services when furnished as Medicare telehealth services from the distant site. This allows for physical therapists, occupational therapists, speech language pathologists, and others, to receive payment for Medicare telehealth services
  • Audio-Only Telehealth for Certain Services
    • This waiver allows the use of audio-only equipment to furnish services described by the codes for audio-only telephone evaluation and management services, and behavioral health counseling and educational service
• Emergency Medical Treatment & Labor Act (EMTALA)
  • Hospitals, psychiatric hospitals, and critical access hospitals (CAHs) can screen patients at a location offsite from the hospital’s campus to prevent the spread of COVID-19
• Verbal Orders
  • CMS is waiving 42 CFR §482.23, §482.24 and §485.635(d)(3) to provide additional flexibility related to verbal orders.
• Telemedicine.
  • CMS is waiving the provisions related to telemedicine at 42 CFR §482.12(a) (8)– (9) for hospitals and §485.616(c) for CAHs.
• Expanded Ability for Hospitals to Offer Long-term Care Services (“Swing-Beds”) for Patients Who do not Require Acute Care but do Meet the Skilled Nursing Facility (SNF) Level of Care Criteria as Set Forth at 42 CFR 409.31
• CAH Length of Stay. CMS is waiving the requirements that CAHs limit the number of beds to 25, and that the length of stay be limited to 96 hours under the Medicare conditions of participation for number of beds and length of stay at 42 CFR §485.620
• CAH Physician Responsibilities. CMS is waiving the requirement for CAHs that a doctor of medicine or osteopathy be physically present to provide medical direction, consultation, and supervision for the services provided in the CAH at § 485.631(b)(2).
• Full List of Rules: https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf

FEMA announces disaster declarations in 29 states

• On May 13, Federal Emergency Management Agency announced disaster declarations in response to the evolving coronavirus crisis.
• These will affect the ability of states and organizations to receive federal relief.
• The scopes of each disaster declaration differ.
• Full FEMA releases are available at: https://www.federalregister.gov/agencies/federal-emergency-management-agency

AHRQ releases resources for novel coronavirus response

• The Agency for Healthcare Research and Quality announced a resource page for healthcare organizations during the duration of the crisis.
• Topics include guidance on:
  • Data Analytics
  • Funding Opportunities
  • Quality Improvement
• Read story: https://www.ahrq.gov/news/blog/ahrqviews/covid-19.html
• Resource page: https://www.ahrq.gov/coronavirus/index.html

CMS Builds on Commitment to Transform Healthcare Through Competition and Innovation

• CMS is proposing a separate new hospital payment category for Chimeric Antigen Receptor (CAR) T-cell therapy.
• The rule includes proposals to remove barriers to new antimicrobials, which are antibiotics to treat drug-resistant infections. Medicare beneficiaries account for the majority of new diagnoses and resulting deaths due to drug-resistant infections, which also remains a public health concern.
• Read full press release: https://www.cms.gov/newsroom/press-releases/cms-builds-commitment-transform-healthcare-through-competition-and-innovation