CMS Regulatory Waivers & Rule Changes Update

On Thursday, April 30, 2020, the Centers for Medicare & Medicaid Services issued another round of regulatory waivers and rule changes to deliver expanded care to the nation’s seniors and provide flexibility to the healthcare system as America reopens. These changes include making it easier for Medicare and Medicaid beneficiaries to get tested for COVID-19 and continuing CMS’s efforts to further expand beneficiaries’ access to telehealth services.

The actions announced on Thursday were informed by requests from healthcare providers as well as by the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act. CMS’s stated goals during the pandemic are to:

1. Expand the healthcare workforce by removing barriers for physicians, nurses, and other clinicians to be readily hired from the local community or other states.

2. Ensure that local hospitals and health systems have the capacity to handle COVID-19 patients through temporary expansion sites (also known as the CMS Hospital Without Walls initiative).

3. Increase access to telehealth for Medicare patients so they can get care from their physicians and other clinicians while staying safely at home.

4. Expand at-home and community-based testing to minimize transmission of COVID-19 among Medicare and Medicaid beneficiaries.

5. Put patients over paperwork by giving providers, healthcare facilities, Medicare Advantage and Part D plans, and states temporary relief from many reporting and audit requirements so they can focus on patient care.

Some specific highlights regarding Medicare Telehealth Services that may be helpful to our clients include:

• For the duration of the COVID-19 emergency, CMS is waiving limitations on the types of clinical practitioners that can furnish Medicare telehealth services. Prior to this change, only doctors, nurse practitioners, physician assistants, and certain others could deliver telehealth services. Now, other practitioners are able to provide telehealth services, including physical therapists, occupational therapists, and speech language pathologists.
• CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians. Now, CMS is broadening that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.

To read the full press release, click here.