CMS sets deadlines for COVID change and phase out

The U.S. Centers for Medicare and Medicaid Services (CMS) has offered additional guidance on what rules will change when the Public Health Emergency (PHE) due to COVID-19 ends on May 11.

Generally, temporary flexibilities and waivers expire with the issuance of a federal declaration. However, some of them will continue in modified form or end at different times to give providers a chance to catch up. Others have been extended by acts of Congress, although the CMS waivers themselves will be terminated.

“The administration is currently planning to extend the state of emergency until May 11 and then [the COVID-19 national emergency and public health emergency] as of this date,” the White House Office of Management and Budget (OMB) recently said in a statement. “This reduction will be in line with the administration’s previous obligation to notify at least 60 days prior to PHE termination.”

The 1135 telemedicine patient recertification waiver will end 151 days after the PHE expires. While the exemption is specifically being lifted, hospices can continue this practice until at least 2024, in accordance with the provisions of the 2023 Consolidated Spending Bill.

During the PHE, CMS waived the requirement for an annual assessment of on-site assistants by a registered nurse or other qualified professional. This flexibility will end when PHE ends and hospices must complete all pending evaluations within 60 days after May 11.

Also returning is a rule requiring annual skill and competency assessments for all caregivers, as well as in-service training and education programs as needed. Operators must meet this requirement by the end of the first full quarter after the PHE declaration expires.

CMS is changing the rules for hospice quality assurance and performance improvement (QAPI) programs, narrowing the scope of these processes to focus on infection control. The Agency maintains the position that other activities should continue to focus on adverse events.

“This modification reduces the burden associated with developing and maintaining a large-scale QAPI program by allowing providers to focus on the aspects of care most closely related to COVID-19 and tracking adverse events during PHE,” CMS said. “Requirement, [home health agencies] and hospices will maintain an effective, ongoing, agency-wide, data-driven quality assessment and performance improvement program.”

From May 11, hospices will be required to ensure that volunteers provide at least 5% of patient care hours. Clinicians will also return to updating comprehensive assessments within 15 days, not 21, and hospices should resume non-essential services as needed. This may include services such as physical therapy, occupational therapy, and speech pathology.

Temporary waivers will also cease for portions of the National Fire Protection Association Life Safety Code for Residential Facilities regarding placement and storage of alcohol-based hand rub products and dispensers (ABHR), temporary building procedures, and fire drills.

For fee-for-service programs, some flexibility regarding provider referrals to Medicare contractors will remain. However, most will end for Medicare Advantage and Part D plans.

CMS will continue to allow contractors to extend appeal deadlines for fee-paying service providers if they have a valid reason for the late filing and their requests meet all regulatory requirements. They will also use the MAC and QIC to process appeals that are missing complete nomination forms or other required elements.

Some flexibilities associated with provider registration will also change after the end of PHE, such as expedited processing of hospice enrollment applications. In addition, from May 11, practitioners providing telehealth services from home will be required to provide their home address when they enroll in the Medicare program.

Also leaving are opportunities for temporary Medicare billing privileges extended during the public health emergency.

“During PHE, CMS established free hotlines for physicians, non-practitioners, and Part A-certified providers and providers who set up isolation wards to enroll and receive temporary Medicare billing privileges,” CMS noted. “When the PHE runs out, the hotlines will be turned off.”

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