Perspective from Conrad L. Flick, MD
Perspective from Neil H. Baum, MD
Source/Disclosures
Disclosures: Verna is CMS administrator.
May 15, 2020
5 min read
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CMS issues more rule changes to cope with COVID-19 — are they enough?

Perspective from Conrad L. Flick, MD
Perspective from Neil H. Baum, MD
Source/Disclosures
Disclosures: Verna is CMS administrator.
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CMS recently announced a second round of regulatory waivers and rule changes to expand care to the nation’s seniors and provide health care systems flexibility.

Though physicians applauded the new measures, they also said that CMS could do more to help primary care physicians recover from the financial toll of COVID-19.

Some of the latest actions include the following:

  • CMS is waiving the video requirement for certain telephone evaluation and management services and adding them to the list of Medicare telehealth services.
  • Payments for telephone visits related to behavioral health and patient education services match similar office and outpatient visits.
  • Orders are no longer required for Medicare beneficiaries to get COVID-19 tests and certain laboratory tests required as part of a COVID-19 diagnosis.
  • Hospitals and practitioners evaluating Medicare beneficiaries and collecting laboratory samples for COVID-19 testing will receive separate payment when that is the only service the patient receives.
  • Medicare and Medicaid will cover certain serology (antibody) tests that help determine if a person may have developed an immune response and may not be at immediate risk for COVID-19 reinfection.
  • Health care providers have greater flexibility during the pandemic to increase the number of beds for patients with COVID-19 while receiving stable, predictable Medicare payments.
  • Hospital systems that include rural health clinics can increase their bed capacity without affecting the rural health clinic’s payments.
  • CMS is paying for Medicare telehealth services provided by rural health clinics and federally qualified health clinics.
  • CMS is allowing payment for outpatient hospital services (eg, wound care, drug administration and behavioral health services) delivered in temporary expansion locations when the locations are temporarily designated part of a hospital.
  • CMS is allowing certain provider-based hospital outpatient departments that relocate off-campus to obtain a temporary exception and continue to be paid under the Outpatient Prospective Payment System.
  • Medicare payments for teaching hospitals that send residents to other hospitals for COVID purposes will not be reduced; nonteaching hospitals that accept residents will not be penalized.
  • Requirements for ambulatory surgery centers to intermittently reappraise medical staff privileges during the COVID-19 emergency declaration are waived.
  • Nurse practitioners, clinical nurse specialists and physician assistants can provide home health services; establish and periodically review such patients’ care; and certify and re-certify the patient’s home health services’ eligibility.
  • Clinicians can allow more of their patients with diabetes to monitor glucose and adjust insulin doses at home.
  • Accountable Care Organizations can extend their status for 1 year without an application; the risk these organizations take will be treated equitably regardless of the extent to which their patient populations are affected by the pandemic.

Health care professionals can begin implementing these actions immediately, CMS stated. CMS’ regulatory waivers and rule changes that were announced during the pandemic are in effect until the national Public Health Emergency Declaration expires.

 

“CMS is seeking to capitalize on our gains by helping to safely reopen the American health care system in accord with President Trump's guidelines,” Seema Verna, MPH, CMS administrator, said in the release. – by Janel Miller

Disclosure: Verna is CMS administrator.