COVID-19: CMS Relaxes Regulatory Requirements for Physicians and Hospitals
On March 30, CMS announced(www.cms.gov) plans to temporarily relax several regulations to help the health care system deal with COVID-19 and expected patient surges. These adjustments, which are retroactive to March 1, reflect recent AAFP advocacy and include the following.
Promoting telehealth in Medicare
- More than 80 additional services to be furnished via telehealth; in addition to interactive apps with audio and video, providers can evaluate beneficiaries who have audio phones only. Achieving this change in payment policy has been a priority for the AAFP; the Academy specifically asked CMS to make this change in a March 26 letter.
- Providers can bill for telehealth visits at the same rate as in-person visits (non-facility rate). Telehealth will fulfill many face-to-face visit requirements for clinicians to see their patients in inpatient rehabilitation facilities, hospice and home health.
- Clinicians to provide remote patient monitoring services to patients with acute and chronic conditions. This can be now be done for patients with only one disease.
- Physicians to supervise clinical staff using virtual technologies when appropriate, instead of requiring in-person presence.
Reducing administrative burden
- Medicare will now cover respiratory-related devices and equipment for any medical reason determined by clinicians.
- Hospitals will not be required to have visitation policies for patients in COVID-19 isolation.
- Hospitals will have more time to provide patients a copy of their medical record.
- CMS is providing temporary relief from many audit and reporting requirements by extending reporting deadlines and suspending documentation requests.
Expanding the healthcare workforce
- Hospitals and health care systems can increase their capacity by removing barriers for local and out-of-state private-practice physicians, nurses, and other clinicians to be hired from the community.
- Hospitals can use physician assistants and nurse practitioners to the fullest extent possible, in accordance with state law.
- Certified registered nurse anesthetists may work when not under the supervision of a physician.
- Benefits and support (meals, laundry, childcare, etc.) can be offered to hospital staff.
- Healthcare providers (clinicians, hospitals and other institutional providers, and suppliers) could enroll in Medicare temporarily to provide care during the public health emergency.
- Ambulances allowed to transport patients to a wider range of locations when other transportation is not medically appropriate. These destinations include community mental health centers, federally qualified health centers, physician’s offices, urgent care facilities, ASCs, and any locations furnishing dialysis services when an ESRD facility is not available.
- Physician-owned hospitals allowed to temporarily increase the number of licensed beds, operating rooms, and procedure rooms.
- Hospitals allowed to bill for services provided outside their facility and relaxing Emergency Medical Labor and Treatment Act requirements.
Increasing hospital capacity
- Ambulatory surgery centers allowed to contract with local health care systems to provide hospital services or enroll and bill as hospitals during the emergency declaration.
- Non-hospital buildings and spaces could be used for patient care and quarantine sites, if approved by the state.
- Hospitals, laboratories, and other entities allowed to perform tests for COVID-19 on people at home and in other community-based settings outside the hospital.
- Hospital emergency departments allowed to test and screen patients for COVID-19 at drive-through and off-campus test sites.
More on COVID-19 advocacy efforts
As the federal government leads the national response to COVID-19, state and local health departments stand on the frontlines. Several states are taking legislative action to mitigate the effects of the outbreak.