Daily COVID-19 CMS News Alert - April 22

Daily COVID-19 News Alert Here is a summary of recent Centers for Medicare & Medicaid Services (CMS) actions taken in response to the 2019 Novel Coronavirus (COVID-19), as part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, click here www.coronavirus.gov. For information specific to CMS, please visit the CMS News Room and Current Emergencies Website. CMS updates these resources on an ongoing basis throughout the day; the information below is current as of April 21, 2020 at 12:00 p.m. CMS Issues Guidance Allowing Independent Freestanding Emergency Departments to Provide Care to Medicare and Medicaid Beneficiaries during the COVID-19 Public Health Emergency Statements from the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services on Interoperability Flexibilities amid the COVID-19 Public Health Emergency CMS Releases Additional Blanket Waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities RHC & FQHCs: Telehealth and Virtual Communications Flexibilities During COVID-19 Public Health Emergency CMS Amends Certain Activities Related to the Health Insurance Exchange Quality Rating System, QHP Enrollee Experience Survey, and Quality Improvement Strategy CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic CMS Issues Guidance Allowing Independent Freestanding Emergency Departments to Provide Care to Medicare and Medicaid Beneficiaries during the COVID-19 Public Health Emergency New guidance provides flexibility to hospitals to ensure they have the ability to expand capacity and treat patients during this public health emergency Today, the Centers for Medicare & Medicaid Services (CMS) issued critical guidance allowing licensed, independent freestanding emergency departments (IFEDs) in Colorado, Delaware, Rhode Island, and Texas to temporarily provide care to Medicare and Medicaid patients to address any surge.  This action by the Trump Administration increases hospital capacity to ensure these states can quickly and effectively care for their most vulnerable citizens.  “Under President Trump’s leadership, CMS is taking historic steps to leverage new resources in the ongoing war against COVID-19,” said CMS Administrator Seema Verma.  “Expanding the number of providers available to Medicare and Medicaid beneficiaries eases some of the burden shouldered by traditional hospitals and allows the healthcare system to treat more patients at a time when capacity is often limited. We must leave no stone unturned as we seek to bolster the healthcare system during this unprecedented crisis.” IFEDs generally offer a range of services including basic imaging services, computed tomography (CT) scans, ultrasound, and basic on-site laboratory services. Current law does not recognize IFEDs as a certified Medicare provider, meaning they cannot bill Medicare and Medicaid for services. However, during this public health emergency these entities can be temporarily certified as a hospital to increase healthcare system capacity as part of each state’s pandemic plan. These new flexibilities are possible thanks to aggressive actions made by the Trump Administration that help healthcare providers contain the spread of COVID-19 through Emergency Declaration Blanket Waivers for Health Care Providers. As a result, CMS is waiving certain Conditions of Participation for hospital operations to maximize the ability to focus on patient care during this public health emergency. IFEDs may participate in Medicare and Medicaid in one of three ways: Becoming affiliated with a Medicare/Medicaid-certified hospital under the temporary expansion 1135 emergency waiver; Participating in Medicaid under the clinic benefit if permitted by the state; or Enrolling temporarily as a Medicare/Medicaid-certified hospital to provide hospital services. These actions, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov. For information specific to CMS, please visit the Current Emergencies Website. To view the COVID 19 Emergency Declaration Blanket Waivers for Health Care providers, visit:  https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf To view CMS’s guidance for Independent Freestanding Emergency Departments, visit: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/guidance-licensed-independent-freestanding-emergency-departments-eds-participate-medicare-and Statements from the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services on Interoperability Flexibilities amid the COVID-19 Public Health Emergency Yesterday, the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS), in conjunction with the HHS Office of Inspector General (OIG) announced a policy of enforcement discretion to allow compliance flexibilities regarding the implementation of the interoperability final rules announced on March 9th in response to the coronavirus disease (COVID-19) public health emergency. ONC, CMS, and OIG will continue to monitor the implementation landscape to determine if further action is needed. “ONC remains committed to ensuring that patients and providers can access electronic health information, when and where it matters most. During this critical time, we understand that resources need to be focused on fighting the COVID-19 pandemic. To support that important work and the information sharing efforts we are already seeing, ONC intends to exercise enforcement discretion for 3 months at the end of certain ONC Health IT Certification Program compliance dates associated with the ONC Cures Act Final Rule to provide flexibility while ensuring the goals of the rule remain on track.”   - Don Rucker, MD, National Coordinator for Health Information Technology.  “Today’s action follows the extensive steps CMS has taken to ease burden on the healthcare industry as it fights COVID-19. Now more than ever, patients need secure access to their healthcare data. Hospitals should be doing everything in their power to ensure that patients get appropriate follow-up care. Nevertheless, in a pandemic of this magnitude, flexibility is paramount for a healthcare system under siege by COVID-19. Our action today will provide hospitals an additional 6 months to implement the new requirements.” – Seema Verma, CMS Administrator For the CMS announcement, visit: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index For the ONC announcement, visit: https://healthit.gov/curesrule. For the OIG announcement, visit: https://oig.hhs.gov/coronavirus/covid19-enforcement-flexibility.pdf CMS Releases Additional Blanket Waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities CMS continues to release additional blanket waivers to the healthcare community in order to provide the flexibilities needed to take care of patients during this public health emergency. Today, CMS is providing additional blanket waivers related to care for patients in Long-Term Care Hospitals (LTCHs), temporary expansion locations of Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), staffing and training modifications in Intermediate Care Facilities for individuals with Intellectual disabilities, and the limit for substitute billing arrangements (locum tenens). Guidance RHC & FQHCs: Telehealth and Virtual Communications Flexibilities During COVID-19 Public Health Emergency To support Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and their patients, Congress and CMS made changes to requirements and payments during the COVID-19 Public Health Emergency, including: New payment for telehealth services, including how to bill Medicare Expansion of virtual communication services Revision of home health agency shortage requirement for visiting nursing services Consent for care management and virtual communication services Accelerated/advance payments MLN Matters SE20016 CMS Amends Certain Activities Related to the Health Insurance Exchange Quality Rating System, QHP Enrollee Experience Survey, and Quality Improvement Strategy CMS is easing burden on Qualified Health Plans (QHPs) during the Public Health Emergency. CMS directed plans that are eligible to report for the Quality Rating System and the Quality Improvement Strategy programs to discontinue collecting clinical quality measure data. Eligible QHPs can discontinue reporting in June 2020 for display on Exchange websites for the 2021 Open Enrollment period. CMS will continue to accept QHP Enrollee survey data submissions for this year, given that the survey administration is already underway. Guidance CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic CMS has approved 53 COVID-related emergency waivers, 39 state amendments, 16 COVID-related Medicaid Disaster Amendments and one CHIP COVID-related Disaster Amendment in record time. States are using a toolkit CMS developed to expedite the application and approval of Medicaid state waivers and State Plan Amendments.  CMS recently approved an additional COVID-related emergency Medicaid waiver for Wisconsin, delivering urgent regulatory relief to ensure the state can quickly and effectively care for its most vulnerable citizens. CMS also recently approved COVID-19 related Medicaid Disaster Amendments that bring relief to Guam, Louisiana, Maryland, and Minnesota. These approvals help to ensure that states have the tools they need to combat COVID-19 through a wide variety of state plan flexibilities. CMS continues to authorize amendments to ensure emergency flexibilities in programs that care for the elderly and people with disabilities, including most recently for the District of Columbia, Florida, Mississippi, Nebraska, Utah, and Virginia. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported. Section 1135 Waivers   1915(c) Waiver Appendix K Amendments Medicaid State Plan Amendments CHIP State Plan Amendments