Medicare-Related COVID-19 Update - Legislative & Policy Changes (April 2, 2020)

Legislative Changes

On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 748 which is the third COVID-related bill to pass Congress in recent weeks. As noted on the Center for Medicare Advocacy’s COVID-19 webpage highlighting such legislation, Medicare-related provisions of this bill include:

• Significant expansion of telehealth services that can substitute for certain visits that usually require in-person visits with health care providers, such as remote patient monitoring for home health services, hospice recertification, and nephrologist visits for those using home dialysis;
• Allowing physician assistants, nurse practitioners, and other professionals to order home health services for beneficiaries;
• Waiving the Inpatient Rehabilitation Facility (IRF) 3-hour rule, which requires that a beneficiary be expected to participate in at least 3 hours of intensive rehabilitation at least 5 days per week to be admitted to an IRF;
• Allowing Up to 3-Month Fills and Refills of Covered Medicare Part D Drugs – requiring that Medicare Part D plans provide up to a 90-day supply of a prescription medication if requested by a beneficiary during the COVID-19 emergency period.

While several of the provisions of the three prior COVID-19 bills provide much-needed assistance to older adults and individuals with disabilities, advocates are pushing for a fourth COVID-19 bill that will fill in further gaps for these populations - see, e.g., websites for the Leadership Council of Aging Organizations (LCAO) and the Consortium for Citizens with Disabilities (CCD).

Policy Changes

On March 30, 2020, as summarized on the Center’s webpage highlighting COVID-19-related materials issued by the Centers for Medicare & Medicaid Services (CMS), the agency issued a Press Release, Fact Sheet  and Interim Final Rule (CMS-1744-IFC) announcing several provider waivers affecting Medicare. These policy changes include:

• Expanding the destinations to which ambulance services can be covered by Medicare;
• Allowing coverage for home testing for COVID-19;
• Further expanding telehealth services to fulfill requirements for visits that usually must be in person (e.g., inpatient rehabilitation hospitals, home health and hospice);
• Emphasized that someone can be “homebound” in order to qualify for home health coverage if a physician determines that it is contraindicated for the Medicare beneficiary to leave home – or due to suspected or confirmed COVID-19. (The homebound requirement was not)