In follow-up to its March 31st interim final rule with comment period (IFC) (WHG summary here), the Centers for Medicare & Medicaid Services (CMS) announced a second set of wide-reaching changes in response to the COVID-19 pandemic.
- What it is. CMS is effectuating these changes through a combination of its IFC rulemaking authority and its application of 1135 blanket waiver authority, the latter of which having been broadened by the recently passed CARES Act.
- Why it is important for you. Broadly, these changes feature several augmentations of previously instituted reforms (e.g., clarifying or modifying billing rules for new temporary services) as well as brand new policies in response to continued stakeholder feedback. Of note, CMS is instituting changes aimed at improving diagnostic testing, including flexibilities around ordering COVID-19 tests for beneficiaries and covering certain serology tests. CMS is also instituting new policies to support its CMS Hospitals Without Walls initiative – including allowing payment for outpatient hospital services in temporary expansion locations (e.g., parking lot tents). To support providers responding to the pandemic, CMS is making certain health care workforce modifications and is also eliminating several administrative requirements that could delay care. Of critical note, CMS is also making even more expansive changes to current telehealth regulations to support this modality during the public health emergency. For example, CMS is expanding the list of eligible providers that can furnish telehealth services, as well as broadening the list of services that providers can furnish via audio-only technologies (i.e., telephones). CMS is also planning to expedite the process by which it adds new services to the approved Medicare telehealth list through using a subregulatory process that bypasses the standard notice and comment procedures.
- Potential next steps. Comments on this IFC are due within 60 days of when it is published in the Federal Register, likely to occur in the next few days. However, the provisions contained in the rule will be effective immediately upon publication. Applicability dates for each provision are retroactive back to either March 1, 2020, January 27, 2020, or otherwise, as detailed in the table on p. 4 of the preview copy. Please note that comments for the March 31st IFC are separate and still due according to that timeline (i.e., June 1, 2020).The new 1135 blanket waiver authorities are applicable beginning on March 1, 2020.