Coronavirus: CMS announces regulatory changes to address patient surge

The Centers for Medicare & Medicaid Services (CMS) released a slew of temporary regulatory changes aimed at addressing patient surges due to the COVID-19 coronavirus pandemic.

The changes, made possible by President Donald J. Trump’s emergency declaration and emergency rulemaking, will apply immediately across the entire country’s healthcare system for the duration of the emergency. They will allow hospitals and health systems to rapidly expand treatment capacity to allow them to separate patients infected with COVID-19 from those who are not, according to a news release.

“Every day, heroic nurses, doctors, and other healthcare workers are dedicating long hours to their patients. This means sacrificing time with their families and risking their very lives to care for coronavirus patients,” CMS Administrator Seema Verma says in the release. “Front line healthcare providers need to be able to focus on patient care in the most flexible and innovative ways possible. This unprecedented temporary relaxation in regulation will help the healthcare system deal with patient surges by giving it tools and support to create non-traditional care sites and staff them quickly.”

The changes also include provisions that waive requirements allowing hospitals to hire local physicians, support physician practices by transferring equipment, and dramatically lessen administrative burdens, the release says.

The temporary actions include:

Increasing hospital capacity

CMS is allowing communities to take advantage of ambulatory surgery centers that have cancelled elective surgeries due to the pandemic as well as using non-hospital building and spaces for patient care and quarantine sites so long as the location is approved by the state and ensures the safety and comfort of patients and staff, the release says.

Hospitals, laboratories, and other entities to perform tests on people at their homes or in community settings such as drive-through testing sites. Ambulances are also enabled to transport patients to a wider range of locations when other transportation is not medically appropriate such as mental health centers, federally qualified health centers, physician’s offices, urgent care facilities, ambulatory surgery centers, and any locations providing dialysis services, according to the release.

Also, hospitals will be able to bill for services they provide outside of their facility.

Expanding the healthcare workforce

With local private practice physicians available for temporary employment due to the cancellation and rescheduling of non-essential medical and surgical services, the temporary requirements remove barriers allowing them to be quickly hired by healthcare facilities in need of staff. These healthcare workers can perform the functions they are qualified and licensed for while they await completion of federal paperwork requirements, the release says.

CMS is issuing waivers allowing hospitals to use practitioners like physician assistants and nurse practitioners to their full capacity in accordance with a state’s emergency preparedness and pandemic plan.

A blanket waiver is also being issued to allow hospitals to supply benefits like multiple daily meals, laundry services, or childcare while the physicians and staff are working at the hospital. Physicians will also be able to enroll in Medicare temporarily to provide care during the emergency, the release says.

Patients over paperwork

The temporary rules eliminate paperwork requirements allowing physicians to spend more time with patients. Medicare is now covering respiratory-related devices and equipment for any medical reason determined by physicians allowing patients to receive the care they need, the release says.

Hospitals will not be required to have written policies on processes and visitation of COVID-19 isolation patients and will have more time to provide patients a copy of their medical records, the release says.

Extended reporting deadlines and suspending documentation request will provide temporary relief form many audit and reporting requirements for physicians, healthcare facilities, Medicare Advantage health plans, Medicare Part D prescription drug plans, and states, according to the release.

Telehealth promotion

CMS will allow more than 80 additional services to be provided by telehealth allowing patients to use interactive apps with audio and video capabilities to visit with their physician for an even broader range of services. Physicians can also evaluate patients with audio phones only, the release says.

Physicians can bill for these telehealth visits at the same rate as in-person visits.