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CMS Updates Summary

Apr 13 2020

Given the current situation CMS has been rapidly announcing actions in response to the COVID-19 virus.  Below is a summary of the most recent CMS updates.

Frontline Workforces Maximization

A number of rules have been suspended temporarily in order to ensure that the healthcare industry has enough staff to deal with the COVID-19 pandemic.  As a result of this action:

  • Doctors can now directly care for patients at rural hospitals, across state lines if necessary, via phone, radio, or online communication, without having to be physically present.
  • Nurse practitioners, in addition to physicians, may now perform some medical exams on Medicare patients at skilled nursing facilities so that patient needs, whether COVID-19 related or not, continue to be met in the face of increased care demands.
  • Occupational therapists from home health agencies can now perform initial assessments on certain homebound patients, allowing home health services to start sooner and freeing home-health nurses to do more direct patient care.
  • Hospice nurses will be relieved of hospice aide in-service training tasks so they can spend more time with patients.

Expanded Coverage for Essential Diagnostic Services

In an effort to remove financial barriers for Americans to receive necessary COVID-19 tests and health services the Trump administration has issued guidance to ensure Americans with private health insurance have coverage of 2019 Novel Coronavirus (COVID-19) diagnostic testing and certain other related services, including antibody testing, at no cost.

Removal of Non-Invasive Ventilator Product Category from DMEPOS Competitive Bidding Program

Due to the novel COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) is removing the non-invasive ventilators (NIV) product category from Round 2021 of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.

Applicability of Diagnoses from Telehealth Services for Risk Adjustment in Medicare Advantage

CMS has stated that Medicare Advantage Organizations and other organizations that submit diagnoses for risk adjusted payment are able to submit diagnoses for risk adjustment that are from telehealth visits when those visits meet all criteria for risk adjustment eligibility.

Additional State Medicaid Waivers and Amendments

CMS approved its 50th COVID-19 Medicaid emergency waiver to Utah delivering urgent regulatory relief to ensure the State can quickly and effectively care for their most vulnerable citizens.  CMS also approved a COVID-19 related Medicaid Disaster Amendment that brings relief to Arizona. CMS continues to authorize amendments to ensure emergency flexibilities in programs that care for the elderly and people with disabilities, including most recently in Georgia.

We will continue to keep you updated on the latest developments as they are released. Please visit the CMS News Room and Current Emergencies Website. CMS updates these resources on an ongoing basis.

Written by Stotler Hayes · Categorized: COVID-19

Stotler Hayes Group, LLC is a national, boutique law firm focused on optimizing recovery for health care providers through Medicaid, Medicare, private collections, training and education. Our attorneys are licensed in, and represent clients before, federal and state courts and agencies in a majority of states around the country.

In the handful of states where Stotler Hayes Group, LLC does not employ a full-time attorney, referrals are made to local counsel, many of whom we have developed close working relationships with over the years. In those cases, our firm works with local counsel throughout the pendency of the case.

Stotler Hayes Group, LLC,

Principal Office: Pawley’s Island, SC, Phone: 843-235-9871; Fax: 888-497-7390; email: info@stotlerhayes.com

This website is for informational purposes only. Please remember that every case is different. Any result we achieve for one client in one matter does not necessarily indicate similar results can be obtained for other clients.

The attorney responsible for the content of this website is Andrea Kirksey, Esq., Executive Director and General Counsel for Stotler Hayes Group, LLC, 297 Willbrook Boulevard,  Pawley’s Island, South Carolina.

She may be contacted at (843) 235-9871, ext. 1002 or at akirksey@stotlerhayes.com.

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