Recent changes in CMS rules are intended to increase the response capabilities of providers and hospitals to the COVID-19 pandemic
The Centers for Medicare and Medicaid Services (CMS) recently released a second interim final rule. CMS-5531-IFC expands access to telehealth, increases COVID-19 testing opportunities for Medicare and Medicaid beneficiaries, and augments the healthcare workforce.
- CMS will increase payments for telephone evaluation and management visits to be similar to office and outpatient visit rates. These payments will be retroactive to March 1, 2020.
- Patients receiving opioid treatment may have their periodic assessments using telehealth.
- CMS will update the telehealth code list on a sub-regulatory basis instead of the formal rule-making process. Requests from providers will be considered in making these updates.
COVID-19 Testing Implications
- A written order by a provider is no longer required for COVID-19 testing for Medicare payment purposes.
- CMS will cover certain COVID-19 serology tests.
- CMS will cover clinical laboratory processing of certain FDA-authorized tests that are self-collected at home.
Increased Flexibility for Hospitals
- CMS will allow temporary exceptions for certain provider-based hospital outpatient departments that relocate off-campus and will continue to pay these departments under the Hospital Outpatient Prospective Payment System.
- Providers may increase the number of beds for COVID-19 patients while receiving stable and predictable Medicare payments.
- Certain requirements are being excepted to allow freestanding inpatient rehab facilities to accept patients from hospitals that are experiencing a surge, even if these patients do not need rehabilitation-related care.
- Nurse practitioners, physician assistants, and clinical nurse specialists will be allowed to provide home health services.
- Medicare payments will not be reduced for teaching hospitals that move their residents to other hospitals in order to meet COVID-19 related needs, and hospitals without teaching programs will not be penalized for accepting these residents.
CMS-5531-IFC builds on previously announced waivers and rules. A complete description of the effects of this new rule change can be reviewed in the CMS regulations found here. Comments must be received no later than 5 p.m., July 7, 2020.