By: Susan St. John
CMS has issued temporary waivers and new rules to help the American health care system address the increased need for health care services caused by COVID-19. Among the waivers, CMS is allowing hospitals to set up services in alternative sites to accommodate increased patient census. Hospitals may be allowed to use ASCs, inpatient rehab hospitals, hotels and dormitories for non-COVID-19 patients or patients not requiring critical inpatient services. Hospitals are also being encouraged to increase staffing, allowing hospitals to increase staff through hiring of local and non-local providers/practitioners as long as they are appropriately licensed in the same state as the hospital or another state. However, even though CMS has created flexibility for rendering services during this pandemic, use of alternative “hospital” sites and expansion of hiring staff must comport with a state’s emergency preparedness or pandemic response plan.
During the public health emergency, CMS is encouraging hospitals to temporarily employ local or non-local clinicians as long as the clinicians are licensed in the same state as the hospital or licensed in another state. While CMS is encouraging temporary employment of clinicians, such temporary employment must be in accordance with a state’s laws under its emergency preparedness or pandemic response plan.
Further, providers, including practitioners, may be able to temporarily enroll in Medicare to be able to assist with the current health care crisis.
CMS is also allowing hospitals to provide benefits to medical staff without running afoul of anti-kickback laws. Such benefits included, providing meals, temporary housing, childcare, or other benefits necessary to light the stress on medical staff caused by increased need for services.
Access to testing for COVID-19 has also been expanded to allow hospitals, labs, and other entities to test patients at home or other community-based settings besides hospitals. Florida has set up many “drive through” testing sites through the state, allowing more people to get tested without the risk of presenting at a hospital.
Ambulances may be used for transportation to physician offices, urgent care centers, ESRD centers, mental health care clinics, and non-hospital health care providers as routine group transportation would require a deviation or breach of required social distancing.
Hospitals may use and bill for telehealth services so that patients can be screened without presenting at a hospital. The telehealth screening will allow hospitals to determine the most appropriate site for care, thereby minimizing the patient’s risk of exposure to COVID-19. Health care providers using telehealth will be able to bill for telehealth services at the same rate as in-person services of the same kind and level. Allowable telehealth services have also been expanded during the health care crisis. Importantly, a patient’s home may now serve as the originating site for Medicare telehealth services. CMS is also allowing for required supervision of lower level clinicians to be accomplished through virtual technology if appropriate for a patient’s particular situation.
This unprecedented time in history is being met with both unprecedented legislation and incredibly fast adaptation. Staying on top of the rapidly changing laws and regulations is going to be essential for all doctors and healthcare providers.