Last Updated: Apr 24, 2020
Over the past few weeks, in response to the COVID-19 outbreak, the Centers for Medicare & Medicaid Services (CMS) have announced a series of federal blanket waivers for health care providers.
Section 1135 of the Social Security Act authorizes the Secretary of the Department of Health and Human Services (HHS) to temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements under specified circumstances to match the particular needs of an emergency event. These waivers are commonly referred to as 1135 waivers. Note that 1135 waivers are generally only for participating Medicare/Medicaid/CHIP providers, and do not affect state requirements such as licensure.
In response to COVID-19, HHS and CMS have announced a series of blanket waivers. Once approved, blanket waivers apply automatically to all applicable providers and suppliers in the emergency area. Providers and suppliers do not need to apply for an individual waiver if a blanket waiver is implemented by CMS.
On April 21, 2020, CMS published an updated guidance document detailing the blanket waivers implemented thus far in response to the COVID-19 emergency. This document can be accessed here.
Examples of Implemented Blanket Waivers Issued During COVID-19 Emergency
The following are a few examples of implemented blanket waivers, but do not constitute a full list of such waivers. Please access the guidance document published by CMS for an extensive listing of waivers.
Medical Staff Privileges
CMS is waiving requirements to allow for physicians whose privileges will expire to continue practicing at the hospital where they had privileges and for new physicians to be able to practice before full medical staff/governing body review to address workforce concerns related to COVID-19.
Physician Visits in Skilled Nursing Facilities/Nursing Facilities
CMS is waiving the requirement in 42 CFR 483.30 for physicians and non-physician practitioners to perform in-person visits for nursing home residents and allow visits to be conducted, as appropriate, via telehealth options.
Subject to certain conditions, CMS temporarily waived requirements that out-of-state practitioners be licensed in the state where they are providing services when they are licensed in another state. Note this waiver does not have the effect of waiving state or local licensure requirements or any requirement specified by the state or a local government as a condition for waiving its licensure requirements. Those requirements would continue to apply unless waived by the state.
For the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances. For more information on CMS telehealth waivers, please click here.
Stark Law Waivers
CMS has issued blanket waivers of certain sanctions under the Physician Self- Referral Law (also known as the “Stark Law”). The blanket waivers may be used now without notifying CMS. Individual waivers of sanctions may be granted upon request. More information on these waivers can be accessed here.
Where Can I Find Additional Information?
Additional information on actions taken by CMS in response to COVID-19 can be found on CMS’s coronavirus waivers and flexibilities page. CMS also recently published a document detailing CMS flexibilities to fight COVID-19 specific to physicians and other clinicians, this document can be accessed here.
The Pennsylvania Medical Society (PAMED) has also established a COVID-19 resource page where you will find additional information and resources on the COVID-19 outbreak.