CMS Issues More Regulatory Relief Waivers for Home Health, Hospice

This afternoon, the U.S. Centers for Medicare and Medicaid Services (CMS) released additional regulatory relief blanket waivers for home health agencies, hospices and other providers.

Please see further details in the link here, including precise references to regulatory citations.

The new waivers are retroactive to March 1, 2020 and go through the end of the public health emergency; however, some of these temporary changes include deadlines that extend past the end of the emergency period.

HCA will be working with federal and state partners to ensure implementation of these new waivers by Medicare Administrative Contractors, state surveyors and other regulatory jurisdictions, including consistency with state regulation, where appropriate. Please contact HCA’s Public Policy staff with questions or concerns.

Home Health Agencies
  • CMS is postponing the 12-hour annual in-service training requirement for home health aides. The deadline for completing this requirement is now at the end of the first full quarter after the declaration of the public health emergency concludes.  
  • To expedite discharge planning, CMS is waiving the requirement to provide detailed information regarding discharge planning to patients and their caregivers/representatives in the selection of post-acute care providers — information that is otherwise required to include data on quality measures and resource use measures.
  • CMS is extending the deadline for agencies to provide patients with a copy of their medical records at no cost during the next visit or within four business days (when requested by the patient). CMS will allow 10 business days to do so.
Home Health and Hospice
  • CMS is waiving the home health and hospice requirements to make annual onsite supervisory visits (direct observation) for each aide that provides services on behalf of the agency. All postponed onsite assessments must be completed by the RN or other professional permitted to do so in each respective setting (home care or hospice) no later than 60 days after the expiration of the public health emergency.
  • CMS is narrowing the scope of the Quality Assurance and Performance Improvement (QAPI) program to concentrate on infection control issues while retaining the requirement that remaining activities should continue to focus on adverse events. (The requirement that home health agencies and hospices maintain an effective, ongoing, agency-wide, data-driven quality assessment and performance improvement program will remain.)
  • CMS is postponing the requirement that hospices annually assess the skills and competence of all individuals furnishing care and provide in-service training and education programs where required. The deadline to complete this requirement is now delayed until the end of the first full quarter after the declaration of the public health emergency expires. (This does not alter the minimum personnel requirements.)
Flexibility for Medicare Telehealth Services
  • Certain health care professionals are newly eligible to furnish and bill for Medicare telehealth services, including physical therapists, occupational therapists, speech language pathologists, and others.
  • CMS is also waiving the requirements for use of interactive telecommunications systems to furnish telehealth services, to the extent they require use of video technology, for certain services. The waiver allows the use of audio-only equipment to furnish services described by the codes for audio-only telephone evaluation and management services, and behavioral health counseling and educational services (see designated codes here). Unless provided otherwise, other services included on the Medicare telehealth services list must be furnished using, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner.
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