By Bruce Chernof, MD, President and CEO, The SCAN Foundationk
Unprecedented times call for unprecedented action, and the Centers for Medicare & Medicaid Services (CMS) has been quick to respond. In the last few weeks, CMS has issued an array of waivers and rules creating new flexibilities that allow health systems to respond to the growing challenges brought forth by COVID-19. These new flexibilities allow health systems to build off current capacities tested in recent years, as well as implement strategies that have never been done before.
People with complex care needs are at the most risk during this pandemic, and federal policies are evolving daily to respond to the current environment. The Better Care Playbook now offers a COVID-19 resource center that compiles federal policy information impacting the care for individuals with complex care needs. Here are highlights of some flexibilities that could positively influence both medical and non-medical services for people with complex care needs.
Telehealth was slowly being tested and implemented with a restricted set of providers, but now is being used in new ways with CMS funding telehealth for 80 additional services.
- Beneficiaries may receive telehealth visits in any health care facility and in their home.
- Medicare is now funding phone-based therapy for mental health services, which wasn’t the case a month ago.
- Home health providers can use telecommunications to monitor individuals remotely in ways that align with their plan of care.
Home- and community-based services can assess and deliver services in new ways to support social distancing and reduce risk of exposure for people with complex care needs.
- Nurse practitioners, clinical nurse specialists, and physician assistants can now order home health. This regulatory change is intended to remain in place.
- Home health providers can assess needs and provide support remotely. This will require processes for determining who in fact needs a home visit, and what types of visits are considered essential.
- Physicians can order home-based services (e.g., home-delivered meals, preventive services and caregiver support services) under the relaxed definition of “home-bound” that now includes individuals staying home due to COVID-19.
Medicaid Waivers(i.e., 1135, Appendix K of 1915c) as well as a blanket waiver have been approved by CMS to give states the following emergency flexibilities and more.
- States can enroll out-of-state or new providers more quickly to be responsive to workforce demands.
- Prior authorization requirements are temporarily suspended to reduce administrative burdens and respond to needs more quickly.
- Some states are allowing care coordination to be provided remotely, and increasing the number of monthly billable hours for care coordination.
To read more of Dr. Bruce Chernoff's article, please click here.
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