We are providing regular updates on changes announced by CMS as well as financial support from the federal government.
Last week, CMS announced further relaxation of certain rules to help address the challenges created by the COVID-19 pandemic. These changes expand on earlier easing of rules around practicing across state lines and enabling providers to work at the highest level they are trained for. Among the newest changes are:
- Doctors practicing at critical access hospitals can provide care across state lines using phones, radio or online communications. Their instructions may be carried out by a nurse practitioner or physician assistant. In fact, the waiver eliminates the need for a physician or osteopath to be on the premises of the hospital so long as they are providing supervision.
- Tasks a physician must perform in-person at skilled nursing facilities may be delegated to nurse practitioners, physician assistants and clinical nurse specialists.
- Occupational therapists working on behalf of home health agencies can now perform some assessments on homebound patients, with the intent of launching home healthcare services sooner, although this does not supersede any state laws that say otherwise.
CARES and Other Funding
The Department of Health & Human Services (HHS) is beginning distribution of $30 billion in grants to hospitals and providers as part of the $100 billion fund authorized by the CARES Act. These are payments, not loans, that are being delivered via direct deposit. Payments began late last week. Here is an overview of who is eligible but more details are available online here.
- All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution.
- Payments to practices that are part of larger medical groups will be sent to the group's central billing office.
- All relief payments are made to the billing organization according to its Taxpayer Identification Number (TIN).
- As a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.
- This quick dispersal of funds will provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers who are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.
- If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.
CMS has approved an additional $34 billion for providers with the accelerated/advance payment program for in addition to the coming grants from the CARES stimulus. According to the press release from CMS, "The streamlined process implemented by CMS for COVID-19 has reduced processing times for a request of an accelerated or advance payment to between four to six days, down from the previous timeframe of three to four weeks."
To further support local economies, the Federal Reserve has released details about its new Main Street lending programs. The $2.3 trillion will come through banks as four-year loans of at least $1 million to companies with up to 10,000 workers and $2.5 billion in revenues. It will also directly buy the bonds of states, counties and cities. The lending program is in addition to the $2 trillion CARES stimulus programs.
Watch for more updates as they evolve throughout the COVID-19 pandemic. For help with patient communications during this difficult time, learn more about how SR Health can help.