The Centers for Medicare and Medicaid (CMS) have been issuing updates regarding Medicare benefits with regard to COVID-19. Information from the federal government is posted below:
- Federal declaration: When the President declares a disaster or emergency under the Stafford Act or National Emergencies Act and the HHS Secretary declares a public health emergency under Section 319 of the Public Health Service Act, the Secretary is authorized to take certain actions in addition to her regular authorities. The AAPA has put together a helpful overview on the 1135 waivers and what they look like. Click here to download that document.
- Telemedicine: CMS has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their providers without having to travel to a healthcare facility. Click here to read the fact sheet on this.
- CMS’s TeleHealth Toolkit: CMS has created toolkits on telehealth that contain electronic links to reliable sources of information on telehealth and telemedicine. They are intended to reduce the amount of time providers spend searching for answers and increase their time with patients. Many of these links will help providers learn about the general concept of telehealth, choose telemedicine vendors, initiate a telemedicine program, monitor patients remotely, and develop documentation tools. Additionally, the information contained within each toolkit will also outline temporary virtual services that could be used to treat patients during this specific period of time. Click here to download the toolkit.
- PAs able to supervise diagnostic tests: The Medicare and Medicaid Programs Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency issued an interim final rule that temporarily authorizes PAs to supervise diagnostic tests. Previously, PAs were able to personally perform Medicare diagnostic tests, but they could not supervise other trained clinical staff who performed the technical component of these diagnostic tests. This policy change is in effect through the federally-declared public health emergency (PHE).
- PAs can certify/order home health for Medicare beneficiaries: In addition, the final rule linked above provides regulations that finalize the ability of PAs to certify/order home health for Medicare beneficiaries. AAPA-sponsored legislation passed as part of the CARES Act in March authorized PAs to order Medicare home health. CMS had six months to implement the legislative provision. Due to lobbying efforts by AAPA and others, CMS expedited the regulatory process and the ability for PAs to order home health are permanent and applicable to services provided on or after March 1, 2020.
- PAs performing SNF visits: Another waiver issued by CMS authorizes PAs to deliver visits to Medicare beneficiaries in a skilled nursing facility (SNF) previously required to be provided by physicians. This latest CMS relaxation in rules includes authorizing PAs to personally perform the SNF comprehensive visit and removes the requirement for PAs and physicians to alternate every other SNF required visit. This waiver is effective immediately and lasts through the federally-declared PHE. AAPA will aggressively push CMS to make these regulatory changes permanent.
- Small Business Loans: If you own your own clinic, you may be eligible for a small business loan under the economic package passed by Congress this week. Visit the Small Business Administration’s website at www.sba.gov.
- TennCare: The Bureau of TennCare has issued guidance regarding COVID-19 testing and telehealth services for TennCare enrollees. Click here to download the memo. Click here to download the memo for behavioral healthcare providers.
- Emergency TANF Cash Assistance: If you have been laid off, furloughed or had your hours cut by 50% because of COVID-19, you can receive cash assistance from the Tennessee Department of Human Services. This assistance is available in addition to any unemployment benefits an individual may be receiving. Click here for more information.
- Executive Order #14: State of Emergency: Gov. Bill Lee declares a state of emergency with regard to COVID-19. Click here to read the full text of the executive order.
- Executive Order #15: Supervision/Collaboration requirements waived: Gov. Lee waives supervision requirements for PAs (section 6). This will allow flexibility for PAs responding to this healthcare crisis. This order also extends the expiration date by three months for licenses expiring between March 12 and May 18. Upon renewal, the new license expiration date shall be 24 months after the original expiration date (section 7). This order also allows telemedicine services to be used by pain management clinics and in the case of chronic nonmalignant pain treatment (section 38). This allows providers to conduct the required face-to-face visits for opioid prescriptions via telemedicine. Click here to read the full text of the executive order, which is in effect until May 18.
- Executive Order #18: Non-essential procedures: This order prohibits non-essential medical procedures (section 2). Click here to read this executive order, which is in effect until April 13.
- Executive Order #20: Suspension of licensure rules: Under this executive order, many rules regarding licensure are suspended. Of particular note, it gives the Commissioner of Health the authority to grant a license, certificate, or registration to a healthcare professional, such as a retired healthcare profession, who has been out of practice for a period of time without requiring that individual to demonstrate continued competency or submit to an interview before the licensing board, provided the individual satisfied all other requirements (section 7.3) It also waives the requirement that individuals submit proof of completing continuing education requirements as a condition of reinstating a license, certification or registration (section 7.4). Click here to read this executive order.
- Executive Order #25: Extension of ban on elective procedures: This executive order extends the ban on elective procedures until April 30. Click here to read this executive order.
- Executive Order #28: Clarification of suspension of collaboration requirements for PAs: This executive order rewrites the section in Executive Order #15 as it pertains to PAs. The new language states: 6.1 The provisions of Tennessee Code Annotated, Title 63, Chapter 19, Tennessee Code Annotated, Section 63-6-204(b), Tenn. Comp. R. & Regs. 0880-03-.01 through Tenn. Comp. R. & Regs. 0880-03-.25, and Tenn. Comp. R. & Regs. 0880-02-.18 are hereby suspended to the extent necessary to relieve physician assistants from the requirement of collaborating with a physician. Click here to read this executive order.
- Executive Order #36: This Executive Order extends the expiration dates of health care licenses to Aug. 31, 2020 for those licenses that are set to expire between March 12 and May 31, 2020; initial health care license application fees are extended until June 30, 2020; and waives notarization requirements for health care applications. Click here to read this executive order.
- Tennessee Medical Reserve Corps: PAs who have been furloughed and are seeking employment should consider registering with the TNMRC to help in the COVID-19 response. Medical responders are needed for both paid and volunteer positions. Click here for more information or to register.