The coronavirus (COVID-19) is affecting all individuals and organizations in significant ways – physically, emotionally, and financially, to name a few. In addition to creating a national health emergency, more people are out of work and without insurance as a result of this crisis.
Thankfully, our patient advocates can continue serving patients during this difficult time. They have been classified as essential staff members and are working on-site to help patients obtain benefits and secure alternative payment methods (including COBRA).
We at EligibilityAdvocates would like to thank all those working in health care who are risking their own safety in order to protect and care for these patients and keep our communities healthy. You are truly health care heroes.
We also want to express appreciation for each one of our patient advocates who is making a critical difference in patients’ lives on the front lines as well.
You are health care heroes too, as you work to minimize the financial impact of this virus on individuals and families.
As you may be aware, the Centers for Medicaid and Medicare Services (CMS) issued emergency blanket waivers in response to COVID-19, which have a retroactive effective date of March 1, 2020 until the end of the emergency declaration.
We’d like to draw your attention to these changes in particular, as stated by CMS:
- 3-Day Prior Hospitalization Waiver for SNF placement – “CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a SNF stay, which provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who experience dislocations, or are otherwise affected by COVID-19. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period (this waiver will apply only for those beneficiaries who have been delayed or prevented by the emergency itself from commencing or completing the process of ending their current benefit period and renewing their SNF benefits that would have occurred under normal circumstances).”
- CAH Length of Stay Waiver – “CMS is waiving the requirements that CAHs limit the number of beds to 25, and that the length of stay be limited to 96 hours under the Medicare conditions of participation for number of beds and length of stay at 42 CFR §485.620.”
States and territories may submit a request for a waiver of statutes and regulations related to Medicaid and CHIP programs using the 1135 waiver checklist; CMS provides these examples of flexibilities they may seek:
- “Waive prior authorization requirements in fee-for-service programs.
- Permits providers located out of state/territory to provide care to another state’s Medicaid enrollee impacted by the emergency.
- Temporarily suspend certain provider enrollment and revalidation requirements to increase access to care.
- Temporarily waive requirements that physicians and other health care professionals be licensed in the state in which they are providing services, so long as they have an equivalent licensing in another state; and,
- Temporarily suspend requirements for certain pre-admission and annual screenings for nursing home residents”
Please see the complete COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers document or contact us for more information.
As always, we are here to help you navigate these new regulatory flexibilities and to assist your patients with the financial challenges they may be facing. We are all in this together as we work to protect the physical and financial health of your patients and their families.